Factores asociados a mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, Hospital de la Samaritana 2007-2013

Introducción y objetivos: Las enfermedades autoinmunes en cuidado intensivo están relacionadas con tasas de mortalidad elevadas. El propósito del presente estudio fue buscar factores asociados a mortalidad en estos pacientes. Materiales y métodos: estudio observacional de casos incidentes, retrospectivo, en base a revisión de historias clínicas de los pacientes que ingresaron a la unidad de cuidado intensivo del Hospital Universitario de la Samaritana; se recolecto un total de 68 eventos con los que se evaluó la relación de las variables estudiadas con mortalidad. Resultados: Las enfermedades autoinmunes se presentan más frecuentemente en mujeres (66%), el lupus eritematoso sistémico fue la afección reumatológica más común (36%), el promedio de edad fue de 46 años, la media de días en ventilación mecánica fue de 10 (desviación estándar 13 días), el valor del APACHE promedio fue de 19 puntos, el sistema orgánico más afectado fue el renal (58,5%) y la mortalidad global fue de 40%. Se encontró asociación estadísticamente significativa con cinco variables: presencia de shock al ingreso a UCI OR: 7,368 (IC95% 1,886-28,794); nivel de procalcitonina mayor a 10 OR: 5,231 (IC95% 1,724-15,869); complemento C3 consumido OR: 4,014 (IC95% 1,223-13,173); serositis en la radiografía de tórax OR: 3,771 (IC95% 1,238-11,492); recuento de plaquetas menor a 100.000 OR: 3,33 (IC95%: 1,037-10,714). Conclusión: Existen factores que pueden estar asociados con mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, su detección temprana y manejo oportuno podría mejorar el pronóstico de estos pacientes.

Alceste: o heroísmo no sacrifício ou o sacrifício do heroísmo? (uma leitura da Alceste de Eurípedes)

O presente artigo tem por objetivo tentar levantar alguns problemas do texto Alceste de Eurípides, levado à cena por volta de 438 a.C. em Atenas. No estudo aqui estabelecido, tenta-se primeiramente verificar como se configura o herói no mundo grego (tendo como base os textos de Homero e os textos de Calino e TirtBu, poetas líricos); depois, verifica em que medida é possível considerar uma heroína a figura de Alceste na Alceste de Eurípides, ou seja, verifica como se confere este estatuto à mulher. Também se discute como a noção de sacrifício entra na noção de heroísmo, sobretudo na figuração heróica da mulher.

Concentration and production of bacteria and bacterial destruction in the photic layer of the Sodruzhestvo Sea area, Southern Ocean

Bacterioplankton in the photic layer of the Sodruzhestvo Sea area and adjoining waters consists in summer primarily of cocci, with fractions smaller than 2 ?m predominating. The average abundance and biomass of microorganisms are 427 thousand cells/ml and 438 mg C/m**2, with ranges of 150-1770 thousand cells/ml and 221-1146 mg C/m**2. The average daily production and bacterial destruction increase from 49 and 104 mg C/m**2 at the beginning of the growth period to 85 and 180 mg C/m**2 in the middle of the period and remain at this level till the end. Despite low rate of increase (daily P/B coefficient averages 0.12), because of its high abundance bacterioplankton in Antarctic waters plays a major role in destruction of organic matter, accounting for 60-85% of energy consumed by heterotrophs.

Juan Antonio González Iglesias: la recepción clásica en un poeta alejandrino posmoderno

Este artículo estudia los elementos clásicos presentes en la poesía de Juan Antonio González Iglesias, poeta y latinista salmantino, en sus poemarios publicados hasta el año 2007. Se estudiará la forma tan peculiar que toma la literatura grecolatina en nuestro poeta, ya que en la posmodernidad la herencia clásica se ve abocada a adoptar nuevas formas, estableciendo así un diálogo con la Antigüedad, de la que se recrean selectivamente algunos elementos. Además, podremos comprobar cómo los elementos clásicos conviven con otros, antiguos y modernos, que se mencionarán cuando se unan a los clásicos.

Síndrome de Burnout y calidad de vida laboral en el personal asistencial de una institución de salud en Bogotá Colombia

El objetivo de este estudio fue describir el Síndrome de Burnout y la Calidad de Vida Laboral en el personal asistencial en una institución de salud de segundo nivel ubicada en Bogotá, y observar si existe relación entre estos constructos. Se aplicó el Inventario de Burnout de Maslach [MBI] y el Cuestionario de Calidad de Vida Profesional [CVP-35] a 62 participantes, pertenecientes a distintos campos del área de la salud. Los resultados indicaron que el 38,7% de los participantes presentaron severidad alta y moderada del síndrome, no obstante, con un nivel de realización personal alto, que unido a la fuerte motivación intrínseca encontrada, constituye un factor protector ante la alta carga laboral y el escaso apoyo directivo. El cansancio emocional correlacionó directamente con la carga laboral e inversamente con la motivación intrínseca. Se resalta la importancia de una eficiente gestión en las organizaciones de salud y la necesidad de una dirección más centrada en las personas a fin de garantizar su bienestar, lo que redundará en su calidad de vida y en la atención ofrecida.

