Enfermedad celíaca y constipación: una manifestación clínica atípica y poco frecuente

OBJECTIVE: To report two cases of patients with celiac disease (CD) whose main complaint was chronic constipation. CASE DESCRIPTION: Two girls, aged 18 and 30 months, had chronic constipation refractory to standard treatment. Both patients concomitantly evidenced low weight gain and short stature. The investigation of the digestive-absorptive function was positive for IgA antibodies against tissue transglutaminase. The diagnosis of CD was confirmed by a small bowel biopsy that showed moderate/severe villous atrophy and increased intraepithelial lymphocytic infiltration. One month after starting the dietary treatment with a gluten-free diet, both patients recovered from constipation, with the passage of soft stools daily. COMMENTS: CD may be presented in the classical, asymptomatic or atypical forms. In the latter form, isolated manifestations, surch as constipation, delay the diagnosis of the disease.OBJETIVO: Relatar dos casos de enfermedad celíaca (EC) con manifestación de constipación. DESCRIPCIÓN DEL CASO: Dos pacientes del sexo femenino, con 18 y 30 meses de edad, respectivamente, presentando historia de constipación crónica refractaria al tratamiento. Como presentaban concomitantemente baja ganancia de peso ponderal y estatural, se realizó investigación de la función digestiva-absortiva, que resultó positiva para el anticuerpo IgA antitransglutaminasa tejidual. El diagnóstico de EC fue confirmado por biopsia de intestino delgado que reveló atrofia vellositaria moderada/intensa e infiltrado linfocítico intraepitelial. Un mes después del inicio del tratamiento con dieta exenta de gluten, ambas pacientes pasaron a presentar heces pastosas diariamente. COMENTARIOS: La EC puede presentarse en la forma clásica, asintomática y atípica, en que manifestaciones aisladas como constipación pueden retardar el diagnóstico.OBJETIVO: Relatar dois casos de doença celíaca (DC) com manifestação de constipação. DESCRIÇÃO DO CASO: Dois pacientes do sexo feminino, com 18 e 30 meses de idade, respectivamente, apresentando história de constipação crônica refratária ao tratamento. Como apresentavam concomitantemente baixo ganho ponderal e estatural, foi realizada investigação da função digestiva-absortiva, que resultou positiva para o anticorpo IgA antitransglutaminase tecidual. O diagnóstico de DC foi confirmado por biópsia de intestino delgado que revelou atrofia vilositária moderada/intensa e infiltrado linfocítico intraepitelial. Um mês após o início do tratamento com dieta isenta de glúten, ambas as pacientes passaram a apresentar fezes pastosas diariamente. COMENTÁRIOS: A DC pode se apresentar nas formas clássica, assintomática e atípica, em que manifestações isoladas como constipação podem retardar o diagnóstico.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Departamento de PediatriaUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Departamento de Anatomia PatológicaUNIFESP, EPM, Depto. de PediatriaUNIFESP, EPM, Depto. de Anatomia PatológicaSciEL

pDNA capture using grafted adsorbents

BACKGROUND: ‘Expanded’ composite materials are of interest as an alternative, or as a supplement, to packed-bed chromatography during bioproduct recovery and purification. Functionalized non-woven fabrics and mega-porous bodies are examples of systems that showed promise. However, there is scarce information on their suitability to capture and release plasmid DNA (pDNA), an important type of product employed in gene therapy. RESULTS: Composite adsorbents were prepared using either chemical (CG-DEAE-NW) or gamma-irradiated graft-polymerization (GIR-DEAE-MP), and subsequently modified to have diethylamino ethanol (DEAE) functionality. Capture experiments showed that pDNA can actually reversibly bind to the two mentioned adsorbents, with capacity values of 2.4 and 1.3 mg per mL, respectively. These values are in the range of what can be expected from commercial beaded adsorbents but lower that the values expected from monoliths. CONCLUSIONS: Expanded materials, due to their high voidage, may present limited capacity for pDNA. However, such materials are able to bind proteins and other contaminants from bacterial lysate, opening the way for their utilization in the ‘negative’ mode.Fil: Singh, Naveen Kumar. University of Notre Dame; Estados Unidos. Jacobs University; AlemaniaFil: Dsouza, Roy N.. Jacobs University; AlemaniaFil: Yelemane, Vikas. Jacobs University; AlemaniaFil: Nentwig, Nina. Jacobs University; AlemaniaFil: Grasselli, Mariano. Universidad Nacional de Quilmes; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Fernández Lahore, Marcelo. Jacobs University; Alemani

