Changes in the epidemiology of invasive fungal disease in a Pediatric Hematology and Oncology Unit: the relevance of breakthrough infections.

BACKGROUND: Invasive fungal disease (IFD) is a significant cause of morbimortality in children under chemotherapy or hematopoietic stem cell transplant (HSCT). The purpose of this study is to describe the changes in the IFD epidemiology that occurred in a Pediatric Hematology-Oncology Unit (PHOU) with an increasing activity over time. METHODS: Retrospective revision of the medical records of children (from 6 months to 18 years old) diagnosed with IFD in the PHOU of a tertiary hospital in Madrid (Spain), between 2006 and 2019. IFD definitions were performed according to the EORTC revised criteria. Prevalence, epidemiological, diagnostic and therapeutic parameters were described. Comparative analyses were conducted using Chi-square, Mann-Whitney and Kruskal-Wallis tests, according to three time periods, the type of infection (yeast vs mold infections) and the outcome. RESULTS: Twenty-eight episodes of IFD occurred in 27 out of 471 children at risk (50% males; median age of 9.8 years old, [IQR 4.9-15.1]), resulting in an overall global prevalence of 5.9%. Five episodes of candidemia and 23 bronchopulmonary mold diseases were registered. Six (21.4%), eight (28.6%) and 14 (50%) episodes met criteria for proven, probable and possible IFD, respectively. 71.4% of patients had a breakthrough infection, 28.6% required intensive care and 21.4% died during treatment. Over time, bronchopulmonary mold infections and breakthrough IFD increased (p=0.002 and p=0.012, respectively), occurring in children with more IFD host factors (p=0.028) and high-risk underlying disorders (p=0.012). A 64% increase in the number of admissions in the PHOU (p<0.001) and a 277% increase in the number of HSCT (p=0.008) were not followed by rising rates of mortality or IFD/1000 admissions (p=0.674). CONCLUSIONS: In this study, we found that yeast infections decreased, while mold infections increased over time, being most of them breakthrough infections. These changes are probably related to the rising activity in our PHOU and an increase in the complexity of the baseline pathologies of patients. Fortunately, these facts were not followed by an increase in IFD prevalence or mortality rates.

Carbohydrate and lipid balances in the positive plant phenotypic response to arbuscular mycorrhiza: increase in sink strength.

The exchange of phosphorus (P) and carbon (C) between plants and arbuscular mycorrhizal fungi (AMF) is a major determinant of their mutualistic symbiosis. We explored the C dynamics in tomato (Solanum lycorpersicum) inoculated or not with Rhizophagus irregularis to study their growth response under different NaH2 PO4 concentrations (Null P, 0 mM; Low P, 0.065 mM; High P, 1.3 mM). The percentage of AMF colonization was similar in plants under Null and Low P, but severely reduced under High P. However, the AMF mass biomarker 16:1ω5 revealed higher fungal accumulation in inoculated roots under Low P, while more AMF spores were produced in the Null P. Under High P, AMF biomass and spores were strongly reduced. Plant growth response to mycorrhiza was negative under Null P, showing reduction in height, biovolume index, and source leaf (SL) area. Under Low P, inoculated plants showed a positive response (e.g., increased SL area), while inoculated plants under High P were similar to non-inoculated plants. AMF promoted the accumulation of soluble sugars in the SL under all fertilization levels, whereas the soluble sugar level decreased in roots under Low P in inoculated plants. Transcriptional upregulation of SlLIN6 and SlSUS1, genes related to carbohydrate metabolism, was observed in inoculated roots under Null P and Low P, respectively. We conclude that P-limiting conditions that increase AMF colonization stimulate plant growth due to an increase in the source and sink strength. Our results suggest that C partitioning and allocation to different catabolic pathways in the host are influenced by AMF performance.

Major depressive episode in mothers during the COVID-19 pandemic: a population-based study in the Southern Brazil.

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

A review on polycyclic aromatic hydrocarbons distribution in freshwater ecosystems and their toxicity to benthic fauna.

