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The purpose of this study is to compare group B Streptococcus (GBS) infection incidence in HIV-exposed uninfected (HEU) and HIV-unexposed (HU) infants in a Spanish cohort. We conducted a retrospective study in 5 hospitals in Madrid (Spain). Infants ≤ 90 days of life with a GBS infection were included from January 2008 to December 2017. Incidence of GBS infection in HEU and HU children was compared. HEU infants presented a sevenfold greater risk of GBS infection and a 29-fold greater risk of GBS meningitis compared to HU, with statistical significance. Early-onset infection was tenfold more frequent in HEU children, with statistical significance, and late-onset infection was almost fivefold more frequent in the HUE infants' group, without statistical significance. CONCLUSION: HEU infants presented an increased risk of GBS sepsis and meningitis. One in each 500 HEU infants of our cohort had a central nervous system infection and 1 in each 200, a GBS infection. Although etiological causes are not well understood, this should be taken into account by physicians when attending this population. WHAT IS KNOWN: ⢠HIV-exposed uninfected infants are at higher risk of severe infections. ⢠An increased susceptibility of these infants to group B Streptococcus infections has been described in low- and high-income countries, including a higher risk of meningitis in a South African cohort. WHAT IS NEW: ⢠Group B Streptococcal meningitis is more frequent in HIV-exposed uninfected infants also in high-income countries. ⢠Physicians should be aware of this increased risk when attending these infants.
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Infecciones por VIH , Meningitis , Sepsis , Infecciones Estreptocócicas , Niño , Lactante , Humanos , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Streptococcus agalactiae , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/epidemiologíaRESUMEN
Background Coronary heart disease has multiple risk factors, including air pollution. Numerous pathophysiological mechanisms have been identified with increasing levels of air pollution, mainly with ozone (O3), nitrogen dioxide (NO2), sulphur dioxide (SO2), particulate matter (PM10), fine particulate matter (PM2.5) and carbon monoxide (CO). In Mexico, the pollution level is reported using an air quality index called IMECA. Methods All patients with STEMI admitted at Hospital Español were collected between 2012 and 2019 (Nâ¯=â¯348). We conducted a retrospective analysis using the air pollution exposure at the time of each event (lag0), the previous 24â¯h (lag1), 48â¯h (lag2), 72â¯h (lag3) and 5-day cumulative lag. The level of air pollution was analyzed independently using IMECA and particle concentrations. The data was divided in two groups: days with one of more STEMI's (MI group) and days free of events (Control group), using ANCOVA to evaluate the difference between means of both groups taking into account confounders. Results: For days with one or more cardiovascular event, a significant increase in SO2 was observed at lag1; similar increase was found in CO, PM2.5, SO2 at lag2. For the 5-day cumulative lag, SO2 and PM2.5 showed a significant increase. No differences were found using the IMECA levels in both groups. Conclusions: The elevated concentrations levels of CO, SO2 and PM2.5 showed significant association with STEMI at different time points before the event. Ozone, PM10 and NO2 showed no difference between groups. IMECA levels showed no association with STEMI in our study.
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We report a new, to the best of our knowledge, record power and efficiency for a 946 nm Nd:YAG laser, producing >110W (5TWm-2sr-1) with a slope efficiency of 80%, with respect to absorbed pump power, and an optical-to-optical efficiency of 74%, with respect to incident power. To achieve this performance, we utilized a closed-cycle acoustic Stirling cryostat to maintain the gain medium temperature at â¼80K and direct in-band pumping with a volume-Bragg-grating stabilized diode laser bar operating at 868 nm. Daily operation, including cycling of the laser crystal temperature, akin to a comparable water-cooled solid-state laser system, is demonstrated.
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El presente artículo recopila un extracto de las distintas ponencias realizadas por investigadores de diferentes lugares del Ecuador en el marco del Simposio sobre Cáncer Cervical y el virus del papiloma humano ocurrido en el 5° Congresosobre enfermedades infecciosas llevado a cabo en octubre del 2018 en la Pontificia Universidad Católica del Ecuador (Quito). Estas presentaciones presentan un diagnóstico acerca de la situación actual del virus de papiloma humano (VPH) y del cáncer cervical en nuestra región. Estas presentaciones complementan la información presentada en un evento similar realizado hace un par de años en las Jornadas Nacionales de Biología Espol 2016, constituyendo estas memorias en conjunto como uno de los pocos documentos disponibles que recopilan los últimos avances realizados en este campo en el Ecuador en años recientes.
