Influence of the ambient color lighting on the accuracy of complete arch implant scans recorded by using two intraoral scanners.

STATEMENT OF PROBLEM: The influence of different ambient factors including lighting has been previously studied. However, the influence of ambient color lighting settings on intraoral scanning accuracy remains uncertain. PURPOSE: The purpose of this in vitro study was to assess the influence of ambient color lighting on the accuracy of complete arch implant scans recorded by using 2 intraoral scanners (IOSs). MATERIAL AND METHODS: An edentulous maxillary cast with 6 implant scan bodies was digitized by using a laboratory scanner (DW-7-140) to obtain a reference file. Two groups were created based on the IOS tested: TRIOS 4 (IOS-1) and i700 (IOS-2). Seven subgroups were developed depending on the ambient color lighting (red, green, blue, yellow, cyan, magenta, and white) (n=15). Scanning accuracy was analyzed by using a metrology software program (Geomagic Control X). The Kruskal-Wallis, 1-way ANOVA, and pairwise comparisons were used to analyze the data (α=.05). RESULTS: Significant trueness and precision values were found across the groups (P<.05) and subgroups (P<.05). For IOS-1, blue ambient lighting obtained the best trueness (19.8 ±1.8 µm) (P<.05); in precision, white light (20.8 ±7.3 µm) and blue light (22.1 ±13.5) showed the best results (P<.05). For IOS-2, white light showed the best trueness (51.9 ±16.7 µm); the best precision was obtained under magenta (38.6 ±10.4 µm) and yellow light (52.6 ±24.0 µm) (P<.05). CONCLUSIONS: The optimal ambient color lighting varied between the IOSs assessed. As the best condition for maximizing accuracy was not found, ambient color lighting must be individualized for the IOS system used.

Impact of color temperature and illuminance of ambient light conditions on the accuracy of complete-arch digital implant scans.

OBJECTIVE: The purpose of the present study was to assess the influence of color temperature and illuminance of ambient light on the accuracy of different intraoral scanners (IOSs) in complete-arch implant scans. METHODS: An edentulous model with six implants and scan bodies was digitized by using a laboratory scanner (DW-7-140; Dental Wings) to obtain a reference mesh. Fifteen scans were performed employing two intraoral scanners (Trios 4;3Shape A/S and i700; Medit Co) at two illuminances (500 and 1000 lux) and three color temperatures (3200, 4400, and 5600 K). Scanning accuracy was measured by using a 3D metrology software program (Geomagic Control X). Kruskal-Wallis, one-way ANOVA, and pairwise comparison tests were used to analyze the data (α = .05). RESULTS: Significant differences in trueness and precision values were found among the different IOSs under the same ambient lighting condition and among the different lighting conditions for a given IOS (p < .05) except for trueness in i700 groups (p > .05). CONCLUSIONS: The influence on the accuracy of color temperature and illuminance varied depending on the intraoral scanner. An optimal ambient scanning light condition was not found; this should be adjusted based on the specific IOS system used. 3200 K of ambient light influences the precision of i700 when performed at 1000 lux, decreasing the accuracy. The variation of color temperature at the same illuminance does not affect the scanning accuracy of TRIOS 4, which obtained better accuracy in all scans at 1000 lux.

Tana, a Healthcare Chatbot to Help Patients During the COVID-19 Pandemic at a University Hospital in Argentina.

A Chatbot or Conversational Agent is a computer application that simulates the conversation with a human person (by text or voice), giving automated responses to people's needs. In the healthcare domain, chatbots can be beneficial to help patients, as a complement to care by health personnel, especially in times of high demand or constrained resources such as the COVID-19 Pandemic. In this paper we share the design and implementation of a healthcare chatbot called Tana at the Hospital Italiano de Buenos Aires. Considering best practices and being aware of possible unintended consequences, we must take advantage of information and communication technologies, such as chatbots, to analyze and promote useful conversations for the health of all people.

Influence of ambient light conditions on the accuracy and scanning time of seven intraoral scanners in complete-arch implant scans.

