Perfil de uso de tigeciclina en un hospital universitario en Chile / Profile of tigecycline use in a university hospital in Chile

INTRODUCCIÓN: El uso de tigeciclina ha ido en aumento en los últimos años, debido al incremento de la resistencia bacteriana y la escasez de alternativas terapéuticas. OBJETIVO: Caracterizar y evaluar las prescripciones de tigeciclina en pacientes internados en un hospital universitario, durante los años 2017 y 2018. METODOLOGÍA: Estudio observacional retrospectivo, donde se caracterizaron los pacientes, las terapias, la microbiología asociada, los desenlaces clínicos y las reacciones adversas asociadas a los tratamientos con tigeciclina. Se determinó la proporción de prescripciones apropiadas por un comité de expertos y el consumo de tigeciclina medido en DDD/100 camas-día. RESULTADOS: Se caracterizaron 89 pacientes, de los cuales 67 (75,3%) cumplieron los criterios de selección. El 53,7% de los pacientes eran hombres, con una edad promedio de 60 ± 15 años. El principal motivo de hospitalización fue quirúrgico (65,7%). El 67,1% de los tratamientos con tigeciclina se inició en una Unidad de Paciente Critico y el foco de infección predominante fue abdominal (64,3%). El 50% de las terapias con tigeciclina fueron dirigidas según la microbiología identificada. En 65,7% de los casos se usó tigeciclina como monoterapia en la dosis habitual (62,9%). Náuseas (8,6%), diarrea (7,1%) y vómitos (4,3%) fueron los efectos adversos más reportados. El 84,3% de los tratamientos se consideraron apropiados. El año 2017 se consumió 0,4 DDD/100 camas-día y 0,6 DDD/100 camas/día el 2018, siendo la UCI el servicio que presentó el mayor uso en ambos años. DISCUSIÓN: Tigeciclina fue utilizada principalmente en monoterapia para el tratamiento de infecciones intraabdominales en pacientes hospitalizados, por motivos quirúrgicos, en una unidad de paciente crítico, en las dosis habituales recomendadas de 100 mg como dosis de carga seguida de 50 mg cada 12 hs IV. En 50% de los casos, la terapia fue dirigida según microbiología. Los eventos adversos más habituales fueron los gastrointestinales. CONCLUSIÓN: La mayoría de las terapias prescritas fueron consideradas apropiadas por el comité de expertos.

BACKGROUND: The use of tigecycline has been increasing in recent years, due to increase in bacterial resistance and the scarcity of therapeutics alternatives. AIM: To characterize and evaluate the tigecycline prescriptions of patients hospitalized in a university hospital, during the years 2017 and 2018. METHODS: A retrospective observational study was carried out, where the patients, the therapies, the associated microbiology, the clinical outcomes and the adverse reactions associated with tigecycline were characterized. The proportion of appropriate prescriptions was determined by committee of experts and the consumption of tigecycline measure in DDD/100 bed-days. RESULTS: 89 patients who used tigecycline were characterized, of which 67 (75.3%) met the selection criteria. 53.7% of the patients were male, with a mean age of 60 +/- 15 years The main reason for hospitalization was surgical (65.7%). 67.1% of the treatments with tigecycline were started in a critical patient unit and the predominant focus of the infection was the abdomen (64.3%). 50% of the therapies with tigecycline were ordered according to the identified microbiology. In 65.7% of the cases, tigecyclin was used as monotherapy at the usual dose (62.9%). Nausea (8.6%), diarrhea (7.1%) and vomiting (4.3%) were the most reported adverse events. 84.3% of the treatments were considered appropriate. In 2017, 0.4 DDD/100 bed/days were consumed and 0.6 DDD/100 bed/days in 2018, with de ICU being the service that presented the highest use in both years. DISCUSSION: Tigecycline was mainly used as monotherapy for the treatment of intra-abdominal infections in patients hospitalized for surgical reasons in a critical patient unit at the usual doses of 100 mg loading followed by 50 mg every 12 hours IV. In 50% of the case the therapy was directed according to microbiology. The most common adverse events were gastrointestinal. CONCLUSION: Most of the prescribed therapies were considered appropriate by the expert committee.