Thisarticle compiles an extract of the different presentations made by researchers from different parts of Ecuador in the framework of the Symposium on Cervical Cancer and the human papillomavirus occurred at the 5th Congress on infectious diseases carried out in October 2018 at the Pontificia Catholic University of Ecuador (Quito). These presentations present a diagnosis about the current situation of human papilloma virus (HPV) and Cervical Cancer in our region. These presentations complement the informationpresented in a similar event held a couple of years ago at the National Conference of Biology Espol2016, constituting these memories together as one of the few documents available that assemble the latest advances made in this field in Ecuador in recent years.
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Femenino , Mujeres , Diagnóstico , Proteínas Dietéticas Animales , Reproducibilidad de los Resultados , GenotipoRESUMEN
Once pasteurized donor milk is thawed for its administration to a preterm or sick neonate, and until it is administered, it is kept refrigerated at 4 to 6°C for 24 h. After this time, unconsumed milk is discarded. This time has not been extended, primarily because of the concern of bacterial contamination. The aim of this study was to determine the changes in pH and bacterial count when pasteurized donor milk was kept under refrigeration for a prolonged period (14 d). In this prospective study, 30 samples of pasteurized donor milk from 18 donors were analyzed. Milk was handled following the regular operating protocols established in the neonatal unit and was kept refrigerated after thawing. pH measurements and bacteriology (on blood agar and MacConkey agar plates) were performed on each sample at time 0 (immediately after thawing) and then every day for 14 d. Changes in pH of samples over time were evaluated with linear mixed-effects regression models. A slow but gradual increase in milk pH was observed starting from the first day [mean (±SD) pH of 7.30 (±0.18) at time 0 and 7.69 (±0.2) on d 14]. No bacterial growth was observed in any of the samples throughout the complete trial except in one sample, in which Bacillus flexus was isolated. In conclusion, pasteurized human donor milk maintains its microbiological quality when properly handled and refrigerated (4-6°C). The slight and continuous increase in milk pH after the first day could be due to changes in the solubility of calcium and phosphate during refrigerated storage.
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Bacterias/aislamiento & purificación , Conservación de Alimentos/métodos , Leche Humana/química , Leche Humana/microbiología , Refrigeración , Carga Bacteriana , Microbiología de Alimentos/métodos , Humanos , Concentración de Iones de Hidrógeno , Pasteurización , Estudios Prospectivos , Factores de Tiempo , Donantes de TejidosRESUMEN
BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) has been increasingly used for prostate cancer (PCa). Recent studies identified distinct molecular subclasses of PCa with recurrent genomic alterations. However, the associations between molecular alterations in PCa and characteristics on mpMRI are unknown. Therefore, the objective of this study was to investigate recurrent molecular alterations in PCa and their associations with mpMRI features. METHODS: Sixty-two PCa nodules >0.5 cm had a preoperative mpMRI. Nodules were evaluated for ERG rearrangement, PTEN deletion, SPINK1 overexpression, SPOP mutation and CHD1 deletion. Each PCa focus was matched to the corresponding location on mpMRI. Lesions were scored by single observer according to the PI-RADSv2 scale. RESULTS: Of the 62 nodules, 22 (35.5%) were ERG positive, 6 (9.7%) had SPINK1 overexpression, 6 (9.7%) had SPOP mutations, 4 (6.5%) had CHD1 deletions and 1 (1.6%) had PTEN deletion. All of the nodules with CHD1 deletions were not visible on mpMRI (P=0.037). All of the nodules with SPINK1 overexpression were visible on mpMRI, although the association was not statistically significant (P=0.06). There were no significant associations between any molecular alteration with the severity of the PI-RADS scores (all P>0.05). CONCLUSIONS: This investigation represents the first description of an association between recurrent molecular alterations and the characterization of PCa nodules on mpMRI. This study can be considered hypothesis-generating for future studies to rigorously evaluate the association of specific PCa molecular subclasses with imaging features and potentially define specific subsets of PCa for which the utility of MRI is higher or lower.
