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1.
Nano Lett ; 23(15): 6927-6936, 2023 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-37489836

RESUMEN

Boron nitride (BN) is an exceptional material, and among its polymorphs, two-dimensional (2D) hexagonal and three-dimensional (3D) cubic BN (h-BN and c-BN) phases are most common. The phase stability regimes of these BN phases are still under debate, and phase transformations of h-BN/c-BN remain a topic of interest. Here, we investigate the phase stability of 2D/3D h-BN/c-BN nanocomposites and show that the coexistence of two phases can lead to strong nonlinear optical properties and low thermal conductivity at room temperature. Furthermore, spark-plasma sintering of the nanocomposite shows complete phase transformation to 2D h-BN with improved crystalline quality, where 3D c-BN possibly governs the nucleation and growth kinetics. Our demonstration might be insightful in phase engineering of BN polymorph-based nanocomposites with desirable properties for optoelectronics and thermal energy management applications.

2.
World J Urol ; 41(12): 3599-3609, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37823942

RESUMEN

PURPOSE: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries. METHODS: From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: gender, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, UC-type, hospitalizationtype, ICU type, facility ownership, and time period. RESULTS: 31,631 patients, hospitalized for 214,669 patient-days, acquired 305 CAUTIs. The pooled CAUTI rate per 1000 UC-days was 2.58, for those using suprapubic catheters, it was 2.99, and for those with indwelling catheters, it was 2.21. The following variables were independently associated with CAUTI: age, rising risk 1% yearly (aOR = 1.01; 95% CI 1.01-1.02; p < 0.0001 female gender (aOR = 1.28; 95% CI 1.01-1.61; p = 0.04), LOS before CAUTI acquisition, rising risk 7% daily (aOR = 1.07; 95% CI 1.06-1.08; p < 0.0001, UC/DU ratio (aOR = 1.14; 95% CI 1.08-1.21; p < 0.0001, public facilities (aOR = 2.89; 95% CI 1.75-4.49; p < 0.0001. The periods 2014-2016 and 2017-2019 had significantly higher risks than the period 2020-2022. Suprapubic catheters showed similar risks as indwelling catheters. CONCLUSION: The following CAUTI RFs are unlikely to change: age, gender, hospitalization type, and facility ownership. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations.


Asunto(s)
Infecciones Relacionadas con Catéteres , Infección Hospitalaria , Infecciones Urinarias , Humanos , Femenino , Infección Hospitalaria/epidemiología , Infecciones Relacionadas con Catéteres/complicaciones , Estudios Prospectivos , Incidencia , América Latina/epidemiología , Infecciones Urinarias/etiología , Unidades de Cuidados Intensivos , Catéteres de Permanencia/efectos adversos , Factores de Riesgo
3.
J Pediatr Hematol Oncol ; 44(6): e930-e938, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35091515

RESUMEN

Limited information is available on outcomes of haploidentical stem cell transplantation (haploSCT) with posttransplant cyclophosphamide using myeloablative conditioning regimens in children and adolescents. We report the results of a single-institution retrospective study of myeloablative haploSCT in 36 children and adolescents (median age, 8 y; range, 9 mo to 22 y) with high-risk hematologic malignancies. Donor engraftment occurred in 31 of 33 evaluable patients (94%). Recovery of neutrophils and platelets occurred at a median of 15 and 20 days. Cumulative incidence of acute graft-versus-host-disease (GVHD) grades II to IV and grades III to IV at 100 days was 36±8.7% and 10±5.4% and of chronic GVHD at 1 year was 55±9.2%, with 31±8.6% moderate to severe. Nonrelapse mortality was 16±6.1% and 22±6.9% at 100 days and 1 year. The cumulative incidence of relapse at 4 years was 32±8.8%. With a median follow-up of 57 months (range, 8 to 89 mo), the overall survival and event-free survival at 4 years was 55.6±8.7% and 44.8±8.5%. Myeloablative conditioning T-replete haploSCT with posttransplant cyclophosphamide is a viable alternative to matched unrelated transplantation for children and adolescents with high-risk hematologic malignancies. The high rates of nonrelapse mortality and chronic GVHD is a concern and deserves careful consideration.