Black Ethnicity Influences Gingival and Bone Thickness: A Cross-Sectional Study.

The aim of the present study was to compare by cone beam computerized tomography (CBCT) the influence of white and black ethnicity on the gingival and bone thickness. Eighty-four individuals, aged between 18 and 59 years old, of both genders, were divided into black (BG n=42) and white groups (WG n=42) and analyzed from June 2020 to April 2021. The gingival and bone thickness were measured using CBCT in all maxillary anterior teeth. T test, Mann-whitney, chi-square, Pearson's correlation and Spearman's correlation were used for comparisons and correlations with a 5% significance level. The black individuals had mean gingival (1.45mm±0.29) and buccal bone plate (1.07mm±0.21) significantly (gingival: p<0.0001, bone: p=0.0002) thicker than white individuals (1.17mm±0.28 and 0.91mm±0.17, respectively). The variables presented greater values for the male individuals. A positive correlation between the thickness of buccal bone plate and gingiva for was found in two teeth in WG (left and right central incisor) and one tooth in BG (left canine). Moreover, a correlation between BBPT and GT immediately below alveolar bone crest (0 mm landmark) was found in four teeth in WG (left and right lateral incisor, left and right central incisor) and BG (left and right canine, left lateral incisor and left central incisor). The black ethnic showed to significantly influence the gingival and buccal bone plate thickness, with black individuals presenting thicker structures than whites.

Nitrogen and potassium synergism influences the yield and quality of Dioscorea cayennensis.

This study aimed to evaluate yield, quality, nematode incidence, chlorophyll content, and primary foliar macronutrients of yam in response to nitrogen and potassium fertilization. A complete randomized block design was used in a factorial scheme (5 x 5), with five nitrogen (0; 60; 120; 180 and 240 kg ha-1 of N) and five potassium doses (0; 60; 120; 180 and 240 kg ha-1 of K2O), with four replicates. The mass, total and commercial productivity of tubers, starch content, ash, leaf N, P, and K content, chlorophyll, and nematode incidence were evaluated. The average mass of tubers obtained was 1.935 kg with doses of 133 kg ha-1 of N and 105 kg ha-1 of K2O. The dose of 178 kg ha-1 of N promoted maximum total tuber productivity (22.56 t ha-1). The doses of 132 kg ha-1 of N and 118 kg ha-1 of K2O resulted in maximum productivity of commercial tubers with 20.35 t ha-1. Leaf N and K, starch, and ash contents were within the standards for yam. The incidence of Meloidogyne, Scutellonema, and Pratylenchus reduced with the increasing simple effect doses of N and K2O. The maximum chlorophyll content was obtained at the dose of 240 kg ha-1 of N. The nitrogen and potassium interaction, despite the antagonistic effects on the accumulation of foliar P and starch, increased the productivity and average mass of commercial tubers, consequently ensuring the profitability of yam cultivation.

Demonstration of multiple quantum interference and Fano resonance realization in far-field from plasmonic nanostructure in Er3+-doped tellurite glass.

It is crucial to control the tuning and improve the emission of a quantum emitter at the nanoscale. We report multiple Fano resonances in metallic nanostructures on an Er3+-doped tellurite glass. Periodic nanoslits were fabricated with a focused gallium ion beam on a gold thin film deposited on the tellurite glass. Is proposed a coupling function with Fano line-shape form, and the asymmetric parameter q for each resonance wavelength in the 515 to 535 nm region was calculated. This asymmetric resonance effect is a consequence of the quantum interaction between the continuum state, generated in the nanostructure, and the Stark splits of the [Formula: see text]H[Formula: see text] state.

Exploring employees' beliefs regarding the potential benefits of virtual worlds for group cohesion: gather town.

As a consequence of advances in Information and Communication Technologies, teleworking is becoming more and more common in organizations. These new ways of working create new challenges for companies such as team cohesion despite working in different locations. This article aims to analyze the effect of the use of so-called "virtual worlds" on the group cohesion of employees in organizations. The focus group methodology has made it possible to gather the beliefs and opinions of company employees about the use of these resources and tools. The results obtained show the positive effect of the use of virtual worlds on the cohesion of the teleworking team.