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Imagen por Resonancia Magnética , Próstata/diagnóstico por imagen , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/genética , Anciano , ADN Helicasas/genética , Proteínas de Unión al ADN/genética , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Masculino , Persona de Mediana Edad , Mutación , Proteínas Nucleares/genética , Fosfohidrolasa PTEN/genética , Próstata/patología , Próstata/cirugía , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/cirugía , Proteínas Represoras/genética , Regulador Transcripcional ERG/genética , Inhibidor de Tripsina Pancreática de Kazal/genéticaRESUMEN
This study was aimed to determine the profiles of serum cytokines (IL-1ß, TNF-α, IL-4, IL-5) and chemokines (MCP-1: monocyte chemoattract protein-1 and RANTES: regulated on activation normal T cell expressed and secreted) in individuals with an asthmatic versus a non-asthmatic background with bacterial, viral or mixed acute respiratory infection. Asthmatic (n = 14) and non-asthmatic (n = 29) patients with acute viral, bacterial or mixed (bacterial and viruses) respiratory infection were studied. Patients were also analysed as individuals with pneumonia or bronchitis. Healthy individuals with similar age and sex (n = 10) were used as controls. Cytokine/chemokine content in serum was determined by ELISA. Increased cytokine/chemokine concentration in asthmatic and non-asthmatic patients was observed. However, higher concentrations of chemokines (MCP-1 and RANTES) in asthmatic patients infected by viruses, bacteria or bacteria and viruses (mixed) than in non-asthmatic patients were observed. In general, viral and mixed infections were better cytokine/chemokine inducers than bacterial infection. Cytokine/chemokine expression was similarly increased in both asthmatic and non-asthmatic patients with pneumonia or bronchitis, except that RANTES remained at normal levels in bronchitis. Circulating cytokine profiles induced by acute viral, bacterial or mixed lung infection were not related to asthmatic background, except for chemokines that were increased in asthmatic status.
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Asma/inmunología , Infecciones Bacterianas/sangre , Bronquitis/sangre , Quimiocinas/sangre , Neumonía/sangre , Virosis/sangre , Adolescente , Adulto , Anciano , Asma/sangre , Infecciones Bacterianas/inmunología , Bronquitis/inmunología , Bronquitis/microbiología , Quimiocina CCL2/sangre , Quimiocina CCL5/sangre , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Interleucina-1beta/sangre , Interleucina-4/sangre , Interleucina-5/sangre , Masculino , Persona de Mediana Edad , Neumonía/inmunología , Neumonía/microbiología , Factor de Necrosis Tumoral alfa/sangre , Virosis/inmunología , Adulto JovenRESUMEN
PURPOSE: We assessed agreement among neurosurgeons on surgical approaches to individual glioblastoma patients and between their approach and those recommended by the topographical staging system described by Shinoda. METHODS: Five neurosurgeons were provided with pre-surgical MRIs of 76 patients. They selected the surgical approach [biopsy, partial resection, or gross total resection (GTR)] that they would recommend for each patient. They were blinded to each other's response and they were told that patients were younger than 50 years old and without symptoms. Three neuroradiologists classified each case according to the Shinoda staging system. RESULTS: Biopsy was recommended in 35.5-82.9%, partial resection in 6.6-32.9%, and GTR in 3.9-31.6% of cases. Agreement among their responses was fair (global kappa = 0.28). Nineteen patients were classified as stage I, 14 as stage II, and 43 as stage III. Agreement between the neurosurgeons and the recommendations of the staging system was poor for stage I (kappa = 0.14) and stage II (kappa = 0.02) and fair for stage III patients (kappa = 0.29). An individual analysis revealed that in contrast to the Shinoda system, neurosurgeons took into account T2/FLAIR sequences and gave greater weight to the involvement of eloquent areas. CONCLUSIONS: The surgical approach to glioblastoma is highly variable. A staging system could be used to examine the impact of extent of resection, monitor post-operative complications, and stratify patients in clinical trials. Our findings suggest that the Shinoda staging system could be improved by including T2/FLAIR sequences and a more adequate weighting of eloquent areas.