Polycyclic aromatic hydrocarbons (PAHs) are a group of organic compounds, found ubiquitously in all environmental compartments. PAHs are considered hazardous pollutants, being of concern to both the environmental and human health. In the aquatic environment, PAHs tend to accumulate in the sediment due to their high hydrophobicity, and thus sediments can be considered their ultimate sink. Concurrently, sediments comprise important habitats for benthic species. This raises concern over the toxic effects of PAHs to benthic communities. Despite PAHs have been the subject of several reviews, their toxicity to freshwater benthic species has not been comprehensively discussed. This review aimed to provide an overview on PAHs distribution in freshwater environments and on their toxicity to benthic fauna species. The distribution of PAHs between sediments and the overlying water column, given by the sediment-water partition coefficient, revealed that PAHs concentrations were 2 to 4 orders of magnitude higher in sediments than in water. The sediment-water partition coefficient was positively correlated to PAHs hydrophobicity. Toxicity of PAHs to benthic fauna was addressed through Species Sensitivity Distributions. The derived hazardous concentration for 5% of the species (HC5) decreased as follows: NAP (376 µg L-1) > PHE > PYR > FLT > ANT (0.854 µg L-1), varying by 3 orders of magnitude. The hazardous concentrations (HC5) to benthic species were inversely correlated to the hydrophobicity of the individual PAHs. These findings are pertinent for environmental risk assessment of these compounds. This review also identified future challenges regarding the environmental toxicity of PAHs to freshwater benthic communities, namely the need for updating the PAHs priority list and the importance of comprehensively and more realistically assess the toxicity of PAHs in combination with other stressors, both chemical and climate-related.

Major depressive episode in mothers during the COVID-19 pandemic: a population-based study in the Southern Brazil / Episódio depressivo maior entre mães durante a pandemia da COVID-19: um estudo populacional no Sul do Brasil / Episodio depresivo mayor en madres durante la pandemia de COVID-19: un estudio de base poblacional en el sur de Brasil

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

A pandemia da COVID-19 tem levado a mudanças em indivíduos e famílias, com efeitos psicológicos adversos, principalmente em adultos jovens, mulheres e pais e mães. O estudo buscou averiguar a prevalência de episódio depressivo maior atual (EDMA) em mães de pré-escolares (até 5 anos de idade) e estressores associados durante a pandemia da COVID-19 em uma cidade no Sul do Brasil. Este é um estudo transversal aninhado em um estudo de base populacional com mães. Todas as mães foram entrevistadas através de contato telefônico durante a pandemia da COVID-19. Os autores usaram a Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para avaliar a presença de EDMA. A análise estatística foi realizada, calculando o qui-quadrado e a regressão logística multivariada. Foram avaliadas 666 mães. A prevalência de EDMA foi de 12,3%. Mães com perdas financeiras apresentaram probabilidade 2,1 vezes maior (IC95%: 1,3-3,4) de apresentar EDMA, comparadas com aquelas que mantiveram a situação financeira. Com base nos resultados, os autores observaram que perdas financeiras foram determinantes para a prevalência maior de depressão materna.

La pandemia de COVID-19 ha provocado cambios en los individuos y las familias, causando efectos psicológicos adversos, especialmente en los adultos jóvenes, las mujeres y los padres y madres. El objetivo de este estudio fue verificar la prevalencia del episodio depresivo mayor actual (EDMA) en madres de preescolares (hasta 5 años) y sus estresores asociados durante la pandemia de COVID-19 en una ciudad del sur de Brasil. Se trata de un estudio transversal anidado en un estudio poblacional con madres. Todas las madres fueron entrevistadas mediante contacto telefónico durante la pandemia de COVID-19. Se utilizó la Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para evaluar la presencia de EDMA. El análisis estadístico se realizó calculando la prueba de chi-cuadrado y una regresión logística multivariante. Se evaluaron 666 madres. La prevalencia de EDMA fue del 12,3%. Las madres con pérdidas económicas tenían un 2,1 (IC95%: 1,3-3,4) más probabilidades de presentar EDMA que las que mantuvieron su situación económica. Teniendo en cuenta los resultados, observamos que las pérdidas económicas fueron determinantes para la mayor prevalencia de depresión materna.

