Dopamine D2 receptor antagonist counteracts hyperglycemia and insulin resistance in diet-induced obese male mice.

Obesity leads to insulin resistance (IR) and type 2 diabetes. In humans, low levels of the hormone prolactin (PRL) correlate with IR, adipose tissue (AT) dysfunction, and increased prevalence of T2D. In obese rats, PRL treatment promotes insulin sensitivity and reduces visceral AT adipocyte hypertrophy. Here, we tested whether elevating PRL levels with the prokinetic and antipsychotic drug sulpiride, an antagonist of dopamine D2 receptors, improves metabolism in high fat diet (HFD)-induced obese male mice. Sulpiride treatment (30 days) reduced hyperglycemia, IR, and the serum and pancreatic levels of triglycerides in obese mice, reduced visceral and subcutaneous AT adipocyte hypertrophy, normalized markers of visceral AT function (PRL receptor, Glut4, insulin receptor and Hif-1α), and increased glycogen stores in skeletal muscle. However, the effects of sulpiride reducing hyperglycemia were also observed in obese prolactin receptor null mice. We conclude that sulpiride reduces obesity-induced hyperglycemia by mechanisms that are independent of prolactin/prolactin receptor activity. These findings support the therapeutic potential of sulpiride against metabolic dysfunction in obesity.

HIV screening and linkage to care in a health department in Valencia, Spain: Lessons learned from a healthcare quality improvement project.

Spain's rate of new human immunodeficiency virus (HIV) diagnoses exceeds that of the European Economic Area average (8.6 vs 5.6:100,000 in 2018). The country has failed to meet the first of United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets for HIV control by 2020, with 87.0% of people living with HIV knowing their status, and late presentation rates of 47.6% and 51.5% country-wide and in the Valencian autonomous community, respectively. Advancing screening and linkage to care (SLTC) practices is necessary to effectively control the epidemic. The Valencia Viral Screening (CRIVALVIR) project adopted the TEST model for opportunistic and systematic HIV SLTC in individuals aged 18 to 80 who required blood work for any purpose, as of February 2019. SLTC was integrated into routine clinical workflow across primary care centers serving a population of 360,000 people in Valencia, Spain. Our project successfully upscaled total HIV testing by 194% to over 32,000 patients tested in 14 months. We found an overall prevalence of 0.13% (0.08-0.21) among those screened per protocol (n = 13,061), with foreign-born citizens presenting a 12.5 times significantly higher likelihood of acquiring HIV (95% confidence interval 4.63-33.96, P < .0001). We improved late presentation by 18.2 percentage points and prevented an estimated 58 to 70 new secondary infections. HIV screening of the general population in primary care is an effective strategy for achieving timely diagnosis and preventing new infections. Opportunistic, systematic, opt-out approaches are essential to control the HIV epidemic.

Gender gaps in research productivity and recognition among elite scientists in the U.S., Canada, and South Africa.

This study builds upon the literature documenting gender disparities in science by investigating research productivity and recognition among elite scientists in three countries. This analysis departs from both the general comparison of researchers across organizational settings and academic appointments on one hand, and the definition of "elite" by the research outcome variables on the other, which are common in previous studies. Instead, this paper's approach considers the stratification of scientific careers by carefully constructing matched samples of men and women holding research chairs in Canada, the United States and South Africa, along with a control group of departmental peers. The analysis is based on a unique, hand-curated dataset including 943 researchers, which allows for a systematic comparison of successful scientists vetted through similar selection mechanisms. Our results show that even among elite scientists a pattern of stratified productivity and recognition by gender remains, with more prominent gaps in recognition. Our results point to the need for gender equity initiatives in science policy to critically examine assessment criteria and evaluation mechanisms to emphasize multiple expressions of research excellence.

Polishing of municipal secondary effluent using native microalgae consortia.

This work evaluates the use of native microalgae consortia for a dual role: polishing treatment of municipal wastewater effluents and microalgae biomass feedstock potential for biodiesel or biofertilizer production. An initial screening was undertaken to test N and P removal from secondary effluents and biomass production by 12 consortia. A subsequent treatment was performed by selected consortia (01 and 12) under three operational conditions: stirring (S), S + 12 h of daily aeration (S + A) and S + A enriched with CO2 (S + AC). All treatments resulted in compliance with environmental regulations (e.g. Directive 91/271/EEC) and high removal efficiency of nutrients: 64-79% and 80-94% of total N and PO43--P respectively. During the experiments it was shown that pH alkalinization due to microalgae growth benefits the chemical removal of ammonia and phosphorus. Moreover, advantages of pH increase could be accomplished by intermittent CO2 addition which in this research (treatment S + AC) promoted higher yield and lipid concentration. The resulting dry biomass analysis showed a low lipid content (0.5-4.3%) not ideal for biodiesel production. Moreover, the high rate of ash (29.3-53.0%) suggests that biomass could be readily recycled as a biofertilizer due to mineral supply and organic constituents formed by C, N and P (e.g. carbohydrate, protein, and lipids).

