Developmental differences in spatially distinct populations of the forensically relevant blow fly Lucilia sericata - About the comparability of developmental studies (and case work application).

The cosmopolitan blow fly Lucilia sericata is often used in forensic case work for estimating the minimum postmortem interval (PMImin). For this, the age of immature specimens developing on the dead body is calculated by measuring the time taken to reach the sampled developmental stage at a given temperature. To test whether regional developmental data of L. sericata is valid on a global scale, the time taken to reach different developmental stages was compared between a population from Mexico and one from Germany at two different constant temperatures. The German population of L. sericata was collected in Frankfurt/Main, while the Mexican population originated near Oaxaca de Juarez and was transported to Germany in the larval stage. Only the F1 generation was used to avoid adaption of the Mexican flies. Eggs were immediately placed at 20 °C and 30 °C. Five times 30 freshly eclosed larvae per replicate (n = 5) were then transferred to a cup of minced meat in separate containers. The larvae were checked every 8 h for migration, pupariation or emergence of adult flies. The time at which the first individual and 50 % of the specimens per container entered each of these stages, was recorded. Significant differences in the time of development between the two populations were observed at both temperatures. At 20 °C, the first specimens of the Mexican population reached all developmental stages a little (< 1 day to < 2 days) earlier than the German L. sericata. At 30 °C, the Mexican flies also reached the post-feeding stage slightly earlier (0.2 days). However, at 30 °C, the German flies started pupariation significantly earlier (after 5 days) than the Mexican flies (6.9 days) and the adults from Germany also emerged earlier (10.5 days compared to 13.1 days). The same pattern was observed when looking at 50 % of the total number of specimens per container. A comparison with previously published developmental studies was difficult as the experimental design varied widely between studies. However, the results were within the range of most studies. Our study has shown that age estimation can vary widely depending on the population on which the reference data used for the calculations are based. This highlights the importance of using local and population-specific developmental data for estimating the age of blow flies in case work.

Montreal Cognitive Assessment (MoCA) as a screening tool for cognitive impairment in early stages of psychosis.

Background: Cognitive alterations have been reported in early stages of psychosis including people with First Episode Psychosis (FEP), Clinical High-Risk Mental State (CHR), and Psychotic-Like Experience (PLE). This study aimed to compare the cognitive function in early stages of psychosis using the Montreal Cognitive Assessment (MoCA), a low-cost and brief assessment tool of cognitive functions. Methods: A total of 154 individuals, including 35 with FEP, 38 CHR, 44 PLE, and 37 healthy controls (HC), were evaluated with the MoCA in Santiago, Chile. We calculated the mean total score of the MoCA and the standard deviation of the mean. Groups were assessed for a trend to lower scores in a pre-determined sequence (HC > PLE > CHR > FEP) using the Jonckheere-Terpstra test (TJT). Results: The mean total MoCA scores were 24.8 ± 3.3 in FEP, 26.4 ± 2.4 in CHR, 26.4 ± 2.3 in PLE, and 27.2 ± 1.8 in HC. The analyses revealed a significant trend (p < 0.05) toward lower MoCA individual domain scores and MoCA total scores in the following order: HC > PLE > CHR > FEP. The mean total scores of all groups were above the cut-off for cognitive impairment (22 points). Conclusions: The MoCA describes lower scores in cognition across early stages of psychosis and may be a useful low-cost assessment instrument in early intervention centers of poorly resourced settings.

Morphometric and microstructural characteristics of hippocampal subfields in mesial temporal lobe epilepsy and their correlates with mnemonic discrimination.