Asunto(s)
Enfermedad Injerto contra Huésped , Neoplasias Hematológicas , Trasplante de Células Madre Hematopoyéticas , Adolescente , Niño , Ciclofosfamida/uso terapéutico , Enfermedad Injerto contra Huésped/etiología , Enfermedad Injerto contra Huésped/prevención & control , Neoplasias Hematológicas/complicaciones , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Acondicionamiento Pretrasplante/métodos
4.
Rev Esp Enferm Dig ; 114(6): 367-368, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35100807

RESUMEN

We report the case of a 62-year-old woman with no history of interest who presented with dyspepsia of 2 years' standing. Gastroscopy revealed a subepithelial lesion at the greater antral curvature with irregular surface and preserved mucosal and vascular pattern, 15 mm in diameter. Because of clinical persistence a radial endoscopic ultrasonogram (EUS) was performed, which showed a well-delimited hypoechoic lesion with heterogeneous areas that was dependent on the muscularis mucosae layer. A biopsy was obtained using the "bite-on-bite" technique, which provided no pathological findings. With these findings an endoscopic submucosal dissection (ESD) procedure was performed with wide margins and no complications. Pathology found low-grade mesenchymal fusicellular proliferation dependent on the muscularis mucosae with immunohistochemistry positive for smooth-muscle vimentin and actin, consistent with plexiform fibromyxoma.


Asunto(s)
Neoplasias del Sistema Digestivo , Resección Endoscópica de la Mucosa , Fibroma , Neoplasias Gástricas , Resección Endoscópica de la Mucosa/métodos , Femenino , Fibroma/diagnóstico por imagen , Fibroma/cirugía , Mucosa Gástrica/patología , Mucosa Gástrica/cirugía , Gastroscopía/métodos , Humanos , Persona de Mediana Edad , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Resultado del Tratamiento
5.
J Pediatr Hematol Oncol ; 42(5): 359-366, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32068649

RESUMEN

We evaluated the outcome of 71 children with de novo acute myeloid leukemia enrolled in 2 consecutive protocols in the main pediatric hospital in Uruguay. In the LAM97 protocol (n=34), patients received, as consolidation, autologous or allogeneic hematopoietic stem cell transplantation (HSCT), depending on the availability or not of a matched sibling donor. In the LAM08 protocol (n=37), patients were stratified into risk groups, autologous HSCT was abandoned, and allogeneic HSCT was limited to intermediate-risk patients with matched sibling donor and to all patients who fulfilled the high-risk criteria. Complete remission was achieved in 91% and 92% of patients in LAM97 and LAM08, respectively. Deaths in complete remission were 9.6% and 17.6%, respectively. The incidence of relapse was significantly higher in LAM97, 35.4%, versus 12.5% in LAM08. The 5-year event-free survival and overall survival were 50.0% and 55.9% in LAM97 and 59.9% and 64.8% in LAM08. The 5-year overall survival rates in each of the risk groups were 85.7% and 100% for low risk, 50.0% and 61.2% for intermediate risk, and 42.9% and 50.0% for high risk in LAM97 and LAM08 protocols, respectively. Survival has improved over the last 2 decades, and results are comparable to those published in Europe and North America.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas/mortalidad , Trasplante de Células Madre Hematopoyéticas/métodos , Leucemia Mieloide Aguda/terapia , Donantes de Tejidos/provisión & distribución , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Leucemia Mieloide Aguda/patología , Masculino , Pronóstico , Inducción de Remisión , Estudios Retrospectivos , Hermanos , Tasa de Supervivencia , Acondicionamiento Pretrasplante , Trasplante Autólogo , Trasplante Homólogo , Uruguay
6.
Helicobacter ; 22(5)2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28771880