PURPOSE: The purpose of this in vitro study was to evaluate the effect of ambient light illuminance on the accuracy and scanning time of different intraoral scanners (IOSs) in complete-arch implant scans. MATERIAL AND METHODS: Seven IOSs (TRIOS 3, Primescan, Element 5D, i700, i500, CS3700, and CS3600) at 5 ambient lighting illuminances (100, 500, 1000, 5000, and 10 000 lux) were evaluated. An edentulous cast with 4 implants was selected as the master model. An implant scan body was tightened on each implant. The cast was digitized by using a laboratory scanner to obtain a reference standard tessellation language (STL) file, and 50 scans (10 per ambient light condition) were recorded with each IOS. Scanning time was recorded by using a digital chronograph. Intraoral scan deviations were calculated by using a 3D metrology software program (Geomagic Control X). Kruskal-Wallis and pairwise comparison tests were used to analyze the data (α=0.05). RESULTS: The trueness and precision values obtained for each IOS tested were significantly different under the varying lighting conditions assessed. TRIOS 3 (34.0 ± 3.3 µm trueness; 24.5 ± 14.9 µm precision), Element 5D (34.5 ± 7.1 µm trueness; 25.9 ± 7.6 µm precision), and CS3700 (34.9. ±13.0 µm trueness; 34.6 ± 19.2 µm precision) performed better under 100 lux illumination, CS3600 (69.5 ± 24.0 µm trueness; 36.6 ± 20.1 µm precision) at 500 lux; i500 (36.2 ± 5.1 µm trueness; 21.4 ± 6.8 µm precision) at 1000 lux; i700 (34.8 ± 2.2 µm trueness; 15.4 ± 5.0 µm precision) at 5000 lux, and Primescan (37.4 ± 37.3 µm trueness; 26.2 ± 26.2 µm precision) at 10,000 lux. Additionally, the scanning time was different under different illuminance for each IOS. The fastest IOS in all light conditions was Primescan, with significant differences with all the groups (P<.01), followed by TRIOS 3 in all groups except under 100 lux illumination, where i700 was the second fastest. CONCLUSIONS: Ambient light influenced the accuracy and scanning time of IOSs assessed; however, the effect was not the same for all devices. It is necessary to optimize ambient light illuminance for each IOS to maximize scanning accuracy.

Molecular and physiological analysis of indole-3-acetic acid degradation in Bradyrhizobium japonicum E109.

Bradyrhizobium japonicum E109 is a bacterium widely used for inoculants production in Argentina. It is known for its ability to produce several phytohormones and degrade indole-3-acetic acid (IAA). The genome sequence of B. japonicum E109 was recently analyzed and it showed the presence of genes related to the synthesis of IAA by indole-3-acetonitrile, indole-3-acetamide and tryptamine pathways. Nevertheless, B. japonicum E109 is not able to produce IAA and instead has the ability to degrade this hormone under saprophytic culture conditions. This work aimed to study the molecular and physiological features of IAA degradation and identify the genes responsible of this activity. In B. japonicum E109 we identified two sequences coding for a putative 3-phenylpropionate dioxygenase (subunits α and ß) responsible for the IAA degradation that were homologous to the canonical cluster of iacC and iacD of Pseudomonas putida 1290. These genes form a separate cluster together with three additional genes with unknown functions. The degradation activity was found to be constitutively expressed in B. japonicum E109. As products of IAA degradation, we identified two compounds, 3-indoleacetic acid 2,3-oxide and 2-(2-hydroperoxy-3-hydroxyindolin-3-yl) acetic acid. Our report proposes, for the first time, a model for IAA degradation in Bradyrhizobium.

What Do We Know About the Publications Related with Azospirillum? A Metadata Analysis.

