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Cysteine proteases from Jacaratia mexicana, an endemic Mexican plant, could compete in industrial applications with papain. Currently the only way to obtain these proteases is by extracting them from the wild plant. An alternative source of these enzymes is by J. mexicana suspension culture. In this work, this culture was carried out in airlift, bubble column and stirred tank bioreactors, and the effects of shear rate and microturbulence on cell growth, protein accumulation and proteolytic activity were determined. The shear rates in the stirred tank, bubble column and airlift bioreactors were 274 1/s, 13 1/s and 36 1/s respectively, and microturbulences (symbolized by λ, in units of μm) were 46, 79, and 77 μm, respectively. Protein levels and proteolytic activity were linearly correlated with both shear rate and microturbulence. A higher shear rate and a more intensive microturbulence occurred in the stirred tank, producing higher protein accumulation and higher proteolytic activity compared with those of the other two bioreactor systems. Higher shear rate and microturbulence had an elicitor effect on protease synthesis, because microturbulence in stirred tank bioreactors was lower than the average length of J. mexicana cells. Furthermore, cells in the stirred tank were smaller and thinner than those grown in shake flask, bubble column and airlift bioreactors. In summary, proteases were produced by J. mexicana cell cultures in a stirred tank under conditions of high shear rate and intensive microturbulence, which are similar to those which occur in industrial stirred tanks. These results encourage continuation of the process development for large scale production of these proteases by this technology. [ABSTRACT FROM AUTHOR]

Introduction. Prolonged exposure to high temperatures can pose a major assault to the body when it can not adapt to high temperatures and is unable to rehydrate. Neurologic manifestations accompanying increase in body temperature is most likely to avoid an early diagnosis of heat stroke and cause death if not taken the initial steps necessary. Little is known about the morbidity and mortality from exposure to extreme temperatures and their consequences, the data are not precise because it is underdiagnosed or variability in the definition of this condition. When the core temperature increases, the center active thermoregulatory efferent fibers of the autonomic nervous system that increases heat loss by producing cutaneous vasodilation (convection) and increased sweating (evaporation). The ability to maintain a high body temperature vasoconstriction (42 °C) may be lost, marking the onset of circulatory collapse. The mechanism underlying the marked vasodilation in the mesenteric artery is unknown, the loss of compensatory vasoconstriction does not appear to be due to the reduction of efferent nerve conduction to the region, since the splenic sympathetic nerve activity and plasma catecholamine levels are elevated for moderate and severe hyperthermia. The α1-adrenergic vascular postsynaptic play a role in the maintenance of peripheral vascular resistance and therefore in control of systemic arterial pressure, there are three subtypes of α1-adrenergic receptor functional α1A, α1B, α1D, which mediates vaso constriction nice and so modulate vascular resistance. In the previous studies did not mention the specific action or expression levels of α1 adrenergic receptors during hyperthermia, which can lead to a specific response that is what drives the body into a state of shock, where failure CVD is a key point for treatment, so it is important to try to explain what the possible answer to this disease in the future can be better studied. Objective. The aim of this study was to determine the response and the expression of α1-adrenergic receptors of mouse mesenteric vascular bed exposed to hyperthermia. Material and methods. Two groups of mice to the development of physiological and molecular, which in the case of physiological studies was divided into a control group at 37 ºC and four experimental groups were exposed to 38, 39 40 and 41 ºC using a model of isolated organ for the implementation of Curves Concentration response in the case of molecular studies was divided into a control group at 37 °C and two experimental groups at 39 and 41 ºC to which they perform PCR real time to analyze the expression of α1 adrenergic receptors to be exposed to different temperatures using the method of 2-ΔΔCT (Livak y cols. 2001). Statistical analysis of data and graphs were performed using Sigma STAT software Sigma Plot version 2.03 and 10.0. ANOVA and Tukey was used to compare changes in expression of α1 adrenergic receptors in mouse mesenteric vascular bed exposed to 37. 39 and 41 ºC. Results: Both groups reduced the response of α1 adrenergic receptors in dose-response curves for concentration decreased appreciate the response to stimulation with non-selective and selective agonist for α1 adrenergic as well as reduction of the maximum response generated by the drug under Increasing the temperature, when performing real-time PCR we observed an increase in receptor expression α1A and α1B adrenergic 39 and 41 ºC, which occurs in α1D adrenergic more important because its expression increases 500 times compared to the control at 37 °C decreasing to zero when exposed to 41 ºC. [ABSTRACT FROM AUTHOR]

This article discusses the provision of the Cabildo Catedral de Puebla (Puebla Cathedral Chapter) in Puebla, Mexico, during the 1830s. The author analyzes the role of the bishop Francisco Pablo Vázquez in the appointment of the members of the Cathedral Chapter. He also considers the relationship between the Catholic Church and the federal government in Mexico, especially in the years following the country's independence in 1821. A brief history of the provision of the Cathedral Chapter in Mexico beginning in the 16th century is also provided.