RESUMEN

BACKGROUND: Helicobacter pylori antibiotic resistance is an increasing problem worldwide. Pylera® may be an option as salvage therapy. AIM: To assess the effectiveness, safety, and tolerance of Pylera® as a third-line in clinical practice. MATERIALS AND METHODS: This was a multicenter, observational, prospective database study in four Spanish hospitals. Consecutive H. pylori-infected individuals treated with Pylera® and a proton-pump inhibitor (PPI) were invited to participate if they had failed to respond to PPI-clarithromycin-amoxicillin as first-line and to levofloxacin-amoxicillin-PPI as second-line therapy. Eradication was tested 4-8 weeks after Pylera® using a C13 -urea breath test. Treatment-related adverse effects (TRAEs) were assessed through a questionnaire and by reviewing databases. A questionnaire on patient satisfaction was completed in the last visit. RESULTS: Of 103 subjects fulfilling the selection criteria, 101 were included in the intention-to-treat (ITT) analysis and 97 in the per-protocol (PP) analysis. A 10 day course was prescribed in all patients. Esomeprazole 40 mg b.i.d. was the most used PPI regimen (ITT=94.1%). Ninety-seven individuals (ITT=96.04%) completed more than 90% of the treatment. Overall eradication rates were ITT=80.2% (95% confidence interval [CI]: 72.3%-88.1%) and PP=84.4% (95% CI: 76.8%-91.8%). One or more TRAEs were experienced by 67.3% (95% CI: 57.7%-75.7%), all mild or moderate. TRAEs and the number of pills were the main complaints. CONCLUSION: In an area of high antibiotic resistance to H. pylori, 10-day Pylera® plus double-dose PPI emerged as an alternative as third-line therapy, although not achieving optimal eradication rates. TRAEs were common but were neither severe nor did they condition compliance.


Asunto(s)
Antiinfecciosos/administración & dosificación , Bismuto/administración & dosificación , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/aislamiento & purificación , Terapia Recuperativa/métodos , Adulto , Anciano , Anciano de 80 o más Años , Pruebas Respiratorias , Quimioterapia Combinada/métodos , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , Inhibidores de la Bomba de Protones/administración & dosificación , España , Encuestas y Cuestionarios , Resultado del Tratamiento , Urea/análisis , Adulto Joven
7.
ACS Appl Mater Interfaces ; 16(22): 29042-29048, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38776549

RESUMEN

High-temperature polymers are attractive for applications in extreme temperatures, where they maintain their mechanical flexibility and electrical insulating properties. However, their heat dissipation capability is limited due to their intrinsically low thermal conductivities. Hexagonal boron nitride (hBN) is a chemically inert, thermally stable, and electrically insulative compound with a high thermal conductivity, making it an ideal candidate as a filler within a high-temperature polymer matrix to increase the thermal conductivity. This study evaluates the effect of filler size and dispersion on thermal conductivity by producing homogeneous composite samples using a combination of solvent mixing and resonant acoustic mixing (RAM). We carefully characterized our samples, including the spread of the size distribution, and observed that the smaller sized hBN centered around 5 µm was able to integrate more seamlessly into the polytetrafluoroethylene (PTFE) matrix with particle size in the 15 µm range and hence outperformed 30 µm, in contrast to the conventional wisdom, which asserts that larger fillers universally perform better than smaller ones. Our thermal conductivity of hBN/PTFE composites at 30 wt % is 2× higher than the literature values. Notably, we reached the record-high value of 3.5 W/m K at 40 wt % with an onset of percolation at 20 wt %, attributed to optimized hBN dispersion that facilitates the formation of thermal percolation. Our findings provide general guidelines to enhance the thermal conductivity of polymer composites for thermal management, ranging from power transmission to microelectronics cooling.

8.
J Crit Care ; 80: 154500, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38128216

RESUMEN

BACKGROUND: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. METHODS: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4-15 month, 16-27 month, and 28-39 month periods. RESULTS: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58-0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46-0.52; P < 0.001); 14.44 at the 4-15 month (RR = 0.51; 95% CI = 0.48-0.53; P < 0.001); 11.40 at the 16-27 month (RR = 0.41; 95% CI = 0.38-0.42; P < 0.001), and to 9.68 at the 28-39 month (RR = 0.34; 95% CI = 0.32-0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention. CONCLUSIONS: This intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period.


