Can double J stent complications be reduced in pediatric patients? / ¿Podemos reducir las complicaciones de doble J en el paciente pediátrico?

OBJECTIVE: The use of double J (DJ) stents is frequent in urological pediatrics, but it is not exempt from morbidity. The objective of this study was to describe the risk factors (RF) of DJ complications in pediatric patients, and to analyze the quality of the information provided to the families with respect to the stent. MATERIALS AND METHODS: A retrospective study of patients undergoing surgery with DJ placement in the urology department from 2017 to 2022 was carried out. Study patients were divided into two groups -complicated (C) and non-complicated (NC). A multivariate analysis was performed to identify complication-related RFs, and a quality analysis as perceived by the families was conducted by means of a satisfaction survey (0 = total dissatisfaction; 10 = maximum satisfaction). RESULTS: 180 patients were included (236 DJs). The main diagnoses included renal transplantation (29.8%), ureteropelvic stenosis (26%), and urolithiasis (20.7%). Complication rate was 21.9%, with a mean comprehensive complication index (CCI) of 26.8. Prophylactic antibiotic therapy was not associated with fewer complications (97.3% vs. 98.1%; p= 0.727). Complication RFs included more than one stent (p< 0.001; OR= 6.628) and bilateral placement (p< 0.05; OR= 4.871). Poor registration in the medical records was associated with greater complications (p= 0.025). In the information quality survey, 20% reported a score lower than 7/10. CONCLUSIONS: DJ-associated morbidity has a direct relationship with DJ duration, bilaterality, and carrying more than one stent in a lifetime. Adequate registration in the medical records is associated with shorter DJ duration, and therefore, fewer complications. Antibiotic prophylaxis did not reduce complications, which means its routine use should be reconsidered.

OBJETIVOS: El uso de catéteres doble J (DJ) es un proceso frecuente en uropediatría, pero no exento de morbilidad. El objetivo de nuestro estudio es describir factores de riesgo (FR) de complicación de los DJ en pacientes pediátricos y comprobar la calidad de la información transmitida a las familias en relación al catéter. MATERIAL Y METODOS: Estudio retrospectivo de pacientes intervenidos en urología con colocación de DJ (2017­2022). Grupos a estudio: complicados (CC) y no complicados (SC). Realizamos un análisis multivariante para identificar FR relacionados con complicaciones y un análisis de calidad percibida por las familias mediante encuesta de satisfacción (0 no satisfacción, 10 máxima satisfacción). RESULTADOS: Incluimos 180 pacientes, (236 DJ). Diagnósticos principales: trasplante renal 29,8%, estenosis pieloureteral 26%, y urolitiasis 20,7%. La tasa de complicaciones fue del 21,9%, con un Comprehensive Complication Index (CCI) medio de 26,8. La antibioterapia profiláctica no se relaciona con menos complicaciones (97,3% vs 98,1% p= 0,727). FR de complicación: acumular más de un catéter (p< 0,001, OR 6,628) o la colocación bilateral (p< 0,05; OR 4,871). Un mal registro en la historia clínica se relacionó con más complicaciones (p= 0,025). En la encuesta de calidad de información recibida, el 20% reflejaron una puntuación inferior a 7/10. CONCLUSIONES: La morbilidad asociada al DJ se relaciona con su duración, la bilateralidad o acumular más de un catéter. Su adecuado registro en la historia clínica se relaciona con menor duración del mismo y, por tanto, menos complicaciones. La profilaxis antibiótica no ha demostrado disminuir las complicaciones, su uso rutinario debe ser revalorado.

Detection of Natural Infection by Leishmania sp. in Bats (Chiroptera, Mammalia) that Inhabit the City of Corrientes, Argentina.

Leishmaniasis is a zoonotic disease of importance in Argentina. It is important to be acquainted with its possible natural hosts and reservoirs. Bats have several reservoir attributes, which means they could fulfill these roles. The aim of this work was to investigate the presence of Leishmania sp. in bats that inhabit the city of Corrientes. Bats were captured and identified. From the captured specimens, spleen samples were taken and Leishmania sp. detection techniques were applied, including both optical microscopy and PCR. It was possible to capture 95 bat specimens belonging to 10 species. Using cytological preparations, a prevalence of 1.29% was detected and using PCR a prevalence of 32% was found. Our results confirm the presence of natural infection by Leishmania sp. in bats of the city of Corrientes which reveals the possibility of these animal species fulfilling a reservoir role for this disease.