Analysis of the subunit organization of the eIF2B complex reveals new insights into its structure and regulation.

Eukaryotic initiation factor 2B (eIF2B) is the guanine nucleotide exchange factor for eIF2 and a critical regulator of protein synthesis, (e.g., as part of the integrated stress response). Certain mutations in the EIF2B genes cause leukoencephalopathy with vanishing white matter (VWM), an often serious neurological disorder. Comprising 5 subunits, α-ε (eIF2Bε being the catalytic one), eIF2B has always been considered an αßγδε heteropentamer. We have analyzed the subunit interactions within mammalian eIF2B by using a combination of mass spectrometry and in vivo studies of overexpressed complexes to gain further insight into the subunit arrangement of the complex. Our data reveal that eIF2B is actually decameric, a dimer of eIF2B(ßγδε) tetramers stabilized by 2 copies of eIF2Bα. We also demonstrate a pivotal role for eIF2Bδ in the formation of eIF2B(ßγδε) tetramers. eIF2B(αßγδε)2 decamers show greater binding to eIF2 than to eIF2B(ßγδε) tetramers, which may underlie the increased activity of the former. We examined the levels of eIF2B subunits in a panel of different mouse tissues and identified different levels of eIF2B subunits, particularly eIF2Bα, which implies heterogeneity in the cellular proportions of eIF2B(αßγδε) and eIF2B(ßγδε) complexes, with important implications for the regulation of translation in individual cell types.

Edad de presentación de los reactivos del Test de Denver II en Niños de 0 a 4 años de edad del Estado de Morelos / Age of presentation of Denver Test items in the first 4 year of life of children from Morelos, Mexico

Uno de los instrumentos más utilizados a nivel internacional en la vigilancia del desarrollo del niño es la segunda versión del Denver Developmental Screening Test (DENVER II), del cual se han hecho evaluaciones y modificaciones en varios países, a partir de la estimación de la edad de presentación de los reactivos, pues constituye la base de su estructura y validez. Objetivo Identificar las edades y secuencias de presentación de los reactivos del Test Denver II en los cuatro primeros años de vida en niños de condición socioeconómica baja de una comunidad del Estado de Morelos, México. Método Se realizaron 2350 evaluaciones a niños de 0 a 48 meses de edad. Mediante un modelo de regresión logística se estimó la edad de presentación de cada reactivo para los percentiles 25, 50, 75 y 90. Se establecieron diferencias con los valores de referencia del instrumento con base en los intervalos de confianza al 95% para el percentil 90. Resultados De los 98 reactivos evaluados, 42 se presentaron con retraso; 23 no mostraron diferencias estadísticas y 33 se lograron antes por los niños del estudio. En las áreas Motor grueso y Personal-social predominaron los retrasos en 19/25 y 11/21 reactivos respectivamente. Por el contrario en Motor Fino-Adaptativo y Lenguaje predominaron los adelantos en 11 de 22 y 16 de 30 reactivos. Conclusiones Existen diferencias en las edades y secuencias de presentación de los reactivos del Test de Denver II en la población estudiada. Se recomienda realizar ajustes antes de implementar su uso en contextos socioculturales específicos.

The Denver Developmental Screening Test (Denver II) is the most used internationally tool for child development surveillance, from which assessments and changes have been made in several countries, from the estimate of the age of presentation of the items, because it constitutes the basis of its structure and validity. Objective To identify the age and sequences acquiring of each item of the Denver-II test during the first four years of life in children of low socioeconomic status from a community of Morelos State, Mexico. Method 2350 assessments were conducted to children from 0 to 48 months of age. A logistic regression model was used to estimate the age of presentation of each item to the centiles 25th, 50th, 75th and 90th. Differences were established with values of reference based on confidence intervals up to 95% for 90th centile. Results Of the 98 items evaluated, 42 were submitted delayed, 23 showed no statistical difference and 33 were acquired in earlier age in children of Morelos. In the Gross Motor and Personal-social areas predominated the delayed with 19/25 and 11/21 items, respectively. By contrast, in Fine Motor-Adaptive and Language predominated the advances, with 11/22 and 16/30 items. Conclusions There are differences in the age and sequence of presentation of the items of the Denver-II test in the population studied. Adjustments are recommended before implementing its use in specific socio-cultural contexts.

