Longitud muscular, dolor y funcionalidad en adultos jóvenes con disfunción de la articulación sacroilíaca

Introducción: La disfunción de la articulación sacroilíaca es un trastorno patomecánico, en la cual se pierde la estabilidad y se altera el funcionamiento de la cintura pélvica; también se modifica la capacidad de trasmitir y disipar fuerzas desde los miembros inferiores hacia la columna y viceversa. El acortamiento de músculos como el dorsal ancho, isquiotibiales y espinales lumbares puede alterar el control motor y generar lumbalgia. Objetivo: Evaluar la longitud muscular del dorsal ancho, los isquiotibiales, los espinales lumbares, el dolor y la funcionalidad en adultos jóvenes a partir de la comparación de tres grupos de estudio: dolor lumbar, disfunción de la articulación sacroilíaca y control. Métodos: Se realizó un estudio de corte transversal. Se incluyeron 114 personas de ambos sexos. La longitud muscular se evaluó a través de pruebas específicas para cada músculo. La escala visual análoga y el Oswestry se utilizaron para medir el dolor y la funcionalidad, respectivamente. Las diferencias de las variables entre los grupos de estudio se calcularon con la prueba de Chi2. Resultados: No se observaron diferencias en cuanto a longitud muscular en los grupos de estudio. El grupo con disfunción de la articulación sacroilíaca presentó más personas con dolor y limitación funcional moderada-severa. Conclusiones: Las retracciones del dorsal ancho, los isquiotibiales y los espinales lumbares no se relacionaron con el dolor lumbar o la disfunción de la articulación sacroilíaca; sin embargo, los adultos jóvenes de este grupo presentaron más molestias y discapacidad.

Introduction: Sacroiliac joint dysfunction is a pathomechanical alteration, in which stability is lost and the functioning of the pelvic girdle is altered; the ability to transmit and dissipate forces from the lower limbs to the spine and vice versa is also modified. The shortening of muscles such as the latissimus dorsi, hamstrings and lumbar spinal muscles can alter motor control and generate low back pain. Objective: To evaluate the muscle length of latissimus dorsi, hamstrings and lumbar spinal muscles, pain and functionality in young adults by comparing three study groups: pain, sacroiliac joint dysfunction and control. Methods: A cross-sectional study was carried out. A total of 114 subjects of both sexes were included. Muscle length was assessed through muscle-specific tests. The Visual Analog Scale and the Oswestry were used to measure pain and functionality, respectively. Differences in variables between study groups were calculated with the Chi2 test. Results: No differences in muscle length were observed in the study groups. The group with sacroiliac joint dysfunction presented more individuals with pain and moderate-severe functional limitation. Conclusions: Latissimus dorsi, hamstring and lumbar spinal retractions were not related to low back pain or sacroiliac joint dysfunction; however, young adults in this group presented more discomfort and disability.

Formate dehydrogenases for CO2 utilization.

New measures for reducing atmospheric CO2 are urgently needed. Formate dehydrogenases (FDHs, EC 1.17.1.9) catalyze conversion of CO2 to formate (HCOO-) via a reverse catalytic ability. This enzymatic conversion of CO2 represents a novel first step approach for biocatalytic carbon capture and utilization targeting both CO2 reduction and substitution of petrochemical-based production of important commodity chemicals. To achieve robust and efficient FDH catalyzed CO2 conversion for sustainable large-scale implementation, it is critical to focus on the efficacy of the electron donor, enzyme stabilization, and on how the desired reverse FDH reactivity can be enhanced. Recent advances include the realization that NADH, the most common natural cofactor for reverse FDH catalysis, is an inefficient electron donor for FDH catalyzed CO2 conversion. Improved understanding of the redox reaction details and structure-function relations of both metal-dependent and metal-independent FDHs provides the foundation for achieving rational technological advancements to promote enzymatic CO2 utilization.

Cuidado de la salud mental de las enfermeras: prioridad en la pandemia por la covid-19 / Nurses' Mental Health Care: Priority in the Covid-19 Pandemic / Cuidado da saúde mental das enfermeiras: prioridade na pandemia pela covid-19

La pandemia por la covid-19 ha tenido implicaciones de diversa índole, entre las que se encuentra la salud mental de las enfermeras; esta se ve afectada en la cotidianidad de su rol como cuidadoras y, por tanto, se hace prioritario atenderla como parte del derecho humano a la salud. Con este convencimiento, y con la experiencia como enfermera asistencial, investigadora y académica, en este editorial se presenta parte de un aprendizaje surgido en el grupo de apoyo y acogimiento para enfermeras en crisis, quienes afrontan la incertidumbre, el sufrimiento por el contagio, así como la muerte de sus propios familiares y compañeros.