La leishmaniose est une zoonose importante en Argentine. La connaissance de ses réservoirs possibles est essentielle. Les chauves-souris ont plusieurs attributs pour remplir ce rôle. L'objectif de ce travail était d'étudier la présence de Leishmania sp. chez les chauves-souris qui habitent la ville de Corrientes. Des captures de chauves-souris ont été faites et celles-ci ont été identifiées. Des échantillons de rates ont été prélevés sur ces spécimens pour rechercher Leishmania sp. en utilisant la microscopie optique et la PCR. Il a été possible de capturer 95 spécimens de chauves-souris appartenant à dix espèces. En utilisant des préparations cytologiques, une prévalence de 1,29 % a été détectée et en utilisant la PCR, une prévalence de 32 % a été trouvée. Nos résultats confirment la présence d'une infection naturelle par Leishmania sp. chez les chauves-souris de la ville de Corrientes, ce qui révèle la possibilité que ces espèces animales jouent un rôle de réservoir pour cette maladie.

Factors related to immediate response to symptoms in patients with stroke or transient ischaemic attack. / Factores relacionados con una respuesta inmediata a los síntomas en pacientes con ictus o accidente isquémico transitorio.

INTRODUCTION: Despite recent advances in the management of acute stroke, fewer than 10% of patients receive reperfusion therapy. One of the main reasons for such a low rate of administration is the delay on the part of patients and their families in seeking medical attention. This study aimed to analyse this delay. METHODS: A prospective observational study was conducted on consecutive stroke or transient ischaemic attack. Data on sociodemographic and clinical parameters, decision delay, pre-hospital delay, and first medical contact were collected. Descriptive, bivariate, and multivariate logistic regression analyses were performed to determine factors associated with seeking medical attention within the first 15minutes of stroke or TIA occurrence. RESULTS: A total of 382 patients were included, 24.9% of whom had a decision delay of 15minutes or less. Stroke severity (OR 1.08; 95% CI, 1.04-1.13; P<.001), patient's son/daughter witnessing the event (OR 3.44; 95% CI, 1.88-6.27; P<.001), and insulin treatment (OR 2.89; 95% CI, 1.35-6.20; P=.006) were related to an immediate reaction. Lacunar infarcts (OR 0.41; 95% CI, 0.17-0.97; P=.042), partial anterior circulation infarcts (OR 0.43; 95% CI, 0.22-0.85; P=.015), and monosymptomatic events not involving limb paresis or aphasia (OR 0.15; 95% CI, 0.033-0.724; P=.018) favoured delays longer than 15minutes. CONCLUSIONS: Severity of the event and presence of a son/daughter are the factors most frequently associated with an immediate response to stroke. Future interventions should emphasise the need for an immediate response irrespective of severity and include a wider spectrum of symptoms.

Fructans from Agave tequilana with a Lower Degree of Polymerization Prevent Weight Gain, Hyperglycemia and Liver Steatosis in High-Fat Diet-Induced Obese Mice.

Fructans from agave have received specific attention because of their highly branched fructan content. We have previously reported that the degree of polymerization (dp) influences their biological activity. Therefore, the aim of this study was to investigate the effect of unfractionated and fractionated fructans (higher and lower dps) from Agave tequilana in high-fat diet-induced (HFD) obese mice. Fructans with a lower dp (HFD+ScF) decreased weight gain by 30 %, body fat mass by 51 %, hyperglycemia by 25 % and liver steatosis by 40 %. Interestingly, unfractionated fructans (HFD+F) decreased glucose and triglycerides (TG), whereas fractionated fructans with a higher dp (HFD+LcF) decreased TG but not glucose; in contrast, HFD+ScF decreased glucose but not TG. Our findings suggest that both higher and lower dp agave fructans have complementary effects in metabolic disorders related to obesity. These findings may contribute to the development of improved food supplements with a specific ratio combination of fructans with different dps.

A modified indirect mathematical model for evaluation of ethanol production efficiency in industrial-scale continuous fermentation processes.

AIMS: To calculate fermentation efficiency in a continuous ethanol production process, we aimed to develop a robust mathematical method based on the analysis of metabolic by-product formation. METHODS AND RESULTS: This method is in contrast to the traditional way of calculating ethanol fermentation efficiency, where the ratio between the ethanol produced and the sugar consumed is expressed as a percentage of the theoretical conversion yield. Comparison between the two methods, at industrial scale and in sensitivity studies, showed that the indirect method was more robust and gave slightly higher fermentation efficiency values, although fermentation efficiency of the industrial process was found to be low (~75%). CONCLUSIONS: The traditional calculation method is simpler than the indirect method as it only requires a few chemical determinations in samples collected. However, a minor error in any measured parameter will have an important impact on the calculated efficiency. In contrast, the indirect method of calculation requires a greater number of determinations but is much more robust since an error in any parameter will only have a minor effect on the fermentation efficiency value. SIGNIFICANCE AND IMPACT OF THE STUDY: The application of the indirect calculation methodology in order to evaluate the real situation of the process and to reach an optimum fermentation yield for an industrial-scale ethanol production is recommended. Once a high fermentation yield has been reached the traditional method should be used to maintain the control of the process. Upon detection of lower yields in an optimized process the indirect method should be employed as it permits a more accurate diagnosis of causes of yield losses in order to correct the problem rapidly. The low fermentation efficiency obtained in this study shows an urgent need for industrial process optimization where the indirect calculation methodology will be an important tool to determine process losses.

