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Potential Use of Vivascope for real-time histological evaluation in endoscopic laryngeal surgery
No full textWe aimed to assess the feasibility of using confocal laser scanning microscopy (CLSM) for the real-time ex vivo examination of histological samples of laryngeal lesions and to evaluate the correlation between CLSM and definitive histological results. This preliminary study included eight consecutive patients with suspected laryngeal lesions who were candidates for endoscopic laryngeal surgery. The obtained samples were evaluated using CLSM and classified as inadequate or adequate (high- and low-grade dysplasia, in situ and invasive carcinoma, positive surgical margin, and inflammatory outbreaks). CLSM showed the macro image in all cases and generated a digital version. All the samples were defined as adequate during CLSM and confirmed at histopathology: low-grade dysplasia (n = 5), low- and high-grade dysplasia (n = 2), and high-grade dysplasia (n = 1). Four samples had an involved resection margin, and three samples revealed the presence of inflammatory outbreaks. CLSM can be applied to larynx pathology with excellent agreement with final histological results
Uroguanylin prevents hepatic steatosis, mitochondrial dysfunction and fibrosis in obesity-associated NAFLD
No full textBackground: The biological mediators supporting the resolution of liver steatosis, inflammation and fibrosis after
bariatric surgery in patients with obesity and NAFLD remain unclear. We sought to analyze whether uroguanylin
and guanylin, two gut hormones involved in the regulation of satiety, food preference and adiposity, are involved
in the amelioration of obesity-associated NAFLD after bariatric surgery.
Methods: Proguanylin (GUCA2A) and prouroguanylin (GUCA2B) were measured in 214 participants undergoing
bariatric surgery with biopsy-proven NAFLD diagnosis. Pathways involved in lipid metabolism, mitochondrial
network and fibrogenesis were evaluated in liver biopsies (n = 137). The effect of guanylin and uroguanylin on
these metabolic functions was assessed in HepG2 hepatocytes and LX-2 hepatic stellate cells (HSC) under lipotoxic and profibrogenic conditions.
Results: Plasma and hepatic expression of GUCA2B were decreased in obesity-associated NAFLD. Both GUCA2A
and GUCA2B levels were increased after sleeve gastrectomy and Roux-en-Y gastric bypass in parallel to the
improved liver function. The liver of patients with type 2 diabetes showed impaired mitochondrial β-oxidation,
biogenesis, dynamics as well as increased fibrosis. Uroguanylin diminished the lipotoxicity in palmitate-treated
HepG2 hepatocytes, evidenced by decresased steatosis and lipogenic factors, as well as increased mitochondrial
network expression, AMPK-induced β-oxidation and oxygen consumption rate. Additionally, uroguanylin, but
not guanylin, reversed HSC myofibroblast transdifferentiation as well as fibrogenesis after TGF-β1 stimulation.
Conclusions: Uroguanylin constitutes a protective factor against lipotoxicity, mitochondrial dysfunction and
fibrosis. Increased GUCA2B levels might contribute to improve liver injury in patients with obesity-associated
NAFLD after bariatric surgery
Burden and risk factors of snakebite in Mopeia, Mozambique: leveraging larger malaria trials to generate data of this neglected tropical disease
No full textBackground: Snakebite is a neglected disease that disproportionally affects the rural poor. There is a dearth of evidence regarding incidence and risk factors in snakebite-endemic countries. Without this basic data, it will be impossible to achieve the target of a 50% reduction of snakebite morbidity and mortality by 2030 as set by the World Health Organization.
Methods: This was a descriptive analysis nested in a 2021 community-based demographic survey of over 70,000 individuals conducted in Mopeia, Mozambique, in preparation for a cluster randomized trial to test an intervention for malaria. We describe the incidence rate, demographics, socioeconomic indicators and outcomes of snakebite in this population.
Findings: We found the incidence of self-reported snakebite in Mopeia to be 393 bites per 100,000 person-years at risk, with 2% of households affected in the preceding 12 months. Whilst no fatalities were recorded, over 3,000 days of work or school days were lost with an individual household economic impact higher than that of uncomplicated malaria. 1 in 6 of those affected did not fully recover at the time of the study. We found significant relationships between age older than 15, use of firewood for household fuel, and animal possession with snakebite.
Conclusions: This study exposes higher than expected incidence and burden of snakebite in rural Mozambique. Whilst snakebite elimination in Mozambique seems unattainable today, it remains a preventable disease with manageable sequelae. We have shown that snakebite research is particularly easy to nest in larger studies, making this a practical and cost-effective way of estimating its incidence
La recepción de la Poética de Aristóteles en el Siglo de Oro: imitación y metáfora en la Philosophía antigua poética (1596) de Alonso López Pinciano
No full textFreight wagon digitalization for condition monitoring and advanced operation
Get PDFTraditionally, freight wagon technology has lacked digitalization and advanced monitoring capabilities. This article presents recent advancements in freight wagon digitalization, covering the system's definition, development, and field tests on a commercial line in Sweden. A number of components and systems were installed on board on the freight wagon, leading to the intelligent freight wagon. The digitalization includes the integration of sensors for different functions such as train composition, train integrity, asset monitoring and continuous wagon positioning. Communication capabilities enable data exchange between components, securely stored and transferred to a remote server for access and visualization. Three digitalized freight wagons operated on the Nassjo-Falkoping line, equipped with strategically placed monitoring sensors to collect valuable data on wagon performance and railway infrastructure. The field tests showcase the system's potential for detecting faults and anomalies, signifying a significant advancement in freight wagon technology, and contributing to an improvement in freight wagon digitalization and monitoring. The gathered insights demonstrate the system's effectiveness, setting the stage for a comprehensive monitoring solution for railway infrastructures. These advancements promise real-time analysis, anomaly detection, and proactive maintenance, fostering improved efficiency and safety in the domain of freight transportation, while contributing to the enhancement of freight wagon digitalization and supervision
Impacto del seguimiento de la recomendación de un programa de optimización de antiinfecciosos (PROA) sobre la prescripción de meropenem en la Clínica Universidad de Navarra.
Get PDFA principios del siglo XX las enfermedades infecciosas eran la principal causa de muerte
en el mundo (1). Este paradigma cambió con el descubrimiento de la penicilina por
Fleming en 1928 (2). A raíz de su utilización en la década de los cuarenta (junto con las
vacunas, la higiene hospitalaria y la cloración del agua), la mortalidad por las
enfermedades infecciosas disminuyó drásticamente, aumentando la esperanza de vida
a 74 años en varones y 80 en mujeres en la década del 2000 (3). Los β-lactámicos representan la familia de antibióticos más utilizados en la actualidad,
tanto a nivel comunitario como nosocomial y representan alrededor del 65% de las
prescripciones de antibióticos inyectables en Estados Unidos (4). En 2017, La tasa media
de consumo comunitario de antibióticos en España fue de 25 DHD (dosis diarias
definidas por 1000 habitantes y día), superando significativamente la media europea de
21,8 DHD, y siendo mucho más alta que las tasas de consumo en países del Norte de
Europa como Alemania (13,7 DHD), Suecia (11,6 DHD) y Holanda (10,1 DHD) (5)
Temas de sátira antigongorina: análisis de la silva “Alguacil del Parnaso, Gongorilla”, atribuida a Quevedo
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