The COVID-19 pandemic has had several repercussions, particularly on the nurses' mental health, which is adversely affected in their everyday life role as caregivers; therefore, it is a priority to take care of this issue as part of the human right to health. With this conviction and my experience as a clinical nurse, researcher, and scholar, this editorial presents part of a lesson learned in the support and fostering group for nurses in crisis, who face uncertainty, suffering due to contagion, and the death of their relatives and coworkers.

A pandemia ocasionada pela covid-19 vem tendo consequências diversas. Entre estas, encontra-se a saúde mental das enfermeiras, que se vê afetada na cotidianidade de seu papel como cuidadoras e, portanto, torna-se prioritário atendê-la como parte do direito humano à saúde. Com essa convicção e com a experiência como enfermeira assistencial, pesquisadora e acadêmica, neste editorial, é apresentada parte de uma aprendizagem que surgiu no grupo de apoio e acolhimento para enfermeiras em crise, as quais enfrentam a incerteza, o sofrimento pelo contágio, bem como a morte de seus familiares e companheiros.

Change in Cofactor Specificity of Oxidoreductases by Adaptive Evolution of an Escherichia coli NADPH-Auxotrophic Strain.

The nicotinamide cofactor specificity of enzymes plays a key role in regulating metabolic processes and attaining cellular homeostasis. Multiple studies have used enzyme engineering tools or a directed evolution approach to switch the cofactor preference of specific oxidoreductases. However, whole-cell adaptation toward the emergence of novel cofactor regeneration routes has not been previously explored. To address this challenge, we used an Escherichia coli NADPH-auxotrophic strain. We continuously cultivated this strain under selective conditions. After 500 to 1,100 generations of adaptive evolution using different carbon sources, we isolated several strains capable of growing without an external NADPH source. Most isolated strains were found to harbor a mutated NAD+-dependent malic enzyme (MaeA). A single mutation in MaeA was found to switch cofactor specificity while lowering enzyme activity. Most mutated MaeA variants also harbored a second mutation that restored the catalytic efficiency of the enzyme. Remarkably, the best MaeA variants identified this way displayed overall superior kinetics relative to the wild-type variant with NAD+. In other evolved strains, the dihydrolipoamide dehydrogenase (Lpd) was mutated to accept NADP+, thus enabling the pyruvate dehydrogenase and 2-ketoglutarate dehydrogenase complexes to regenerate NADPH. Interestingly, no other central metabolism oxidoreductase seems to evolve toward reducing NADP+, which we attribute to several biochemical constraints, including unfavorable thermodynamics. This study demonstrates the potential and biochemical limits of evolving oxidoreductases within the cellular context toward changing cofactor specificity, further showing that long-term adaptive evolution can optimize enzyme activity beyond what is achievable via rational design or directed evolution using small libraries. IMPORTANCE In the cell, NAD(H) and NADP(H) cofactors have different functions. The former mainly accepts electrons from catabolic reactions and carries them to respiration, while the latter provides reducing power for anabolism. Correspondingly, the ratio of the reduced to the oxidized form differs for NAD+ (low) and NADP+ (high), reflecting their distinct roles. We challenged the flexibility of E. coli's central metabolism in multiple adaptive evolution experiments using an NADPH-auxotrophic strain. We found several mutations in two enzymes, changing the cofactor preference of malic enzyme and dihydrolipoamide dehydrogenase. Upon deletion of their corresponding genes we performed additional evolution experiments which did not lead to the emergence of any additional mutants. We attribute this restricted number of mutational targets to intrinsic thermodynamic barriers; the high ratio of NADPH to NADP+ limits metabolic redox reactions that can regenerate NADPH, mainly by mass action constraints.

