Extrahepatic causes of death in cirrhosis compared to other chronic conditions in the United States, 1999-2017.

INTRODUCTION AND OBJECTIVES: Cirrhosis-related mortality is underestimated and is increasing; extrahepatic factors may contribute. We examined trends in cirrhosis mortality from 1999-2017 in the United States attributed to liver-related (varices, peritonitis, hepatorenal syndrome, hepatic encephalopathy, hepatocellular carcinoma, sepsis) or extrahepatic (cardiovascular disease, influenza and pneumonia, diabetes, malignancy) causes, and compared mortality trends with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) populations. MATERIALS AND METHODS: A national mortality database was used. Changes in age-standardized mortality over time were determined by joinpoint analysis. Average annual percentage change (AAPC) was estimated. RESULTS: Cirrhosis cohort: From 1999-2017, both liver-related (AAPC 1.3%; 95% confidence interval [CI] 0.7-1.9) and extrahepatic mortality (AAPC 1.0%; 95% CI 0.7-1.2) increased. Cirrhosis vs other chronic disease cohorts: changes in all-cause mortality were higher in cirrhosis (AAPC 1.0%; 95% CI 0.7-1.4) than CHF (AAPC 0.1%; 95% CI -0.5- 0.8) or COPD (AAPC -0.4%; 95% CI -0.6- -0.2). Sepsis mortality was highest in cirrhosis (AAPC 3.6%, 95% 3.2- 4.1) compared to CHF (AAPC 0.6%, 95% CI -0.5- 1.7) or COPD (AAPC 0.8%, 95% CI 0.5- 1.2). Cardiovascular mortality increased in cirrhosis (AAPC 1.3%, 95% CI 1.1- 1.5), declined in CHF (AAPC -2.0%, 95% CI -5.3- 1.3) and remained unchanged in COPD (AAPC 0.1%, 95% CI -0.2- 0.4). Extrahepatic mortality was higher among women, rural populations, and individuals >65 years with cirrhosis. CONCLUSIONS: Extrahepatic causes of death are important drivers of mortality and differentially impact cirrhosis compared to other chronic diseases.

Subcutaneous allergen immunotherapy for asthma: A randomized, double-blind, placebo-controlled study with a standardized Blomia tropicalis vaccine.

BACKGROUND: Sensitization to Blomia tropicalis (Bt) is very frequent in the tropics, and particularly in Cuba, being a significant cause of allergic asthma. Allergen immunotherapy (AIT) with Bt can be a therapeutic option, however, placebo-controlled clinical trials have not been reported. OBJECTIVE: To assess the therapeutic effect and safety of AIT for asthma using a standardized allergen vaccine of B. tropicalis by subcutaneous route, in allergic asthmatic patients exposed and sensitized to this mite species. METHODS: A double-blind, placebo-controlled Phase II trial was conducted in 35 adults (18 with treatment and 17 with placebo), with mild to moderate asthma, predominantly sensitized to Bt. AIT was administered subcutaneously in increasing doses from 4 to 6000 Biological Units using a locally manufactured standardized extract (BIOCEN, Cuba). Patient assessment was performed using symptom-medication score (SMS), peak expiratory flow and skin reactivity relative to Histamine as measured by skin prick test (SPT). RESULTS: The 12-month treatment achieved a significant (p < 0.001) decrease of SMS. Symptom score showed only 41% (CI: 26-61) of placebo values, whereas medication was 34.5% (22.4%-63.3%). Treatment was regarded clinically effective in 67% of patients (OR 32; 95%CI: 17 to 102). The effect size on symptoms and medication was higher than has been reported with equivalent allergen dosages of D. pteronyssinus and D. siboney in Cuban asthmatic patients. Skin reactivity to Bt was also significantly reduced (p = 0.0001), increasing 148-fold the allergen threshold to elicit a positive skin test. This desensitization effect was specific to Bt and did not modify the reactivity to Dermatophagoides. The change of specific skin reactivity was significantly (p < 0.05) correlated to clinical improvement. All adverse events were local with a frequency of 2.4% of injections. CONCLUSIONS: Subcutaneous AIT with Blomia tropicalis was effective and safe in asthmatic adults exposed and sensitized to this mite species in a tropical environment. TRIAL REGISTRATION: Cuban Public Registry of Clinical Trials: RPCEC00000026 (WHO International Clinical Trial Registry Platform ICTRP).