Asunto(s)
Infección Hospitalaria , Neumonía Asociada al Ventilador , Humanos , Neumonía Asociada al Ventilador/epidemiología , Neumonía Asociada al Ventilador/prevención & control , Control de Infecciones/métodos , Incidencia , América Latina/epidemiología , Unidades de Cuidados Intensivos , Medio Oriente , Asia , Europa Oriental/epidemiología , Infección Hospitalaria/epidemiología
9.
Infect Control Hosp Epidemiol ; 45(5): 567-575, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38173347

RESUMEN

OBJECTIVE: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors. DESIGN: A prospective cohort study. SETTING: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries. PARTICIPANTS: The study included 169,036 patients, hospitalized for 1,166,593 patient days. METHODS: Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression. RESULTS: Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower-middle-income countries (3.05); and with patients in public hospitals (5.89).The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P < .0001), female sex (aOR, 1.39; P < .0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P < .0001), UC DU ratio (aOR, 1.09; P < .0001), public facilities (aOR, 2.24; P < .0001), and neurologic ICUs (aOR, 11.49; P < .0001). CONCLUSIONS: CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities.Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.


Asunto(s)
Infecciones Relacionadas con Catéteres , Infección Hospitalaria , Infecciones Urinarias , Humanos , Infecciones Relacionadas con Catéteres/epidemiología , Catéteres , Infección Hospitalaria/prevención & control , Hospitales Públicos , Incidencia , Unidades de Cuidados Intensivos , Estudios Prospectivos , Infecciones Urinarias/epidemiología
12.
Adv Mater ; 35(47): e2304624, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37707242

RESUMEN

Understanding the emergent electronic structure in twisted atomically thin layers has led to the exciting field of twistronics. However, practical applications of such systems are challenging since the specific angular correlations between the layers must be precisely controlled and the layers have to be single crystalline with uniform atomic ordering. Here, an alternative, simple, and scalable approach is suggested, where nanocrystallinetwo-dimensional (2D) film on 3D substrates yields twisted-interface-dependent properties. Ultrawide-bandgap hexagonal boron nitride (h-BN) thin films are directly grown on high in-plane lattice mismatched wide-bandgap silicon carbide (4H-SiC) substrates to explore the twist-dependent structure-property correlations. Concurrently, nanocrystalline h-BN thin film shows strong non-linear second-harmonic generation and ultra-low cross-plane thermal conductivity at room temperature, which are attributed to the twisted domain edges between van der Waals stacked nanocrystals with random in-plane orientations. First-principles calculations based on time-dependent density functional theory manifest strong even-order optical nonlinearity in twisted h-BN layers. This work unveils that directly deposited 2D nanocrystalline thin film on 3D substrates could provide easily accessible twist-interfaces, therefore enabling a simple and scalable approach to utilize the 2D-twistronics integrated in 3D material devices for next-generation nanotechnology.

13.
Rev Esp Patol ; 55(1): 36-40, 2022.
Artículo en Español | MEDLINE | ID: mdl-34980438

RESUMEN

Adenomyoma of the cervix is a rare, benign lesion. It is a localized form of adenomyosis, which is surrounded by a benign muscle proliferation forming a tumor similar to leiomyoma. Of the three histological variants of adenomyomas, the most frequent is the endocervical type. We present a case of a 34-year-old woman with a tumor in the lower uterine segment which enlarged during pregnancy, replacing the entire cervix and resulting in the occlusion of the endocervical canal. Ultrasound and tomography showed a mixed tumor pushing aside the uterus and bladder. Speculoscopy revealed that the tumor protruded towards the vaginal canal. Histopathological established the diagnosis of a cervical adenomyoma of the endometrioid type.


Asunto(s)
Adenomioma , Leiomioma , Lesiones Precancerosas , Neoplasias del Cuello Uterino , Adenomioma/diagnóstico por imagen , Adenomioma/patología , Adulto , Femenino , Humanos , Leiomioma/patología , Ultrasonografía , Neoplasias del Cuello Uterino/patología
14.
J Equine Vet Sci ; 94: 103199, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33077066