Raoultella ornithinolytica urinary tract infection in a pediatric patient with T-cell precursor acute lymphoblastic leukemia / Infección de vías urinarias por Raoultella ornithinolytica en un paciente pediátrico con leucemia linfoblástica aguda de células T

Abstract Background: Currently, Raoultella ornithinolytica is considered an emerging pathogen of community- and hospital-acquired infection, particularly in patients with immunodeficiencies, malignancies, anatomical abnormalities, or after invasive procedures. Pediatric infections with R. ornithinolytica are exceedingly rare, with only six previously reported cases, of which only two were reported as a urinary tract infection. Case report: Here, we describe a polymicrobial urinary tract infection (R. ornithinolytica and Enterococcus faecalis) in a pediatric patient with T-cell precursor acute lymphoblastic leukemia, which was successfully treated with ampicillin-sulbactam. Conclusions: To the extent of our knowledge, we report the seventh case in a pediatric patient and only the third case of a urinary tract infection in this age group caused by R. ornithinolytica.

Resumen Introducción: Actualmente Raoultella ornithinolytica es considerado un patógeno emergente involucrado en infecciones adquiridas en la comunidad y en el hospital, en particular en pacientes con algún tipo de inmunodeficiencia, malignidad, alteraciones anatómicas o sometidos a procedimientos invasivos. Las infecciones pediátricas causadas por R. ornithinolytica son sumamente raras, con solo seis casos publicados, de los cuales nada más dos se presentaron como infección de vías urinarias. Caso clínico: Se describe una infección de vías urinarias polimicrobiana (R. ornithinolytica y Enterococcus faecalis) en un paciente pediátrico con leucemia linfoblástica aguda de células T, que fue tratado satisfactoriamente con ampicilina-sulbactam. Conclusiones: Con base en lo que se sabe hasta el momento, se reporta el séptimo caso en un paciente pediátrico y el tercer caso de infección de vías urinarias causada por R. ornithinolytica en este grupo de edad.

Raoultella ornithinolytica urinary tract infection in a pediatric patient with T-cell precursor acute lymphoblastic leukemia.

BACKGROUND: Currently, Raoultella ornithinolytica is considered an emerging pathogen of community- and hospital-acquired infection, particularly in patients with immunodeficiencies, malignancies, anatomical abnormalities, or after invasive procedures. Pediatric infections with R. ornithinolytica are exceedingly rare, with only six previously reported cases, of which only two were reported as a urinary tract infection. CASE REPORT: Here, we describe a polymicrobial urinary tract infection (R. ornithinolytica and Enterococcus faecalis) in a pediatric patient with T-cell precursor acute lymphoblastic leukemia, which was successfully treated with ampicillin-sulbactam. CONCLUSIONS: To the extent of our knowledge, we report the seventh case in a pediatric patient and only the third case of a urinary tract infection in this age group caused by R. ornithinolytica.

Transmission of malaria from donors to solid organ transplant recipients: A case report and literature review.

Malaria is a febrile and potentially fatal infection. It is typically transmitted to humans through the bite of Anopheles mosquitoes and less frequently can be contracted through blood transfusions, sharing contaminated needles and syringes, mother-to-child transmission, or after solid organ transplantation. Posttransplant malaria has rarely been reported in the literature, even in endemic areas. We report the cases of three solid organ recipients in which Plasmodium vivax infection was documented during postsurgical evaluation 30 days after transplant surgery. The diagnosis of donor-derived malaria was confirmed in all patients by demonstrating Plasmodium in a peripheral blood smear and by polymerase chain reaction (PCR). All recipients had symptoms. The liver transplant recipient had myalgia, arthralgia, and thrombocytopenia; the kidney transplant recipient developed acute renal failure; and the heart transplant recipient had fever, cephalalgia, and tonic-clonic seizures. Pre-transplant screening of donors and recipients from endemic regions may not be sufficient to safely rule out persistent malaria. In Colombia, according to legislation, no mandatory testing is required for the diagnosis of malaria in organ donors in nonendemic areas. Therefore, donor screening by questionnaire is the only tool for preventing transplant-borne malaria. The migratory trend from Venezuela to Colombia has increased the number of imported cases of malaria, and the infection may be present in endemic and nonendemic regions. Although donor evaluation is not standardized in current guidelines, we suggest that donors be tested for malaria with a peripheral blood smear, detection of specific IgG antibodies against Plasmodium, and techniques such as PCR, if possible.

Endogenous auxin accumulation/localization during zygotic and somatic embryogenesis of Capsicum chinense Jacq.

