The phase 1/2 trial of indomethacin in chronic pancreatitis (The PAIR trial): Protocol for a parallel multi-center randomized controlled trial.

BACKGROUND/OBJECTIVES: Current treatments for chronic pancreatitis focus on symptom management and therapeutics targeting disease reversal are lacking. Given the role of the cyclooxygenase-2 (COX-2) enzyme in producing prostaglandin E2 (PGE2), a key component in the inflammatory pathway of chronic pancreatitis, this study evaluates the physiologic effect of oral indomethacin, a COX-2 inhibitor, on PGE2 levels in pancreatic fluid. METHODS: This pilot two-center randomized controlled trial seeks to examine 32 subjects with chronic pancreatitis who have no contraindications to indomethacin. Subjects will be randomized to either oral indomethacin 50 mg twice a day or placebo twice a day for a total of 28 days. Baseline (pre-treatment) assessment of pain and quality of life will be performed using the Brief Pain Inventory and the PROMIS-10 questionnaires, respectively. Biological specimens including blood, urine, and saliva will be collected at pre-treatment and post-treatment(day 28). Endoscopic pancreatic function testing with concomitant pancreatic fluid collection will also be performed pre- and post-treatment to assess the change in pancreatic fluid PGE2 levels. The relationship between pancreatic fluid PGE2 levels with blood and saliva PGE2 levels will be examined. CONCLUSIONS: This study will elucidate the effect of oral indomethacin on PGE2 levels in the pancreas to assess its role in the inflammatory pathway of chronic pancreatitis. Should indomethacin significantly reduce PGE2 levels, this may represent a potential disease-altering treatment for chronic pancreatitis.

Benefits of near-zero freight: The air quality and health impacts of low-NOx compressed natural gas trucks.

The use of low-NOx compressed natural gas (CNG) medium-duty vehicles (MDVs) and heavy-duty vehicles (HDVs) has the potential to significantly reduce NOx emissions and yield improvements in regional air quality. However, the extent of air quality improvement depends on many factors including future levels of vehicle deployment, the evolution of emissions from other sources, and meteorology. An analysis of the impacts requires modeling the atmosphere to account for both primary and secondary air pollutants, and the use of health impact assessment tools to map air quality changes into quantifiable metrics of human health. Here, we quantify and compare the air quality and health impacts associated with the deployment of low-NOx CNG engines to power future MDV and HDV fleets in California relative to both a business-as-usual and a more advanced fleet composition. The results project that reductions in summer ground-level ozone could reach 13 ppb when compared to a baseline fleet of diesel and gasoline HDV and MDV and could reach 6 ppb when compared to a cleaner fleet that includes some zero-emission vehicles and fuels. Similarly, for all CNG cases considered reductions in PM2.5 are predicted to range from 1.2 ug/m3 to 2.7 ug/m3 for a summer episode and from 3.1 ug/m3 to approximately 7.8 ug/m3 for a winter episode. These improvements yield short-term health benefits equivalent to $47 to $56 million in summer and $38 to $43 million in winter during episodes conducive to poor air quality. Additionally, the use of zero emission vehicle options such as battery electric and hydrogen fuel cell trucks could achieve approximately 25% to 31% higher benefits for an equivalent fleet penetration level due to the additional emission reductions achieved.Implications: The paper provides a quantitative estimate of the air quality and human health benefits that can be achieved through the use of novel compressed natural gas engines (i.e., low-NOx CNG) in medium- and heavy-duty vehicles and provide a comparison with zero emission vehicles. Thus, our findings will provide support for policy development seeking to transform the trucking sector to meet clean air and climate goals given the current struggle policymakers have with selecting between alternative truck technologies due to variance in factors like cost and technical maturity.

Manejo de complicación postraumática dental. Informe de caso / Management of the postraumatic dental complication. A case report

Resumen Se presenta el caso clínico de una paciente femenina de 7 años de edad, la cual sufrió traumatismo dental en el central superior derecho permanente, al impactarse de manera directa en el pavimento al caer de una bicicleta. Se presenta necrosis pulpar como complicación postraumática a un mes de ocurrido el evento. El objetivo de este caso es mostrar que el diagnóstico adecuado y el conocimiento sobre un protocolo para el manejo del paciente con trauma dental son indispensables para el éxito del tratamiento y pronóstico del diente.

Abstract The clinical case of a 7-year-old female patient who suffered dental trauma in the permanent upper right central incisor presented by directly impacting the pavement after falling from a bicycle. Pulpar necrosis is presented as a postraumatic complication one month after the event. The objective of this case is to show that the adequate diagnosis and knowledge about the protocol for the management of the patient with dental trauma is essential for the success of the treatment and prognosis of the tooth.