Introduction. Gestational diabetes (GD) is a systemic disorder that produces metabolic changes in the mother and the product making them susceptible to multiple diseases. Some genes have been associated with T2DM among them the Hepatocyte Nuclear Factor 4-α (HNF4-α), which is a protein that is part of a network of transcription important for the development, differentiation and function of b-pancreatic cells and is directed almost exclusively by the promoter 2 (P2). Objective. Search for the association of rs1884614 and rs2144908 polymorphisms in the promoter 2 of HNF4-α gene with the DG. Material and methods. We analyzed the genetic material of 80 patients, obtained from buccal cheek scraping. rs1884614 and rs2144908 variants were amplified by PCR and sequenced to obtain electropherograms, we determined the degree of association between the study populations, through allele frequencies, genotype, haplotype and statistical significance using the Χ² test. Results. No relationship was found between the study variables and DG. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Sanidad Militar is the property of Direccion General de Sanidad Secretaria de la Defensa Nacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Sanidad Militar is the property of Direccion General de Sanidad Secretaria de la Defensa Nacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Sanidad Militar is the property of Direccion General de Sanidad Secretaria de la Defensa Nacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Pediatria is the property of Sociedad Mexicana de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Sanidad Militar is the property of Direccion General de Sanidad Secretaria de la Defensa Nacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Convalescent plasma (CP), despite limited evidence on its efficacy, is being widely used as a compassionate therapy for hospitalized patients with COVID-19. We aimed to evaluate the efficacy and safety of early CP therapy in COVID-19 progression.Methods and Findings: The study was an open-label, single-center randomized clinical trial performed in an academic medical center in Santiago, Chile, from May 10, 2020, to July 18, 2020, with final follow-up until August 17, 2020. The trial included patients hospitalized within the first 7 days of COVID-19 symptom onset, presenting risk factors for illness progression and not on mechanical ventilation. The intervention consisted of immediate CP (early plasma group) versus no CP unless developing prespecified criteria of deterioration (deferred plasma group). Additional standard treatment was allowed in both arms. The primary outcome was a composite of mechanical ventilation, hospitalization for >14 days, or death. The key secondary outcomes included time to respiratory failure, days of mechanical ventilation, hospital length of stay, mortality at 30 days, and SARS-CoV-2 real-time PCR clearance rate. Of 58 randomized patients (mean age, 65.8 years; 50% male), 57 (98.3%) completed the trial. A total of 13 (43.3%) participants from the deferred group received plasma based on clinical aggravation. We failed to find benefit in the primary outcome (32.1% versus 33.3%, odds ratio [OR] 0.95, 95% CI 0.32-2.84, p > 0.999) in the early versus deferred CP group. The in-hospital mortality rate was 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17 p = 0.246), mechanical ventilation 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17, p = 0.246), and prolonged hospitalization 21.4% versus 30.0% (OR 0.64, 95% CI, 0.19-2.10, p = 0.554) in the early versus deferred CP group, respectively. The viral clearance rate on day 3 (26% versus 8%, p = 0.204) and day 7 (38% versus 19%, p = 0.374) did not differ between groups. Two patients experienced serious adverse events within 6 hours after plasma transfusion. The main limitation of this study is the lack of statistical power to detect a smaller but clinically relevant therapeutic effect of CP, as well as not having confirmed neutralizing antibodies in donor before plasma infusion.Conclusions: In the present study, we failed to find evidence of benefit in mortality, length of hospitalization, or mechanical ventilation requirement by immediate addition of CP therapy in the early stages of COVID-19 compared to its use only in case of patient deterioration.Trial Registration: NCT04375098. [ABSTRACT FROM AUTHOR]