Phylogenetic classification and clinical aspects of a new putative Deltapapillomavirus associated with skin lesions in cattle.

Bovine papillomaviruses (BPVs) are recognized as causal agents of benign and malignant tumors in cattle. Thirteen types of BPVs have already been described and classified into 3 distinct genera. Divergences in the nucleotide sequence of the L1 gene are used to identify new viral types through the employment of PCR assays with degenerated primers. In the present study, a method for identifying BPVs based on PCR-RFLP and DNA sequencing allowed the identification of a new putative Deltapapillomavirus, designated JN/3SP (JQ280500.1). The analysis of the L1 gene showed that this strain was most closely related to the BPVs -1, -2, -13 , and OaPV1 (71-73% genetic similarity). In this study, we describe the detection of this new putative Deltapapillomavirus type and verify its phylogenetic position within the genus.

Expression and in Silico analysis of the recombinant bovine papillomavirus E6 protein as a model for viral oncoproteins studies.

Bovine papillomaviruses (BPVs) are recognized as the causal agents of economical relevant diseases in cattle, associated with the development of tumors in skin and mucosa. The oncogenesis process is mainly associated with different viral oncoprotein expressions, which are involved in cell transformation. The expression and characterization of recombinant viral oncoproteins represent an attractive strategy to obtain biotechnological products as antibodies and potential vaccines, Thus, the aim of this work was to clone and express the BPV-1 and BPV-2 E6 recombinant proteins and perform in silico analysis in order to develop a strategy for the systematic study of other papillomaviruses oncoproteins. The results demonstrated that BPV-1 and BPV-2 E6 recombinant proteins were expressed and purified from bacterial system as well as its in silico analysis was performed in order to explore and predict biological characteristics of these proteins.

[Role of laparoscopy in premature infants with suspicion of necrotizing enterocolitis]. / Papel de la laparoscopia en prematuros con sospecha de enterocolitis necrotizante.

INTRODUCTION: The indication of surgery in necrotizing enterocolitis (NEC) can be difficult in the absence of pneumoperitoneum or peritonitis. We propose laparoscopy for early diagnosis of intestinal perforation or necrosis in order to avoid unneccessary laparotomies. MATERIAL AND METHODS: A new protocol was proposed which included diagnostic and therapeutic laparoscopy in cases of uncertain surgical ECN indication. Subsequently, a prospective study of the 7 patients who underwent laparoscopy was performed, analyzing pathophysiological effects in the premature, technical difficulties of the procedure, and postoperative diagnostic consistency. RESULTS: The mean gestational age at birth was 27 weeks (range 25 to 31) with an average weight of 1.147 kg (range 0.900 to 1.600) two trocars were placed as the focal oriented scanning or radiography, using a pneumoperitoneum 6-10 mmHg for an average of 17 min. Laparoscopy avoided laparotomy in a patient who did well after washing and drainage and magnified lesions in one patient who did not require laparotomy after intestinal bypass. In other cases, laparoscopy was followed by minilaparotomy oriented to the lesions and stoma formation. There were no surgical complications attributable to the procedure, which was well tolerated in all cases. CONCLUSIONS: Laparoscopy can be a useful tool for evaluation of lesions of NEC in cases of uncertain surgical indications. In our experience, it is well tolerated in neonates of low weight, allowing oriented minilaparotomies or even to avoid laparotomy.

[The paraurethral cyst or Skene's duct cyst in the female newborn]. / Quiste parauretral de Skene en niña recién nacida.

The paraurethral cyst or Skene's duct cyst is a rare congenital anomaly in the female newborn. It appears like a round, yellow or orange-colored cystic mass on either side of the urethral meatus. The reported incidence is 1 in 2.000 to 7.000 female births. The low frequency of the Skene's duct cyst and the little awareness of it and its benignity may lead to wrong diagnosis that underestimates its incidence. There are authors that agree with surgical treatment of paraurethral cyst to obtain an early resolution, even though a majority agrees to manage conservatively.