On the mechanisms of phenothiazine-induced mitochondrial permeability transition: Thiol oxidation, strict Ca(2+) dependence, and cyt c release

Phenothiazines (PTZ) are drugs widely used in the treatment of schizophrenia. Trifluoperazine, a piperazinic PTZ derivative, has been described as inhibitor of the mitochondrial permeability transition (MPT). We reported previously the antioxidant activity of thioridazine at relatively low concentrations associated to the inhibition of the MPT (Brit. J. Pharmacol., 2002;136:136-142). In this study, it was investigated the induction of MPT by PTZ derivatives at concentrations higher than 10 mu M focusing on the molecular mechanism involved. PTZ promoted a dose-response mitochondrial swelling accompanied by mitochondrial transmembrane potential dissipation and calcium release, being thioridazine the most potent derivative. PTZ-induced MPT was partially inhibited by CsA or Mg(2+) and completely abolished by the abstraction of calcium. The oxidation of reduced thiol group of mitochondrial membrane proteins by PTZ was upstream the VIP opening and it was not sufficient to promote the opening of PTP that only occurred when calcium was present in the mitochondrial matrix. EPR experiments using DMPO as spin trapping excluded the participation of reactive oxygen species on the PTZ-induced MPT. Since 117 give rise to cation radicals chemically by the action of peroxidases and cyanide inhibited the PTZ-induced swelling, we propose that VIZ bury in the inner mitochondrial membrane and the chemically generated 117 cation radicals modify specific thiol groups that in the presence of Ca(2+) result in MPT associated to cytochrome c release. These findings contribute for the understanding of mechanisms of MET induction and may have implications for the cell death induced by PTZ. (C) 2010 Elsevier Inc. All rights reserved.

Ca(2+) binding to c-state of adenine nucleotide translocase (ANT)-surrounding cardiolipins enhances (ANT)-Cys(56) relative mobility: A computational-based mitochondrial permeability transition study

The oxidation of critical cysteines/related thiols of adenine nucleotide translocase (ANT) is believed to be an important event of the Ca(2+)-induced mitochondrial permeability transition (MPT), a process mediated by a cyclosporine A/ADP-sensitive permeability transition pores (PTP) opening. We addressed the ANT-Cys(56) relative mobility status resulting from the interaction of ANT/surrounding cardiolipins with Ca(2+) and/or ADP by means of computational chemistry analysis (Molecular Interaction Fields and Molecular Dynamics studies), supported by classic mitochondrial swelling assays. The following events were predicted: (i) Ca(2+) interacts preferentially with the ANT surrounding cardiolipins bound to the H4 helix of translocase, (ii) weakens the cardiolipins/ANT interactions and (iii) destabilizes the initial ANT-Cys(56) residue increasing its relative mobility. The binding of ADP that stabilizes the conformation ""m"" of ANT and/or cardiolipin, respectively to H5 and H4 helices, could stabilize their contacts with the short helix h56 that includes Cys(56), accounting for reducing its relative mobility. The results suggest that Ca(2+) binding to adenine nucleotide translocase (ANT)-surrounding cardiolipins in c-state of the translocase enhances (ANT)-Cys(56) relative mobility and that this may constitute a potential critical step of Ca(2+)-induced PTP opening. (C) 2009 Elsevier B.V. All rights reserved.

Activation of c-Jun in the nuclei of neurons of the CA-1 in thrombin preconditioning occurs via PAR-1.

Recently it has been shown that the c-Jun N-terminal kinase (JNK) plays a role in thrombin preconditioning (TPC) in vivo and in vitro. To investigate further the pathways involved in TPC, we performed an immunohistochemical study in hippocampal slice cultures. Here we show that the major target of JNK, the AP-1 transcription factor c-Jun, is activated by phosphorylation in the nuclei of neurons of the CA1 region by using phospho-specific antibodies against the two JNK phosphorylation sites. The activation is early and transient, peaking at 90 min and not present by 3 hr after low-dose thrombin administration. Treatment of cultures with a synthetic thrombin receptor agonist results in the same c-Jun activation profile and protection against subsequent OGD, both of which are prevented by specific JNK inhibitors, showing that thrombin signals through PAR-1 to JNK. By using an antibody against the Ser 73 phosphorylation site of c-Jun, we identify possible additional TPC substrates.

Activation of c-Jun in the nuclei of neurons of the CA-1 in thrombin preconditioning occurs via PAR-1.

Recently it has been shown that the c-Jun N-terminal kinase (JNK) plays a role in thrombin preconditioning (TPC) in vivo and in vitro. To investigate further the pathways involved in TPC, we performed an immunohistochemical study in hippocampal slice cultures. Here we show that the major target of JNK, the AP-1 transcription factor c-Jun, is activated by phosphorylation in the nuclei of neurons of the CA1 region by using phospho-specific antibodies against the two JNK phosphorylation sites. The activation is early and transient, peaking at 90 min and not present by 3 hr after low-dose thrombin administration. Treatment of cultures with a synthetic thrombin receptor agonist results in the same c-Jun activation profile and protection against subsequent OGD, both of which are prevented by specific JNK inhibitors, showing that thrombin signals through PAR-1 to JNK. By using an antibody against the Ser 73 phosphorylation site of c-Jun, we identify possible additional TPC substrates.