Zygotic and somatic embryogenesis in plants is a fascinating event that is finely regulated through the expression of a specific group of genes and dynamic levels of plant hormones whose concerted action determines the fate that specific cells follow towards zygotic or somatic embryo development. This work studied different stages of Capsicum chinense Jacq. zygotic and somatic embryogenesis. HPLC quantification determined that the levels of indole-3-acetic acid (IAA) increase as the zygotic or somatic embryogenesis progresses, being higher at maturity, thus supporting a positive correlation between embryo cell differentiation and IAA increase. A monoclonal anti-IAA-antibody was used to detect IAA levels. Findings revealed a dynamic pattern of auxin distribution along the different embryogenic embryonic stages. In the early stages of zygotic embryos, the IAA gradient was observed in the basal cells of the suspensor and the hypostases, suggesting that they are the initial source of the IAA hormone. As embryogenesis proceeds, the dynamic of the IAA gradient is displaced to the embryo and endosperm cells. In the case of induced somatic embryogenesis, the IAA gradient was detected in the dividing cells of the endodermis, from where pre-embryogenic cells emerge. However, the analysis of somatic embryos revealed that IAA was homogeneously distributed. This study shows evidence supporting a correlation between IAA levels during zygotic or somatic embryogenesis in Capsicum chinense species.

Artes y humanidades en la formación de personal de salud y en la atención integral en un hospital universitario / Artes e humanidades na formação de pessoal de saúde e na atenção integral em um hospital universitário / Arts and humanities in the training of health personnel and in comprehensive care in a university hospital

Resumen El objetivo de este artículo es presentar las múltiples formas de aplicación de las artes y las humanidades en contextos hospitalarios y en la formación profesional en las Facultades de Medicina y Enfermería y un Hospital Universitario de la ciudad de Bogotá-Colombia en el periodo 2008-2018. La caracterización se hizo a partir de métodos cualitativos, interpretativos, con aplicación de entrevistas semiestructuradas a actores identificados por bola de nieve y auto reporte. También se hizo observación participante en algunos lugares y prácticas. Se indagó sobre los sentidos y usos de las artes y humanidades con relación a la salud y la formación en salud. Los diversos actores asignan sentidos a estas prácticas relacionándolas con una mayor receptividad en el proceso enseñanza aprendizaje, la posibilidad de generar sentido de trascendencia sobre lo que se hace, dar respuesta a preguntas existenciales, proporcionar bienestar a las personas en condiciones de hospitalización y en menor medida a generar bienestar propio o de los profesionales de salud. Su lugar en los contextos explorados aún se percibe como subalterno, y se sostienen en su mayoría a partir de iniciativas individuales y voluntariado. Debe insistirse en su legitimidad para avanzar en su sentido social y emancipador.

Resumo O objetivo deste artigo é identificar e descrever as múltiplas formas de aplicação das artes e humanidades em contextos hospitalares e de formação profissional nas Faculdades de Medicina e Enfermagem e em um Hospital Universitário da cidade de Bogotá-Colômbia no período de 2008 -2018. A caracterização foi feita a partir de métodos qualitativos, interpretativos, com aplicação de entrevistas semiestruturadas aos atores identificados por bola de neve e autorrelato. A observação participante também foi feita em alguns locais e práticas. Foram investigados os significados e usos das artes e humanidades em relação à saúde e à educação em saúde. Os diversos atores atribuem significados a essas práticas, relacionando-as a uma maior receptividade no processo ensino-aprendizagem, a possibilidade de gerar um sentido de transcendência sobre o que é feito, respondendo a questões existenciais, proporcionando bem-estar às pessoas em condições de hospitalização e em menor. medida para gerar bem-estar próprio ou dos profissionais de saúde. Seu lugar nos contextos explorados ainda é percebido como subalterno, e eles são sustentados principalmente por iniciativas individuais e voluntariado. Deve-se insistir em sua legitimidade para avançar em seu sentido social e emancipatório.

Abstract The objective of this article is present the multiple forms of application of the arts and humanities in hospital contexts and in professional training in the Faculties of Medicine and Nursing and a University Hospital of the city of Bogotá-Colombia in the period 2008 -2018. The characterization was made from qualitative, interpretive methods, with application of semi-structured interviews to actors identified by snowball and self-report. Participant observation was also made in some places and practices. The meanings and uses of the arts and humanities in relation to health and health education were investigated. The various actors assign meanings to these practices, relating them to a greater receptivity in the teaching-learning process, the possibility of generating a sense of transcendence about what is done, answering existential questions, providing well-being to people in hospitalization conditions and in less measure to generate own well-being or that of health professionals. Their place in the explored contexts is still perceived as subaltern, and they are mostly sustained by individual initiatives and volunteerism. Its legitimacy must be insisted upon in order to advance in its social and emancipatory sense.

