[From genetics to genomics in the rational design of new Mycobacterium tuberculosis vaccines]. / De la genética a la genómica en el diseño de nuevas vacunas contra la tuberculosis.

Tuberculosis (TB) is an infectious disease affecting people from all ages all over the world. It is estimated that one third of the world population lives infected with the causal agent: Mycobacterium tuberculosis. Despite availability and systematic administration of BCG vaccine in endemic areas, TB transmission remains elusive to control, partly because BGC efficacy has been shown to have wide variability (0-80%). Such variability in protection is attributed to factors including: the BCG strain used for immunization, pre-existing exposure to environmental saprophytic Mycobacterium species, and host genetic factors. In this context, efforts regarding to re-engineering BCG vaccines with the ability to prevent latent TB reactivation, providing long lasting protection, and devoid from collateral effects in immunosuppressed people are urgent. In this work we review the actual molecular «gene-by-gene¼ strategies aimed at generating BCG alternatives, and discuss the urgent necessity of high throughput technology methods for a rational design for a new TB vaccine.

Description of the Step-by-Step Technique With Snare Catheter for TAVR in Horizontal Aorta.

The presence of a horizontal aorta in patients treated with transcatheter aortic valve replacement increases the difficulty of the procedure. We present 5 cases with aortic stenosis with a horizontal aorta who underwent transcatheter aortic valve replacement using a self-expanding prostheses, with the objective of describing the techniques used and obtaining success with a snare catheter. (Level of Difficulty: Intermediate.).

Time-trends in the epidemiology of peptic ulcer bleeding.

OBJECTIVE: Despite the introduction of effective medical treatment of peptic ulcer disease, bleeding is still a frequent complication. The aim of this study was to investigate whether the incidence and the risk profile of peptic ulcer haemorrhage have changed within a 10-year period. MATERIAL AND METHODS: In a prospective epidemiological and observational study the incidence and risk profile of peptic ulcer haemorrhage in Düsseldorf, Germany were compared between two time periods (period A: 1.3.89-28.2.90 and period B: 1.4.99-31.3.2000), involving nine hospitals with both surgical and medical departments. Patients with proven peptic ulcer haemorrhage at endoscopy or operation were included in the study; those with bleeding under defined severe stress conditions were excluded. RESULTS: No differences in bleeding ulcer incidence were observed between periods A and B (51.4 per 100,000 person-years versus 48.7), or for duodenal ulcer (24.9 versus 25.7) or for gastric ulcer bleeding (26.5 versus 23.0). A marked increase in incidence rates was observed with increasing age. In period B, patients with bleeding ulcers were older (56% versus 41% 70 years or older), were usually taking non-steroidal anti-inflammatory drugs (NSAIDs) (45% versus 27%) and were less likely to have a history of ulcer (25% versus 59%) compared with patients in period A. CONCLUSIONS: The persisting high incidence of peptic ulcer disease is a superimposing of two trends: a higher incidence in the growing population of elderly patient with a higher intake of NSAIDs and a lower incidence among younger patients due to a decrease in incidence and improved medical treatment.

De la genética a la genómica en el diseño de nuevas vacunas contra la tuberculosis / From genetics to genomics in the rational design of new Mycobacterium tuberculosis vaccines

La tuberculosis es una enfermedad infectocontagiosa que afecta a seres humanos de todas las edades, y se considera que la tercera parte de la población mundial está infectada con el bacilo de Koch. Aunque la vacuna BCG es aplicada sistemáticamente en áreas endémicas, su efectividad varía de 0-80% dependiendo de diversos factores que incluyen: la cepa vacunal utilizada, la exposición a micobacterias ambientales, e incluso a factores genéticos. La incidencia de la enfermedad va en aumento en todo el mundo, y es urgente contar con una vacuna alternativa a la BGC. En la presente revisión se hace una descripción de las estrategias moleculares puntuales y a escala genómica que se están llevando a cabo para el diseño de una nueva vacuna, y se pone de manifiesto la necesidad del uso de las nuevas tecnologías de alto rendimiento para lograr un diseño verdaderamente racional de una nueva vacuna contra la tuberculosis (AU)

Tuberculosis (TB) is an infectious disease affecting people from all ages all over the world. It is estimatedthat one third of the world population lives infected with the causal agent: Mycobacterium tuberculosis.Despite availability and systematic administration of BCG vaccine in endemic areas, TB transmissionremains elusive to control, partly because BGC efficacy has been shown to have wide variability (0-80%).Such variability in protection is attributed to factors including: the BCG strain used for immunization, preexistingexposure to environmental saprophytic Mycobacterium species, and host genetic factors. In thiscontext, efforts regarding to re-engineeringBCGvaccines with the ability to prevent latent TB reactivation,providing long lasting protection, and devoid from collateral effects in immunosuppressed people areurgent. In this work we review the actual molecular «gene-by-gene» strategies aimed at generating BCGalternatives, and discuss the urgent necessity of high throughput technology methods for a rational designfor a new TB vaccine (AU)