Responses of benthic diatoms to waters affected by post-fire contamination.

Wildfire effects go beyond direct impact in terrestrial ecosystems. Specifically, the periphytic communities of aquatic ecosystems standing within and downstream the burnt areas are relevant ecological receptors of post-fire runoff contamination. Nevertheless, the off-site impacts of wildfires in these communities are limitedly studied so far. The present study aimed to assess the effects of river water contaminated with ash-loaded runoff in the growth benthic diatom Navicula libonensis (Schoeman 1970). Four surface water samples were collected approximately one year after the wildfire for laboratory testing with the diatom: one was collected from a site upstream the burnt area, within the Unhais river (UU); three were collected from sites standing within the burnt area, one in the Unhais river (UB) and two in the Zêzere river (Z1 and Z2), reflecting different hydrological regimes. N. libonensis was proven able to discriminate among river sites affected and unaffected by wildfire runoff, reflecting, in general, the expected trends considering the physico-chemical characterization of the water samples. The water samples from the sites standing within the burnt area inhibited the biomass yield and growth rate of the tested diatom, ranking the samples regarding toxicity as follows: Z1 > UB > Z2 > UU. However, UB rather than Z1 presented the highest contaminant burden, namely metal elements, and some were found above widely accepted safety benchmarks (polycyclic aromatic hydrocarbons were not detected). This inconsistency can be linked to unknown interactions among metals within each water sample, to differential nutrient enrichment of samples, as well as hydrological factors. Overall, our results suggest that monospecific laboratory assays with sensitive diatoms can be valuable as cost-effective screening tools to prioritize sites affected by wildfires runoff requiring in-depth monitoring of negative effects in benthic producer communities.

An Updated Review on the Modulation of Carbon Partitioning and Allocation in Arbuscular Mycorrhizal Plants.

Arbuscular mycorrhizal fungi (AMF) are obligate biotrophs that supply mineral nutrients to the host plant in exchange for carbon derived from photosynthesis. Sucrose is the end-product of photosynthesis and the main compound used by plants to translocate photosynthates to non-photosynthetic tissues. AMF alter carbon distribution in plants by modifying the expression and activity of key enzymes of sucrose biosynthesis, transport, and/or catabolism. Since sucrose is essential for the maintenance of all metabolic and physiological processes, the modifications addressed by AMF can significantly affect plant development and stress responses. AMF also modulate plant lipid biosynthesis to acquire storage reserves, generate biomass, and fulfill its life cycle. In this review we address the most relevant aspects of the influence of AMF on sucrose and lipid metabolism in plants, including its effects on sucrose biosynthesis both in photosynthetic and heterotrophic tissues, and the influence of sucrose on lipid biosynthesis in the context of the symbiosis. We present a hypothetical model of carbon partitioning between plants and AMF in which the coordinated action of sucrose biosynthesis, transport, and catabolism plays a role in the generation of hexose gradients to supply carbon to AMF, and to control the amount of carbon assigned to the fungus.

Testing the response of benthic diatom assemblages to common riverine contaminants.