Azospirillum is one of the most successful plant growth-promoting bacteria (PGPB) genera and it is considered a study model for plant-bacteria interactions. Because of that, a wide broad of topics has been boarded and discussed in a significant number of publications in the last four decades. Using the Scopus® database, we conducted a bibliographic search in order to analyze the number and type of publications, the authors responsible of these contributions, and the origin of the researchers, as well as the keywords and journals selected by the authors, among other related characteristics, with the aim to understand some less addressed details about the work done with Azospirillum worldwide since its discovery in 1925. Despite that the largest numbers of publications about this bacterium were obtained between the 1970 and 1980s, there is still a linear increase tendency in the number of published works. Understanding the mechanisms involved in the ability of these bacteria to promote growth in a wide broad of plant species under both laboratory and field conditions has been a preferential target for these published articles. This tendency could be considered a cause or consequence of the current increase in the number of commercial products formulated with Azospirillum around the world and a catalyzer for the increase of published articles along time.

Correction to: Evaluation of growth and motility in non-photosynthetic Azospirillum brasilense exposed to red, blue, and white light.

In the original article, last name and first names of all the authors are inverted. The correct names should appears as "Romina Molina, Gastón López, Belén Rodríguez, Susana Rosas, Verónica Mora, Fabricio Cassán".

Desarrollo de marcadores moleculares del tipo SCAR para la identificación de Azospirillum brasilense Az39 / Development of sequence characterized amplified región markers for identification of Azospirillum brasilense Az39

Resumen Azospirillum brasilense Az39 es utilizada por empresas productoras de inoculantespara la formulación de bioinsumos en América del Sur desde hace más de 30 a˜nos. Esta cepapuede promover el crecimiento, desarrollo, así como la capacidad de tolerar diferentes tiposde estrés en las plantas inoculadas, lo que determina un aumento de la productividad de culti-vos de interés agronómico. En la actualidad, no existen protocolos en Argentina que permitanconfirmar la identidad de Az39 en productos comerciales a nivel de laboratorios de control decalidad de inoculantes. Por ello, el objetivo de este trabajo fue desarrollar una metodología enbase molecular que permita la identificación certera de A. brasilense Az39. Con la secuenciacompleta del genoma y mediante herramientas bioinformáticas, se pudieron reconocer frag-mentos de ADN presentes únicamente en el genoma de Az39. Se dise˜naron cebadores dirigidosa amplificar por PCR dichas secuencias. Como resultado se observaron los productos específicosúnicamente en la presencia de la cepa de interés. La reacción pudo detectar un título mínimode 105UFC/ml (4,5 ng/l ADN) o de 102UFC/ml (0,88 ng/l ADN) o una concentración mínimade 0,098 ng/l ADN, dependiendo del método de extracción utilizado. Los cebadores fueronevaluados en el análisis de productos comerciales obtenidos del mercado nacional, arrojandoresultados positivos, tanto en muestras directas como así también en pruebas confirmatoriasa partir de colonias aisladas de tales productos. La metodología desarrollada en este trabajo,permite la detección certera de A. brasilense Az39 en cultivos puros o mezclas complejas demicroorganismos.

Abstract Azospirillum brasilense Az39 has been used since more than 30 years by several companies in South America for biofertilizers production. This strain may promote plants growth and development, as well as the ability of inoculated plants to tolerate environmental stresses, which determines an increase in the productivity under field conditions. At present, there are no protocols in Argentina to confirm the identity of Az39 in commercial products; however, such biofertilizers are formulated almost exclusively with this strain. Therefore, the objective of this paper was to develop a molecular methodology that allows the accurate identification of A. brasilense Az39. Using the complete genome sequence and several bioinformatics tools, fragments of DNA present only in the Az39 genome were recognized. A set of PCR primers to amplify these sequences were designed, and the specific products were observed only in the strain of our interest. The sensitivity of the methodology was evaluated, where the strain could be detected up to a titer of 105 CFU/ml (4.5 ng/pl ADN) or 102 CFU/ml (0.88 ng/pl DNA) or in a minimal concentration of 0.098 ng/pl DNA, depending on the DNA extraction methodology used. Primers were tested against direct samples of commercial inoculants and cultures, in both cases there were specifics products, both in direct samples and in confirmatory tests from isolated colonies from those products. The procedure presented in this paper allows the accurate identification of A. brasilense Az39 in pure cultures, mixtures of microorganisms, and commercial biofertilizers.