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Neoplasias Encefálicas/cirugía , Glioblastoma/cirugía , Estadificación de Neoplasias/métodos , Procedimientos Neuroquirúrgicos/normas , Adulto , Neoplasias Encefálicas/patología , Ensayos Clínicos Fase II como Asunto , Glioblastoma/patología , Humanos , Masculino , Persona de Mediana Edad , Neurocirujanos/normas , Procedimientos Neuroquirúrgicos/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Encuestas y CuestionariosRESUMEN
Vascular endothelial growth factor (VEGF) and its receptor (VEGFR) are overexpressed in the majority of renal cell carcinomas. This characteristic has supported the rationale of targeting VEGF-driven tumour vascularization, especially in clear cell RCC. VEGF-inhibiting strategies include the use of tyrosine kinase inhibitors (sunitinib, axitinib, pazopanib, and sorafenib) and neutralizing antibodies such as bevacizumab. Hypertension (HTN) is one of the most common adverse effects of angiogenesis inhibitors. HTN observed in clinical trials appears to correlate with the potency of VEGF kinase inhibitor against VEGFR-2: agents with higher potency are associated with a higher incidence of HTN. Although the exact mechanism by tyrosine kinase inhibitors induce HTN has not yet been completely clarified, two key hypotheses have been postulated. First, some studies have pointed to a VEGF inhibitors-induced decrease in nitric oxide synthase (NOS) and nitric oxide (NO) production, that can result in vasoconstriction and increased blood pressure. VEGF, mediated by PI3K/Akt and MAPK pathway, upregulates the endothelial nitric oxide synthase enzyme leading to up-regulation of NO production. So inhibition of signaling through the VEGF pathway would lead to a decrease in NO production, resulting in an increase in vascular resistance and blood pressure. Secondly a decrease in the number of microvascular endothelial cells and subsequent depletion of normal microvessel density (rarefaction) occurs upon VEGF signaling inhibition. NO donors could be successfully used not only for the treatment of developed angiogenesis-inhibitor-induced hypertension but also for preventive effects.
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Antihipertensivos/uso terapéutico , Antineoplásicos/efectos adversos , Hipertensión/tratamiento farmacológico , Indoles/efectos adversos , Donantes de Óxido Nítrico/uso terapéutico , Pirroles/efectos adversos , Animales , Antihipertensivos/farmacología , Antineoplásicos/uso terapéutico , Humanos , Hipertensión/inducido químicamente , Indoles/uso terapéutico , Donantes de Óxido Nítrico/farmacología , Pirroles/uso terapéutico , Transducción de Señal , Sunitinib , Factor A de Crecimiento Endotelial Vascular/fisiologíaRESUMEN
INTRODUCTION: Ecuador is a country with limited nutritional information, with exception of some general studies supported by Food Agriculture Organization (FAO). AIMS: To carry out a nutritional assessment of the Ecuadorian diet and determine the percentage of contribution to the intake of different nutrients according to the order of the meal (breakfast, morning snack, lunch, afternoon snack, and dinner snack) and Dietary Reference Intake (DRI). METHODS: For that purpose a pilot survey based on 24-h food recall method was carried out in three specific regions in Ecuador and collected information was processed, analyzed statistically and compared with DRIs established for Latin-American population. RESULTS: The study found significant differences for energy and certain vitamins in men and women in addition to determining that the highest energy contribution was obtained in lunch, followed by the afternoon snack and breakfast. Intermediate meals (morning snack, afternoon snack and dinner snack) contributed significantly less in the daily diet in comparison with other types of meal. Furthermore, it was observed that analyzed intakes did not meet the DRI for Carbohydrates, some vitamins (Thiamin, Pantothenic, Biotin, Folate Vitamin D and Vitamin E) and minerals (Ca, K, Cu, Mn, I and Fe). The Na intakes were quite above the DRI and Tolerable Upper Limit given by USDA, indicating a Public Health problem in relation with this electrolyte. CONCLUSIONS: The present pilot survey can be considered as a starting point to get insight into the Ecuadorian diet. This will allow to determine consumption patterns affecting population welfare and to evidence attendant positive and adverse effects.