Relationships between leisure participation and quality of life of people with developmental disabilities.

BACKGROUND: Studies of people with developmental disabilities suggest that participation in leisure activities might be a key factor for good quality of life. This study explores the relationships between objective and subjective quality of life and leisure participation of adults with developmental disabilities. MATERIALS AND METHODS: A cross-sectional design was used with a convenience sample of 125 people, aged 17-65, living in the community. Participants completed the subjective scale of Integral Quality Scale and the Leisure Assessment Inventory in the form of an individual interview. Staff completed the GENCAT Scale. RESULTS: No relationship was found between objective quality of life and leisure participation. However, correlations between some leisure participation dimensions and specific subjective quality of life domains were observed. The results establish a predictive relationship between leisure participation and material, emotional, and physical well-being. Personal and environmental variables analyzed were not found to have a moderating effect on the relationship between leisure participation and quality of life. CONCLUSIONS: These findings indicate that some aspects of leisure participation may significantly contribute to enhancing the quality of life of young people and adults with developmental disabilities living in the community.

Aspectos relevantes de la restricción del crecimiento intrauterino / Highlights on Intrauterine Growth Restriction

Introducción: la restricción del crecimiento intrauterino (RCIU) es una afección caracterizada por una limitación del potencial del crecimiento fetal de causa heterogénea y manifestaciones variables. Su importancia no solo radica en lo que significa en la morbilidad y la mortalidad infantil, sino también, en que estos niños tienen habitualmente múltiples problemas posteriores. Objetivos: precisar la incidencia, así como la frecuencia con que se asociaron diversos factores de riesgo y otras situaciones habitualmente relacionadas con este problema de salud. Precisar incidencia de la restricción del crecimiento intrauterino. Identificar diagnóstico y seguimiento oportunos por área y consulta del nivel secundario. Métodos: se realizó un estudio descriptivo, retrospectivo y de corte longitudinal, sobre un total de 133 gestantes con restricción del crecimiento intrauterino, atendidas en el Hospital Materno Infantil 10 de Octubre, entre el 1º de enero y el 31 de julio de 2011. Resultados: el 7,7 porciento de los nacidos fueron pequeños para su edad gestacional. La altura uterina se presentó disminuida solo en el 26,3 porciento de nuestros casos. El peso deficiente al inicio del embarazo (32,5 porciento), así como la insuficiente ganancia de peso durante la gestación (61,2 porciento) fueron situaciones frecuentes. Pocos casos habían sido seguidos en consulta de RCIU hospitalaria (10 porciento), se hizo el diagnóstico al nacimiento. Conclusiones: la sensibilidad de la medición de la altura uterina y del ultrasonido fueron bajas para contribuir a la sospecha de esta entidad

Introduction:the intrauterine growth restriction (IUGR) is a condition characterized by limited fetal growth potential due to heterogeneous causes and it has variable manifestations. Its importance lies not only in what it means in morbidity and mortality, but also that these children usually have multiple problems further. Objectives: to determine the incidence and frequency of associated risk factors and other conditions commonly associated with this health problem, to determine incidence of intrauterine growth restriction, to identify appropriate diagnosis and follow-up strategies by area and secondary consultation. Methods: we conducted a descriptive, retrospective and longitudinal section study of 133 pregnant women with IUGR, who were assisted at the Teaching Maternal and Child Hospital Diez de Octubre, from January 1st to July 31st, 2011. Results: 7.7 percent of the infants were small for their gestational age. The uterine height decreased in only 26.3 percent of our cases. The underweight in early pregnancy (32.5 percent) and insufficient weight gain during pregnancy (61.2 percent)were frequent situations. Few cases have been followed up in IUGR hospital consultation (10 percent)and were diagnosed at birth. Conclusions: The sensitivity of the uterine height measurement and ultrasound were low to support the suspicion of this entity

Screening for high-yielding Pichia pastoris clones: the production of G protein-coupled receptors as a case study.