Ten years ago, a 73 year-old patient presented at our unit with a right nephritic colic and elevated serum creatinine (2.1 mg/dl). This was the first time that the patient had consulted for a urology workup. An abdominal X-ray was performed in which we observed a severe bilateral nephrocalcinosis with right ureteral lithiasis. One of the causes of nephrocalcinosis is distal renal tubular acidosis (dRTA), in that sense the patient presented metabolic acidosis (pH 7.25) together with normopotassaemia (4.4 meq/L) and normochlorine (105 mEq/L). A 24-hour urine test detected citrate (55 mg/dl), calcium (12 mg/dl) and pH of 6.5. A diuretic renogram showed the right relative renal function as 91.2% and left relative renal function as 8.8%. A test with bicarbonate and acetazolamide was performed, confirming a diagnosis of dRTA because the urinary CO2 pressure was 32 mmHg (normal, greater than 70 mmHg). Treatment with potassium citrate and increased intake of liquids was prescribed. Consequently, the patient's serum creatinine normalized, her blood pH rose to 7.35 and urinary citrate increased to 154 mg/dl. After 10 years of treatment with potassium citrate the patient remains stable. We believe that in these patients it is crucial to carry out an alkalizing treatment: patients with dRTA cannot acidify the urine because a defect in the permeability of the tubule membrane prevents secretion of H+. It is important to administer potassium citrate continuously to improve blood pH, increase urinary citrate and reduce the risk of calcium phosphate crystallization. [ABSTRACT FROM AUTHOR]

Background: Although most thyroid nodules with indeterminate cytology are benign, in most of the world, surgery remains as the most frequent diagnostic approach. We have previously reported a 10-gene thyroid genetic classifier, which accurately predicts benign thyroid nodules. The assay is a prototype diagnostic kit suitable for reference laboratory testing and could potentially avoid unnecessary diagnostic surgery in patients with indeterminate thyroid cytology. Methods: Classifier performance was tested in two independent, ethnically diverse, prospective multicenter trials (TGCT-1/Chile and TGCT-2/USA). A total of 4061 fine-needle aspirations were collected from 15 institutions, of which 897 (22%) were called indeterminate. The clinical site was blind to the classifier score and the clinical laboratory blind to the pathology report. A matched surgical pathology and valid classifier score was available for 270 samples. Results: Cohorts showed significant differences, including (i) clinical site patient source (academic, 43% and 97% for TGCT-1 and -2, respectively); (ii) ethnic diversity, with a greater proportion of the Hispanic population (40% vs. 3%) for TGCT-1 and a greater proportion of African American (11% vs. 0%) and Asian (10% vs. 1%) populations for TGCT-2; and (iii) tumor size (mean of 1.7 and 2.5 cm for TGCT-1 and -2, respectively). Overall, there were no differences in the histopathological profile between cohorts. Forty-one of 155 and 45 of 115 nodules were malignant (cancer prevalence of 26% and 39% for TGCT-1 and -2, respectively). The classifier predicted 37 of 41 and 41 of 45 malignant nodules, yielding a sensitivity of 90% [95% confidence interval; CI 77–97] and 91% [95% CI 79–98] for TGCT-1 and -2, respectively. One hundred one of 114 and 61 of 70 nodules were correctly predicted as benign, yielding a specificity of 89% [95% CI 82–94] and 87% [95% CI 77–94], respectively. The negative predictive values for TGCT-1 and TGCT-2 were 96% and 94%, respectively, whereas the positive predictive values were 74% and 82%, respectively. The overall accuracy for both cohorts was 89%. Conclusions: Clinical validation of the classifier demonstrates equivalent performance in two independent and ethnically diverse cohorts, accurately predicting benign thyroid nodules that can undergo surveillance as an alternative to diagnostic surgery. [ABSTRACT FROM AUTHOR]

The article describes the case of a 44-year-old Senegalese male patient living in Spain with renal cell carcinoma manifesting as a giant cervical adenopathy. The patient has a medical history of asthenia, weight loss, mild flank pain without fever or other symptoms which he experienced even as he continue normal activity and work. He died two months after receiving sunitinib.