Body mass index influence in female urinary incontinence

PURPOSE: to evaluate and compare the effects of body mass index (BMI) on the severity of female urinary incontinence (UI) using the quality of life questionnaire King's Health Questionnaire (KHQ), variables of urodynamic studies and the medical history taken. METHODS: cross-sectional clinical study. We selected 65 patients with stress urinary incontinence (SUI) who were divided into three groups: Group I (BMI: 18-25 kg/m²), Group II (BMI: 25-30 kg/m²) and Group III (BMI>30 kg/m²). The KHQ domains were compared between these groups. In addition, some clinical history urodynamic data (presence of nocturia, enuresis, urgency and urge incontinence) were also related to BMI by calculating the Odds Ratio (OR). The BMI in the presence and absence of non-inhibited detrusor contractions and Valsalva leak point pressure (VLPP) 60 cmH2O were evaluated. Finally, the correlation between BMI and the nine KHQ domains has been tested in order to detect some association. RESULTS: the KHQ did not record deterioration of quality of life in women with UI with increasing BMI in any of its areas. The OR for the presence of enuresis in relation to a BMI was 1.003 [CI: 0.897-1.121], p=0.962. The OR for nocturia was 1.049 [CI: 0.933-1.18], p=.425. The OR for urgency was 0.975 [CI: 0.826-1.151], p=0.762, and the OR for incontinence was 0.978 [CI: 0.85-1.126], p=0.76. We studied the BMI in patients with and without non-inhibited detrusor contractions and detected medians of 26.4±4.8 and 28.3±5.7 kg/m², respectively (p=0.6). Similarly, the median BMI values for the groups with VLPP 60 cmH2O were 29.6±4.1 and 27.7±5.7 kg/m², respectively (p=0.2). Finally, we failed to demonstrate an association between BMI and any of the nine KHQ domains by means of the Spearman correlation. CONCLUSION: there was no association of KHQ scores with BMI. There was also no correlation between the parameters of clinical history and of the urodynamic study with BMI.OBJETIVOS: avaliar e comparar os efeitos do índice de massa corporal (IMC) sobre severidade da incontinência urinária (IU) feminina por meio do questionário de qualidade de vida King's Health Questionnaire (KHQ), variáveis do estudo urodinâmico e dados da anamnese. MÉTODOS: estudo clínico transversal. Foram selecionados 65 pacientes com incontinência urinária de esforço (IUE) que foram divididas em três grupos: Grupo I (IMC entre 18 e 25 kg/m²); Grupo II (IMC entre 25 e 30 kg/m²) e Grupo III (IMC>30 kg/m²). Os domínios do KHQ foram comparados entre esses grupos. Além disso, alguns dados da anamnese e do estudo urodinâmico (presença de noctúria, enurese, urgência e urge-incontinência) foram também relacionados ao IMC calculando-se o OR (Odds Ratio). O IMC, na presença e na ausência de contrações não inibidas do detrusor, bem como no VLPP (valsalva leak point pressure) 60 cmH2O foi avaliado. Por fim, foram realizados testes de correlação do IMC com os nove domínios do KHQ a fim de se evidenciar alguma associação. RESULTADOS: o KHQ foi incapaz de registrar, em qualquer um de seus domínios, deterioração da qualidade de vida das mulheres com IU na medida em que ocorreu elevação do IMC. Encontramos OR para a presença de enurese em relação ao IMC de 1,003 [IC: 0,897-1,121], valor p=0,962. Para a noctúria, o OR foi de 1,049 (IC: 0,933-1,18), valor p=0,425. O valor de OR=0,975 (IC: 0,826-1,151), valor p=0,762 foi encontrado para a urgência. No que se refere à urge-incontinência, encontrou-se OR=0,978 (IC: 0,85-1,126), valor p=0,76. Estudou-se o IMC nos grupos com e sem contrações não-inibidas do músculo detrusor e foram encontradas, respectivamente, medianas de 26,4±4,8 e 28,3±5,7 kg/m² (p=0,6). De forma semelhante, as medianas do IMC nos grupos com VLPP60 cmH2O foram, respectivamente, de 29,6±4,1 e 27,7±5,7 kg/m² (p=0,2). Finalmente, não tivemos êxito em demonstrar associação do IMC com qualquer um dos nove domínios do KHQ por meio da correlação de Spearman. CONCLUSÃO: não houve associação dos escores do KHQ com o IMC. Também não houve correlação entre os parâmetros clínicos da anamnese e do estudo urodinâmico com o IMC.Faculdade de Medicina do ABC Departamento de Obstetrícia e Ginecologia Setor de Uroginecologia e Cirurgia VaginalUniversidade Federal de São Paulo (UNIFESP) Departamento de PediatriaUNIFESP, Depto. de PediatriaSciEL