Benthic diatoms constitute keystone assemblages in riverine ecosystems, and their structure is used to support regulatory water quality assessment. However, no standard ecotoxicological tests exist using integrated responses of the benthic diatom assemblages. This work aimed to assess whether benthic diatom assemblages are responsive to different riverine contaminants through a previously developed rapid toxicity test, supporting future attempts towards its standardization and integration in both prospective and retrospective Environmental Risk Assessment (ERA) schemes. We selected two benthic diatoms assemblages likely responding similarly to pollution (similar IPS diatom index score), collected from two rivers in Northern-Central Portugal (sites: Palhal and Cabreia). Fresh whole diatom assemblages were exposed for 48 h to five model contaminants (glyphosate, imidacloprid, SDS, CuSO4, and Pb). At the end of the test, changes induced by the exposures in overall yield and in the yield of each diatom genus were assessed. The assemblage collected at Palhal was invariably more responsive and sensitive than that collected at Cabreia, both considering overall and genus-specific yields, regardless of the tested contaminant. Achnanthes, Fragilaria and Navicula were the most responsive genus, regardless of the tested contaminant or assemblage. The distinct response profiles observed for the two assemblages to the same contaminants at the same concentration ranges suggest that using this test method to support prospective ERA is inadequate. However, the method can be an asset supporting retrospective ERA, as the responses seem to be shaped by the interplay of resilience drivers promoted by the local conditions, e.g. adaptive changes in assemblage structure.

Suitable climatic habitat changes for Mexican conifers along altitudinal gradients under climatic change scenarios.

The high biodiversity of the Mexican montane forests is concentrated on the Trans-Mexican Volcanic Belt, where several Protected Natural Areas exist. Our study examines the projected changes in suitable climatic habitat for five conifer species that dominate these forests. The species are distributed sequentially in overlapping altitudinal bands: Pinus hartwegii at the upper timberline, followed by Abies religiosa, the overwintering host of the Monarch butterfly at the Monarch Butterfly Biosphere Reserve, P. pseudostrobus, the most important in economic terms, and P. devoniana and P. oocarpa, which are important for resin production and occupy low altitudes where montane conifers merge with tropical dry forests. We fit a bioclimatic model to presence-absence observations for each species using the Random Forests classification tree with ground plot data. The models are driven by normal climatic variables from 1961 to 1990, which represents the reference period for climate-induced vegetation changes. Climate data from an ensemble of 17 general circulation models were run through the classification tree to project current distributions under climates described by the RCP 6.0 watts/m2 scenario for the decades centered on years 2030, 2060 and 2090. The results suggest that, by 2060, the climate niche of each species will occur at elevations that are between 300 to 500 m higher than at present. By 2060, habitat loss could amount to 46-77%, mostly affecting the lower limits of distribution. The two species at the highest elevation, P. hartwegii and A. religiosa, would suffer the greatest losses while, at the lower elevations, P. oocarpa would gain the most niche space. Our results suggest that conifers will require human assistance to migrate altitudinally upward in order to recouple populations with the climates to which they are adapted. Traditional in situ conservation measures are likely to be equivalent to inaction and will therefore be incapable of maintaining current forest compositions.

Using flow cytometry for bacterioplankton community analysis as a complementary tool to Water Framework Directive to signal putatively impacted sites.

Metal contamination, as well as pesticides, organic matter and nutrient input are main factors leading to freshwater ecosystems degradation. The Water Framework Directive (WFD) was implemented within the European Union with the ultimate goal of promoting a good ecological status in all European waterbodies. However, the broad implementation of the bioassessment behind WFD is costly and time-consuming and the search for complementary methodologies has been given significant attention. In this context, the main goal of this study was to evaluate whether flow cytometry (FCM) and denaturing gradient gel electrophoresis (DGGE) can be used as cellular/molecular tools to efficiently assess riverine bacterioplankton communities and relevantly inform on the ecological quality of these ecosystems. Caima river was chosen as case study using three sampling sites reflecting different levels and types of contamination (point-source organic and metal input). Both bacterioplankton community assessment approaches (DGGE and FCM), as well as macroinvertebrate and periphyton communities were consistent in signaling organic contamination. The putatively metal-loaded site bears some contradictory results depending on the community focused, possibly due to the overall low levels of metals actually found and seasonality. When comparing the two bacterioplankton community analysis tools, DGGE and FCM, the results obtained were essentially coherent, with FCM being simpler, faster and still accurate for screening bacteria communities via quantification of bacteria of high and low DNA content. This highlights the suitability of the FCM approach for prioritization of contaminated sampling sites and reinforces the suitability of using bacterioplankton communities as the focus of rapid tools to complement bioassessment sensu the WFD methodology, e.g. assisting the prioritization of potentially impacted areas.