In Vivo Selection for Formate Dehydrogenases with High Efficiency and Specificity toward NADP.

The efficient regeneration of cofactors is vital for the establishment of biocatalytic processes. Formate is an ideal electron donor for cofactor regeneration due to its general availability, low reduction potential, and benign byproduct (CO2). However, formate dehydrogenases (FDHs) are usually specific to NAD+, such that NADPH regeneration with formate is challenging. Previous studies reported naturally occurring FDHs or engineered FDHs that accept NADP+, but these enzymes show low kinetic efficiencies and specificities. Here, we harness the power of natural selection to engineer FDH variants to simultaneously optimize three properties: kinetic efficiency with NADP+, specificity toward NADP+, and affinity toward formate. By simultaneously mutating multiple residues of FDH from Pseudomonas sp. 101, which exhibits practically no activity toward NADP+, we generate a library of >106 variants. We introduce this library into an E. coli strain that cannot produce NADPH. By selecting for growth with formate as the sole NADPH source, we isolate several enzyme variants that support efficient NADPH regeneration. We find that the kinetically superior enzyme variant, harboring five mutations, has 5-fold higher efficiency and 14-fold higher specificity in comparison to the best enzyme previously engineered, while retaining high affinity toward formate. By using molecular dynamics simulations, we reveal the contribution of each mutation to the superior kinetics of this variant. We further determine how nonadditive epistatic effects improve multiple parameters simultaneously. Our work demonstrates the capacity of in vivo selection to identify highly proficient enzyme variants carrying multiple mutations which would be almost impossible to find using conventional screening methods.

Genes involved in the deformations of the shoot apical meristem in somatic embryos of Capsicum chinense Jacq.

Somatic embryos (SE) of habanero pepper (Capsicum chinense Jacq.) represent persistent deformations in the shoot apical meristem (SAM), which inhibits their capacity to form organs and subsequently plants. In dicotyledonous plants, SAM is formed in the apex, between cotyledons and it plays a central role in postembryonic shoot organ formation. Based on the previous knowledge on the role of some families of gene in the formation, organization and maintenance of the SAM, the expression patterns of WUS, WOX2, NAM, STM, PIN1 and PIN7 genes were analysed, which would allow us to elucidate the possible implication of these genes in SAM deformations in the SE of C. chinense. The results show that the expression patterns of STM and PIN1 in the SE were completely opposite to the respective expression pattern obtained in zygotic embryos (ZE). Moreover, NAM and PIN7 showed an over accumulation of transcripts in SE, compared with ZE. This is the first time in the genus Capsicum that alterations in the expression pattern of key genes of the SE development are reported, as well as its possible implication in the persistent deformations of the SAM.

Efecto sobre el temor a caer y la funcionalidad de tres programas de intervención. Ensayo clínico aleatorizado / Effect on fear of falling and functionality of three intervention programs. A randomised clinical trial

Introducción: El temor a caer tiene una alta prevalencia en la comunidad, los programas de intervención para esta condición son escasos y se hace necesario fortalecerlos ante sus consecuencias en la población anciana. Objetivo: Establecer la eficacia de tres programas de intervención en la reducción del temor a caer y el incremento de la funcionalidad en adultos mayores de la ciudad de Manizales. Participantes y métodos: Se llevó a cabo un ensayo aleatorizado con adultos mayores ambulatorios con temor a caer y limitación funcional de la ciudad de Manizales. Se aleatorizaron 125 individuos a una de tres intervenciones: taichí (TCh), terapia cognitiva comportamental (TCC) y ejercicios de control postural (CP), y se analizaron sus efectos sobre el temor a caer (evaluado con la Falls Efficacy Scale [FES-I]) y la funcionalidad, evaluada mediante la Short Physical Performance Battery (SPPB). Los datos se recogieron antes de iniciar las intervenciones y luego de terminar las 8 semanas de las mismas. Resultados: Se realizó un análisis por intención de tratar de 119 adultos mayores. Las tres intervenciones disminuyeron el temor a caer y mejoraron la funcionalidad, sin diferencias entre ellas (p=0,13). En velocidad de la marcha, solo se encontraron diferencias entre la pre- y postintervención con CP (p<0,001). Conclusiones: Los resultados muestran que las intervenciones de TCh, TCC y CP ayudan a los adultos mayores a disminuir su temor a caer; solo CP demostró mejoría de la velocidad de la marcha al finalizar las 8 semanas de intervención (identificador NCT03211429)