Investigation of Tritrichomonas foetus in cryopreserved bovine semen by culture and polymerase chain reaction / Pesquisa por Tritrichomonas foetus em sêmen bovino criopreservado mediante isolamento e reação em cadeia da polimerase

Bovine Trichomoniasis (BT) is an infectious disease caused by Tritrichomonas foetus that can be transmitted either sexually or by fomites. In males, the disease is asymptomatic and permanent. T. foetus has been detected in semen samples where it is able to remain viable even when frozen. The objective of this study was to investigate the presence of T. foetus in 27 samples of commercial frozen bovine semen by culture and Polymerase Chain Reaction (PCR). Samples were thawed in water at 37°C. Part of the samples was inoculated in a test tube containing Diamond's medium and incubated at 35°C. Growth was evaluated every 24 hours via direct examination under a microscope. The other part was placed in an Eppendorf tube and frozen for later molecular analysis. After 10 days of culture, all samples were negative for T. foetus. The Quick-DNA Miniprep Kit (Zymo Research) without proteinase K was used for DNA extraction. The primers used in PCR were TRF3 and TRF4. PCR results were negative for all samples. In conclusion, bovine semen samples were negative for T. foetus in both diagnostic methods, according to the adopted methodology.(AU)

A tricomonose genital bovina (TGB), uma doença infectocontagiosa causada pelo Tritrichomonas foetus, é transmitida por via venérea e fômites contaminados. Em machos a doença é assintomática e permanente. O agente já foi encontrado em amostras de sêmen e é capaz de permanecer viável quando congelado. Este trabalho teve por objetivo investigar a presença de T. foetus em 27 amostras de sêmen bovino comercial congelado, por meio de cultivo e reação em cadeia da polimerase (PCR). As amostras foram descongeladas em água a 37ºC; parte foi inoculada em tubo de ensaio contendo meio Diamond, incubada a 35ºC com consequente avaliação de crescimento e avaliada a cada 24 horas, via exame direto em microscópio, e a outra parte foi diluída em PBS para análise molecular. Após 10 dias de cultivo, todas as amostras foram negativas. Para a detecção molecular foi utilizado o kit Quick-DNA Miniprep (Zymo Research) sem proteinase K para extração do DNA. Os iniciadores utilizados na PCR foram TRF3 e TRF4. O resultado da PCR foi negativo para todas as amostras. Conclui-se que as amostras utilizadas foram realmente negativas para a presença do patógeno em ambos os métodos diagnósticos, o que comprovou a inocuidade do sêmen testado.(AU)

The Effects of Testosterone Therapy Combined with Swimming Exercise on Adipose Tissue and Biochemical Parameters in Male Obese Wistar Rats.

Context: Exercise and anabolic steroids are anticipated to promote fat mass reduction and so to decrease the number of comorbidities related to excessive weight. Objective: The aim of this study was to verify the influence of aerobic exercise and the use of steroids on the accumulation of adipose tissue and on the biochemical limitations of Wistar rats nourished by a hypercaloric diet. Methods: Forty, young male Wistar rats were split into four groups: obese control (n=10), obese under treatment (n=10), obese under aerobic exercise (n=10) and obese under aerobic exercise and treatment (n=10). All animals were fed with a hypercaloric diet and animals under treatment received intramuscular testosterone. Body (weight and visceral fat) and blood (lipidogram, glucose, and liver enzymes) parameters were assessed. Results: The group treated with aerobic exercise and testosterone revealed a reduction in body weight and visceral, perirenal, retroperitoneal and epididymal fats, accompanied by the blood levels of glucose, lactate, LDL-cholesterol, HDL-cholesterol, and lactate dehydrogenase; following high-intensity physical activity. Conclusion: The results support the theory that the combination of steroids and physical activity reduces the side-effects of androgenic-anabolic hormones and conveys benefits to some constraints.