Objetivos: Realizar una evaluación nutricional de la dieta ecuatoriana y determinar el porcentaje de contribución de la ingesta de diferentes nutrientes en función del tipo de comida (desayuno, almuerzo, comida, merienda, y cena) y de la Referencia de Ingesta Dietética (RID). Métodos: Se realizó una encuesta piloto basada en el método del recordatorio de alimentación de 24 h en tres regiones concretas de Ecuador y se procesó la información recogida, se analizó y se comparó con las RID establecidas para la población latinoamericana. Resultados: El estudio encontró diferencias significativas para energía y ciertas vitaminas en hombres y en mujeres, además de determinar que la mayor contribución energética se obtenía en la comida, seguida de la merienda y el desayuno. Las comidas intermedias (almuerzo, merienda y cena) contribuían de una manera significativamente menor en la dieta diaria en comparación con otros tipos de comidas. Además, se observó que las ingestas analizadas no alcanzaban las RID para hidratos de carbono, algunas vitaminas (tiamina, ácido pantoténico, biotina, folato, vitamina D y vitamina E) y minerales (Ca, K, Cu, Mn, I y Fe). La ingesta de NA estaba bastante por encima de las RID y el Límite Superior Tolerable proporcionado por la USDA, lo que indica un problema de salud pública en relación con este electrolito. Conclusiones: Esta encuesta piloto puede considerarse como un punto de partida para obtener una visión más profunda de la dieta ecuatoriana. Esto permitirá determinar los patrones de consumo que afectan al bienestar de la población y establecer efectos positivos y efectos adversos del patrón de consumo en Ecuador.
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Registros de Dieta , Dieta , Valor Nutritivo , Encuestas y Cuestionarios , Adulto , Ecuador , Femenino , Humanos , Masculino , Recuerdo Mental , Persona de Mediana Edad , Proyectos Piloto , Registros , Factores de Tiempo , Adulto JovenRESUMEN
Ongoing intensification and specialisation of livestock production lead to increasing volumes of manure to be managed, which are a source of the greenhouse gases (GHGs) methane (CH4) and nitrous oxide (N2O). Net emissions of CH4 and N2O result from a multitude of microbial activities in the manure environment. Their relative importance depends not only on manure composition and local management practices with respect to treatment, storage and field application, but also on ambient climatic conditions. The diversity of livestock production systems, and their associated manure management, is discussed on the basis of four regional cases (Sub-Saharan Africa, Southeast Asia, China and Europe) with increasing levels of intensification and priorities with respect to nutrient management and environmental regulation. GHG mitigation options for production systems based on solid and liquid manure management are then presented, and potentials for positive and negative interactions between pollutants, and between management practices, are discussed. The diversity of manure properties and environmental conditions necessitate a modelling approach for improving estimates of GHG emissions, and for predicting effects of management changes for GHG mitigation, and requirements for such a model are discussed. Finally, we briefly discuss drivers for, and barriers against, introduction of GHG mitigation measures for livestock production. There is no conflict between efforts to improve food and feed production, and efforts to reduce GHG emissions from manure management. Growth in livestock populations are projected to occur mainly in intensive production systems where, for this and other reasons, the largest potentials for GHG mitigation may be found.
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Contaminantes Atmosféricos/metabolismo , Contaminación del Aire/prevención & control , Crianza de Animales Domésticos/métodos , Gases/metabolismo , Efecto Invernadero , Estiércol , África del Sur del Sahara , Animales , Asia , Europa (Continente)RESUMEN
BACKGROUND: The TMPRSS2-ERG gene fusion resulting in ERG overexpression has been found in around 50% of prostate cancers (PCa) and is a very early event in tumorigenesis. Most studies have reported on selected surgical cohorts with inconsistent results. We hypothesized that ERG gene rearrangements impact tumor development and investigated the frequency of ERG overexpression in the context of clinicopathological tumor characteristics. METHODS: ERG overexpression (ERG+ or ERG-) was determined by immunohistochemistry (IHC) in 1039 radical prostatectomy (RP) tumors and association with PSA, D'Amico risk score, histopathology, biochemical recurrence, body mass index and age of PCa cases was analyzed. RESULTS: ERG+ was associated with younger age at diagnosis (P<0.0001), lower serum PSA (P=0.002) and lower prostate volume (PV) (P=0.001). It was most frequent in the youngest age quartile (≤55 years, 63.9% ERG+) and decreased constantly with increasing age to 40.8% in the oldest age quartile (≥67 years, P<0.0001). In the PSA range <4 ng ml(-1) the frequency of ERG positivity was 60.2% compared with 47.5 and 49.1% in the PSA ranges 4-10 and ≥10 ng ml(-1), respectively. In the first age quartile, ERG+ patients had lower median serum PSA and fPSA% and smaller PV. In the highest age quartile tumor volume (TV) was increased. Similar differences were observed in the low PSA range. Multivariate analysis identified the first age quartile as a predictor for ERG status (odds ratios (OR) 2.05, P=0.007). No association was found with the D'Amico progression risk score and with biochemical tumor recurrence. CONCLUSIONS: ERG+ tumors manifest clinically at lower PSA levels and their prevalence is age dependent. This suggests acceleration of tumor development by ERG overexpression that results in earlier tumor detection in young patients. Long-term results are warranted to determine the impact of ERG overexpression on disease outcome.