Pichia pastoris is an established host for the production of a wide range of recombinant proteins including membrane proteins. The system has a particularly good track record for the production of G protein-coupled receptors (GPCRs). Generation and screening of expression clones with this system use standard molecular biology techniques. Multiple clones can be generated and screened in a matter of a few weeks making this similar to Escherichia coli in terms of speed. In addition, basic buffer components and the lack of expensive equipment make small-scale expression screening in P. pastoris very cost-effective. Here we describe the procedures used for small-scale GPCR production screening.

Large-scale production of membrane proteins in Pichia pastoris: the production of G protein-coupled receptors as a case study.

One of the major advantages of using Pichia pastoris is that it is readily adapted to large-scale culture in bioreactors. Bioreactors allow precise regulation of cell growth parameters increasing both yields and reproducibility of the culture. P. pastoris cultures grow to very high cell densities which helps minimise culture volume and facilitates downstream processing of the sample. Here, we provide protocols for the large-scale production of the human adenosine A(2A) receptor (A(2A)R) and provide some details of how bioreactor cultures can be used for optimisation of expression of the human dopamine D2 receptor (D2DR).

Personal factors and perceived barriers to participation in leisure activities for young and adults with developmental disabilities.

Participation in leisure activities has been identified as a factor that favors inclusion in the community and it also contributes to a better quality of life. This study analyzed the influence of certain personal characteristics and environmental factors in the participation in leisure activities of youngsters and adults with developmental disabilities. A cross-sectional design was used with a convenience sample of 237 people, aged 17-65, living in the community. The participants completed the Spanish version of the Leisure Assessment Inventory, and information about the personal and disability-related factors was obtained through a questionnaire. Multiple regression analyses were conducted to determine the personal factors, disability-related factors, and perceived barriers to leisure participation. The results show that participation in leisure activities is determined more by personal factors and perceived barriers than by disability-related factors.

[Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical activity]. / Mejora en el control de los diabéticos tipo 2 tras una intervención conjunta: educación diabetológica y ejercicio físico.

OBJECTIVE: To study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with Type 2 Diabetes (DM2) in a specific Health Care Area after group intervention through the community: diabetes education (DE) and physical exercise (PE). DESIGN: A single blind, randomised controlled clinical trial. INTERVENTION: group 1: DE; group 2: ED and PE; group 3: only PE, and "control" group-4: Individual consultations. LOCATION: Urban health centre/municipal sports centre. PARTICIPANTS: 108 DM2, age: 40-70, glycated haemoglobin (HbA(1)c) ≤ 8.5%, blood pressure (BP)<160/90 and body mass index (BMI)<45, excluding those with chronic complications and/or acute decompensation. INTERVENTIONS: During 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3 hours a week). MAIN MEASUREMENTS: Primary variable pre- and post- intervention: reduction in HbA(1)c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey). RESULTS: After intervention, more diabetics had a lower HbA(1)c following a full intervention: "DE" and "PE", RR: 1.93 (0.85-4.40) and exercise, RR: 1.56 (0.65-3.76). With simultaneous DE and PE, the BMI, RR: 1.61 (0.85-3.03) and LDL cholesterol, RR: 1.82 (0.99-3.36), of many subjects decreased. Dietary compliance, RR: 1.29 (0.32-5.22) and exercise, RR: 1.93 (0.76-4.91) also increased, more patients performing their own checks, RR: 3.86 (0.90-16.55) and improving motivation/attitudes in "strict control management", RR: 1.48 (0.94-2.34). With PE, systolic and diastolic BP decreased in more patients RR: 1.35 (0.72-2.52), 1.87 (0.72-4.84) while in the DE group only diastolic values decreased 1.80 (0.69-4.67). CONCLUSIONS: Patient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size.

Enfermedad inflamatoria pélvica por Actinomyces y Síndrome de inmunodeficiencia adquirida (SIDA) / Pelvic inflammatory disease from Actinomyces and acquired immunodeficiency syndrome (AIDS)