Intervenciones psicológicas para el manejo y reducción de estrés en pacientes hipertensos: una revisión sobre su efectividad / Psychological interventions on stress management and reduction for hypertensive patients: a review of their effectiveness

Resumen La hipertensión está considerada como una de las principales problemáticas de salud pública, pues es una enfermedad crónica asintomática caracterizada por una elevación de presión arterial, en la que inciden los niveles de estrés que percibe el paciente y cuyas consecuencias pueden ser devastadoras tanto en la salud física como emocional de este grupo. Se realizó una revisión analítica enfocada a la efectividad de diversos tipos de intervención psicológica, para disminuir los niveles de presión sistólica, controlar el nivel de la presión diastólica, disminuir la percepción del estrés de los sujetos y propiciar una mayor adherencia al tratamiento. La búsqueda se realizó en la base de datos Springer, donde 50 artículos cumplieron con los criterios de exclusión y de inclusión, para el periodo 2000-2013. La revisión arrojó una mayor inclinación hacia las intervenciones de tipo conductual (38%), sin embargo, las intervenciones cognitivo-conductuales fueron las más eficaces para disminuir los niveles de estrés y generar la reducción más significativa en presión arterial, con un 100% de resultados positivos, mientras que solo el 68.4% de los estudios conductuales reportó una mejoría.

Abstract Hypertension an asymptomatic chronic disease characterized by elevated blood pressure, is considered a public health problem, affected by stress levels perceived by the patient, with physical and emotional health consequences that can be devastating for this population. This study presents an analytical review focused on the effectiveness of different types of psychological intervention to reduce systolic blood pressure levels, controlling the level of diastolic pressure, decreasing stress perception of subjects and fostering greater adherence. The search was conducted by means of the Springer database, with 50 articles selected on the basis of the inclusion and exclusion criteria for the period 2000-2013. Results showed greater inclination towards behavioral type interventions (38%), while cognitive-behavioral interventions were the most effective for decreasing stress levels and producing the most significant reduction in blood pressure, 100% of the studies based on this type of intervention showed positive results, while the behavioral type only registered 68.4% of success.

Son las maloclusiones un problema de salud pública en el Uruguay / Malocclusions: are a public health issue in Uruguay

Este trabajo es un estudio descriptivo (observacional) de tipo transversal. La muestra considerada abarcó 542 niños seleccionados de los departamentos de Montevideo y Rivera. Se observaron niños de ambos sexos, de escuelas públicas y privadas, en grupo de preescolares y escolares de 1er. Año con el objetivo de cuantificar las maloclusiones presentadas en ese grupo etario, su prevalencia y determinar si son un problema de Salud Pública.En esta tarea se utilizó una ficha de relevamiento epidemiológico generada con los pautas de la OMS, redactada y reestructurada ergonómicamente para acortar el tiempo de inspección. El trabajo se realizó con operadores previamente calibrados. El relevamiento fue realizado durante una jornada de 8 horas en cada institución.Se comparó el estudio del año 1999 en Rivera con el relevamiento del 2001 de niños de la capital del mismo grupo etario. La prevalencia de maloclusiones en este grupo etario ascendió al 70,7%, reflejando un elevado índice de maloclusiones. Surgen como rasgos nocivos más significativos; la exposición a hábitos orales como la deglución atípica y la respiración bucal, lafalta de espacio (apiñamientos) y la presencia de frenillos anómalos (labiales superior e inferior).