• A better psychosocial work environment is associated with direct participation (DP). • Low skilled jobs could be designed healthier by using direct participation formulas. • Psychosocial work environment is better for women when direct participation is used. • Direct participation practices by themselves would not degrade working conditions. • DP appears to be a valid component for primary prevention at workplace level. To explore the relationship between the psychosocial work environment and labour management practices involving direct participation among salaried workers; to examine whether this relationship varies according to occupational group and sex. Based on a representative survey of the wage-earning population in Spain (n = 4911) using the Spanish version of the Copenhagen Psychosocial Questionnaire (COPSOQ-ISTAS21), ordinal logistic models were fitted in order to assess associations. The psychosocial work environment factors control , social support and rewards were significantly and positively associated with direct participation practices, after adjusting for ten indicators of other labour management practices (working hours, contractual relationship, promotion, salary and staffing) and three socioeconomic characteristics (occupational group, sex and age). No association was observed with the factor demands. When used simultaneously, delegative and consultative direct participation practices obtained more frequent and stronger associations with psychosocial work environment factors than when used separately. Stratifying the salaried population by sex and occupational group, associations were observed in all strata except for supervisors and higher professionals. A better psychosocial work environment is associated with direct participation practices among lower level occupational groups and among women. Direct participation practices appear to be valid components of preventive interventions at the workplace level, and may help to reduce occupational health inequalities. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 23-year-old woman being identified of having a ballpen into her bladder due to sexual practice. She was submitted to an emergency department where she was subjected to an abdominal plain X-ray to confirm the object inside her body. Furthermore, the department has performed a bladder ultrasound and an endoscopic removal to extract the object. A discussion on several cases of foreign bodies inside the human bladder is provided.

The article presents a case study of 52-year-old man who was presented with medical conditions of enlarged veins of the scrotum. The diagnostic report of the patient shows variocele medical condition and presence of abdominal mass in kidney. It also presents images depicting computed tomography reports of the patient which shows presence of tumor mass in the left kidney and development of variocele.

A letter to the editor is presented discussing the extraction of vaginal vibrator from the rectum of a young man.

Powdery mildew, caused by Uncinula necator (Schwein) Burrill is one of the most damaging disease affecting grapevines (Vitis vinifera L.) in Mendoza and worldwide, reducing yield and fruit quality. Throughout six growing seasons (2001/02; 2002/03; 2005/06; 2007/08; 2008/09; 2009/10), powdery mildew incidence values (expressed as daily epidemic increment rates) were observed in clusters from flowering to onset of ripening (change of color of the grape berries), in a grapevine planted with the susceptible Chenin cultivar at the EEA INTA Mendoza (Luján de Cuyo). From hourly values of thermal-moisture elements recorded by upper canopy sensors, meteorological variables were calculated in the 15 previous days of each epidemic observation. Using variables which integrate the effects of air temperature and humidity and frequency of light precipitations over the epidemic progress, logistic models were adjusted for estimating the probability of occurrrence of severe, moderate and nil epidemic increment rates, reaching maximum prediction accuracy of 92.5% (two variable models, N=40). Predicted values by the univariate model (selected by Stepwise procedure; prediction accuracy: 87.5%) were validated with the epidemic curve observed during 2000/2001 growing season. These model predictions could complement epidemic observations, giving regional scale to warning systems for improving the decision making process regarding disease chemical control. [ABSTRACT FROM AUTHOR]

Tourism places pressures on the environment through the services provided (accommodation, food, leisure activities, and transport), meanwhile it is particularly vulnerable to global warming as climate is a crucial component of destinations' attractiveness. As a result, research focusing on the impacts of tourism has increased significantly. Practitioners consult a plethora of frameworks and publications to environmentally assess tourism but none of the existing guidelines provides specific recommendations making difficult to obtain reliable results that can be properly replicated and compared. This paper discusses the use of Footprint family indicators in tourism through a review of studies that measure the Water, Carbon, and Ecological Footprint of tourists. Results show a lack of specific data, and an absence of consensus about the system boundaries and methodologies used for calculation. Food production and transportation are the main drivers of environmental burdens. The Footprint indicators help to understand the trade-offs between environmental effects which can be used to prioritize sustainability efforts in the tourism industry. Additionally, this study presents a critical analysis of the influence on the trip's Footprint of the services provided to different rated tourism experiences (high, medium, and low rated) and offers a reflective comparison on the pressure exerted by visitors and the local population. • Tourism Footprint studies lack trustworthy datasets due to gaps in specific data. • Lack of consensus on boundaries in tourism Footprint studies hinders result comparison. • Tourism Footprint studies generally ignore end-of-life environmental impacts. • High-rated vacations impose the highest environmental burdens. • Tourists exert more pressure on natural resources and ecosystems than residents. [ABSTRACT FROM AUTHOR]