ABSTRACT
Los avances tecnológicos y del conocimiento hicieron que un mayor número de pacientes con enfermedad crónica gastrointestinal pasen de ser atendidos por el pediatra al control por los médicos de adultos durante una de las etapas más vulnerables de la vida: la adolescencia. El Grupo de Trabajo de Transición del Comité de Gastroenterología de la Sociedad Argentina de Pediatría realizó una búsqueda de literatura exhaustiva y convocó a especialistas referentes del país, con el objeto de unificar los criterios basados en la evidencia y la experiencia. De esta manera, se proponen una serie de recomendaciones para todo el equipo de salud (pediatra, gastroenterólogo infantil, nutricionista, gastroenterólogo de adultos, psicólogo, enfermería), incluso para pacientes y familias, que faciliten el proceso de transición y optimicen el seguimiento, el control, la prevención de complicaciones y la calidad de vida de los pacientes con enfermedades crónicas gastrointestinales
Technological advances and the globalization of knowledge have led to a considerable increase in the number of patients with chronic gastrointestinal disease who transition from pediatric to adult care during one of the most vulnerable life stages: adolescence. The Transition Working Group of the Gastroenterology Committee of the Sociedad Argentina de Pediatría conducted an exhaustive literature search and summoned leading specialists in the most frequent chronic pathologies from all over the country to unify criteria based on evidence and experience. As a result, a series of recommendations are proposed for the whole health team (pediatrician, pediatric gastroenterologist, nutritionist, adult gastroenterologist, psychologist, and nurse) including patients and families, to facilitate the transition process, optimize follow-up, prevent complications, and improve the quality of life of patients with chronic gastrointestinal diseases.
Subject(s)
Humans , Adolescent , Adult , Inflammatory Bowel Diseases , Transition to Adult Care , Gastroenterology , Gastrointestinal Diseases/therapy , Quality of Life , Chronic DiseaseABSTRACT
Technological advances and the globalization of knowledge have led to a considerable increase in the number of patients with chronic gastrointestinal disease who transition from pediatric to adult care during one of the most vulnerable life stages: adolescence. The Transition Working Group of the Gastroenterology Committee of the Sociedad Argentina de Pediatría conducted an exhaustive literature search and summoned leading specialists in the most frequent chronic pathologies from all over the country to unify criteria based on evidence and experience. As a result, a series of recommendations are proposed for the whole health team (pediatrician, pediatric gastroenterologist, nutritionist, adult gastroenterologist, psychologist, and nurse) including patients and families, to facilitate the transition process, optimize follow-up, prevent complications, and improve the quality of life of patients with chronic gastrointestinal diseases.
Los avances tecnológicos y del conocimiento hicieron que un mayor número de pacientes con enfermedad crónica gastrointestinal pasen de ser atendidos por el pediatra al control por los médicos de adultos durante una de las etapas más vulnerables de la vida: la adolescencia. El Grupo de Trabajo de Transición del Comité de Gastroenterología de la Sociedad Argentina de Pediatría realizó una búsqueda de literatura exhaustiva y convocó a especialistas referentes del país, con el objeto de unificar los criterios basados en la evidencia y la experiencia. De esta manera, se proponen una serie de recomendaciones para todo el equipo de salud (pediatra, gastroenterólogo infantil, nutricionista, gastroenterólogo de adultos, psicólogo, enfermería), incluso para pacientes y familias, que faciliten el proceso de transición y optimicen el seguimiento, el control, la prevención de complicaciones y la calidad de vida de los pacientes con enfermedades crónicas gastrointestinales.
Subject(s)
Gastroenterology , Gastrointestinal Diseases , Inflammatory Bowel Diseases , Transition to Adult Care , Adolescent , Humans , Adult , Child , Quality of Life , Chronic Disease , Gastrointestinal Diseases/therapyABSTRACT
Inteins excise themselves out of precursor proteins by the protein splicing reaction and have emerged as valuable protein engineering tools in numerous and diverse biotechnological applications. Split inteins have recently attracted particular interest because of the opportunities associated with generating a protein from two separate polypeptides and with trans-cleavage applications made possible by split intein mutants. However, natural split inteins are rare and differ greatly in their usefulness with regard to the achievable rates and yields. Here we report the first functional characterization of new split inteins previously identified by bioinformatics from metagenomic sources. The N- and C-terminal fragments of the four inteins gp41-1, gp41-8, NrdJ-1, and IMPDH-1 were prepared as fusion constructs with model proteins. Upon incubation of complementary pairs, we observed trans-splicing reactions with unprecedented rates and yields for all four inteins. Furthermore, no side reactions were detectable, and the precursor constructs were consumed virtually quantitatively. The rate for the gp41-1 intein, the most active intein on all accounts, was k = 1.8 ± 0.5 × 10(-1) s(-1), which is â¼10-fold faster than the rate reported for the Npu DnaE intein and gives rise to completed reactions within 20-30 s. No cross-reactivity in exogenous combinations was observed. Using C1A mutants, all inteins were efficient in the C-terminal cleavage reaction, albeit at lower rates. C-terminal cleavage could be performed under a wide range of reaction conditions and also in the absence of native extein residues flanking the intein. Thus, these inteins hold great potential for splicing and cleavage applications.