Rediseño del Sitio Web del Centro Nacional de Biopreparados de acuerdo con las tendencias actuales en homólogos / Redesign of the Website of the National Center for Bioproducts according to current trends in homologous

Los sitios web empresariales deben asegurar que sus empleados, proveedores, competidores, clientes y partes interesadas puedan encontrar información general y específica de la empresa. Este trabajo se propuso determinar los elementos necesarios para el rediseño del Sitio Web del Centro Nacional de Biopreparados (BioCen) de acuerdo con las tendencias actuales en homólogos. Para esto se determinaron, mediante entrevistas a directivos y especialistas del Centro, los sitios web de empresas homólogas. Se escogieron siete para la identificación de las tendencias en la Arquitectura de la Información a partir de cinco categorías de análisis. Estas tendencias no se vieron reflejadas en el sitio web actual de BioCen. La propuesta de rediseño incluyó, según homólogos, las etiquetas; la definición de contenidos, en el formato OnePage; la estructura de la página principal con diferentes y pocos niveles informativos; el uso de imágenes, acorde con los textos; diferentes sistemas de navegación; cambios en los componentes del cabezal y pie de página(AU)

Business websites must ensure that their employees, suppliers, competitors, customers and stakeholders can find general and company-specific information. This work proposed the presentation of the necessary elements for the redesign of the Website of the National Center for Bioproducts (BioCen) according to the current tendencies in homologous. For this, through interviews with managers and specialists of the center, the websites of homologous companies were determined. Seven were chosen for the identification of trends in Information Architecture from five categories of analysis. These trends were not reflected on the current BioCen website. The redesign proposal includes, according to counterparts, the labels; the definition of content, in the OnePage format; the structure of the main page with different and few informative levels; the use of images, according to the texts; different navigation systems; changes in the head and footer components(AU)

Obtention and characterization of the recombinant simian Interleukin-15 in Escherichia coli for the preclinical assessment of an IL-15-based therapeutic vaccine.

Recombinant simian IL-15 (siIL-15) was obtained for the preclinical assessment of an anti-human IL-15 vaccine. For this purpose, the cDNA from peripheral blood mononuclear cells of a Macaca fascicularis monkey was cloned into a pIL-2 vector. The siIL-15 was expressed in Escherichia coli strain W3110 as an insoluble protein which accounted for 13% of the total cellular proteins. Inclusion bodies were solubilized in an 8 M urea solution, which was purified by ion exchange and reverse phase chromatography up to 92% purity. The protein identity was validated by electrospray ionization-mass spectrometry, confirming the presence of the amino acids which distinguish the siIL-15 from human IL-15. The purified siIL-15 stimulates the proliferation of cytotoxic T-lymphocytes line (CTLL)-2 and Kit 225 cells with EC50 values of 3.1 and 32.5 ng/mL, respectively. Antisera from modified human IL-15-immunized macaques were reactive to human and simian IL-15 in enzyme-linked immunosorbent assays. Moreover, the anti-human IL-15 antibodies from immune sera inhibited siIL-15 activity in CTLL-2 and Kit 225 cells, supporting the activity and purity of recombinant siIL-15. These results indicate that the recombinant siIL-15 is biologically active in two IL-15-dependent cell lines, and it is also suitable for the preclinical evaluation of an IL-15-based therapeutic vaccine.

Vinculación ciencia, innovación y sociedad: experiencias del Centro Nacional de Cirugía de Mínimo Acceso / Science, innovation and society entailment: experiences of the Minimal Access Surgery National Center

Introducción: El vínculo entre la ciencia, la innovación y la sociedad se contempla no solo por la introducción de nuevos productos y servicios por las instituciones hospitalarias, sino como un amplio conjunto de acciones, que incluyen las actividades de gestión hospitalaria, relacionadas también con el proceso docente-educativo y orientadas a que el conocimiento se convierta en la base fundamental del crecimiento económico y el aumento de la calidad de vida de la población. Objetivo: Mostrar la experiencia del Centro Nacional de Cirugía de Mínimo Acceso como entidad de Ciencia e Innovación Tecnológica del Ministerio de Salud Pública y los beneficios científico-técnicos y sociales que le proporciona a la población cubana. Material y Métodos: Se emplearon las técnicas siguientes de observación participativa: análisis del contenido de documentos y trabajo en equipo. Resultados: El análisis realizado ha permitido delimitar tres etapas fundamentales en la trayectoria del Centro: Germen (1980-1992); Fundación (1993-2004) y Consolidación (2005-Actual). Actualmente, el Centro es una institución de salud consolidada y orientada hacia a la excelencia en su gestión. Conclusiones: A lo largo de su trayectoria, el Centro ha obtenido importantes logros científicos y ha realizado aportes a la sociedad en el cumplimiento de su misión, que integra la asistencia médica, la docencia y la investigación, constituyéndose en uno de los logros más importantes de la Medicina cubana y un ejemplo fehaciente de cómo es posible a través de múltiples estrategias consolidar el vínculo entre la ciencia y la innovación(AU)