RESUMEN

Equid alphaherpesvirus 3 (EHV-3) is the etiological agent of equine coital exanthema (ECE). Because no vaccines or antiviral therapies are available, prevention consists of clinical examination of mares and stallions before mating or semen collection and resting from breeding activities when lesions are present. However, this methodology does not identify subclinically infected animals. Ganciclovir is the most potent compound known to reduce EHV-3 replication. This study aimed to evaluate the efficacy of topical ganciclovir application to reduce EHV-3 replication in experimentally infected mares. A pilot study, after a double-blind completely randomized design, was carried out. Twenty mares were randomly divided into five groups (three treated with ganciclovir with different regimen of doses, one treated with a placebo, and one nontreated). Mares were experimentally infected with EHV-3 on day 0. Rectal temperature, clinical signs, and lesions were recorded. Daily perineal and vaginal swabs were evaluated by quantitative polymerase chain reaction for virus detection. The antibody response was assessed by a virus neutralization test in serum samples collected weekly. Mares experimentally infected with EHV-3 and treated with ganciclovir twice a day for 13 days showed reduced levels and duration of viral excretion and less severe lesions. The viral excretion period was reduced from 18 to nine days compared with the untreated groups. We concluded that ganciclovir had an antiviral effect on EHV-3 replication when topically administered in mares showing clinical signs of ECE. Further trials should be performed to optimize the dose of the antiviral for a definitive formulation.


Asunto(s)
Exantema , Herpesvirus Équido 3 , Enfermedades de los Caballos , Animales , Exantema/veterinaria , Femenino , Ganciclovir , Caballos , Masculino , Proyectos Piloto
15.
Am J Infect Control ; 46(6): 674-679, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29329916

RESUMEN

BACKGROUND: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in 11 hospitals within 5 cities of Argentina from January 2014-April 2017. METHODS: A multicenter, prospective, before-after surveillance study was conducted through the use of International Nosocomial Infection Control Consortium Surveillance Online System. During baseline, we performed outcome surveillance of VAP applying the definitions of the Centers for Disease Control andPrevention's National Healthcare Safety Network. During intervention, we implemented the IMA, which included a bundle of infection prevention practice interventions, education, outcome surveillance, process surveillance, feedback on VAP rates and consequences, and performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention. RESULTS: We recorded 3,940 patients admitted to 14 intensive care units. At baseline, there were 19.9 VAPs per 1,000 mechanical ventilator (MV)-days-with 2,920 MV-days and 58 VAPs, which was reduced during intervention to 9.4 VAPs per 1,000 MV-days-with 9,261 MV-days and 103 VAPs. This accounted for a 52% rate reduction (incidence density rate, 0.48; 95% confidence interval, 0.3-0.7; P .001). CONCLUSIONS: Implementing the IMA was associated with significant reductions in VAP rates in intensive care units within Argentina.


Asunto(s)
Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Unidades de Cuidados Intensivos , Neumonía Asociada al Ventilador/epidemiología , Neumonía Asociada al Ventilador/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Argentina/epidemiología , Ciudades/epidemiología , Femenino , Hospitales , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos
16.
Infect Control Hosp Epidemiol ; 39(4): 445-451, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29427997

RESUMEN

OBJECTIVE To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017. DESIGN This prospective, pre-post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate. RESULTS During the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34-0.6; P<.001). CONCLUSIONS Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina. Infect Control Hosp Epidemiol 2018;39:445-451.


Asunto(s)
Bacteriemia , Infecciones Relacionadas con Catéteres , Catéteres Venosos Centrales/efectos adversos , Infección Hospitalaria , Control de Infecciones , Argentina/epidemiología , Bacteriemia/epidemiología , Bacteriemia/etiología , Bacteriemia/prevención & control , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/etiología , Infecciones Relacionadas con Catéteres/prevención & control , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Humanos , Incidencia , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Evaluación de Procesos y Resultados en Atención de Salud , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Factores de Riesgo
17.
Rev. esp. patol ; 55(1): 36-40, ene-mar 2022. ilus, tab
Artículo en Español | IBECS (España) | ID: ibc-206769

RESUMEN

El adenomioma constituye una patología benigna, poco frecuente a nivel del cérvix. Se define como una forma localizada de adenomiosis que se encuentra rodeada de una proliferación muscular benigna conformando una tumoración similar al leiomioma. De las tres variantes histológicas que se describen en el cérvix, la que se observa con mayor frecuencia es la de tipo endocervical. Presentamos el caso de una mujer de 34años con una tumoración en segmento uterino inferior que creció durante la gestación reemplazando todo el cérvix hasta ocluir el canal endocervical. La ecografía y la tomografía mostraron un tumor mixto que lateralizaba el útero y la vejiga. En la especuloscopia se observó que la tumoración protruía hacia el canal vaginal. La evaluación histopatológica permitió establecer el diagnóstico de un adenomioma de tipo endometrioide localizado en el cérvix.(AU)