Introduction: Pattern separation (PS) is a fundamental aspect of memory creation that defines the ability to transform similar memory representations into distinct ones, so they do not overlap when storing and retrieving them. Experimental evidence in animal models and the study of other human pathologies have demonstrated the role of the hippocampus in PS, in particular of the dentate gyrus (DG) and CA3. Patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HE) commonly report mnemonic deficits that have been associated with failures in PS. However, the link between these impairments and the integrity of the hippocampal subfields in these patients has not yet been determined. The aim of this work is to explore the association between the ability to perform mnemonic functions and the integrity of hippocampal CA1, CA3, and DG in patients with unilateral MTLE-HE. Method: To reach this goal we evaluated the memory of patients with an improved object mnemonic similarity test. We then analyzed the hippocampal complex structural and microstructural integrity using diffusion weighted imaging. Results: Our results indicate that patients with unilateral MTLE-HE present alterations in both volume and microstructural properties at the level of the hippocampal subfields DG, CA1, CA3, and the subiculum, that sometimes depend on the lateralization of their epileptic focus. However, none of the specific changes was found to be directly related to the performance of the patients in a pattern separation task, which might indicate a contribution of various alterations to the mnemonic deficits or the key contribution of other structures to the function. Discussion: we established for the first time the alterations in both the volume and the microstructure at the level of the hippocampal subfields in a group of unilateral MTLE patients. We observed that these changes are greater in the DG and CA1 at the macrostructural level, and in CA3 and CA1 in the microstructural level. None of these changes had a direct relation to the performance of the patients in a pattern separation task, which suggests a contribution of various alterations to the loss of function.

Cultural competence in a primary healthcare center in Santiago de Chile: a mixed methods design.

BACKGROUND: The immigrant population in Chile is growing significantly, challenging the health care system's capacity to provide sensitive and effective care. AIM: To assess the cultural competence of Chilean primary health workers. MATERIAL AND METHODS: This mixed-methods study used a quantitative scale and semi-structured interviews to examine the cultural competence of a Chilean primary health care team in their care for the international migrant population. The study pointed to specific variables that were associated with increased cultural competence, including age, intercultural life experiences, and having received relevant training. RESULTS: The two approaches produced largely convergent results. The dimensions of cultural competence with the highest scores on the quantitative scale were also the theoretical dimensions with the greatest discursive density in the qualitative analysis. CONCLUSIONS: The analysis provides a starting point for policies aimed at the development of cultural competence in the national scenario, suggesting a general direction to foster transcultural competence in health, such as formal training and the promotion of informal spaces ofsensibilization.

Growth of the Black Soldier Fly Hermetia illucens (Diptera: Stratiomyidae) on Organic-Waste Residues and Its Application as Supplementary Diet for Nile Tilapia Oreochromis niloticus (Perciformes: Cichlidae).

The black soldier fly, Hermetia illucens (BSF, Diptera: Stratiomyidae) is an insect with high protein value and a potential feed agent for animals aimed for human consumption. The growth parameters of BSF larvae reared on four substrates-restaurant-waste, fruit-waste, fish-waste, and commercial tilapia food-for 41 days before processing for inclusion into Oreochromis niloticus (Perciformes: Cichlidae, Nile tilapia) commercial fry diets at 30% (70:30) were determined. On fly larvae, the food substrate based on restaurant waste yielded the greatest larval weight and length. BSF larvae fed a fish-waste diet showed the shortest developmental time. The fruit-waste diet induced the lowest weight and length in the fly larvae/pre-pupae (immature stage). The pre-pupal protein values were similar to commercial food. On fry-fish, the diets with pre-pupae grown on fish waste showed the greatest yields regarding weight (biomass), length, and nutritional content. These results suggest the BSF has the potential to be used in fish feed and provides an alternative for commercial cultivation.

The Impact of Frailty Screening on Radiation Treatment Modification.

BACKGROUND: Care overburden makes it difficult to perform comprehensive geriatric assessments (CGAs) in oncology settings. We analyzed if screening tools modified radiotherapy in oncogeriatric patients. METHODS: Patients ≥ 65 years, irradiated between December 2020 and March 2021 at the Hospital Provincial de Castellón, completed the frailty G8 and estimated survival Charlson questionnaires. The cohort was stratified between G8 score ≤ 14 (fragile) or >14 (robust); the cutoff point for the Charlson index was established at five. RESULTS: Of 161 patients; 69.4% were male, the median age was 75 years (range 65-91), and the prevailing performance status (PS) was 0-1 (83.1%). Overall, 28.7% of the cohort were frail based on G8 scores, while the estimated survival at 10 years was 2.25% based on the Charlson test. The treatment administered changed up to 21% after frailty analysis. The therapies prescribed were 5.8 times more likely to be modified in frail patients based on the G8 test. In addition, patients ≥ 85 years (p = 0.01), a PS ≥ 2 (p = 0.008), and limited mobility (p = 0.024) were also associated with a potential change. CONCLUSIONS: CGAs remain the optimal assessment tool in oncogeriatry. However, we found that the G8 fragility screening test, which is easier to integrate into patient consultations, is a reliable and efficient aid to rapid decision making.