Introduction: The fear of falling has a high prevalence in the community, and intervention programs for this condition are scarce, making it is necessary to strengthen this type of therapy in order to prevent adverse consequences in the elderly population. Objective: To establish the effectiveness of three intervention programs in reducing the fear of falling and increasing functionality in elderly people in the city of Manizales. Participants and methods: A randomised trial was conducted on ambulatory elderly patients with fear of falling and functional limitation of the city of Manizales. A total of 125 individuals were randomised to one of three interventions: Tai Chi (TCh), cognitive behavioural therapy (CBT), and postural control (CP) exercises. The primary outcomes were: fear of falling (evaluated by the Falls Efficacy Scale [FES-I]), and functionality using the Short Physical Performance Battery (SPPB). The data was collected before initiating the interventions and after the 8 weeks intervention. Results: An intention-to-treat analysis was conducted on 119 elderly patients. The three interventions reduced the fear of falling and increased physical performance, with no significant differences observed between them (P=.13). As regards gait speed, differences were only found between the pre- and post-intervention with CP (P<.001). Conclusions: The results suggest that the TCh, CBT and CP interventions helped the elderly to reduce their fear of falling. Only CP demonstrated an improvement in the speed of walking at the end of the eight weeks of intervention (identifier NCT03211429)

Metabolic alkalosis is related to delayed response to treatment of hypokalemia in non-surgical critically ill patients.

Background: Potassium (K+) homeostasis is closely related to acid - base disorders. The aim of this study is to analyze the possible causes of hypokalemia non-surgical critically ill patients including acid - base disorders and its relationship with response to K+ supplementation. Methods: We performed a retrospective cohort study of 122 consecutive non-surgical patients admitted to the Intensive Care Unit during July 2016 Patients were classified according to the presence of hypokalemia or not. Demographic data, morbidities associated with hypokalemia, with emphasis in acid-base disorders and response to treatment were described and analyzed. Results: Hypokalemia was observed in 32,7% (n = 40) of the patients included. Hypokalemic group had a higher value of base excess (median of -0.65 [IQR -3.3-5.2] Vs -3.2 [IQR -5.1--1.4]; p < 0.001). The patients with hypokalemia that achieved normal serum K+ in more than 25 h had a higher value of excess base than those who did so in less than 24 h (median of 4.3 [IQR -2.1-5.5] vs -1.9 [IQR -4.8-3]; p < 0.05). Neither the degree of hypokalemia, the time to development, route of administration or solution concentration, speed of infusion, the amount of K+ administered per day per kg of weight were related with the response of treatment. Conclusions: Hypokalemia is a common disorder in non-surgical critically ill patients. Hypokalemic patients had a higher incidence of metabolic alkalosis. Patients with hypokalemia and metabolic alkalosis needed a higher amount of potassium administration and higher time to achieve correction.

[Effect on fear of falling and functionality of three intervention programs. A randomised clinical trial]. / Efecto sobre el temor a caer y la funcionalidad de tres programas de intervención. Ensayo clínico aleatorizado.

INTRODUCTION: The fear of falling has a high prevalence in the community, and intervention programs for this condition are scarce, making it is necessary to strengthen this type of therapy in order to prevent adverse consequences in the elderly population. OBJECTIVE: To establish the effectiveness of three intervention programs in reducing the fear of falling and increasing functionality in elderly people in the city of Manizales. PARTICIPANTS AND METHODS: A randomised trial was conducted on ambulatory elderly patients with fear of falling and functional limitation of the city of Manizales. A total of 125 individuals were randomised to one of three interventions: Tai Chi (TCh), cognitive behavioural therapy (CBT), and postural control (CP) exercises. The primary outcomes were: fear of falling (evaluated by the Falls Efficacy Scale [FES-I]), and functionality using the Short Physical Performance Battery (SPPB). The data was collected before initiating the interventions and after the 8 weeks intervention. RESULTS: An intention-to-treat analysis was conducted on 119 elderly patients. The three interventions reduced the fear of falling and increased physical performance, with no significant differences observed between them (P=.13). As regards gait speed, differences were only found between the pre- and post-intervention with CP (P<.001). CONCLUSIONS: The results suggest that the TCh, CBT and CP interventions helped the elderly to reduce their fear of falling. Only CP demonstrated an improvement in the speed of walking at the end of the eight weeks of intervention (identifier NCT03211429).