La enfermedad inflamatoria pélvica en la actualidad debe sospecharse en toda mujer en edad fértil y sexualmente activa, es más frecuente y agresiva en la adolescencia. El actinomyces iraelli posee formas de presentación disimiles, lo que entorpece su diagnóstico, llega a la formación de abscesos con expansión física de un órgano encapsulado. El sida, enfermedad inmunodepresora, es capaz de facilitar y enmascarar cualquier proceso infeccioso, por lo que ante las dos circunstancias anteriores debemos pensar en esta posibilidad diagnóstica. El caso que presentamos comienza con una pequeña tumoración que después se agranda, acompañada de un cortejo sintomático respiratorio, vaso oclusivo y toma del estado general, se realiza el diagnóstico presuntivo y se impone tratamiento para el actinomyces, mejorando abruptamente toda sintomatología, llega más tarde el diagnóstico de ser portador del sida. Conclusión: siempre debemos sospechar ante una enfermedad inflamatoria pélvica en cualquiera de sus formas clínicas, la presencia del actinomyces como uno de los posibles gérmenes causales, sobre todo en pacientes con enfermedades inmunosupresoras como el sida

The pelvic inflammatory illness at the present time debit side to suspect in all woman in fertile and sexually active age, being more frequent and more aggressive in the adolescence The actinomyces iraelli possesses forms of presentation dissimilar, what hinders its diagnosis arriving to the formation of abscesses with physical expansion of an encapsulated organ. The AIDS illness inmunodepresora, is able to mask any infectious process, for what we should think of this diagnostic possibility before the 2 previous circumstances. the case that we present begins with a small tumor that later enlarges, accompanied by a breathing symptomatic retinue, occulsive glass and taking of the general state, he/she is carried out the I diagnose presumptive and empiric treatment is imposed for the actinomyces, improving all sintomatología abruptly, arriving but it takes the I diagnose of being carrier of the AIDS. Conclusion: we should. Always suspect before any Pelvic Inflammatory Illness in anyone in their clinical ways the presence of illnesses inmunosupresoras like the AIDS and the presence of the actinomyces inside their causal germs

Large-scale functional expression of WT and truncated human adenosine A2A receptor in Pichia pastoris bioreactor cultures.

BACKGROUND: The large-scale production of G-protein coupled receptors (GPCRs) for functional and structural studies remains a challenge. Recent successes have been made in the expression of a range of GPCRs using Pichia pastoris as an expression host. P. pastoris has a number of advantages over other expression systems including ability to post-translationally modify expressed proteins, relative low cost for production and ability to grow to very high cell densities. Several previous studies have described the expression of GPCRs in P. pastoris using shaker flasks, which allow culturing of small volumes (500 ml) with moderate cell densities (OD600 ~15). The use of bioreactors, which allow straightforward culturing of large volumes, together with optimal control of growth parameters including pH and dissolved oxygen to maximise cell densities and expression of the target receptors, are an attractive alternative. The aim of this study was to compare the levels of expression of the human Adenosine 2A receptor (A2AR) in P. pastoris under control of a methanol-inducible promoter in both flask and bioreactor cultures. RESULTS: Bioreactor cultures yielded an approximately five times increase in cell density (OD600 ~75) compared to flask cultures prior to induction and a doubling in functional expression level per mg of membrane protein, representing a significant optimisation. Furthermore, analysis of a C-terminally truncated A2AR, terminating at residue V334 yielded the highest levels (200 pmol/mg) so far reported for expression of this receptor in P. pastoris. This truncated form of the receptor was also revealed to be resistant to C-terminal degradation in contrast to the WT A2AR, and therefore more suitable for further functional and structural studies. CONCLUSION: Large-scale expression of the A2AR in P. pastoris bioreactor cultures results in significant increases in functional expression compared to traditional flask cultures.

[Mozart's music in the prenatal period]. / La música de Mozart en el periodo prenatal.

Diverse studies demonstrate that the future baby reacts to the sounds and the light in uterus four months before being born, that is to say, he is able to recognize stimulus which was exposed habitually, like the beats of the mothers heart and the voice of the same one when talk him before being born, likewise the music he used to heard during pregnancy. The babies who through their mother listened to music of Mozart in uterus and return it to listen in the delivery room of when they are born feel greater tranquility and less aggressiveness. Mozart was a genius and the most beautiful from it is the so important impact in the cognitive development, social and affective of those who are exposed to the wonderful sounds and rythm of music from the maternal belly. The previous thing is based on experiments scientifically controlled that revalue the communication between the mother and the future baby as well as the importance of this link.