SuPepMem: A database of innate immune system peptides and their cell membrane interactions.

Host defense peptides (HDPs) are short cationic peptides that play a key role in the innate immune response of all living organisms. Their action mechanism does not depend on the presence of protein receptors, but on their ability to target and disrupt the membranes of a wide range of pathogenic and pathologic cells which are recognized by their specific compositions, typically with a relatively high concentration of anionic lipids. Lipid profile singularities have been found in cancer, inflammation, bacteria, viral infections, and even in senescent cells, enabling the possibility to use them as therapeutic targets and/or diagnostic biomarkers. Molecular dynamics (MD) simulations are extraordinarily well suited to explore how HDPs interact with membrane models, providing a large amount of qualitative and quantitative information that, nowadays, cannot be assessed by wet-lab methods at the same level of temporal and spatial resolution. Here, we present SuPepMem, an open-access repository containing MD simulations of different natural and artificial peptides with potential membrane lysis activity, interacting with membrane models of healthy mammal, bacteria, viruses, cancer or senescent cells. In addition to a description of the HDPs and the target systems, SuPepMem provides both the input files necessary to run the simulations and also the results of some selected analyses, including structural and MD-based quantitative descriptors. These descriptors are expected to be useful to train machine learning algorithms that could contribute to design new therapeutic peptides. Tools for comparative analysis between different HDPs and model membranes, as well as to restrict the queries to structural and time-averaged properties are also available. SuPepMem is a living project, that will continuously grow with more simulations including peptides of different sequences, MD simulations with different number of peptide units, more membrane models and also several resolution levels. The database is open to MD simulations from other users (after quality check by the SuPepMem team). SuPepMem is freely available under https://supepmem.com/.

Application of pharmacovigilance tools in a case of subacute anterior angle narrowing while under furosemide exposure.

Sulfonamides have been related to drug-induced acute angle closure of the eye, but scarce reports exist concerning furosemide. We describe the second case of acute chamber narrowing (ACN) during furosemide exposure. A 65-year-old man with a renal transplant presented with ACN, after 3 months of furosemide intake. Finally, the patient required a bilateral iridotomy and right lens replacement. ACN has been associated with drugs containing sulfonamide derivatives, but an evaluation with pharmacovigilance scales for adverse drug reaction (ADR)-standardised causality assessment has not been provided. We use this case to illustrate how medicines and an ADR should be evaluated and reported. The spreading of pharmacovigilance information on what should be a rare and unexpected condition related to a drug could mean that other reports emerge about ADR with this drug and regulatory agencies perform consequently, as happened with topiramate.

Clinical study of Maggot therapy for Fournier's gangrene.

Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture-directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.

A plant volatile alters the perception of sex pheromone blend ratios in a moth.

Mate finding in most moths is based on male perception of a female-emitted pheromone whose species specificity resides in component chemistry and proportions. Components are individually detected by specialized olfactory receptor neurons (ORNs) projecting into the macroglomerular complex (MGC) of the male brain. We asked how robust ratio recognition is when challenged by a plant volatile background. To test this, we investigated the perception of the pheromone blend in Agrotis ipsilon, a moth species whose females produce a blend of Z7-dodecenyl acetate (Z7-12:Ac), Z9-tetradecenyl acetate (Z9-14:Ac), and Z11-hexadecenyl acetate in a 4:1:4 ratio optimally attractive for males. First, we recorded the responses of specialist ORNs for Z7 and Z9 and showed that heptanal, a flower volatile, activated Z7 but not Z9 neurons. Then, we recorded intracellularly the responses of MGC neurons to various ratios and showed that heptanal altered ratio responses of pheromone-sensitive neurons. Finally, we analyzed the behavior of males in a wind tunnel and showed that their innate preference for the 4:1:4 blend was shifted in the presence of heptanal. Pheromone ratio recognition may thus be altered by background odorants. Therefore, the olfactory environment might be a selective force for the evolution of pheromone communication systems.