[Therapeutic strategy in cloacal exstrophy]. / Estrategia terapéutica en la extrofia de cloaca femenina.

Cloacal exstrophy is a complex multisistemic anomaly that involves gastrointestinal and genitourinary issues. The aim of our paper is to report our experience in dealing with genital reconstruction and faecal and urinary continence in patients with female cloacal anomalies. We reviewed the clinical records from the three patients we have achieved a final reconstruction. We recorded the surgical management and both functional and anatomic results. The three of them required a bladder neck closure associated with a continent stoma, they are dry with intermittent catheterization and free of upper urinary complications. Genital reconstruction required a unique plan for each one, according to their anatomy and their cosmetic desires. One of the patients reported satisfactory sexual intercourse. Management of patients with cloacal exstrophy has major concerns about urinary and fecal continence and about genital reconstruction and function. Knowing the long-term results may help to develop management strategies and improve counselling for patients who have under-gone reconstruction.

Mice plasma fibrinogen consumption by thrombin-like enzyme present in rattlesnake venom from the north-east region of Argentina

Due to variability of venom components from the same species of snakes that inhabit different regions, particular properties of the venom of Crotalus durissus terrificus that inhabits the North-East of Argentina were studied. Gyroxin, a thrombin-like enzyme, was isolated from this venom by gel filtration and affinity chromatography, it was found to be homogeneous according to SDS-PAGE, with a molecular weight of 33 kDa. [quot ]Gyroxin syndrome[quot ] in mice was tested and it showed changes in the animal behavior, confirming that the isolated thrombin-like enzyme is gyroxin. Effects of this enzyme and the crude venom on mice plasmatic fibrinogen levels were determined. The mice plasma fibrinogen decreased rapidly until incoagulability during the first hour after thrombin-like enzyme injection, then reaching its normal level 10 hours after injection; whereas crude venom resulted in a 60% decrease of the mice plasma fibrinogen, reaching its normal level after the same period of time. After 1 hour of gyroxin inoculation, intravascular coagulation was observed in histological cuttings of lung, cardiac muscle and liver. The isolated enzyme showed strong hydrolyzing activity on fibrinogen and fibrin in vitro, whereas the crude venom exhibited weak hydrolyzing activity on both substrates. It is probable that this very low activity is due to the low percentage of the enzyme in the crude venom. Decreasing of plasmatic fibrinogen levels may be due to either the coagulant or hydrolyzing actions of the enzyme.

Teniendo en cuenta la variabilidadde los componentes del veneno de serpientes de una misma especie que habitan regiones diferentes, se decidióestudiar las propiedades particulares del veneno de Crotalus durissus terrificus que habita el nordeste de Argentina, Giroxina, una enzima con actividad trombínica, fue aislada del veneno por cromatografía de filtración por gel y de afinidad; se comprobó su homogeneidad y se determinó su peso molecular, 33 kDa, por SDSPAGE. Se ensayó el síndrome giroxina en ratones, los que mostraron cambios en el comportamiento, confirmandoque la enzima tipo trombina aislada es giroxina. Se evaluó la acción de esta enzima sobre los niveles de fibrinógeno plasmático en ratones, comparándola con la del veneno crudo. Se comprobó que la enzima provoca una disminución de los niveles plasmáticos de fibrinógeno hasta la incoagulabilidad, durante la primer hora de inoculación, mientras que el veneno entero produjo una reducción del nivel plasmático en un 60%; sin embargo, en ambos casos, se evidenció una rápida reposición de fibrinógeno plasmático, alcanzando sus valores normales en un plazo de 10 horas. Se observó coagulación intravascular con la administración de giroxina una hora después de la inoculación, evidenciados en estudios histológicos de tejido pulmonar, cardíaco y hepático. En ensayos realizados in vitro, la enzima aislada mostró capacidad de degradar fibrinógeno como así también coágulos de fibrina, mientras que el veneno exhibió débil actividad hidrolítica sobre ambos sustratos. Es probable que esta baja actividad sea debida a la baja concentración de la enzima en el veneno. La disminución de los niveles de fibrinógeno plasmático observado en ratones se debería a la acción coagulante de la enzima, sin embargo no se descarta que también contribuya a este proceso una acción hidrolítica sobrefibrinógeno y fibrina por parte de la enzima.

First Spanish Trauma Registry: analysis of 1500 cases.