[Development of sequence characterized amplified region markers for identification of Azospirillum brasilense Az39]. / Desarrollo de marcadores moleculares del tipo SCAR para la identificación de Azospirillum brasilense Az39.

Azospirillum brasilense Az39 has been used since more than 30 years by several companies in South America for biofertilizers production. This strain may promote plants growth and development, as well as the ability of inoculated plants to tolerate environmental stresses, which determines an increase in the productivity under field conditions. At present, there are no protocols in Argentina to confirm the identity of Az39 in commercial products; however, such biofertilizers are formulated almost exclusively with this strain. Therefore, the objective of this paper was to develop a molecular methodology that allows the accurate identification of A. brasilense Az39. Using the complete genome sequence and several bioinformatics tools, fragments of DNA present only in the Az39 genome were recognized. A set of PCR primers to amplify these sequences were designed, and the specific products were observed only in the strain of our interest. The sensitivity of the methodology was evaluated, where the strain could be detected up to a titer of 105 CFU/ml (4.5 ng/µl ADN) or 102 CFU/ml (0.88 ng/µl DNA) or in a minimal concentration of 0.098 ng/µl DNA, depending on the DNA extraction methodology used. Primers were tested against direct samples of commercial inoculants and cultures, in both cases there were specifics products, both in direct samples and in confirmatory tests from isolated colonies from those products. The procedure presented in this paper allows the accurate identification of A. brasilense Az39 in pure cultures, mixtures of microorganisms, and commercial biofertilizers.

Design and Implementation of a Tool for Pharmacists to Register Potential Errors in Prescribed Medication.

Adverse drug events are frequent and may be mitigated with the implementation of functionalities within Health Information Systems. We developed a tool that allows Pharmacists to register and communicate to providers potential errors in prescribed drugs in terms of medication omission, unjustified stop of medication or other reasons. We included all interventions performed by Pharmacists for admitted patients between July, 31st 2018 and October, 23rd 2018. During the study period, 193 interventions were carried out by Pharmacists. 117 (60%) were intended for registering medication omission, 7 (4%) for unjustified stop of medication and 69 (36%) for other reasons. 112 interventions lead to the provider performing the suggested action (58%), 77 (40%) were rejected and 4 (2%) required no action. Although there were errors in the use of the tool, a great amount of interventions were accepted, thus representing a better quality of care for patients.

Telemedicine for Upper Respiratory Tract Infections During 2018 Epidemiological Outbreak in South America.

Telemedicine is an increasingly used strategy for providing care to patients. The prevention and treatment of Upper Respiratory Tract Infections (URTIs) during outbreaks still require new management approaches. We aimed to describe patients' characteristics and the care process after the creation and implementation of a virtual care program for patients with URTI during the epidemiological outbreak. We studied all consultations that took place between May, 21st, and September, 14th 2018 at Hospital Italiano de Buenos Aires (HIBA). After applying exclusion criteria 218 consultations were left for the analysis. Most patients did not need a referral to a care center for a face-to-face assessment. The consultation rate to the Emergency Department (ED) within 7 days was 11.92% (26/218) with a 95% CI of 7.94-16.99%. This new approach in patient care has a great potential for relieving the overcrowding in EDs, decreasing waiting times and preventing the infection spread in waiting rooms.

Regulation of IAA Biosynthesis in Azospirillum brasilense Under Environmental Stress Conditions.