Bactericidal Activity of Chrysomya rufifacies and Cochliomyia macellaria (Diptera: Calliphoridae) Larval Excretions-Secretions Against Staphylococcus aureus (Bacillales: Staphylococcaceae).

The inhibitory effect of Chrysomya rufifacies (Macquart) and Cochliomyia macellaria (Fabricius) larval excretions-secretions (ES) on Staphylococcus aureus was determined using a portable colorimetric method without the need for any dedicated spectral instrument. Polystyrene 96 well microplates were used and 100 µl of the bacterial inoculum (5 × 105 CFU/ml) plus 100 µl of the dipteran exosecretions at different concentrations were added to each well. Subsequently, 50 µl of a 1% solution of the triphenyl tetrazolium chloride stain was added to each well to determine the bacterial viability. The color development in each well was measured with the ImageJ software S. aureus was exposed to different concentrations of the ES of both species individually. At a concentration of 800 ppm ES of C. rufifacies or Co. macellaria, bacterial growth was inhibited 97.45 ± 1.70% and 82.21 ± 1.88%, respectively. As expected, exposure to a lower concentration (i.e., 50 ppm) was less inhibitory (C. rufifacies ES, 77.65 ± 4.25% and Co. macellaria ES, 43.54 ± 4.63%). This study demonstrates for the first time the bactericidal activity of C. rufifacies and Co. macellaria ES against S. aureus. This finding is promising as it could result in the identification and synthesis of proteins capable of suppressing pathogen development in wounds. Additionally, the proposed method can simplify the use of expensive laboratory instruments for antimicrobial activity determination.

Rapid cultivar identification of barley seeds through disjoint principal component modeling.

Classification of barley varieties is a crucial part of the control and assessment of barley seeds especially for the malting and brewing industry. The correct classification of barley is essential in that a majority of decisions made regarding process specifications, economic considerations, and the type of product produced with the cereal are made based on the barley variety itself. This fact combined with the need to promptly assess the cereal as it is delivered to a malt house or production facility creates the need for a technique to quickly identify a barley variety based on a sample. This work explores the feasibility of differentiating between barley varieties based on the protein spectrum of barley seeds. In order to produce a rapid analysis of the protein composition of the barley seeds, lab-on-a-chip micro fluid technology is used to analyze the protein composition. Classification of the barley variety is then made using disjoint principle component models. This work included 19 different barley varieties. The varieties consisted of both winter and summer barley types. In this work, it is demonstrated that this system can identify the most likely barley variety with an accuracy of 95.9% based on cross validation and can screen summer barley with an accuracy of 95.2% and a false positive rate of 0.0% based on cross validation. This demonstrates the feasibility of the method to provide a rapid and relatively inexpensive method to verify the heritage of barley seeds.

Patient safety first... a California partnership for health.

BACKGROUND: In California in 2009, Anthem Blue Cross joined forces with three regional hospital associations (RHAs) and an independent evaluator in an initial three-year, $6-million effort to address patient safety. METHODS: During Phase 1 of the Patient Safety First... a California Partnership for Health program (2010-2012), more than 180 of the 395 hospitals represented by the RHAs shared and implementated best practices in learning collaboratives. The three initial areas of focus were (1) health care-associated infections-ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI); (2) sepsis mortality; and (3) perinatal care-reduction of elective deliveries prior to 39 weeks of gestation. To measure progress, the difference in the average rates from 2009 (baseline) to 2012 was calculated using data from hospitals that reported for every quarter from 2009 through 2012. RESULTS: The rate decreases-57% for VAP cases per 1,000 ventilator-days, 43% for CLABSI cases per 1,000 central line-days, 24% reduction for CAUTI cases per 1,000 patient-days, 26% reduction for sepsis deaths per 100 sepsis cases, and 74% for elective deliveries < 39 gestational weeks-were statistically significant at the .05 level, except for CAUTI. A cost-avoidance analysis showed that these reductions were associated with a saving of 3,576 lives and an avoidance of $63.8 million in costs statewide (not limited to Anthem Blue Cross members). CONCLUSION: The Patient Safety First program provides a long-term opportunity for collaboration among different health care sectors to share best practices to improve health care for Californians. Phase 2 will continue to addresssepsis and elective deliveries and add other initiatives.