Streptococus mutans: su relación con la actividad cariogénica / Streptococcus mutans: its relation to cariogenic activity

Esta investigación se realizó con el fin de conocer la relación entre el grado de infección por el Streptococcus mutans en la saliva y la prevalencia de caries y con la posterior incidencia, en el término de 1 año. Se estudiaron 931 niños de 2 y 3 años de edad de la Ciudad de la Habana y la provincia Sancti Spiritus, y 10 series diferentes de escolares de 6 a 12 años de edad de ambas provincias, con un total de 848 niños. Se halló una relación directa significativa entre el grado de infección por el S. mutans y la prevalencia de caries (tanto por ciento de afectados y el índice co/COPD) en los grupos estudiados. De igual forma, en la relación entre la incidencia de caries con el grado previo dc infección, las diferencias fueron significativas en los niños de 2 y 3 años y el 6 de las 10 series de niños escolares con una correlación (r) de 0,216. Se analiza que a pesar de que el grado de infección por el Streptococcus mutans es el parámetro que más correlaciona con la actividad cariogénica, su valor predictivo no es suficiente por sí solo, por lo que se necesita recurrir a una valoración conjunta con otros parámetros que estén relacionados también con la actividad carigénica, para poder alcanzar la validez necesaria en los pronósticos

Comprobación clínica del efecto preventivo de caries de los enjuagues bucales con la solución mineralizante sobre la dentición permanente recién brotada / Clinical verification of caries preventing effect of oral rinsing with mineralizing solution on recently erupted permanent dentition

Se estudia el efecto de los enjuagues bucales quincenales con la solución mineralizante (Minersol) sobre la dentición permanente recién brotada. La reducción obtenida en la incidencia de caries en el término de 1 año estuvo en el rango entre 49,2 y 82,1% para los primeros molares, y en el rango entre 23,4 y 36,3% para los segundos molares; ambas diferencias fueron significativas, pero no se obtuvo reducción alguna en la incidencia de caries de las bicúspides. El efecto preventivo obtenido se atribuye a la incorporación iónica en los planos superficiales del esmalte, que reduce la difusiòn de los ácidos que actúan en la desmineralización. Se concluye que el empleo de la solución mineralizante en las edades de brote de la dentición permanente reduce la incidencia de caries y se recomienda, por tanto, su utilización como mètodo preventivo

La resistencia del esmalte a la disolución ácida: su relación con la actividad cariogénica / Enamel resistence to acid dissolution: its relation to cariogenic activity

Se estudió la relación existente entre la resistencia del esmalte (mediante la técnica colorimétrica desarrollada) y la experiencia anterior de caries y con la posterior incidencia en el término de 1 año, en escolares de 6, 8, 10 y 12 años. el estudio comprendiò a 336 niños en el periodo 1985 a 1986 y a 385 niños en el de 1986 a 1987. No se halló correlación positiva significativa entre los valores de la Prueba Colorimètrica y la experiencia anterior de caries; pero si se halló correlaciòn positiva con la posterior incidencia en la denticiòn permanente. Se concluye que la Prueva Colorimetrica resulta útil en la selección de niños con un esmalte muy susceptible así como en la predicción de la actividad cariogénica valorada conjuntamente con otros parámetros

Infecciones hospitalarias: estudio de prevalencia de infección hospitalaria y consumo de antimicrobianos en el Centro de Asistencia del Sindicato Médico del Uruguay / Hospital infections: study of prevalence of hospital infections and antimicrobial consumption at the medical center of Sindicato Médico del Uruguay

Se presenta un estudio de prevalencia de infecciones hospitalarias (IH) y de consumo de antimicrobiano, realizado en los Sanatorios propios del Centro de Asistencia del Sindicato Médico del Uruguay (CASMU). Se comenta el protocolo utilizado para el estudio y las definiciones operacionales adoptadas para llevarlo a la práctica. Se analiza una población de 299 pacientes internados, de los cuales 206 ingresaron sin infección, 93 con infección adquirida en la comunidad y 39 se encontraron dentro de los criterios de IH lo que equivale a un 13 por ciento. Se analizan las localizaciones más frecuentes de IH destacándose las infecciones urinarias, las infecciones de herida operatoria y las infecciones de piel, vinculadas al rasurado, preoperatorio en su mayoría. De 107 pacientes con intervención quirúrgica estudiados, el 7 por ciento presentó infección de la herida operatoria, que correspondió en todos los casos a cirugía sucia o contaminada. Se exponen los resultados de los exámenes microbiológicos efectuados, así como los procedimientos invasivos y los porcentajes de controlo bacteriológico. Se realizan algunas consideraciones sobre el promedio de días de estada en los pacientes infectados que es dos veces y media mayor que en los no infectados. Se discute la antibioticoterapia utilizada, el carácter y la adecuación de la misma