Indole-3-acetic acid (IAA) is one of the most important molecules produced by Azospirillum sp., given that it affects plant growth and development. Azospirillum brasilense strains Sp245 and Az39 (pFAJ64) were pre-incubated in MMAB medium plus 100 mg/mL L-tryptophan and treated with or exposed to the following (a) abiotic and (b) biotic stress effectors: (a) 100 mM NaCl or Na2SO4, 4.0% (w/v) PEG6000, 0.5 mM H2O2, 0.1 mM abscisic acid, 0.1 mM 1-aminocyclopropane 1-carboxylic acid, 45 °C or daylight, and (b) 4.0% (v/v) filtered supernatant of Pseudomonas savastanoi (Ps) or Fusarium oxysporum (Fo), 0.1 mM salicylic acid (SA), 0.1 mM methyl jasmonic acid (MeJA), and 0.01% (w/v) chitosan (CH). After 30 and 120 min of incubation, biomass production, cell viability, IAA concentration (µg/mL), and ipdC gene expression were measured. Our results show that IAA production increases with daylight or in the presence of PEG6000, ABA, SA, CH, and Fo. On the contrary, exposure to 45 °C or treatment with H2O2, NaCl, Na2SO4, ACC, MeJA, and Ps decrease IAA biosynthesis. In this report, growth and IAA biosynthesis in A. brasilense under biotic and abiotic stress conditions are discussed from the point of view of their role in bacterial lifestyle and their potential application as bioproducts.

User-Centered Design Practices to Redesign a Nursing e-Chart in Line with the Nursing Process.

Regarding the user-centered design (UCD) practices carried out at Hospital Italiano of Buenos Aires, nursing e-chart user interface was redesigned in order to improve records' quality of nursing process based on an adapted Virginia Henderson theoretical model and patient safety standards to fulfil Joint Commission accreditation requirements. UCD practices were applied as standardized and recommended for electronic medical records usability evaluation. Implementation of these practices yielded a series of prototypes in 5 iterative cycles of incremental improvements to achieve goals of usability which were used and perceived as satisfactory by general care nurses. Nurses' involvement allowed balance between their needs and institution requirements.

Release of outer membrane vesicles in Pseudomonas putida as a response to stress caused by cationic surfactants.

Pseudomonas putida A (ATCC 12633), a degrader of cationic surfactants, releases outer membrane vesicles (OMVs) when grown with tetradecyltrimethylammonium bromide (TTAB) as the sole carbon, nitrogen and energy source. The OMVs exhibit a bilayer structure and were found to be composed of lipopolysaccharides, proteins and phospholipids (PLs) such as cardiolipin, phosphatidylcholine, phosphatidic acid and phosphatidylglycerol (PG). The OMVs showed a marked increase in the PG content, approximately 43 % higher than the amount registered in the parent cells from which the vesicles were derived. After growth of P. putida with TTAB, the amount of lipoprotein covalently cross-linked to the peptidoglycan showed a twofold decrease when compared with values found after growth without the surfactant [16 ± 2 and 28 ± 3 µg (mg cell envelope protein)- 1, respectively]. This decrease in the amount of lipoprotein can be related to areas of loss of contact between the outer membrane and the peptidoglycan and, therefore, to OMV production. In addition, due to its amphiphilic nature, TTAB can contribute to OMV biogenesis, through a physical mechanism, by induction of the curvature of the membrane. Taking into account that OVMs were produced when the cells were grown under external stress, caused by the surfactant, and that TTAB was detected in the vesicles [48 nmol TTAB (nmol PL)- 1], we concluded that this system of TTAB elimination is a mechanism that P. putida A (ATCC 12633) would utilize for alleviating stress caused by cationic surfactants.

Multimedia Health Records: user-centered design approach for a multimedia uploading service.

Multimedia elements add value to text documents by transmitting information difficult to express in words. In healthcare, many professional and services keep this elements in their own repositories. This brings the problem of information fragmentation in different silos which hinder its access to other healthcare professionals. On the other hand patients have clinical data of their own in different formats generated in different healthcare organizations which is not accessible to professionals within our healthcare network. This paper describes the design, development and implementation processes of a service which allows media elements to be loaded in a patient clinical data repository (CDR) either through an electronic health record by professionals (EHR) or through a personal health record (PHR) by patients, in order to avoid fragmentation of the information.