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Neoplasias de la Próstata/genética , Transactivadores/genética , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Detección Precoz del Cáncer , Expresión Génica , Humanos , Calicreínas/sangre , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Proteínas de Fusión Oncogénica/biosíntesis , Proteínas de Fusión Oncogénica/genética , Modelos de Riesgos Proporcionales , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/metabolismo , Sensibilidad y Especificidad , Transactivadores/biosíntesis , Regulador Transcripcional ERG , Translocación GenéticaRESUMEN
Introducción: La gravedad, las implicancias neurológicas y el alto costo del tratamiento de la fractura cervical, hacen de esta lesión un tema de suma importancia. Esta injuria provoca graves limitaciones e invalidez a los afectados, en su mayoría en plena actividad laboral, impactando en lo médico, social y económico. Objetivos: Describir los pacientes tratados quirúrgicamente de fractura cervical traumática en el Hospital Regional Rancagua, por el equipo de Neurocirugía dentro de un periodo de 4 años. Materiales y Métodos: Se evaluó - 24 pacientes con antecedente de fractura cervical el mecanismo del trauma, el tiempo transcurrido desde el ingreso hospitalario hasta la cirugía, nivel y compromiso de la lesión medular, tipo de abordaje quirúrgico, complicaciones médicas, quirúrgicas y seguimiento post-operatorio, entre otros. Resultados: 5 mujeres y 19 hombres, edad promedio 39 años (rango de edad 14 a 75 años), principales mecanismos de trauma fueron los accidentes automovilísticos-atropello (58 por ciento). El nivel medular más frecuentemente lesionado fue C4-C5 (25 por ciento). En el 50 por ciento de los pacientes se clasificó de entrada como Frankel A, por lo que un 50 por ciento de todos los pacientes ingresaron tetrapléjicos, y de estos, un 33 por ciento egresó tetraparéticos. Del ingreso a cirugía hubo un tiempo de espera promedio 5 días. Dentro de las complicaciones médicas la causa respiratoria (46 por ciento) fue la más frecuente, necesitando 64 por ciento de estos pacientes ventilación mecánica. Se registró 1 infección de herida operatoria donde el abordaje fue posterior. El Índice de Barthel promedio de 14 pacientes fue de 49 puntos. De 6 pacientes con puntaje Cero, 85 por ciento de estos ingresaron como Frankel A y 50 por ciento egresaron tetrapléjicos. Los pacientes se rehabilitaron en promedio de 2.5 meses. Discusión: Logramos objetivar nuestra realidad. La técnica quirúrgica fue prácticamente uniforme entre los pacientes, sin complicaciones...