Adenomyoma of the cervix is a rare, benign lesion. It is a localized form of adenomyosis, which is surrounded by a benign muscle proliferation forming a tumor similar to leiomyoma. Of the three histological variants of adenomyomas, the most frequent is the endocervical type. We present a case of a 34-year-old woman with a tumor in the lower uterine segment which enlarged during pregnancy, replacing the entire cervix and resulting in the occlusion of the endocervical canal. Ultrasound and tomography showed a mixed tumor pushing aside the uterus and bladder. Speculoscopy revealed that the tumor protruded towards the vaginal canal. Histopathological established the diagnosis of a cervical adenomyoma of the endometrioid type.(AU)


Asunto(s)
Humanos , Femenino , Adulto , Adenomioma , Cuello del Útero , Neoplasias del Cuello Uterino , Neoplasias/diagnóstico , Diagnóstico Diferencial , Estudios de Casos y Controles
18.
Cienc. tecnol. salud ; 9(2): 189-198, 2022. il^c27
Artículo en Español | LILACS, DIGIUSAC, LIGCSA | ID: biblio-1415975

RESUMEN

La contaminación por plásticos petroquímicos es una grave amenaza para el medio ambiente que requiere im-plementar alternativas como los bioplásticos para lograr un desarrollo sostenible. Los polihidroxialcanoatos (PHA) son polímeros utilizados para la producción de plásticos biodegradables y que han llamado la atención como sustitutos de los plásticos de base fósil. Sin embargo, el costo de producción de los PHA constituye una barrera para su producción industrial a gran escala. Las de bacterias de hábitats salinos son microorganismos prometedores para la síntesis de PHA debido a sus características tales como altos requisitos de salinidad que previenen la contaminación microbiana, la alta presión osmótica intracelular que permite una fácil lisis celular para purificar los PHA y la capacidad para usar un amplio espectro de sustratos. La presente investigación planteó determinar las cepas nativas de bacterias halófilas y halotolerantes de la Laguna de Ayarza capaces de producir PHA, establecer la capacidad que tienen de utilizar residuos agrícolas para la producción de PHA y determinar su eficiencia. Esto se logró a través de la inoculación de las cepas productoras de PHA en medios de fermentación con pulpa de café, cáscaras de plátanos y salvado de trigo lo que permitió determinar las cepas más eficientes. Se encontró que las bacterias productoras de PHA pertenecen a las especies: Alcaligenes faecalis, Bacillus idriensis, Bacillus megaterium, Exiguobacterium acetylicum, E. aurantiacum, Pseudomonas cuatrocienegasensis y Sta-phylococcus capitis y que las cepas AP21-14, AP21-10 y AP21-03 mostraron los mejores resultados que podrían ser prometedores para la producción a nivel industrial.


Pollution by petrochemical plastics is a serious threat to the environment that requires the implementation of al-ternatives such as bioplastics to achieve sustainable development. Polyhydroxyalkanoates (PHAs) are polymers used for the production of biodegradable plastics and have drawn attention as substitutes for fossil-based plastics. However, the cost of producing PHAs constitutes a barrier to their large-scale industrial production. Bacteria from saline environments bacteria are promising microorganisms for PHA synthesis due to their characteristics such as high salinity requirements that prevent microbial contamination, high intracellular osmotic pressure that allows easy cell lysis to purify PHAs, and the ability to use a broad spectrum of substrates. This research project aimed to determine the native strains of halophilic and halotolerant bacteria from Laguna de Ayarza capable of producing PHA, establish their ability to use agricultural residues for the production of PHA, and determine their efficiency. This was achieved through the inoculation of the PHA-producing strains in fermentation media with coffee pulp, banana peels and wheat bran, which allowed determining the most efficient strains. It was found that the PHA-producing bacteria belong to the species: Alcaligenes faecalis, Bacillus idriensis, Bacillus mega-terium, Exiguobacterium acetylicum, E. aurantiacum, Pseudomonas cuatrocienegasensis and Staphylococcus capitis and that the strains AP21-14, AP21-10 and AP21-03 showed the best results that could be promising for production at an industrial level.