Introduction: The link between science and innovation is not only considered in the introduction of new products and services by the hospitals, but also as a wide range of actions, which include healthcare management activities, related to the educational process and focused on turning knowledge into the foundation of the economic growth and the increased quality of life of the population. Objective: To present the experience of the Center for Minimal Access Surgery as an entity of science and technological innovation of the Ministry of Public Health and Center of Postgraduate Studies of the University of Medical Sciences of Havana, as well as the scientific, technical and social benefits that this experience has provided to the Cuban population. Material and Methods: The following techniques are used: participative observation: content analysis of documents and teamwork. Results: The analysis carried out comprises three main stages: Seed (1980-1992); Foundation (1993-2004) and Consolidation (2005-Present). Nowadays, the Center is a consolidated healthcare institution, oriented towards the excellence in its management practices. Conclusions: Throughout its history, the Center has reached significant scientific achievements and has contributed to society while fulfilling its mission, which integrates healthcare, teaching and research, constituting one of the most important achievements in the Cuban medicine and a clear example of how it is possible to strengthen the link between science and innovation by means of multiple strategies(AU)

Calcium carbonate precipitation by heterotrophic bacteria isolated from biofilms formed on deteriorated ignimbrite stones: influence of calcium on EPS production and biofilm formation by these isolates.

Heterotrophic CaCO3-precipitating bacteria were isolated from biofilms on deteriorated ignimbrites, siliceous acidic rocks, from Morelia Cathedral (Mexico) and identified as Enterobacter cancerogenus (22e), Bacillus sp. (32a) and Bacillus subtilis (52g). In solid medium, 22e and 32a precipitated calcite and vaterite while 52g produced calcite. Urease activity was detected in these isolates and CaCO3 precipitation increased in the presence of urea in the liquid medium. In the presence of calcium, EPS production decreased in 22e and 32a and increased in 52g. Under laboratory conditions, ignimbrite colonization by these isolates only occurred in the presence of calcium and no CaCO3 was precipitated. Calcium may therefore be important for biofilm formation on stones. The importance of the type of stone, here a siliceous stone, on biological colonization is emphasized. This calcium effect has not been reported on calcareous materials. The importance of the effect of calcium on EPS production and biofilm formation is discussed in relation to other applications of CaCO3 precipitation by bacteria.

Fundación de la Sociedad Cubana de Ciencias Morfológicas / The Foundation of Cuban Society Morphologic Sciences

El Instituto de Ciencias Básicas y Preclínicas Victoria de Girón se fundó en La Habana en octubre de 1962. Allí se inició el desarrollo de las Ciencias Básicas Biomédicas en Cuba, hasta convertirse en el centro rector para su enseñanza. Durante los 50 años transcurridos hasta el 2012, el ICBP Victoria de Girón ha logrado salir de sus muros para apoyar otras tareas como la creación de otras universidades médicas en Cuba, apoyar el desarrollo de centros de investigaciones Biomédicas, e impulsar, desde los principios de la década del 70, la fundación de asociaciones relacionadas con el perfil de las ciencias biomédicas. Es así que en 1973 los profesionales que trabajaban en los Departamentos de Ciencias Morfológicas solicitaron al Consejo de Sociedades Científicas de la Salud, fundar la Sociedad Cubana de Ciencias Morfológicas (SCCM). El propósito de este trabajo es describir cómo aconteció la fundación de la SCCM y quiénes fueron sus promotores. El estudio realizado, a través de documentos y evidencias testimoniales, mostró que fueron 40 profesionales (médicos, estomatólogos y doctores en farmacia) que se dedicaban a la enseñanza de la Anatomía (15), la Histología (16) y la Embriología (9). Todos pertenecían al ICBP Victoria de Girón y al Centro Nacional de Investigaciones Científicas. En la actualidad 16 miembros fundadores se mantienen activos, dando su aporte a esta asociación(AU)