Physical activity by children: an analysis based on Social Network Theory / Actividad física en escolares: un análisis desde la Teoría de redes sociales

Introduction: Physical inactivity is a risk factor for obesity and non-transmissible chronic diseases; this represents a burden for health services and limits the development of social capital. Objective: To identify the structure of the school and the community social network for the practice of structured and unstructured physical activity (PA) by schoolchildren. Methods: Cross-sectional study based on Social Network Theory conducted in Morelos, Mexico. A convenience sample of 33 children aged 8 to 10 years-old was selected from two public elementary schools. PA evaluations through pedometry, anthropometric assessments, and PA social network assessments (size, density, homophily, and centrality of actors) were performed. Results: The overall PA network was composed by 239 actors that were mostly peers (40.2%). The school sub-network had an average of 122 actors (87.0% children/peers and 13.0% teachers). Most children conducted PA in groups with their peers; overweight/obese children (mostly girls) lingered in the periphery of the school sub-network. The community sub-network had an average of 160 actors (55.0% parents/family members, 41.2% children/peers, and 3.8% Soccer-coaches). This sub-network, composed mostly by men (60.6%), was highly fragmented (19 sets of actors); they generally promoted unstructured "masculine" activities. The girls who did not perform structured PA and did not meet the recommended number of steps/day were in isolated and small community networks. Conclusions: School teachers are key actors in promoting structured PA. Male peers stand out as promoters of unstructured activity in the school and the community. Overweight and obese girls are a vulnerable group by having fragmented social networks. Public health interventions based in social networks should empower girls motor activity and adult women to become prestige leaders for promoting PA among children.

Introducción: La inactividad física es factor de riesgo para desarrollar enfermedades crónicas no transmisibles como la obesidad, limitando el desarrollo del capital social. Objetivo: Identificar la estructura de las redes sociales escolar y comunitaria para la práctica de la actividad física (AF) en escolares. Metodología: Estudio transversal basado en la Teoría de redes sociales, realizado en escuelas primarias públicas de Morelos, México, en 33 niños de 8 a 10 años de edad. Se realizaron mediciones de AF estructurada y no estructurada mediante podometría, evaluaciones antropométricas y de la estructura de las redes sociales de los escolares (tamaño, densidad, homofilia, y centralidad). Resultados: La red general incluyó 239 actores, la mayoría (40.2%) pares de los escolares. La sub-red escolar incluyó 122 actores, 87.0% escolares/pares y 13.0% maestros. Las niñas con sobrepeso/obesidad se ubicaron en la periferia de la sub-red; la mayoría de los escolares realizaron AF grupal con sus pares. La sub-red comunitaria incluyó 160 actores (55.0% padres/otros familiares, 41.2% escolares/pares y 3.8% entrenadores de futbol). Esta sub-red estuvo altamente fragmentada (19 conjuntos de actores), con 60.6% hombres promotores de actividades no estructuradas "masculinas". Las niñas sedentarias y que no realizaban AF estructurada formaron redes pequeñas y aisladas. Conclusión: Los maestros y pares de sexo masculino son actores clave en la promoción de AF en la escuela y la comunidad. Las niñas con sobrepeso/obesidad son un grupo vulnerable al tener redes fragmentadas. Intervenciones de salud pública basadas en redes sociales, deben empoderar a niñas y mujeres para convertirse en líderes promotoras de AF en escolares.

Effects of curcumin on brain-derived neurotrophic factor levels and oxidative damage in obesity and diabetes.

We evaluated the effects of curcumin treatment on protein oxidation (PO), lipid peroxidation (LP) and brain-derived neurotrophic factor (BDNF) levels in the hippocampus and frontal cortex (FC) of diabetic db/db mice (DM) and in sera of obese humans. Thus, DM were treated daily with 50 mg/kg of curcumin during an 8-week period. Obese human were treated daily with 500 and 750 mg of curcumin that was administered orally for 12 weeks; BDNF, PO and LP levels in sera were determined at in weeks 0, 2, 6 and 12 of treatment. BDNF levels decreased in hippocampus and FC of DM as compared with untreated wild-type mice. Curcumin improved or restored BDNF levels to normal levels in DM, but curcumin did not have any effect on BDNF levels in sera of obese humans. In hippocampus and FC of DM, hyperglycaemia and curcumin did not have effect on LP levels. Hyperglycaemia increased PO levels in hippocampus and FC, whereas curcumin decreased these levels in hippocampus but not in FC. In sera of obese humans, the 500-mg dose decreased LP levels in weeks 6 and 12 when compared with basal levels, but the 750-mg dose did not have any effect; both doses of curcumin decreased PO levels in weeks 2, 6 and 12 of treatment when compared with basal levels. Present results suggest a therapeutic potential of curcumin to decrease oxidation caused by obesity in humans and also show that curcumin restores BDNF levels in DM.

