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Abstract Metabolic-dysfunction-associated fatty liver disease (MAFLD) is a comorbidity that generally increases in people living with HIV (PLWH). This condition is usually accompanied by persistent inflammation and premature immune system aging. In this prospective cohort study, we describe a straightforward methodology for quantifying biomarkers of aging, such as DNA methylation and telomere length, in PLWH and in the context of another relevant condition, such as MAFLD. Fifty-seven samples in total, thirty-eight from PLWH and nineteen from non-PLWH participants with or without MAFLD, were obtained and subjected to DNA extraction from peripheral blood mononuclear cells (PBMCs). Global DNA methylation and telomere length quantification were performed using an adapted enzyme-linked immunosorbent assay (ELISA) and qPCR, respectively. The quantification results were analysed and corrected by clinically relevant variables in this context, such as age, sex, and metabolic syndrome. Our results show an increased association of these biomarkers in PLWH regardless of their MAFLD status. Thus, we propose including the quantification of these age-related factors in studies of comorbidities. This will allow a better understanding of the effect of comorbidities of HIV infection and MAFLD and prevent their effects in these populations in the future.

Las asignaturas de Patología general y Anatomía patológica son impartidas durante el quinto y sexto semestre de la carrera de Medicina de la Universidad de Concepción. En estas se utiliza un estilo de enseñanza tipo aula invertida y se realiza una actividad práctica de “Diseño de Casos Clínico-Patológicos” (DCCP), iniciada en sala de patología quirúrgica, donde los estudiantes vivencian en forma real el trabajo del anatomopatólogo en grupos de 3 a 4 personas, realizando desde el dictado macroscópico hasta el diagnóstico microscópico, con una presentación final del caso a estudiantes y docentes. Se realizó un estudio observacional analítico transversal a una muestra de 87 estudiantes que cursaron ambas asignaturas. Se efectuó un análisis descriptivo cuantitativo y un método cualitativo de análisis de contenido, codificándose y clasificándose las respuestas de 2 instrumentos. La satisfacción general de la actividad DCCP fue de 82,4%, siendo percibida como innovadora y útil para el desarrollo de habilidades y aprendizajes teóricos de patología, que prepara a los alumnos de mejor manera para enfrentar los desafíos del mundo real como profesionales de la salud. No se debe olvidar la importancia de considerar las preferencias y necesidades de los estudiantes al diseñar estrategias de enseñanza. La evaluación cualitativa de la actividad DCCP y de las asignaturas entregó valiosa información para un mejoramiento continuo; reafirmando la importancia de incorporar éstas en las evaluaciones de prácticas docentes. Se concluye que la actividad práctica DCCP ayuda de mejor forma a los estudiantes de medicina a entender los aspectos macroscópicos y microscópicos de la Anatomía Patológica; superando incluso al aula invertida. La combinación de enfoques centrados en el alumno, trabajo en entornos reales, un apoyo docente adecuado y material de estudio de calidad puede conducir a una experiencia de aprendizaje más efectiva y satisfactoria para los estudiantes en estas disciplinas.

IntroductionMetabolic dysfunction-associated steatotic liver disease (MASLD), has emerged as an increasingly recognized problem among people living with HIV (PLWH). The gut-liver axis is considered to be strongly implicated in the pathogenesis of MASLD. We aimed to characterize the gut microbiota composition in PLWH and MASLD and compare it with that of two control groups: PLWH without MASLD and individuals with MASLD without HIV infection.MethodsWe collected clinical data and stool samples from participants. Bacterial 16S rRNA genes were amplified, sequenced, and clustered into operational taxonomic unit. Alpha diversity was studied by Shannon and Simpson indexes. To study how different the gut microbiota composition is between the different groups, beta diversity estimation was evaluated by principal coordinate analysis (PCoA) using Bray-Curtis dissimilarity. To further analyze differences in microbiome composition we performed a linear discriminant analysis (LDA) effect size (LEfSe).ResultsWe included 30 HIV+MASLD+, 30 HIV+MASLD- and 20 HIV-MASLD+ participants. Major butyrate producers, including Faecalibacterium, Ruminococcus, and Lachnospira dominated the microbiota in all three groups. Shannon’s and Simpson’s diversity metrics were higher among MASLD+ individuals (Kruskal-Wallis p = 0.047). Beta diversity analysis showed distinct clustering in MASLD-, with MASLD+ participants overlapping regardless of HIV status (ADONIS significance

The automatic prediction of the course of action of agents involved in social or economic trends is an imperative challenge nowadays. However, it is a difficult task because stance or opinion is often spread throughout long, complex texts, such as news articles. The current study tests sentence predicates as features to automatically determine the writer’s stance in news articles. We capture the semantics and stance of the text by encoding features such as the attribute of copulative sentences, the predicate of transitive sentences, adjectival phrases, and the section of the article. Under the assumption that these features are informative enough to model the semantics of the text, each word sequence is disambiguated and assigned a sentiment value using weighting rules. Different experiments were run using either SentiWordNet and ML-Senticon to determine words’ sentiment. Feature vectors are automatically built to populate a database that is tested using two machine learning algorithms. An efficiency of 69% was achieved using a SVM with Gaussian kernel along with a feature selection strategy. This score outperformed the bag-of-words baseline in 12%. These results are promising considering that the sentiment analysis is performed on very complex texts written in Spanish.