Asunto(s)
Humanos , Halomonas , Polihidroxialcanoatos/análisis , Plásticos Biodegradables/química , Pseudomonas/química , Bacillus megaterium/química , Laguna Costera , Alcaligenes faecalis/química , Fermentación , Staphylococcus capitis , Exiguobacterium/química , Guatemala , Residuos Industriales/efectos adversos
19.
Environ Sci Pollut Res Int ; 24(34): 26424-26435, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28948526

RESUMEN

The effectiveness of electrokinetic remediation for soils depends on several factors such as the arrangement and shape of electrodes. This paper presents a numerical study on external electrostatic field generated by seven different electrode configurations in any unbounded two-dimensional domain. The boundary condition at infinity for the voltage is approximated by the iterative algorithm that expands the domain till the limit of the specified tolerance (threshold value). The numerical results indicate that there is no unique configuration with larger effective area for all spacings between the oppositely charged electrodes. In addition, the configuration with the smallest inactive electric field strength spots for all spacings between the electrodes is not unique. Moreover, the voltage profile for all electrode configurations is nonlinear, and the external electric field strength varies widely near the electrodes. Only in the intermediate region between the electrodes the external electric field strength approaches a constant value.


Asunto(s)
Electrodos , Restauración y Remediación Ambiental , Modelos Teóricos , Suelo/química , Electricidad Estática , Restauración y Remediación Ambiental/instrumentación , Restauración y Remediación Ambiental/métodos , Cinética
20.
Vet Parasitol ; 236: 62-67, 2017 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-28288767

RESUMEN

The goal of the current study was to evaluate the comparative efficacy of ivermectin (IVM) against small strongyles (cyathostomins) following its oral and intramuscular (IM) administration, in naturally parasitized horses. The parasitological data were complemented with the assessment of the plasma disposition kinetics of IVM. The trial included two different experiments. In experiment I, 40 horses naturally infected with small strongyles were randomly allocated into four experimental groups (n=10) and treated with IVM (0.2mg/kg) as follows: IVM oral paste, animals were orally treated with Eqvalan® (IVM 1.87% paste, as the reference formulation) by the oral route; IVM oral solution, animals were orally treated with Remonta® (IVM 2% solution, as a test formulation); IVM IM solution, animals were IM treated with the test product (Remonta® IVM 2% solution); and control, animals were kept without treatment as untreated controls. In experiment II, 24 horses naturally parasitized with small strongyles were randomly allocated into the same four experimental groups (n=6) described for experiment I. Faecal samples were individually collected directly from the rectum of each horse prior (day -1) and at 7 and 15 (Experiment I) or 7, 15 and 21 (Experiment II) days after-treatment, to assess the eggs per gram (epg) counts and estimate the efficacy of the treatments. Additionally, the comparative plasma disposition kinetics of IVM in treated animals was assessed in experiment II. In both experiments, an excellent (100%) IVM efficacy was observed after its oral administration (test and reference formulations). However, the IM administration of IVM resulted in a low efficacy (36-64%). Similar IVM plasma concentration was observed after its oral administration as a paste or as a solution. The higher IVM plasma profiles observed after the IM administration accounted for an enhanced systemic availability. The improved IVM efficacy observed against adult cyathostomins after its oral administration can be explained by an enhanced drug exposure of the worms located at the lumen of the large intestine. These findings may have a direct impact on the practical use of macrocyclic lactones in horses.


Asunto(s)
Antihelmínticos/administración & dosificación , Ivermectina/administración & dosificación , Infecciones Equinas por Strongyloidea/tratamiento farmacológico , Strongyloidea/efectos de los fármacos , Administración Oral , Animales , Antihelmínticos/farmacología , Vías de Administración de Medicamentos/veterinaria , Heces/parasitología , Caballos , Inyecciones Intramusculares/veterinaria , Ivermectina/farmacología , Recuento de Huevos de Parásitos/veterinaria , Strongyloidea/fisiología
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