Rapid Resolution of Post-COVID-19 Inflammatory Syndrome in an Adult With Targeted Inhibition of Interleukin-1B.

Multisystem inflammatory syndrome (MIS) is a severe inflammatory response that occurs days to weeks following the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). Initially known in children and named MIS-C, recently several cases of MIS in adults have been reported to the Centers for Disease Control and Prevention (CDC), leading to the recognition of a new disease MIS in adults (MIS-A). The current treatment options include high-dose steroids, intravenous immunoglobulin (IVIG), and immunosuppressive therapy. However, the pharmacologic approach remains limited to case reports and pending official guidelines to treat cases with MIS-A.  We present a case of an adult patient who had a severe inflammatory state following COVID-19 infection, who was treated with IL-1 antagonist therapy with a successful outcome.

Prognostic Value of Serum Lactate Levels in Critically Ill Patients in an Intensive Care Unit.

INTRODUCTION: The patient in critical condition, regardless of the cause of admission, continues to be a challenge for health systems due to the high mortality that it reports. There is a need to identify some marker of early obtaining, easy to interpret and with high relevance in the prognosis of these patients. OBJECTIVE: To determine the prognostic value of serum lactate in an Intensive Care Unit (ICU). METHOD: One hundred and forty-five patients admitted to an ICU were enrolled in the study. The Acute Physiology and Chronic Health Evaluation II (APACHE) prognosis score, Sequential Organ Failure Assessment, hemodynamic support need, mechanical ventilation, cause of admission, stay in ICU, analytical and physiological variables were determined. The probability of survival of patients who had elevated and normal serum lactate levels was calculated. The risk of dying was determined using the Cox regression model. RESULTS: Twenty-eight patients died (19%) in the ICU. The serum lactate value was higher in the group of patients with trauma, infections, APACHE II and high creatinine levels; as well as with decreased mean arterial blood pressure, need for hemodynamic support and mechanical ventilation. The survival capacity was higher in patients who had normal serum lactate. Serum lactate was the sole independent predictor of mortality (AHR 1.28 [1.07-1.53], p = 0.008). CONCLUSIONS: Patient assessment through the determination of serum lactate levels provides useful information in the initial evaluation of the critical patient.

Propagation of Homeostatic Sleep Signals by Segregated Synaptic Microcircuits of the Drosophila Mushroom Body.

The Drosophila mushroom body (MB) is a key associative memory center that has also been implicated in the control of sleep. However, the identity of MB neurons underlying homeostatic sleep regulation, as well as the types of sleep signals generated by specific classes of MB neurons, has remained poorly understood. We recently identified two MB output neuron (MBON) classes whose axons convey sleep control signals from the MB to converge in the same downstream target region: a cholinergic sleep-promoting MBON class and a glutamatergic wake-promoting MBON class. Here, we deploy a combination of neurogenetic, behavioral, and physiological approaches to identify and mechanistically dissect sleep-controlling circuits of the MB. Our studies reveal the existence of two segregated excitatory synaptic microcircuits that propagate homeostatic sleep information from different populations of intrinsic MB "Kenyon cells" (KCs) to specific sleep-regulating MBONs: sleep-promoting KCs increase sleep by preferentially activating the cholinergic MBONs, while wake-promoting KCs decrease sleep by preferentially activating the glutamatergic MBONs. Importantly, activity of the sleep-promoting MB microcircuit is increased by sleep deprivation and is necessary for homeostatic rebound sleep (i.e., the increased sleep that occurs after, and in compensation for, sleep lost during deprivation). These studies reveal for the first time specific functional connections between subsets of KCs and particular MBONs and establish the identity of synaptic microcircuits underlying transmission of homeostatic sleep signals in the MB.

Calcitonin gene-related peptide neurons mediate sleep-specific circadian output in Drosophila.

BACKGROUND: Imbalances in amount and timing of sleep are harmful to physical and mental health. Therefore, the study of the underlying mechanisms is of great biological importance. Proper timing and amount of sleep are regulated by both the circadian clock and homeostatic sleep drive. However, very little is known about the cellular and molecular mechanisms by which the circadian clock regulates sleep. In this study, we describe a novel role for diuretic hormone 31 (DH31), the fly homolog of the vertebrate neuropeptide calcitonin gene-related peptide, as a circadian wake-promoting signal that awakens the fly in anticipation of dawn. RESULTS: Analysis of loss-of-function and gain-of-function Drosophila mutants demonstrates that DH31 suppresses sleep late at night. DH31 is expressed by a subset of dorsal circadian clock neurons that also express the receptor for the circadian neuropeptide pigment-dispersing factor (PDF). PDF secreted by the ventral pacemaker subset of circadian clock neurons acts on PDF receptors in the DH31-expressing dorsal clock neurons to increase DH31 secretion before dawn. Activation of PDF receptors in DH31-positive DN1 specifically affects sleep and has no effect on circadian rhythms, thus constituting a dedicated locus for circadian regulation of sleep. CONCLUSIONS: We identified a novel signaling molecule (DH31) as part of a neuropeptide relay mechanism for circadian control of sleep. Our results indicate that outputs of the clock controlling sleep and locomotor rhythms are mediated via distinct neuronal pathways.