Curcumin decreases oxidative stress in mitochondria isolated from liver and kidneys of high-fat diet-induced obese mice.

Oxidative stress plays a key role in obesity and diabetes-related mitochondrial dysfunction. Mitochondrial dysfunction is characterized by increased oxidative damage, nitric oxide (NO) synthesis, and a reduced ratio of adenosine-5'-triphosphate (ATP) production/oxygen consumption. Curcumin represents a potential antioxidant and anti-inflammatory agent. In this study, our objective was to determine the effect of curcumin treatment on oxidative stress and mitochondrial dysfunction in high-fat diet (HFD)-induced obese mice (OM). These results suggest that curcumin treatment increased oxygen consumption and significantly decreased lipid and protein oxidation levels in liver mitochondria isolated from HFD-induced OM compared with those in the untreated OM (UOM). In kidney mitochondria, curcumin treatment significantly increased oxygen consumption and decreased lipid and protein peroxidation levels in HFD-induced OM when compared with those in UOM. Curcumin treatment neither has any effect on body weight gain nor have any effects on mitochondrial NO synthesis. These findings suggest that obesity induces oxidative stress and mitochondrial dysfunction, whereas curcumin may have a protective role against obesity-induced oxidative stress and mitochondrial dysfunction.

Vulvovaginitis y balanopostitis pustular sugerente a herpesvirus caprino-1 en cabras (Querétaro, México) / Pustular vulvovaginitis and balanoposthitis suggestive of caprine herpesvirus-1 infection in goats (Queretaro, Mexico)

Infectious pustular vulvovaginitis and balanoposthitis in goats is caused by caprine herpesvirus 1 (CpHV-1), from the Herpesviridae family Alphaherpesvirinae subfamily, sometimes produces abortion, neonatal enteritis and respiratory disease in adult goats. In a herd of 244 dairy and meat goats, physical examinations were performed in does and bucks, presenting vulvar and preputial lesions. Necropsies were done in four discarded animals (one male and two females) and one stillborn; immunohistochemistry (IHC) with bovine herpesvirus 1 (BHV-1) antibodies in prepuce and vulva samples was carried out. Penis and prepuce exfoliative cytology was carried out in six bucks. Prepuce biopsies were collected for electron microscopy and viral isolation. Macroscopically, moderate to severe coalescent multifocal pustular and ulcerative vulvovaginitis was observed; and severe coalescent multifocal pustular and ulcerative balanoposthitis. Microscopically, different degrees of inflammatory lesions with presence of eosinophilic and amphophilic intranuclear inclusion bodies were present. In electron microscopy, the prepuce samples and MBDK cell culture showed several intranuclear viral particles of 150 to 230 nm size. There was slight epithelial cell positivity in IHC with BHV-1 antibodies in vulva and prepuce histological cuts made at necropsy. In the viral isolate was observed a cytopathic effect and the presence of viral particles by microscopy electronic suggesting herpes virus. This is the first documented report suggesting the presence of herpes virus outbreak in caprine herds in Mexico.

La vulvovaginitis y balanopostitis pustular infecciosa en cabras es producida por herpesvirus caprino 1 (CpHV-1), de la familia Herpesviridae subfamilia Alphaherpesvirinae, que ocasionalmente produce aborto, enteritis neonatal y enfermedad respiratoria en las cabras adultas. En un rebaño de 244 cabras de genotipo lechero y cárnico; se realizaron exámenes físicos de hembras y sementales en los que se observaron lesiones vulvares y prepuciales. Se realizó la necropsia de cuatro animales adultos de desecho (dos hembras y un macho) y un neonato muerto; se realizó inmunohistoquímica (IHQ) con anticuerpos de herpesvirus bovino 1 (BHV1) en muestras de prepucio y vulva. Se analizaron las citologías exfoliativas de pene y prepucio de 6 sementales. Se recolectaron y analizaron biopsias de prepucio para microscopía electrónica y aislamiento viral. Macroscópicamente, en las hembras se observó vulvovaginitis pustular y ulcerativa de moderada a grave multifocal coalescente, además de balanopostitis pustular y ulcerativa grave multifocal coalescente en los machos. Microscópicamente, se presentaron lesiones inflamatorias en diferentes grados, con presencia de cuerpos de inclusión intranucleares eosinofílicos y amfofílicos. En microscopía electrónica, las muestras de prepucio y cultivo celular de MBDK presentaron numerosas partículas virales intranucleares de un tamaño de 150 a 230 nm. En los cortes histológicos de prepucio y vulva de las necropsias se detectó una ligera positividad en las células epiteliales con anticuerpos BHV-1. En el aislamiento viral se observó efecto citopático, y la presencia de partículas virales mediante microscopía electrónica sugerentes a herpes virus. Este es el primer informe documentado que sugiere la presencia de herpes virus en rebaños caprinos de México.