Parental stress and children adjustment in kinship foster families.

This work focuses on a multidimensional exploration of the stress experienced by kinship foster carers. This study is the first one conducted on Spanish sample, with 116 kinship foster families and foster children, between the ages of 4 and 11 years. In general, data indicate that the carer's parental stress scores are within the normative range. The existing heterogeneity among these families is also reported, highlighting a carers group with high stress levels. Parental stress correlated with children variables (initial adversity index, adaptation, evolution and behavioral adjustment); caregiver and family variables (main carer's health, no correlation was found with social support network or with economic needs) and child-carer relationship variables (acceptance-rejection, relationship with the main caregiver and with other family members). Finally, the predictive model performed shows that the more behavioral and emotional problems foster children exhibit, the more stress the carers experience. This is also true the worse the relationships with other relatives are and the poorer the health of the main carer is.

Misalignments in the retinal nerve fiber layer evaluation using cirrus high-definition optical coherence tomography.

PURPOSE: To evaluate the frequency and characteristics of misalignments (MAs) in the retinal nerve fiber layer (RNFL) analysis protocol of spectral-domain optical coherence tomography (Cirrus) and determine factors associated with MAs. METHODS: Three hundred eyes (162 normal and 138 glaucomatous eyes) were included in this cross-sectional study. The MAs were considered limited when they affected only part of the scan line, and complete (CMA) when they were observed in the entire scan line. A subgroup (153 cases) with repeated scans was analyzed to compare the RNFL thicknesses in the scans with and without CMAs. RESULTS: Two hundred ninety-nine limited MAs were found in 140 eyes (46.7%) and 151 CMAs were found in 91 eyes (30.3%). The frequency and number of CMAs were significantly related to age (P<0.05). Seventy-two CMAs were in the measurement ring in 48 eyes, more frequently in the 3 and 9-o'clock positions (P=0.001) and the horizontal quadrants (P=0.001). Among the repeated scans, the number of cases with CMAs was similar to the first scan (P=0.32). No significant differences were found in global or quadrant RNFL thickness between scans with and without CMAs. CONCLUSIONS: CMAs were present in the first or second scans in about 30% of cases and were related to older age. CMAs were more frequently in horizontal meridians and quadrants. No differences in RNFL thickness were found between scans with and without CMAs in the same patients. Scans with CMAs in the measurement ring can be considered in the RNFL evaluation.

Contribution of hypoxia-measuring molecular imaging techniques to radiotherapy planning and treatment.

Hypoxia is related to poor prognosis because it is associated to chemo- and radioresistance. During recent years the evolution of imaging methods like PET/CT and MRI has meant the appearance of new perspectives with direct implications in radiation therapy. We discuss previous experiences in staging, planning and in the follow-up process with these techniques for measuring tumour hypoxia.

Responders and non-responders to probiotic interventions: how can we improve the odds?

As with many clinical studies, trials using probiotics have shown clearly that some patients benefit from the treatment while others do not. For example if treatment with probiotics leads to 36% cure rate of diarrhea, why did the other 64% not have the same result? The issue is important for human and indeed experimental animal studies for two main reasons: (i) Would changing the design of the study result in more subjects responding to treatment? (ii) If a subject does not respond what are the mechanistic reasons? In order to tackle the issue of responders and non-responders to therapy, a workshop was held by the International Scientific Association for Probiotics and Prebiotics (ISAPP). The outcome was four recommendations. 1. Clearly define the end goal: this could be supporting a health claim or having the highest clinical effect and impact. 2. Design the study to maximize the chance of a positive response by identifying precise parameters and defining the level of response that will be tested. 3. Base the selection of the intervention on scientific investigations: which strain(s) and/or product formulation should be used and why. 4. Carefully select the study cohort: use biological or genetic markers when available to stratify the patient population before enrollment and decide at what point intervention will provide the best outcome (for example, in acute phase of disease, or during remission, with or without use of pharmaceutical agents). By following these recommendations and selecting an appropriate primary outcome, it is hoped that clinical data will emerge in the future that expands our knowledge of which probiotics benefits which subjects and by what mechanism.