Baba Yaga: An Ecofeminist Analysis of the Witch of the Woods

In this thesis, I will argue that Baba Yaga’s prevalence in Russia’s culture and media provide a unique opportunity to gain insight into the junctures between the climate crisis and gender inequality in Russia. Despite the persistent gender inequities present in current Russian society, ecofeminist frameworks and ideologies are already deeply embedded in Russian culture. Women, as a group, have always been politically active in Russia, from resisting the introduction of Christianity in the 9th century, to the feminist resistance group Pussy Riot founded in 2011. I will examine Baba Yaga’s history, her role in the Russian folktale, and her associated symbols and objects through an ecofeminist lens. To do this, I will examine the unique qualities of the folklore genre, analyze two famous folktales containing Baba Yaga that exemplify her potential as an ecofeminist icon, and briefly discuss the significance of the environment where Baba Yaga lives

The association of A1166C gene polymorphism of angiotensin receptors with the parameters of central pulse wave in normotensive persons and patients with hypertension

Introduction. Available information about the impact of the polymorphic structure of type 1 angiotensin receptor (ATR1) gene on the central pulse wave is scarce and contradictory. The aim of the study was to establish a possible association of A1166C polymorphism of ATR1 gene with the pulse wave parameters obtained by applanation tonometry. Material and metods. We examined male and female persons aged 25 to 76 years. They were divided into two groups: the basic consisting of 150 hypertensive patients and the control group presented by 128 individuals with normal blood pressure. In addition to the general clinical exam three-fold measurements of systolic and diastolic blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP], respectively) with the automatic blood pressure monitor Omron M3 were provided mandatory. The structure of the polymorphic receptor gene ATR1 was defined in all participants by polymerase chain reaction on the thermocycler PHC (Techne, UK). Pulse wave analysis was provided with applanation tonometry. For this purpose we used Sphygmocor XCEL equipment (AtCor Medical, Australia). Results. Analysis of mean SBP and DBP in dependence on ATR1 genotype and existence of arterial hypertension showed that there was a tendency to rise with increasing number of C alleles, but statistical significance of the trend had been confirmed by ANOVA only for SBP in patients with hypertension. Also it was shown a significant difference in central diastolic blood pressure (CDBP) and pulse pressure augmentation (PPA) in hypertensive patients compared with normotensive. It was found a tendency to decrease CDBP and PPA with increasing number of C alleles. The subjects of the control group demonstrated the same trend of PPA as in the group of hypertensive patients. Conclusion. Thus, we established the association between decrease of PPA and increase of C alleles number in the ATR1 gene

Implementation of the “Vascular Age Index” for the interpretation of applanation tonometry

Background The application of pulse wave analysis in clinical practice is significantly limited due to the difficulties with evaluation of obtained data. The aim of the study was to propose the new index named “Vascular Age Index” for the improvement and simplification of pulse wave analysis. Material and methods We examined male and female persons aged from 25 to 76. 128 normotensive participants (the control group, CG) and 150 patients with essential hypertension (EH) were subdivided into subgroups of 25–44, 45–64 and 65 or more years. Each of them included 50 patients. The exception was the oldest subgroup of CG consisting of 28 persons. All participants underwent office blood pressure measurement by automatic blood pressure monitor “Omron 3” and pulse wave analysis carried out with «Sphygmocor XCEL» equipment (AtCor Medical, Australia). Besides common parameters of pulse wave such as augmentation index (AIx) and pulse wave velocity (PWV) the new indicator — “Vascular Age Index” was determined in all persons by the formula: VAI (year) = PWV × AIx ÷ 20. Results All studied parameters of pulse wave showed strong relationship with age, but the relationship of VAI with age was superior in its strength and significance. It was especially strong (r = 0.90; p < 0.001) in normotensive patients. The values of VAI obtained in subjects of the control group were approaching to the calendar age, and in patients with hypertension — often exceeded it. Conclusions Our data confirmed the relationship between AIx and PWV on the one hand, and age and blood pressure on the other. It was shown that in patients of 25–44 years pathological changes of central pulse wave parameters could serve as an additional argument for the diagnosis of hypertension. VAI significantly simplifies the interpretation of central pulse wave study and increases the compliance. Moreover, the diagnostic accuracy of VAI application is rather high. Thus, the implementation of VAI in the routine practice may be recommended