Relación entre estrés postraumático, afrontamiento represivo y rumiación en estudiantes universitarios chilenos / The relationship between post-traumatic stress, epressive coping and ruminationn among Chilean university students

Los desastres naturales pueden tener distinto tipo de impactos en el bienestar psicológico y salud mental. Una de las respuestas que se ha asociado con mayor frecuencia a los desastres es la denominada sintomatología postraumática. El impacto psicológico de los desastres naturales está infuido por distintos factores. Un factor individual que probablemente puede infuir es la forma de afrontamiento empleada por cada persona. Objetivo: La presente investigación evaluó la relación entre estrés postraumático y dos formas de afrontamiento, el estilo represivo y la rumiación. Material y método: muestra de 314 estudiantes universitarios que vivieron el terremoto y tsunami del 27 de febrero de 2010 en la zona centro-sur de Chile, quienes respondieron una batería de instrumentos de autoinforme. Se realizó análisis bivariado y multivariado. Resultados: Se observaron asociaciones inversas entre el afrontamiento represivo y estrés postraumático y asociaciones directas entre rumiación y estrés postraumático. El afrontamiento represivo y la rumiación mostraron ser variables con una relación inversa entre sí. Conclusiones: Estos resultados son de interés para una mejor comprensión de la relación entre el tipo de respuesta de afrontamiento empleadas por las personas y su susceptibilidad a responder en forma negativa a situaciones traumáticas como los desastres naturales. El afrontamiento represivo puede no ser una respuesta negativa y podría contribuir a una menor rumiación, la que sí muestra ser un factor que se asocia a una mayor sintomatología postraumática.

Natural disasters have different impacts on people’s psychological well-being and mental health. One of the most frequent consequences is the post-traumatic symptomatology. The psychological impact of disasters might be influenced by several factors. The coping style is one of the personal factors that infuence the psychological impact of disasters. Objective: The current research assessed the relationship between post-traumatic stress and two ways of coping, repressive style and rumination in a sample of 314 undergraduate students that lived the earthquake and tsunami in the central region of Chile and that answered self-informed tools. Results: An inverse relationship between repressive coping and post-traumatic stress was found, as well as direct relationship between rumination and post-traumatic stress. Repressive coping and rumination showed an inverse relationship. Conclusion: These results allow a better understanding of the relationship between coping responses and person’s propensity to answer negatively to traumatic experiences such as natural disasters. Repressive coping may not be a negative response and so could contribute to a decreased rumination, which is a factor that is associated to a greater post-traumatic symptomatology.

El punto de partida... oclusión en la odontología restauradora / The point of item... occlusion in the Odontolgy restorer

Una de las decisiones más difíciles de tomar en odontología restauradora, es el llamado "punto de partida". ¿Dónde se debe iniciar rehabilitación?. Cuando se trata de reahabilitar el sistema masticatorio como un todo, debemos tener presente, que el concepto más importante en Oclusión, es la posición más superior y media del cóndilo en su respectiva fosa glenoidea (Relación Céntrica), y entender que muchos de los problemas oclusales, tienen su origen en las posiciones excéntricas del cóndilo, que resultan en su función incoordinada de los músculos masticadores y como consecuencia de eso, se dan los llamados signos de inestabilidad, que son perfectamente diagnosticables. Es el objetivo de este artículo explicar de una manera simple, cómo logar este "punto de partida" y de esta manera hacer más predecibles todos los tratamientos.

Simulacion dinamica de una maquina sincronica conectada a una barra infinita

La simulacion dinamica puede considerarse un instrumento imprescindible para la planificacion y operacion optima de los sistemas de potencia aislados e interconectados. En este trbajo se presenta un modelo de simulacion completo que cubre los procesos dinamicos y permite un calculo exacto de los procesos transitorios y subtransitorios. Los modelos incluidos del generador, excitacion y turbina-gobernador hacen del mismo una herramienta importante para estudios de estabilidad transitoria, subtransitoria y dinamica conectados mediante una linea de transmision a una barra infinita. Un sistema de potencia se debe diseñar y operar de manera tal que la inestabilidad no se presente. Por esto es importante realizar pruebas de simulacion para analizar los limites que se deben cuidar durante la operacion para no ocasionar una inestabilidad del sistema.