This study is descriptive transversal type. The population observed was 542 children selected among Montevideo and Rivera Uruguayan provinces. Both sexes, public and private schools students, integrating preschoolers, and first degree were observed.The goal was to quantify the prescuted malocclusions in this group, its prevalence and to determine if it is a Public health issue.The age range used to quantify the malocclusions was this to determine if it is a public issue in Public health. In this task, a form was designed to consider the OMS parameters, written and restructured. Operators were calibrated for this job, which was donein 8hs in each institution. This analysis was compared in Rivera 1999 to the one done in the capital city in 2001, considering this age range. The result was the prevalence of the malocclusions in this age range in 70,7%, what reflects a high index of malocclusions.The relevant findings were oral health habits like atipic deglution, oral breath, as well as frenum (upper and lingual).

Avaliação muscular subjetiva como parâmetro complementar de diagnóstico nutricional em pacientes no pré-operatório / Subjective muscle assessment as a complementary parameter for the nutritional diagnosis in presurgical patients

OBJETIVO: Comparar a Avaliação Muscular Subjetiva com métodos objetivos de avaliação nutricional em pacientes que serão submetidos à cirurgia. MÉTODOS: Trata-se de um estudo de comparação entre métodos de avaliação nutricional, com características transversais, envolvendo dados primários em pacientes no pré-operatório. Realizaram-se medidas antropométricas, laboratoriais e a Avaliação Muscular Subjetiva para diagnóstico nutricional dos pacientes. Utilizou-se o Coeficiente de Tau-b de Kendall, adotando-se como concordância excelente entre os métodos valores maiores ou iguais a 80 por cento. RESULTADOS: Foram incluídos no protocolo 168 pacientes adultos, de ambos os sexos, com indicação de cirurgia de médio e grande porte. Para a Avaliação Muscular Subjetiva os valores observados no teste de concordância inter e intra-examinador foram 77,0 por cento e 89,0 por cento, respectivamente. Os grupamentos musculares que apresentaram maior percentual de alterações tróficas foram o temporal e masseter para ambos os sexos (feminino=53,5 por cento; masculino=82,0 por cento). Para o sexo feminino, o grau de concordância entre a Avaliação Muscular Subjetiva e os métodos objetivos foi baixo (<=51,0 por cento), exceto para albumina e músculo gastrocnêmio (83,0 por cento). Encontrou-se, para o sexo masculino, Coeficiente de Kendall com valores entre 60,0 por cento e 70,0 por cento, representando boa concordância ( > ou = 60,0 por cento e <80,0 por cento), ao comparar o índice de massa corporal e a circunferência do braço com os músculos da deambulação, da mastigação e dos interósseos. CONCLUSÃO: 1. A Avaliação Muscular Subjetiva apresentou boa reprodutibilidade diagnóstica; 2. Alterações tróficas subjetivas foram prevalentes nos músculo temporal e masseter; 3. Não foi encontrada concordância excelente entre a Avaliação Muscular Subjetiva e os métodos objetivos de avaliação nutricional para ambos os sexos, exceto entre a albumina e o músculo gastrocnêmio...

OBJECTIVE: This study will compare Subjective Muscle Assessment with objective methods of nutritional assessment in presurgical patients. METHODS: This is a cross-sectional study to compare nutritional assessment methods involving primary data in presurgical patients. Anthropometric measurements, laboratory tests and Subjective Muscle Assessment were carried out to assess the subjects' nutritional status. Kendall's tau-b coefficient was employed and values equal to or above 80.0 percent were considered excellent in terms of reliability. RESULTS: The protocol included 168 adult patients of both genders who would undergo major surgery. For Subjective Muscular Assessment, inter and intra-rater reliability was shown to be 77.0 percent and 89.0 percent, respectively. The muscle groups that presented the greatest percentage of trophic changes were the temporal and the masseter for both genders (female=53.5 percent; male=82.0). For women, a low reliability rate (<=51.0 percent) was found between Subjective Muscle Assessment and the objective methods, except for albumin and the gastrocnemius muscle (83.0 percent). Kendall's coefficient for men was shown to be 60.0 percent and 70.0 percent, thus revealing good reliability ( > or = 60.0 percent and <80.0 percent) when the body mass index and the arm circumference were compared with walking, mastication and interosseous muscles. CONCLUSION: 1. Subjective Muscle Assessment showed good diagnostic reproducibility. 2. Subjective trophic changes prevailed in the temporal and masseter muscles. 3. No excellent reliability was found between Subjective Muscle Assessment and the objective methods of nutritional assessment for both genders, except for that between albumin and the gastrocnemius muscle for women.