Subject(s)
Inteins/physiology , Metagenome/physiology , Mutation , Protein Splicing/physiology , Proteins/metabolism , Proteins/genetics , Recombinant Proteins/genetics , Recombinant Proteins/metabolismSubject(s)
Colitis, Ulcerative/complications , Thromboembolism/etiology , Adult , Female , Humans , Severity of Illness IndexSubject(s)
Humans , Female , Adult , Thromboembolism/complications , Thromboembolism/diagnosis , Venous Thromboembolism/complications , Colitis, Ulcerative/complications , Colitis, Ulcerative/diagnosis , /methods , Paracentesis/methods , Thrombophilia/complications , Colitis, Ulcerative/pathology , Colitis, Ulcerative/surgery , Colitis, Ulcerative , Heparin/therapeutic use , Budd-Chiari Syndrome/complications , Budd-Chiari Syndrome , Abdominal Pain/complications , Abdominal Pain/etiologyABSTRACT
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Subject(s)
Humans , Male , Adult , Gastroenteritis/diagnosis , Eosinophilia/diagnosis , Ascites/diagnosis , Asthma/complicationsABSTRACT
In contrast to mammalian transglutaminases (TGs), plant members of the superfamily are poorly characterized. In order to produce pure and active TG for its functional and structural studies, variants of maize chloroplast transglutaminase (TGZ, Patent WWO03102128) were sub-cloned into a pET28 vector and overexpressed in Escherichia coli BL21 (DE3) cells. The recombinant proteins were present mainly as insoluble inclusion bodies. The TGZ4p variant with four B-type repeats (M(r) approximately 55 kDa), was affinity purified from urea-solubilized inclusion bodies. TGZ4p was refolded by rapid dilution in a Ca(2+)- and guanidine-containing buffer. Active TGZ4p shows the general catalytic characteristics described for other TGs.
Subject(s)
Biotechnology/methods , Chloroplasts/enzymology , Escherichia coli/enzymology , Transglutaminases/metabolism , Zea mays/enzymology , Electrophoresis, Polyacrylamide Gel , Escherichia coli/metabolism , Guanidine/chemistry , Protein Denaturation , Protein Folding , Recombinant Proteins/chemistry , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Urea/chemistryABSTRACT
BACKGROUND: Biliary diseases represent particular diagnostic and therapeutic problems in elderly patients. METHODS: Patients 90 years of age or older who underwent ERCP from January 1993 to September 2001 were studied retrospectively. RESULTS: A total of 126 patients underwent 147 ERCP procedures (range 1-5 per patient). Twelve additional ERCPs were performed in 9 of the patients during follow-up because of recurrent symptoms. A total of 159 procedures were, therefore, available for analysis. The most frequent indications were suspicion of bile duct stones (46.8%) and obstructive jaundice (35.7%). Midazolam (95.6%) was used for conscious sedation and hyoscine (74.8%) for duodenal ileus. Patient tolerance of the procedure was good in 92.4% of sessions. Diagnoses included bile duct stones (54%), bile duct dilatation without any apparent obstruction (11.9%), and malignant stenosis (9.5%). Therapeutic procedures were indicated in 95.6% of diagnosed patients and completed in 96.3% of cases. Complications occurred in association with 2.5% of the ERCP procedures; the procedure-related mortality rate was 0.7%. CONCLUSIONS: ERCP in elderly patients is practicable. The complication rate is low, and therapeutic efficacy is good.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Gallstones/diagnosis , Gallstones/therapy , Jaundice, Obstructive/diagnosis , Jaundice, Obstructive/therapy , Adjuvants, Anesthesia , Age Factors , Aged , Aged, 80 and over , Anesthetics, Intravenous , Biliary Tract Neoplasms/complications , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Conscious Sedation/methods , Female , Follow-Up Studies , Humans , Male , Midazolam , Retrospective Studies , Scopolamine , Sphincterotomy, Endoscopic , StentsSubject(s)
Celiac Disease/complications , Intestinal Neoplasms/etiology , Leiomyoma/etiology , Humans , Male , Middle AgedABSTRACT
En orina de ratones, infectados en forma aguda experimental con la cepa Tulahuén de T cruzi, se detectó señales radioautográficas en inmunodot, desarrollado con suero humano chagásico. En inmunoelectrotransferencia (IET) de orina murina concentrada, desarrollada con suero de humanos seropositivos, se detectó bandas de pesos moleculares 66, 56 (también presentes en orinas normales), 19, 12, 10 y 8 kDa. En orina de humanos seropositivos, sometida a IET contra una dilusión adecuada de sueros de estos mismos individuos se detectó bandas de 66, 56 (también presentes en orinas normales), 87, 46, 36 y 26 kDa. Hubo diferencias importantes en relación al número de éstos polipéptidos presentes en cada muestra. Curiosamente, si todos estos polipéptidos urinarios se enfrentan en IET a sueros humanos normales (seronegativos para T cruzi), son detectados en grado variable. este problema, a pesar de la sensibilidad de los ensayos usados y de la extensiva concentración a que se sometió los especímenes, cuestiona seriamente la especificidad del método, por lo cual el uso de orina como especímen para el diagnóstico expedito de Chagas, experimental y humano, no parece ser muy promisorio