The inappropriateness of left ventricular mass and echoreflectivity in males with essential hypertension and different CYP11B2 gene polymorphisms

Background. The CYP11B2 gene as the main controller of aldosterone plasma activity is likely to be responsible as for the BP level as for the expression of different traits of hypertensive cardiac remodeling such as increased left ventricular mass and myocardial fibrosis. The main objective of our study was to define the differences in myocardial remodeling depending on CYP11B2 gene polymorphism. It was shown that some special techniques of echocardiography such as the assessment of inappropriate left ventricular mass and myocardial echoreflectivity proved additional information in patients with hypertensive heart disease. That’s why these techniques were used for a more precise assessment of hypertensive cardiac remodeling. Material and methods. Our study involved 150 males aged 45–60 years. They were divided into three groups: Group 1–50 patients with normal BP without any echocardiographic abnormalities, Group 2–52 patients with essential hypertension without left ventricular hypertrophy, and Group 3–48 patients with essential hypertension and left ventricular hypertrophy. Results. It was found that in patients with inappropriate LVM the prevalence of CC genotype was almost twice higher than among those with appropriate LVM. On the other hand, hypertensive patients with CC genotype and LVH demonstrated higher echoreflectivity parameters. Conclusions. We assume that CC polymorphism of CYP11B2 may be an indicator of more expressed signs of hypertensive cardiac remodeling, in particular myocardial hypertrophy and myocardial fibrosis, in males with essential hypertension

Antimicrobial hydrogels based on autoclaved poly(vinyl alcohol) and poly(methyl vinyl ether-alt-maleic anhydride) mixtures for wound care applications

Novel antimicrobial hydrogels with good mechanical and physical properties were synthesized by autoclaving aqueous mixtures of poly(vinyl alcohol) and poly(methyl vinyl ether-alt-maleic anhydride). The structure of these materials was studied by infrared spectroscopy, scanning electron microscopy and solid state nuclear magnetic resonance. The swelling behavior, mechanical properties and adhesion of the hydrogels to porcine skin were evaluated. It was established that these hydrogels exhibited antimicrobial properties and inhibited bacteria growth against Staphylococcus aureus. The biocompatibility of the hydrogels was confirmed using an MTT assay (indirect cytotoxicity) and by monitoring cell proliferation in contact with the gels (direct cytotoxicity)

Digital receivers for low-frequency radio telescopes UTR-2, URAN, GURT

This paper describes digital radio astronomical receivers used for decameter and meter wavelength observations. This paper describes digital radio astronomical receivers used for decameter and meter wavelength observations. Since 1998, digital receivers performing on-the-fly dynamic spectrum calculations or waveform data recording without data loss have been used at the UTR-2 radio telescope, the URAN VLBI system, and the GURT new generation radio telescope. Here we detail these receivers developed for operation in the strong interference environment that prevails in the decameter wavelength range. Data collected with these receivers allowed us to discover numerous radio astronomical objects and phenomena at low frequencies, a summary of which is also presented.Comment: 24 pages, 15 figure

The health and indoor environmental quality impacts of residential building envelope retrofits: A literature review

Retrofitting existing buildings to improve energy efficiency is an important strategy to meet increasingly stringent energy efficiency targets. While the primary objective of energy efficiency retrofits is to reduce energy consumption and greenhouse gas emissions, retrofits can also result in non-energy impacts (NEIs), which contribute to decision-making processes and overall value of the retrofit. NEIs have been studied extensively in retrofitted residential buildings; however, these studies have historically grouped passive (i.e., building envelope) and active (i.e., heating, ventilation, and air conditioning (HVAC) and energy system) upgrades, making it difficult to identify the underlying mechanism(s) of action for each NEI and developing effective retrofit strategies, based on occupant need. The purpose of this study was to better account for NEIs, based on a literature review, summarizing the current state of knowledge on NEIs associated with residential building envelope retrofits. We limited our search to health- and indoor environmental quality-related NEIs. The review identified strong evidence that building envelope retrofits improve acoustic comfort, wintertime thermal comfort, and respiratory and cardiovascular health outcomes. IAQ outcomes were mixed, with studies reporting both increases and decreases to indoor contaminant concentrations following retrofits. The strength of the effect was generally governed by pre-retrofit contaminant concentrations and whether indoor concentrations were dominated by indoor or outdoor sources. Most studies evaluating summertime thermal comfort identified increased incidence of summertime overheating; however, none of these studies linked the change in thermal conditions to health outcomes. Recommendations for future work include expanding studies to include more market rate housing and the health impacts of summertime overheating in retrofitted buildings