The C-terminal portion of the Hrs protein interacts with Tsg101 and interferes with human immunodeficiency virus type 1 Gag particle production.

The human immunodeficiency virus type 1 (HIV-1) Gag protein recruits Tsg101 to facilitate HIV-1 particle budding and release. In uninfected cells, the Hrs protein recruits the ESCRT-I complex to the endosome, also through an interaction with Tsg101, to promote the sorting of host proteins into endosomal vesicles and multivesicular bodies. Here, we show that the overexpression of the C-terminal fragment of Hrs (residues 391 to 777) or Hrs mutants lacking either the N-terminal FYVE domain (mutant dFYVE) or the PSAP (residues 348 to 351) motif (mutant ASAA) all efficiently inhibit HIV-1 Gag particle production. Expression of the dFYVE or ASAA mutants of Hrs had no effect on the release of Moloney murine leukemia virus. Coimmunoprecipitation analysis showed that the expression of Hrs mutant dFYVE or ASAA significantly reduced or abolished the HIV-1 Gag-Tsg101 interaction. Yeast-two hybrid assays were used to identify two new and independent Tsg101 binding sites, one in the Hrs coiled-coil domain and one in the proline/glutamic acid-rich domain. Scanning electron microscopy of HeLa cells expressing HIV-1 Gag and the Hrs ASAA mutant showed viral particles arrested in "lump-like" structures that remained attached to the cell surface. Together, these data indicate that fragments of Hrs containing the C-terminal portion of the protein can potently inhibit HIV-1 particle release by efficiently sequestering Tsg101 away from the Gag polyprotein.

PPPYVEPTAP motif is the late domain of human T-cell leukemia virus type 1 Gag and mediates its functional interaction with cellular proteins Nedd4 and Tsg101 [corrected].

The human T-cell leukemia virus type 1 (HTLV-1) Gag polyprotein contains two adjacent proline-rich motifs (sequence PPPYVEPTAP) in the C terminus of the matrix domain [corrected]. Proline-to-alanine mutations were introduced into either or both motifs of HTLV-1 to determine the effect on the release of HTLV-1 virus-like particles from 293T cells. The release of both single mutants was significantly reduced, whereas a double mutation in both motifs abolished the release of the HTLV-1 particles. Two-hybrid and in vitro binding assays showed that the HTLV-1 Gag polyprotein binds both Tsg101 and Nedd4 proteins. The interaction with HTLV-1 Gag required the central WW domain of Nedd4 and the ubiquitin enzyme variant (UEV) domain of Tsg101. We expressed various fragments of Nedd4 and Tsg101 proteins in 293T cells and tested for their ability to interfere with virion release mediated by the HTLV-1 Gag-Pro polyprotein. Fragments consisting of the N-terminal UEV domain of Tsg101 and the central WW and C-terminal Hect domains of Nedd4 protein all caused transdominant inhibition of HTLV-1 particle release. Similarly, inhibition of the proteasome significantly decreased HTLV-1 particle release. Furthermore, the WW domain overexpression caused an early arrest of HTLV-1 particle morphogenesis before the membrane is deformed into the typical half-shell structure. This result suggests that Nedd4 is involved early in budding of HTLV-1.

Role of residues in the tryptophan repeat motif for HIV-1 reverse transcriptase dimerization.