Análisis del impacto del aumento del coseguro en un servicio de emergencias

Definimos como coseguro a la participación directa del paciente en un porcentaje del costo de los servicios sanitarios en el momento de utilizarlos. Con el pago del coseguro además de contener el uso de los servicios se puede obtener una financiación adicional para el sistema. Los Servicios de Emergencias tienen como complemento la atención domiciliaria no urgente o consultas. En los cuales el coseguro, se utiliza como método de racionalización del uso del servicio. De esta manera, se busca que sea utilizado de la forma más efectiva posible. Se ha descripto como influencian el copago en la atención primaria pero poco se ha planteado en la atención pre hospitalaria. Por este motivo, debemos valorar si el aumento del coseguro es efectivo para restringir el uso del servicio y si el mismo trae consecuencias sobre la salud de las personas. Se realizó un estudio retrospectivo, de Cohorte longitudinal, donde se recolectaron los datos de la asistencia médica de un Servicio de Emergencias comprendidos entre Setiembre 2011 hasta abril 2013 en la ciudad de Córdoba Capital. Los datos surgidos fueron analizados en dos periodos, los cuales se denominaron: periodo 1 que incluye aquellas consultas con coseguro realizadas desde Septiembre de 2011 a Septiembre de 2012. El período 2, que incluye aquellas consultas con coseguro realizadas entre Septiembre de 2012 a Septiembre de 2013. En este período se realizó un aumento del 100% del coseguro. Todas las prestaciones serán dominadas “auxilios”, y serán clasificados en Grado 1, 2 y 3, dependiendo de su complejidad. Los mismos son registrados desde el Despacho del Servicio de Emergencias Médicas y registrados por el sistema DTM 26 Socorro Medico ®, posteriormente se exportaran los datos a planilla Excel 2010®. comparando los dos períodos mes a mes no se encuentran diferencias significativas en las consultas o Grado 3 (p= 0,19)...

We define as co-insurance to the direct participation of the patient in a percentage of the cost of health services at the time of use. With the payment of the co-insurance in addition to containing the use of the services you can get an additional funding for the system. The Emergency Services have as a complement the home care not urgent or medical consultations. In which the co-insurance, is used as a method of rationalization of the use of the service. In this way, are looking to be used in the most effective way possible. Has been described as influence the copayment in primary care but little has been raised in the attention pre-hospital care. For this reason, we must assess whether the increase in the Co-insurance is effective to restrict the use of the service and if the same brings consequences on the health of the people. A retrospective study was performed of longitudinal cohort, where data were collected from the medical assistance of an Emergency Service between September 2011 to April 2013 in the city of Cordoba Capital. The data were analyzed in two periods, which were termed: period 1 that includes those consultations with coinsurance carried out from September 2011 to September 2012. The period 2 this includes those consultations with coinsurance undertaken between September 2012 to September 2013. In this period was an increase of 100 per cent of the co-insurance. All the benefits shall be dominated "aid", and shall be classified in grade 1, 2 and 3, depending on its complexity. The same are recorded from the Office of the Medical Emergency Service and registered by the DTM 26 Medical Relief ®, subsequently exported data to Excel 2010®. Comparing both periods , month by month, no significant differences are found in the consultations or Grade 3 (p= 0.19)...

Coordinated response of phospholipids and acyl components of membrane lipids in Pseudomonas putida A (ATCC 12633) under stress caused by cationic surfactants.

The present study assessed the role of membrane components of Pseudomonas putida A (ATCC 12633) under chemical stress conditions originated by treatment with tetradecyltrimethylammonium bromide (TTAB), a cationic surfactant. We examined changes in fatty acid composition and in the fluidity of the membranes of cells exposed to TTAB at a specific point of growth as well as of cells growing with TTAB. The addition of 10-50 mg TTAB l(-1) promoted an increase in the saturated/unsaturated fatty acid ratio. By using fluorescence polarization techniques, we found that TTAB exerted a fluidizing effect on P. putida A (ATCC 12633) membranes. However, a complete reversal of induced membrane fluidification was detected after 15 min of incubation with TTAB. Consistently, the proportion of unsaturated fatty acids was lower in TTAB-treated cells as compared with non-treated cells. In the presence of TTAB, the content of phosphatidylglycerol increased (120 %), whilst that of cardiolipin decreased (60 %). Analysis of the fatty acid composition of P. putida A (ATCC 12633) showed that phosphatidylglycerol carried the major proportion of saturated fatty acids (89 %), whilst cardiolipin carried an elevated proportion of unsaturated fatty acids (18 %). The increase in phosphatidylglycerol and consequently in saturated fatty acids, together with a decrease in cardiolipin content, enabled greater membrane resistance, reversing the fluidizing effect of TTAB. Therefore, results obtained in the present study point to changes in the fatty acid profile as an adaptive response of P. putida A (ATCC 12633) cells to stress caused by a cationic surfactant.