Abstract Background Streptococcus pneumoniae (SP) is one of the most common pathogens of Community-Acquired Pneumonia (CAP), but recent reports suggest that its incidence may be declining in relation to the use of the conjugate 13-valent pneumococcal vaccine in children. We compared the result of the immunochromatographic SP urinary antigen test (SPUAT) and clinical outcomes in patients with CAP admitted in two periods of time: 2001–2002(CAP1) and 2015–2016(CAP2). Methods This was a matched nested case-control study of two prospectively recorded cohorts of patients admitted with CAP, with SPUAT and blood culture performed in all patients. CAP2 cases and CAP1 controls were matched for age ± 4 years, sex, and Pneumonia Severity Index (PSI) score ± 10 points. Odds ratios (OR) for having SPUAT positive was estimated by conditional logistic regression. A multivariate model assessed the contribution of individual variables. Results Four hundred ninety-eight patients were recruited; 307 during the CAP1 and 191 during the CAP2 periods. Comparing both periods we observed differences, in age, PSI score, and the percentage of smokers, outpatients, previously immunized with pneumococcal vaccine, and positive SPUAT. On the other hand, mortality, admission from nursing homes, pneumococcal bacteremia and hospital admission were not different. After matching, pneumonia due to SP per the SPUAT was observed in 34(23.4%) of CAP1 and in 12(8.3%) of CAP2 patients (p

Diaphragmatic paralysis is an uncommon cause of pulmonary dysfunction and can occur after traumatic phrenic nerve injury. Penetrating and blunt trauma to the neck is the most recognized mechanism of injury being stretching of the nerves very uncommon. We report a case of a 39-year-old man with bilateral diaphragmatic paralysis due to violent stretching of the phrenic nerves. Clinical features and diagnosis methods are also reviewed. Keywords: Diaphragmatic paralysis, Phrenic nerve injury

Eosinophilic esophagitis is a chronic immunoallergic inflammatory disease of the esophagus that represents a major cause of digestive morbidity among the pediatric and young adult populations. Despite the fact that key symptoms in adults include dysphagia and food impaction, many patients lack structural changes in the esophagus to account for their complaints, which suggests the presence of underlying motor disorders and esophageal distensibility impairment. In the last few years the esophageal motility of these patients has been studied using various approaches, most particularly high-resolution manometry, ambulatory manometry, and impedance planimetry. This review focuses on the most relevant findings and scientific evidence regarding esophageal motor disorders in eosinophilic esophagitis.

Background: Normal values for water-perfused esophageal high-resolution manometry have still not been established in our environment, despite its generalized use and the recommendation to determine reference values for each Motility Unit based on their equipment. Normal values established with solid-state high-resolution manometry are currently being used as reference values for water-perfused high-resolution manometry. Objectives: To obtain normal values for water-perfused esophageal high-resolution manometry, based on the esophageal motility analysis of healthy subjects. Methods: 16 healthy volunteers without history of digestive complaints or esophageal symptoms were included. 22-channel water-perfused high-resolution manometry was performed. Results: Normal values were calculated as 5th-95th percentile ranges for the following parameters; upper esophageal sphincter resting pressure (UESRP) (40-195 mmHg); upper esophageal sphincter residual pressure (UESResP) (30-115 mmHg), contractile front velocity (CFV) (2.4-7.1 cm/s), distal contractile integral (DCI) (285-2820 mmHg.s.cm), distal contraction latency (DL) (6.1-10.9 s), intrabolus pressure (IBP) (7-19 mmHg), integrated relaxation pressure (IRP 4s) (2-20 mmHg), lower esophageal sphincter resting pressure (LESRP) (5-54 mmHg), esophageal shortening (Es) (0.3-1.3 cm) and lower esophageal sphincter lift (LESL) (0,1-1,2 cm). Conclusion: Normal values for the most important parameters (such as IRP 4s, DL and CFV), obtained using a 22-channel water-perfused system resemble previously published data from other perfusion devices. However, there exist small but significant variations compared with values established with solid-state high-resolution manometry. Thus, when using water-perfused catheters, caution is required when normative values are used that were established with solid-state catheters.