Introduction: Gravity, neurological implications and high costs of treating cervical fracture, makes of this injury an issue of most importance. This injury causes severe limitations and disability to those affected, mostly in full working activity, impacting on the medical, social and economic. Objectives: To describe patients surgically treated for traumatic cervical fracture at the Rancagua Regional Hospital, by the team of Neurosurgery Department, within a period of 4 years. Materials and Methods: We evaluated 24 patients with an history of cervical fracture mechanism of trauma, the time from hospital admission to surgery, and commitment level of spinal cord injury, type of surgery, medical and surgical complications and follow-up post -operation, among others. Results: 5 women and 19 men, average age 39 years (ranging age from 14 to 75 years), major trauma mechanisms were motor vehicle accidents (58 percent). The most frequently injured spinal level was C4-C5 (25 percent). 50 percent of patients were classified as Frankel A at the admission, so that 50 percent of all patients admitted were quadriplegics, and of these, 33 percent were discharged as tetraparétic. Admission to the surgery were an average of 5 days. Within cause respiratory medical complications (46 percent) was the most frequent, requiring 64 percent of these patients mechanical ventilation. There was only 1 wound infection where the approach was posterior. The average Barthel Index of 14 patients was 49 points. In 6 patients with zero score, 85 percent were admitted as Frankel A and 50 percent egressed as tetraplejic. Patients were rehabilitated an average of 2.5 months. Conclusions: We were able to objectify our reality. The surgical technique was nearly uniform among patients without severe postoperative surgical complications...
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Humanos , Adolescente , Adulto , Adulto Joven , Persona de Mediana Edad , Accidentes por Caídas , Accidentes , Accidentes de Tránsito , Agresión , Traumatismos del Cuello/cirugía , Traumatismos del Cuello/complicaciones , Traumatismos del Cuello/epidemiología , Traumatismos del Cuello/etiología , Traumatismos del Cuello/mortalidad , Agua , Chile , Estudios RetrospectivosRESUMEN
AIM: To evaluate the diagnostic value of interleukin-6 (IL-6) to predict the likelihood of neonatal sepsis in order to design an algorithm to decide antibiotic therapy. METHODS: IL-6 and C-reactive protein (CRP) were determined in 42 newborns with clinical suspicion of infection. Newborns were classified as a confirmed, probable or no infection, based on the results of cultures, chest X-rays and the involvement of four or more clinical areas on a scale of eight. Samples for IL-6 were collected in the initial assessment and frozen until its determination at the end of the study. Blinded IL-6 measurements were performed using a rapid test. Receiver operator characteristics curves (ROC) for CRP and IL-6 versus infection (confirmed or probable) were determined. RESULTS: Among the 42 cases included in the study 11 (26.2%) were classified as confirmed or probable infection. The area under curve (AUC) for IL-6 was 0.9, with a cut-off value of 53 pg/ml: sensitivity 90.91%, specificity 80%, positive predictive value (PPV) 62.5% and negative (NPV) 96% The level of IL-6>96 pg/ml and/or the combination of IL-6>53+CRP>13.3 mg/l, were the markers that best predicted infection: specificity 100% and PPV: 100%. CONCLUSIONS: Assessment of IL-6 could allow withholding or early discontinuation of antibiotics in newborns with IL-6<54 pg/ml. In cases with IL-6>96 pg/ml and/or IL-6>53+ CRP>13.3, antibiotics should be started promptly, given the high likelihood of infection. Implementation of an algorithm based on the determination of IL-6 and CRP, in the initial assessment of the newborn with clinical suspicion of infection, could reduce unnecessary antibiotic therapy.
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Proteína C-Reactiva/análisis , Interleucina-6/sangre , Sepsis/sangre , Sepsis/diagnóstico , Algoritmos , Pruebas Hematológicas , Humanos , Recién Nacido , Infecciones/sangre , Infecciones/diagnóstico , Valor Predictivo de las Pruebas , Factores de TiempoRESUMEN
In recent years, the scientific community has provided many tools to assist with pathway analysis. Some of these programs can be used to manage functional annotation of gene products, others are oriented to exploring and analyzing data sets and many allow both possibilities. Potential users of these tools are faced with the necessity to decide which of the existing programs are the most appropriate for their needs. SerbGO is a user-friendly web tool created to facilitate this task. It can be used (i) to search for specific functionalities and determine which applications provide them and (ii) to compare several applications on the basis of different types of functionalities. Iterating and combining both functionalities can easily lead to selecting an appropriate tool. Data required by SerbGO is either the desired capabilities within a defined Standard Functionalities Set or the list of the tools to be compared. The analysis performed carries out a cross-classification that produces an easily readable output with the list of tools that implement the capabilities demanded or a table with the categorization of the GO tools that one wishes to compare. SerbGO is freely available and does not require a login. It can be accessed either directly at our server (http://estbioinfo.stat.ub.es/apli/serbgo) or at the GO Consortium website (http://www.geneontology.org/GO.tools.microarray.shtml#serbgo).