The costs of stroke in Spain by aetiology: the CONOCES study protocol.

INTRODUCTION: Patients with stroke associated with non-valvular atrial fibrillation (NVAF) are a specific group, and their disease has a considerable social and economic impact. The primary objective of the CONOCES study, the protocol of which is presented here, is to compare the costs of stroke in NVAF patients to those of patients without NVAF in Spanish stroke units from a societal perspective. MATERIALS AND METHODS: CONOCES is an epidemiological, observational, naturalistic, prospective, multicentre study of the cost of the illness in a sample of patients who have suffered a stroke and were admitted to a Spanish stroke unit. During a 12-month follow-up period, we record sociodemographic and clinical variables, score on the NIH stroke scale, level of disability, degree of functional dependency according to the modified Rankin scale, and use of healthcare resources (hospitalisation at the time of the first episode, readmissions, outpatient rehabilitation, orthotic and/or prosthetic material, medication for secondary prevention, medical check-ups, nursing care and formal social care services). Estimated monthly income, lost work productivity and health-related quality of life measured with the generic EQ-5D questionnaire are also recorded. We also administer a direct interview to the caregiver to determine loss of productivity, informal care, and caregiver burden. RESULTS AND CONCLUSIONS: The CONOCES study will provide more in-depth information about the economic and clinical impact of stroke according to whether or not it is associated with NVAF.

A novel mutation I215V in the PRNP gene associated with Creutzfeldt-Jakob and Alzheimer's diseases in three patients with divergent clinical phenotypes.

Genetic human prion diseases are autosomal dominant disorders associated with different mutations in the PRNP gene that are manifested as distinct clinical phenotypes. Here, we report a new pathogenic missense mutation (c.[643A>G], p.[I215V]) in the PRNP gene associated with three pathologically confirmed cases: two of Creutzfeldt-Jakob disease (CJD) and one of Alzheimer's disease (AD) in two different families from the same geographical region in Spain. This mutation has not been found in any of more than 2,000 control cases studied. It represents a conservative amino acid change, and the same change is observed in the PRNP gene from other species. The two CJD cases were homozygous at codon 129 (M/M), but showed divergent clinical phenotypes with onset at ages 55 and 77 years and illness durations of 15 and 6 months, respectively. The postmortem neuropathological analysis of these cases showed homogeneous features compatible with CJD. Interestingly, the AD case (a brother of one of the CJD cases) was heterozygous at codon 129 (M/V). No familiar history was documented for any of the cases, suggesting a de novo mutation, or a partial, age-dependent penetration of the mutation, perhaps related to codon 129 status. This new mutation extends the list of known pathogenic mutations responsible for genetic CJD, reinforces the clinical heterogeneity of the disease, and advocates for the inclusion of PRNP gene examination in the diagnostic workup of patients with poorly classifiable dementia, even in the absence of family history.

La oliguria y su contexto / Oliguria and its context

La oliguria fue definida con un volumen urinario (VU) <400 ml/día. Los consensos del Grupo ADQI (Acute Dialysis Quality Initiative) a través del RIFLE y el AKIN (Acute Kidney Injury Network), incluyeron el VU en la estratificación de la injuria renal aguda (IjRA) y consideraron que su medición horaria es un marcador sensible del compromiso de la función renal. El tema central es que el VU y la creatininemia son signos de alarma tardíos en la IjRA. En la presente revisión se refieren la utilidad y limitaciones de los mismos así como de los índices bioquímicos urinarios. Se destaca la importancia de los nuevos biomarcadores de injuria que permitirán implementar medidas terapéuticas tempranas que mejoren la elevada morbimortalidad de la IjRA.