OBJECTIVES: To develop the first Spanish Pediatric Trauma Registry to collect and evaluate infomation concerning aspects of injuries in our pediatric population. METHODS: From January 1995 to August 1998, 35,946 children younger than 16 years were treated in our hospital for acute injury: 1500 were admitted and included in our database. Our file registry consists of 108 data points including: patient identification, type, place and mechanism of injury, pre-hospital care, transport, assessment on admission, severity scores, diagnostic studies, injuries, treatment morbidity and mortality. RESULTS: Accidents were more frequent in males (68%) than in females. The predominant age group was 12-15 years of age (34%). Accidents were more frequent in the street (35.1%) than at home (18.9%) or school (13%). Falls and traffic-related accidents were the leading cause of injury (39% and 21.2%, respectively). Two hundred and thirty-five (15.7%) had a Pediatric Trauma Score < or = 8. Fifty of these sustained multiple trauma (33%) (Injury Severity Score > or = 15). Musculoskeletal and head trauma were the most frequent injuries (48.5% and 42.0%, respectively). Surgical or orthopedic procedures were performed in 906 patients (56.5%). The average length of stay was 4.5 days (range 1-93 days). Functional impairment in children older than 4 years of age was found in 413 children (33.3%). We encountered 7 deaths in the 1500 patients, or an overall mortality of 0.5%. These 7 deaths were only seen in the I.S.S. > or = 15 group (50 patients) with 14% mortality. CONCLUSIONS: The goals of this Registry are to establish the epidemiology of our injured pediatric population, to review patient care, to develop prevention programs and to compare results with other centers so that potential deficiencies can be corrected.

Macrophage inflammatory protein-1beta (MIP-1beta) produced endogenously in brain during E. coli fever in rats.

Macrophage inflammatory protein-1 (MIP-1) evokes an intense fever, independent of a prostaglandin mechanism, and is now thought to play an important role in the defence response to bacterial pyrogens. The purpose of this study was 2-fold: (i) to determine whether the potent doublet of this cytokine, MIP-1beta, is actually produced in the brain in response to a pyrogenic dose of a lipopolysaccharide of Escherichia coli and (ii) to determine the anatomical site of synthesis of this cytokine in the brain. Following the intense fever produced by intraperitoneal administration of lipopolysaccharide in the unrestrained rat, MIP-1beta immunoreactivity was identified post mortem in two regions of the brain implicated in fever: the organum vasculosum laminae terminalis (OVLT) and the anterior hypothalamic, preoptic area (AH/POA). Microinjection of goat anti-mouse MIP-1beta antibody (anti-MIP-1beta) directly int the AH/POA markedly suppressed fever in rats in response to lipopolysaccharide. Further anti-MIP-1beta administered 180 min after the injection of lipopolysaccharide acted as an antipyretic and reversed the fever induced by the endotoxin. anti-MIP-1beta or control immunoglobulin G antibody microinjected into the hypothalamus immediately before the intraperitoneal injection of the control saline did not alter the temperature of the rats. Taken together, the present results demonstrate that MIP-1beta is produced in the brain in response to a bacterial endotoxin. These observations, in the light of earlier data on fever induced by MIP-1beta, further support the hypothesis that endogenously synthesized MIP-1beta acts as an intermediary factor in the evocation of fever by acting on the thermosensitive cells of the brain.

GABAergic and cholinergic mediation in the antinociceptive action of homotaurine.

1. The role of GABAergic and cholinergic mechanisms in the antinociceptive effect of homotaurine (22.25-111.24 mg/kg i.p.) in chemical (acetic acid) and thermal (tail flick, tail immersion) tests has been studied by means of the interaction with baclofen and anticholinergic drugs. 2. Baclofen (2 mg/kg p.o.) and scopolamine sulfate (2.5 mg/kg i.p.) potentiate the antinociceptive effect of the amino acid in the chemical test. 3. Bicuculline (1 mg/kg i.p.) pretreatment does not modify the antinociceptive effect of homotaurine in the tail immersion and tail flick tests. 4. Scopolamine sulfate and methylnitrate (1 mg/kg i.p.) antagonise the effect of homotaurine (111.24 mg/kg i.p.) in the tail flick test. 5. The above results imply that peripheral GABAB and central cholinergic mechanisms play a role in the antinociceptive effect of homotaurine.

Removal of instrument signature from mariner 9 television images of Mars.

The Mariner 9 spacecraft was inserted into orbit around Mars in November 1971. The two vidicon camera systems returned over 7300 digital images during orbital operations. The high volume of returned data and the scientific objectives of the Television Experiment made development of automated digital techniques for the removal of camera system-induced distortions from each returned image necessary. This paper describes the algorithms used to remove geometric and photometric distortions from the returned imagery. Enhancement processing of the final photographic products is also described.