Evaluación de un activador del sistema lactoperoxidasa en leche sin refrigerar recolectada de pequeños productores / Evaluation of an of lacto-peroxidase system activator in milk without refrigeration on small dairy farms

La investigación se realizó en el Centro de Acopio Lechero del sector Mune Alto, comuna de Pitrufquén, IX región, Chile. Los objetivos de éste estudio fueron evaluar el efecto de la aplicación de un activador del Sistema Lactoperoxidasa compuesto por 700 tiocin de sodio y 1,7 grs de percarbonato de sodio. (Sistema LP), sobre el crecimiento bacteriano en leche entregada por los pequeños productores asociados al Centro de Acopio y mantenida a temperaturas ambientales durante la época de verano por 12 y 15 horas; evaluar la reactivación del sistema lactoperoxidasa luego de 8 horas y evaluar el activador del sistema lactoperoxidasa, bajo las condiciones de calidad higiénica exigidas por la industria lechera en Chile. Para evaluar el efecto del activador del Sistema LP, se seleccionaron al azar dos tarros de leche fresca recién ordeñadas de 50 litros cada uno. Una vez homogenizado su contenido, esta mezcla se dividió nuevamente en dos tarros de 50 litros, que conformaron la leche cruda (LC), sin aplicación del activador y la leche tratada (LT), con aplicación del activador, procedimiento que se repitió en nueve oportunidades. Para evaluar el efecto de la reactivación del Sistema LP, se utilizó el mismo procedimiento anterior, homogenizando la leche de tres tarros, conformando la LC, sin aplicación del activador; la LT1, con aplicación del activador; y la LT2, con aplicación del activador y una segunda dosis de percarbonato de sodio a las 8 horas de almacenamiento. De todos los tarros de leche se obtuvieron muestras, a los distintos tiempos determinados para el estudio, Las cuales fueron sometidas a análisis de recuentos bacterianos, presencia de inhibidores y peróxidos. Los resultados obtenidos muestran diferencias estadísticamente significativas (P<0,05) en el incremento de recuentos bacterianos entre la LC y LT al cabo de 12 horas de almacenamiento de la leche fresca a temperatura ambiente. La reactivación del Sistema LP, no muestra diferencias estadísticas significativas en el desarrollo de las cargas bacterianas entre el LT1 y LT2 (P>0,05) a las 15 horas de almacenamiento de la leche fresca a temperatura ambiente, pero sí entre estos dos y el LC (P>0,05)

Aplicación de la nefelometría laser en inmunología y microbiología / Laser nefelometry immunology and microbiology

Objetivo: evaluar la utilidad de la nefelometría láser en los estudios inmunológicos y microbiológicos. Material y métodos: se realizaron cuantificaciones de diversas proteínas plasmáticas: IgG, IgA, IgM, C3 y C4 por nefelometría laser utilizando como controles los estándares proporcionados por una casa comercial. Para su análisis los datos se transformaron a escalas logarítmicas y se calcularon ecuaciones de regresión lineal. Para la evaluación microbiológica se realizaron concentraciones bacterianas decimales hasta 10 a la 6 de E. coli en caldo de Hinto-Muller. Todas las concentraciones se leyeron cada 5 o 10 minuto durante 70 minutos para determinar la cinética de crecimiento. También se midió inhibición de amikacina sobre E. coli. Resultados: las ecuaciones calculadas empíricamente mostraron una buena reproducibilidad y una vigencia aproximada de seis meses para las proteínas plasmáticas. Así mismo la nefelometría mostró que permite realizar un cálculo rápido de la concentración mínima inhibitoria de crecimiento bacteriano