NADPH-Auxotrophic E. coli: A Sensor Strain for Testing in Vivo Regeneration of NADPH.

Insufficient rate of NADPH regeneration often limits the activity of biosynthetic pathways. Expression of NADPH-regenerating enzymes is commonly used to address this problem and increase cofactor availability. Here, we construct an Escherichia coli NADPH-auxotroph strain, which is deleted in all reactions that produce NADPH with the exception of 6-phosphogluconate dehydrogenase. This strain grows on a minimal medium only if gluconate is added as NADPH source. When gluconate is omitted, the strain serves as a "biosensor" for the capability of enzymes to regenerate NADPH in vivo. We show that the NADPH-auxotroph strain can be used to quantitatively assess different NADPH-regenerating enzymes and provide essential information on expression levels and concentrations of reduced substrates required to support optimal NADPH production rate. The NADPH-auxotroph strain thus serves as an effective metabolic platform for evaluating NADPH regeneration within the cellular context.

Dengue virus enters and exits epithelial cells through both apical and basolateral surfaces and perturbs the apical junctional complex.

Dengue is the most relevant mosquito-borne viral disease in the world. It has been estimated that 390 million infections of dengue occur each year. Dengue virus (DENV) infection can be asymptomatic or can produce a self-limited febrile illness called dengue fever (DF) or a severe form of the infection called severe dengue. In some viruses, the entry and egress from cells, occur in a specific domain of polarized endothelial and epithelial cells. In this study, we investigated whether the entry and release of DENV was polarized in epithelial cells, and evaluated the effect of DENV infection on cellular junctions of epithelial cells. We used MDCK epithelial cells, which serve as an excellent model to study a functional barrier due to the presence of an apical junctional complex (AJC), and showed that entry and release of DENV from the cells, is bipolar. Additionally, we performed paracellular flux, diffusion of membrane lipid, immunofluorescence and immunoblotting assays to evaluate the integrity of the AJC during DENV infection. We observed that at later stages of infection, DENV altered the barrier function causing a decrease in the transepithelial electrical resistance and the degradation and delocalization of TJ and AJ proteins. The present study contributes to understand how DENV traverse epithelia in order to cause a productive infection, and provides insights into the mechanism of DENV pathogenesis.

Development of the ovule and seed of Habanero chili pepper (Capsicum chinense Jacq.): Anatomical characterization and immunocytochemical patterns of pectin methyl-esterification.

Ovule and seed development in plants has long fascinated the scientific community given the complex cell coordination implicated in these processes. These cell events are highly conserved but are not necessarily representative of all plants. In this study, with the aim of obtaining information regarding the cellular patterns that follow the usual development of the ovule and the zygotic embryo, we carried out an integral anatomical study of the Capsicum chinense Jacq., floral buds and seeds at various days during maturation. This study allowed us to identify the main histo-morphological stages accompanying the transition of somatic cells into the macrospore, female gamete, and the zygotic embryogenesis. This knowledge is fundamental for future biotechnological research focused on solving the morphological recalcitrance observed during the in vitro induction of somatic or microspore embryogenesis in Capsicum. For the first time in C. chinense, we have described the hypostases, a putative source of plant growth regulators, and "the corrosion cavity", a space around the embryo. Additionally, the cell wall pectin-esterification status was investigated by immunohistology. At early stages of morphogenesis, the pectin is highly methyl-esterified; however, methyl-esterification decreases gradually throughout the process. A comparison of the results obtained here, together with the histo- and immunological changes occurring during the somatic and microspore embryogenesis, should help to elucidate the biochemical mechanisms that trigger the morphogenic events in Capsicum spp.

Transcriptional Study of the RsmZ-sRNAs and Their Relationship to the Biosynthesis of Alginate and Alkylresorcinols in Azotobacter vinelandii.

The GacS/A system in Azotobacter vinelandii regulates alginate and alkylresorcinols production through RsmZ1, a small regulatory RNA (sRNA) that releases the translational repression of the algD and arpR mRNAs caused by the RsmA protein. In the Pseudomonadaceae family, the Rsm-sRNAs are grouped into three families: RsmX, RmsY and RsmZ. Besides RsmZ1, A. vinelandii has six other isoforms belonging to the RsmZ family and another one to the RsmY. Environmental signals controlling rsmsRNAs genes in A. vinelandii are unknown. In this work, we present a transcriptional study of the A. vinelandii rsmZ1-7-sRNAs genes, whose transcriptional profiles showed a differential expression pattern, but all of them exhibited their maximal expression at the stationary growth phase. Furthermore, we found that succinate promoted higher expression levels of all the rsmZ1-7 genes compared to glycolytic carbon sources. Single mutants of the rsmZ-sRNAs family were constructed and their impact on alginate production was assessed. We did not observe correlation between the alginate phenotype of each rsmZ-sRNA mutant and the expression level of the corresponding sRNA, which suggests the existence of additional factors affecting their impact on alginate production. Similar results were found in the regulation exerted by the RsmZ-sRNAs on alkylresorcinol synthesis.

Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients / Resultados clínicos en receptores de trasplante renal posterior a la conversión a ImTOR

Abstract Introduction: mTOR inhibitors Sirolimus and Everolimus are an alternative for inmunosuppression in renal transplant recipients. The aim of the study was to describe the experience of patients with switch to mTOR inhibitors, followed up for more than five years. Materials and methods: Patients with renal transplantation from 1995 to 2013, who had indication of calcineurin inhibitor (CNI) withdrawl after the third month post-transplant were included. All patients underwent renal biopsy prior to conversion. No patient had a diagnosis of chronic nephtopathy, IFTA>40 % or proteinuria >350mg/24h. A descriptive analysis for all variables was devoloped. Kaplan-Meier method was used for the patient's and graft survival and graft rejection incidence. Results: From 1273 renal transplants, the switch from CNI to mTOR inhibitors was performed in 166 (13 %), 78 % (n=129) were switched to Sirolimus. 12,6 % of the patients lost graft function and 4,2 % (n=7) died. 37% had mTOR inhibitors withdrawal, and the major cause was pathologic proteinuria. The incidence of graft rejection after switching to mTOR inhibitors was 9,6 %. The one and five year graf survival was 96,6 % and 83,5 %. The patient survival at one and five years was 98 % and 97 %. Conclusions: The use of mTOR inhibitors drugs appears to be safe in the managgement of specific renal transplant recipients, with a low rejection rate and good survival.

Resumen Introducción: los ImTOR, sirolimus y everolimus son una alternativa de inmunosupresión en personas que han recibido transplantes renales. En este artículo, se describe la experiencia de pacientes que han experimentado una conversión a ImTOR, y a los que se les ha hecho un seguimiento por más de cinco años. Materiales y métodos: se incluyeron pacientes con transplantes renales desde 1995 hasta 2013, quienes tuvieron indicación de suspensión del inhibidor de calcineurina (ICN) después del tercer mes posterior al trasplante. Todos los pacientes fueron sometidos a biopsia renal antes de la administración de ImTOR. Ningún paciente tuvo diagnóstico de nefropatía crónica, IFTA >40 % o proteinuria >350 mg/24h. Se elaboró un análisis descriptivo para todas las variables. Para estudiar la supervivencia del paciente y del injerto, y la incidencia de rechazo agudo, se usó el método de Kaplan-Meier. Resultados: de 1273 trasplantes renales, la conversión de ICN a ImTOR se realizó en 166 casos (13 %). Al 78 % (n=129) se le administró sirolimus. El 13 % de los pacientes perdió la función del injerto y 7 pacientes (4,2 %) fallecieron. En el 37 % de los casos, se retiró el ImTOR. La principal causa de retiro fue el hallazgo de proteinuria patológica. La incidencia de rechazo agudo después del cambio a ImTOR fue de 9,6 %. La supervivencia del injerto tras uno y cinco años fue de 96,6 % y 83,5 %, respectivamente; y la supervivencia del paciente a uno y cinco años fue de 98 % y 97 %, respectivamente. Conclusiones: el uso de inhibidores ImTOR parece ser seguro en este grupo de pacientes trasplantados, pues hubo una baja tasa de rechazo y buena supervivencia del injerto.

Vigilancia de siniestros viales ocurridos en Resistencia en 2016 relevados en la Coordinación de Emergencias Médicas / Surveillance of Road Accidents in the City of Resistencia during 2016 by the Emergency Medical Coordination Center

En 2016 se registró un total de 4995 siniestros viales en la ciudad de Resistencia, Provincia de Chaco, por los cuales 6106 personas debieron ser asistidas. El 60,1% correspondió al sexo masculino y el 39,9%, al femenino. La edad promedio fue de 29,5 años (DE ± 15,01). Los días viernes se atendió al mayor número de personas, y los horarios de mayor frecuencia fueron las 8:00, 13:00 y 19:00 horas.