Frank C. Chapman, Chicago, Illinois, ca. 1890

Studio portrait of Frank C. Chapman, Chicago, Illinois, ca. 1890.

Charles C. Chapman with his daughter Ethel and son Stanley, ca. 1905.

Remnant of a portrait photograph of Charles C. Chapman with his daughter Ethel and son Stanley, ca. 1905.

The plasmodium receptor for activated C kinase protein inhibits Ca(2+) signaling in mammalian cells

Plasmodium falciparum, the most lethal malarial parasite, expresses an ortholog for the protein kinase C (PKC) activator RACK1. However, PKC has not been identified in this parasite, and the mammalian RACK1 can interact with the inositol 1,4,5-trisphosphate receptor (InsP3R). Therefore we investigated whether the Plasmodium ortholog PfRACK also can affect InsP3R-mediated Ca(2+) signaling in mammalian cells. GFP-tagged PfRACK and endogenous RACK1 were expressed in a similar distribution within cells. PfRACK inhibited agonist-induced Ca(2+) signals in cells expressing each isoform of the InsP3R, and this effect persisted when expression of endogenous RACK1 was reduced by siRNA. PfRACK also inhibited Ca(2+) signals induced by photorelease of caged InsP3. These findings provide evidence that PfRACK directly inhibits InsP3-mediated Ca(2+) signaling in mammalian cells. Interference with host cell signaling pathways to subvert the host intracellular milieu may be an important mechanism for parasite survival. (C) 2009 Elsevier Inc. All rights reserved.

¿Centros de poder? Sociedad y poblamiento en la Meseta Norte española (ca. 800-400 a.C.)

[ES]La aparición de los primeros centros fortificados en la Meseta Norte durante la Primera Edad del Hierro es un proceso cuya comprensión se encuentra aún en sus inicios. No obstante, los resultados de las investigaciones arqueológicas más recientes proporcionan una imagen considerablemente mejorada sobre el desarrollo de estos sitios autosuficientes, algunos de los cuales se aglomeraron formando grupos mayores y más complejos al final del período. La configuración de asentamientos y comunidades, la interpretación sociológica de sus correspondientes necrópolis y los patrones regionales de poblamiento nos acercan a la organización social de las gentes que habitaron la Meseta en aquel período. [EN] The appearance of the first fortified settlements in the Northern Plateau (Spain) during the Early Iron Age is a process whose understanding is still far from resolved. We know when some small settlements were founded, but the evolution of these communities into other ones that were somewhat larger and more complex is not clear. However, the results of the latest archaeological research provide significantly improved image on the development of these sites, some of which were nucleated into larger and more complex groups at the end of this period. The configuration of settlements and communities, the sociological interpretation of their cemeteries and the regional settlement patterns reveal the social organisation of the people who inhabited the plateau in that period.

Studi su Cimone. Saggio di storia greca, ca. 478-461 a.C.

La monografia propone un’analisi del periodo ca. 478-461 a.C. della storia ateniese e delle vicende di Cimone figlio di Milziade entro il contesto contemporaneo. Lo studio dell’Atene, e più in generale di varie realtà elleniche affacciate sull’Egeo, negli immediati anni ‘post-persiani’ si articola in due parti: la prima ripercorre in senso cronologico le notizie, essenzialmente letterarie, disponibili in merito alle attività politiche e militari di Atene, quale guida dell’alleanza greca; la seconda trae conclusioni di respiro più ampio, fondate sull’analisi precedente, e cerca una sintesi del periodo e del personaggio nel superamento di stereotipi e condizionamenti letterari. In tale ottica si esprime una riflessione, a partire dalla scarna trattazione tucididea, sui meccanismi attraverso i quali la tradizione ha deformato e sedimentato le informazioni disponibili generando un progressivo arricchimento che ha portato alla definizione, di fatto, di una ‘era cimoniana’ che è possibile mettere in discussione in alcuni tratti essenziali. Si mira dunque a proporre una valutazione del periodo priva di alcuni elementi, in ultimo evidenti soprattutto nell’approccio plutarcheo alla materia, che appaiono alieni al contesto di riferimento per la prima parte del V secolo: i temi principali ai quali si dedica la riflessione sono quelli dell’imperialismo ateniese, del filolaconismo, della bipolarità tra democrazia e oligarchia, della propaganda politico-mitologica. Il rapporto di Atene con Sparta, con gli Ioni e con le altre realtà del mondo egeo viene letto alla luce degli indizi disponibili sul clima di incertezza e di delicati equilibri creatosi all’indomani della ritirata delle forze persiane. Il ritratto di Cimone che si propone è quello di una figura indubbiamente significativa nella politica contemporanea ma, al contempo, fortemente condizionata e talora adombrata da dinamiche in qualche modo condivise all’interno dello scenario politico ateniese, improntato alla soddisfazione di necessità e volontà che la tradizione renderà archetipiche del paradigma democratico.