The tryptophan repeat motif of the human immunodeficiency virus type-1 (HIV-1) reverse transcriptase (RT) is comprised of a cluster of six tryptophan residues at codons 398, 401, 402, 406, 410 and 414 that are highly conserved amongst primate lentiviral RTs. To determine the contributions of each of these residues for HIV-1 RT dimerization, we introduced changes into cloned DNA and tested the mutant subunits for their capacity to mediate heterodimerization in the yeast two-hybrid system. Changes of residue 401 to either leucine or alanine (but not phenylalanine) and residue 414 to leucine resulted in major reductions in beta-galactosidase activity produced from the reporter gene as compared to yeast expressing wild-type p66 bait and p51 prey fusions. Subunit selective mutagenesis revealed that the effect of these mutations was mediated mainly through the p66 subunit. Introduction of tryptophan mutants into the bacterial expression vector pRT6H/NB-PROT showed that RTs containing W401A or W401L substitutions (but not W401F) and W414L were defective for dimerization in vitro. Consistent with their dimerization defect, the W401A, W401L and W414L mutants were devoid of RT activity. Using the yeast two-hybrid system, we identified several second-site suppressors in p66 that restored interaction of the p66W401A bait to the p51W401A prey. The suppressors (T409I, D110G, V372A and I393M) also restored heterodimerization of bacterially expressed W401A subunits. When introduced into the W401A mutant, T409I was able to restore RT activity to 50% of the wild-type level. Examination of the RT structures revealed that K331 in p51 makes multiple hydrogen bond contacts with residues in the p66 loop spanned by W401 and W414. Consistent with this observation, the K331A RT mutant was dimerization-defective. We conclude that mutations at codons 401 and 414 in p66 impair dimerization by altering the proper positioning of structural elements in between these residues that make important contacts with p51.

Monitoreo hemodinámico en la unidad coronaria / Hemodynamic monitorization in the cardiac unit

El monitoreo hemodinámico del corazón es un proceso altamente sofisticado y de gran utilidad. El catéter de Swan Ganz es adecuado para la medición del gasto cardiaco, conocer la presión del llenado ventricular izquierdo, determinación de la saturación de oxígeno, conocer la presión de la aurícula izquierda y la presión pulmonar capilar, conocer la presión de la arteria pulmonar y estudiar la respuesta ante el uso de fármacos que afectan la función ventricular. Las indicaciones para el uso de este catéter son la insuficiencia ventricular izquierda, choque cardlogénico, síndrome de bajo gasto cardiaco, sobrecarga aguda de cavidades cardiacas, pacientes cardiópatas que requieren grandes cantidades de líquidos y pacientes cardiópatas que usan medicamentos que alteran la función ventricular. La línea articular es el registro de la presión arterial directa. Se utiliza para obtener la presión arterial en pacientes que no la tienen palpable, para obtener sangre arterial frecuente y para la monitorización constante de la presión arterial El tercer tipo de monitorización es el catéter de aurícula izquierda. Este se coloca directamente dentro de la aurícula izquierda al final de la cirugía cardiaca, a cielo abierto, y mide la presión interior de la urícula, permitiendo una precisión más exacta de la presión venosa central, evaluándose el volumen de reposición, la presión de llenado de la aurícula izquierda y la presión diastólica final del ventrículo izquierdo.

Hemodynamic memorization of the heart is a highly sophisticated and most useful procedure. The Swan Gam catheter is appropriate for the study of cardiac output, filling pressure of the left ventricle, measure of oxigen saturation, measure of the pressure of the left ventricle and pulmonary caplillary pressure, measure the pressure of the pulmonary artery and explore the hemodynamics of the heart after the use of drugs. This catheter is useful in left ventricular insufficiency, cardiogenic shock, low cardiac output, acute cardiac overloading cardiac patients whoneedmassive liquid aplicación and cardiac patients receiving drugs that affect ventricular function. The arterial line is a direct registration of arterial pressure. It is used in patients whose arterial pressure cannot be felt, when frequent arterial blood samples are required, or for continuos pressure monitorization. The third type of monitorization is the left auricle catheter. It is placed directly within the auricleupon finishingopen heart surgery, and measures the pressure within the auricle, allowing beaer precision of the central venous pressure, evaluation of volume recovery, the fillingpressure of the left auricle, as well at the final diastolic pressure in the left ventricle.