IMPORTANCEOpioid prescriptions for treatment of pain in emergency departments (EDs) are associated with long-term opioid use. The temporal pattern of opioid prescribing in the context of the opioid epidemic remains unknown. OBJECTIVE To examine the temporal pattern of opioid prescribing within an ED for varying pain conditions between 2009 and 2018. DESIGN, SETTING, AND PARTICIPANTS A population-based, cross-sectional study was conducted at the ED of an urban academic medical center. All patients treated within that ED between January 1, 2009, and December 31, 2018, were included. MAIN OUTCOMES AND MEASURESThe proportion of patients prescribed an opioid for treatment of pain in the ED temporally by condition, condition type, patient demographics, and physician prescriber.

S. aureus is still the most common pathogen in acute knee infections in our environment. Gram staining, absence of fever and normal leukocyte count cannot be used to rule out septic arthritis.

Un cuadro de meningitis aséptica, en el contexto de un paciente inmunosuprimido con diagnóstico de infección por Virus de Inmunodeficiencia Humana (VIH), debe llevar a pensar en múltiples diagnósticos diferenciales. Entre estos, se incluye el virus varicela zóster (VVZ) como uno de los principales agentes causales de meningitis a líquido cefalorraquídeo claro. Su reactivación da lugar a múltiples manifestaciones neurológicas potencialmente mortales en las que se consideraba al rash vesicular, o exantema ápulo/vesículo/ costroso como un signo fundamental para su diagnóstico. No obstante, las lesiones cutáneas están ausentes en más de un tercio de los pacientes con compromiso del sistema nervioso central. A continuación, se presenta el caso de un paciente con infección por VIH que presenta cefalea más fiebre, con hallazgos en líquido cefalorraquídeo de pleocitosis neutrofílica y una prueba molecular confirmatoria para virus varicela zóster, en ausencia de rash vesicular previo que guiara hacia este diagnóstico.

BackgroundNicotinamide adenine dinucleotide (NAD+) is an essential molecule in the energy metabolism of living beings, and it has various cellular functions. The main enzyme in the biosynthesis of this nucleotide is nicotinamide/nicotinate mononucleotide adenylyltransferase (NMNAT, EC 2.7.7.1/18) because it is the convergence point for all known biosynthetic pathways. NMNATs have divergences in both the number of isoforms detected and their distribution, depending on the organism.MethodsIn the laboratory of basic research in biochemistry (LIBBIQ: acronym in Spanish) the NMNATs of protozoan parasites (Leishmania braziliensis, Plasmodium falciparum, Trypanosoma cruzi, and Giardia duodenalis) have been studied, analysing their catalytic properties through the use of proteins. Recombinants and their cellular distribution essentially. In 2014, O’Hara et al. determined the cytoplasmic localization of NMNAT of P. falciparum, using a transgene coupled to GFP, however, the addition of labels to the study protein can modify several of its characteristics, including its sub-cellular localization.ResultsThis study confirms the cytoplasmic localization of this protein in the parasite through recognition of the endogenous protein in the different stages of the asexual life cycle. Additionally, the study found that PfNMNAT could be a phosphorylation target at serine, tyrosine and threonine residues, and it shows variations during the asexual life cycle.ConclusionsThese experiments confirmed that the parasite is situated in the cytoplasm, fulfilling the required functions of NAD+ in this compartment, the PfNMNAT is regulated in post-transcription processes, and can be regulated by phosphorylation in its residues.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2307-4) contains supplementary material, which is available to authorized users.