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Bases de Datos Genéticas , Genes , Programas Informáticos , Perfilación de la Expresión Génica , Internet , Interfaz Usuario-Computador , Vocabulario ControladoRESUMEN
Dutch regulations for ammonia emission require farmers to inject slurry into the soil (shallow) or to apply it in narrow bands at the surface. For one commercial dairy farm in the Netherlands it was hypothesized that its alternative farming strategy, including low-protein feeding and surface spreading, could be an equally effective tool for ammonia emission abatement. The overall objective of the research was to investigate how management at this farm is related to nitrogen (N) losses to the environment, including groundwater and surface water. Gaseous emission of ammonia and greenhouse gasses from the naturally ventilated stables were 8.1 and 3.1 kg yr(-1) AU(-1) on average using the internal tracer (SF(6))-ratio method. Measurements on volatilization of ammonia from slurry application to the field using an integrated horizontal flux method and the micrometeorological mass balance method yielded relatively low values of ammonia emissions per ha (3.5-10.9 kg NH(3)-N ha(-1)). The mean nitrate concentration in the upper ground water was 6.7 mg L(-1) for 2004 and 3.0 mg L(-1) for 2005, and the half-year summer means of N in surface water were 2.3 mg N L(-1) and 3.4 mg N L(-1) for 2004 and 2005, respectively. Using a nutrient budget model for this farm, partly based on these findings, it was found that the calculated ammonia loss per ton milk (range 5.3-7.5 kg N Mg(-1)) is comparable with the estimated ammonia loss of a conventional farm that applies animal slurry using prescribed technologies.
Asunto(s)
Contaminantes Atmosféricos/análisis , Amoníaco/análisis , Crianza de Animales Domésticos , Industria Lechera , Estiércol , Animales , Bovinos , Ambiente , Contaminación Ambiental/prevención & control , Femenino , Vivienda para Animales , Masculino , Estiércol/análisis , Metano/análisis , Nitratos/análisis , Nitritos/análisis , Nitrógeno/análisis , Óxido Nitroso/análisis , Fosfatos/análisis , Fósforo/análisis , Compuestos de Amonio Cuaternario/análisis , Ovinos , Contaminantes Químicos del Agua/análisis , Abastecimiento de Agua/análisisRESUMEN
This study evaluated the levels of soluble interleukin-2 receptor (sIL-2R) and soluble intercellular adhesion molecule-1 (sICAM-1) in patients with dengue. Sera from 17 patients with dengue fever (DF), 15 with dengue hemorrhagic fever (DHF) and 12 healthy individuals were obtained. Increased levels of sIL-2R and sICAM-1 were found in patients with DF and DHF when compared to normal; those were not correlated with leukocytes, hepatic serum enzyme levels or haemostatic parameters. Levels of sIL-2R were related to the different grades of DHF. These results suggest that increased levels of sIL-2R and sICAM-1 are a common feature of dengue.
Asunto(s)
Molécula 1 de Adhesión Intercelular/sangre , Receptores de Interleucina-2/sangre , Dengue Grave/sangre , Dengue Grave/inmunología , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , Humanos , Lactante , Molécula 1 de Adhesión Intercelular/análisis , Persona de Mediana Edad , Receptores de Interleucina-2/análisisRESUMEN
A new succulenticolous Myxomycete species, Didymium wildpretii, found on decaying remains of various species of cacti, is described from two arid zones of the world. This species was collected from central Mexico, at the southern limit of the Chihuahuan Desert, and from the Canary Islands (Spain). The new species has small, pale yellow sporocarps, 0.1-0.7 mm high, that are sessile or have short, orange-yellow, calcareous stalks and small, uniformly warted spores. The stability of the taxonomic characters of the species was confirmed with both moist chamber cultures and spore-to-spore culture on agar. Life cycle events are described from germination to sporulation. Myxomycete specimens were examined with scanning electron microscopy and light microscopy, and micrographs of relevant morphological details are included.