The Institute of Preclinical and Basic Sciences Victoria de Girón was founded in Havana in October 1962. There began the development of basic Biomedical Sciences in Cuba until it became the head center for their teaching. During the last 50 years up to 2012, the Institute of Preclinical and Basic Sciences Victoria de Girón has surpassed its walls to support the foundation of other medical science universities in Cuba and other countries as well to support the creation of Biomedical research centers. Sincethe beginning of 70´s decade, Victoria de Girón has promoted the foundation of scientific societies related to Biomedical Sciences. In 1973 the professionals who worked at thedepartments of Morphological Sciences asked the Council of Health Societies the permission to create the Cuban Society of Morphological Sciences (SCCM, for its initials in Spanish). The purpose of this paper is describe the foundation of the SCCM and whowere its promoters. Throughdocuments and testimonies it was shown that there were 40 professionals(Physicians, Dentists and Pharmacy doctors), who dedicated their life to teach Anatomy (15), Histology (16) and Embryology (9). All of them belonged either to Victoria de Girón or to the National Center of Scientific Research. At present there are 16 foundation members that are still active in the society and giving their experience(AU)

The distribution of recombination repair genes is linked to information content in bacteria.

The concept of a 'proteomic constraint' proposes that the information content of the proteome exerts a selective pressure to reduce mutation rates, implying that larger proteomes produce a greater selective pressure to evolve or maintain DNA repair, resulting in a decrease in mutational load. Here, the distribution of 21 recombination repair genes was characterized across 900 bacterial genomes. Consistent with prediction, the presence of 17 genes correlated with proteome size. Intracellular bacteria were marked by a pervasive absence of recombination repair genes, consistent with their small proteome sizes, but also consistent with alternative explanations that reduced effective population size or lack of recombination may decrease selection pressure. However, when only non-intracellular bacteria were examined, the relationship between proteome size and gene presence was maintained. In addition, the more widely distributed (i.e. conserved) a gene, the smaller the average size of the proteomes from which it was absent. Together, these observations are consistent with the operation of a proteomic constraint on DNA repair. Lastly, a correlation between gene absence and genome AT content was shown, indicating a link between absence of DNA repair and elevated genome AT content.

Fundación de la Sociedad Cubana de Ciencias Morfológicas / The Foundation of Cuban Society Morphologic Sciences

El Instituto de Ciencias Básicas y Preclínicas "Victoria de Girón" se fundó en La Habana en octubre de 1962. Allí se inició el desarrollo de las Ciencias Básicas Biomédicas en Cuba, hasta convertirse en el centro rector para su enseñanza. Durante los 50 años transcurridos hasta el 2012, el ICBP "Victoria de Girón" ha logrado salir de sus muros para apoyar otras tareas como la creación de otras universidades médicas en Cuba, apoyar el desarrollo de centros de investigaciones Biomédicas, e impulsar, desde los principios de la década del 70, la fundación de asociaciones relacionadas con el perfil de las ciencias biomédicas. Es así que en 1973 los profesionales que trabajaban en los Departamentos de Ciencias Morfológicas solicitaron al Consejo de Sociedades Científicas de la Salud, fundar la Sociedad Cubana de Ciencias Morfológicas (SCCM). El propósito de este trabajo es describir cómo aconteció la fundación de la SCCM y quiénes fueron sus promotores. El estudio realizado, a través de documentos y evidencias testimoniales, mostró que fueron 40 profesionales (médicos, estomatólogos y doctores en farmacia) que se dedicaban a la enseñanza de la Anatomía (15), la Histología (16) y la Embriología (9). Todos pertenecían al ICBP "Victoria de Girón" y al Centro Nacional de Investigaciones Científicas. En la actualidad 16 miembros fundadores se mantienen activos, dando su aporte a esta asociación.

The Institute of Preclinical and Basic Sciences "Victoria de Girón" was founded in Havana in October 1962. There began the development of basic Biomedical Sciences in Cuba until it became the head center for their teaching. During the last 50 years up to 2012, the Institute of Preclinical and Basic Sciences "Victoria de Girón" has surpassed its walls to support the foundation of other medical science universities in Cuba and other countries as well to support the creation of Biomedical research centers. Sincethe beginning of 70´s decade, "Victoria de Girón" has promoted the foundation of scientific societies related to Biomedical Sciences. In 1973 the professionals who worked at thedepartments of Morphological Sciences asked the Council of Health Societies the permission to create the Cuban Society of Morphological Sciences (SCCM, for its initials in Spanish). The purpose of this paper is describe the foundation of the SCCM and whowere its promoters. Throughdocuments and testimonies it was shown that there were 40 professionals(Physicians, Dentists and Pharmacy doctors), who dedicated their life to teach Anatomy (15), Histology (16) and Embryology (9). All of them belonged either to Victoria de Girón or to the National Center of Scientific Research. At present there are 16 foundation members that are still active in the society and giving their experience.