Afectación respiratoria por coronavirus (COVID-19) / Respiratory involvement by coronavirus (COVID-19)

In December 2019, an epidemic of cases with unexplained lower respiratory infections detected in Wuhan, China was first reported to the WHO China Office. The respiratory picture presents in various ways, from asymptomatic or paucisymptomatic forms, to clinical conditions characterized by respiratory failure that require mechanical ventilation and support in the ICU, with multi-organ and systemic manifestations in terms of sepsis, septic shock and multiple organ dysfunction syndromes. The etiological agent was identified as a virus belonging to the coronavirus family (CoV) with a high contagion capacity that determined its rapid spread, triggering a pandemic with high morbidity and mortality. This review attempts to address the basics of this disease.

Efficacy of sodium hypochlorite and peracetic acid against Aspergillus nomius in Brazil nuts.

The objective of this work was to assess the efficacy of sodium hypochlorite and peracetic acid for sanitization of Brazil nuts. To evaluate the natural microbiota of the nuts, the total bacteria and fungi as well as the Aspergillus section Flavi were counted. The moisture, water activity and the presence of aflatoxins was quantified. The response surface method was used to determine the influence of exposure time and sanitizers concentration on the reduction of Aspergillus nomius inoculated on the nuts. Microbiological, sensory and quantification analyzes of aflatoxins were performed under optimum conditions The evaluation of the initial contamination of the nuts, despite presenting high microbiological contamination, humidity and water activity, was not detected aflatoxins in any samples. In artificially inoculated samples, the response surface and the desirability function were obtained to determine the optimal point of use for each sanitizer. The nuts had high microbiological contamination, moisture content and water activity. Aflatoxins were not detected in any samples. The response surface and desirability function indicated the optimal sanitization conditions were 250 mg/L and 8.5 min and 140 mg/L and 15 min for sodium hypochlorite and peracetic acid, respectively. Reductions greater than 2 log CFU/g were obtained with sodium hypochlorite and of 1 log CFU/g for peracetic acid. In the tests performed with new Brazil nuts samples under the optimized conditions, reductions of less than 2 log CFU/g were obtained. Aflatoxin B1 was detected in one untreated sample (1.51 µg/kg), one sample treated with sodium hypochlorite (0.60 µg/kg) and two samples treated with peracetic acid (0.64 and 0.72 µg/kg). Demonstrating that the sanitizers in the concentrations used had no action on aflatoxins, despite being efficient for fungal control. The treatments did not cause an unacceptable sensorial impact on the samples.

Complex systems that incorporate cyclodextrins to get materials for some specific applications.

Cyclodextrins (CDs) are a family of biodegradable cyclic hydrocarbons composed of α-(1,4) linked glucopyranose subunits, the more common containing 6, 7 or 8 glucose units are named α, ß and γ-cyclodextrins respectively. Since the discovery of CDs, they have attracted interest among scientists and the first studies were about the properties of the native compounds and in particular their use as catalysts of organic reactions. Characteristics features of different types of cyclodextrins stimulated investigation in different areas of research, due to its non-toxic and non-inmunogenic properties and also to the development of an improved industrial production. In this way, many materials with important properties have been developed. This mini-review will focus on chemical systems that use cyclodextrins, whatever linked covalently or mediated by the non covalent interactions, to build complex systems developed mainly during the last five years.

Prophylactic Use of Laser Light and Methylene Blue on Ischemia and Liver Reperfusion Injury.

OBJECTIVE: This study aimed to evaluate the effect of hepatic preconditioning with laser light in the presence of methylene blue (MB) in the liver ischemia-reperfusion injury process. METHOD: Forty male Wistar rats were divided into 8 experimental groups (n = 5). Saline (.5 mL) or MB (15 mg/kg) was injected intravenously (inferior vena cava). After 2 minutes, 660 nm laser light was applied at a dose of 112.5 DE. Fifteen minutes after the application of saline or MB, 1 hour partial ischemia followed by 15 minutes of reperfusion was applied when the rats were sacrificed. The mitochondrial function parameters (O2 consumption rates in states 3 and 4 and the respiratory control ratio), osmotic swelling, and determination of malondialdehyde were evaluated. Hepatic function was studied using the serum determination of the alanine aminotransferase and aspartate aminotransferase enzymes. RESULTS AND CONCLUSIONS: MB therapy alone showed the capacity of preserving the rate of oxygen consumption in the mitochondrial respiratory state of the group submitted to ischemia compared to the sham group. However, when combined with low-intensity laser therapy, it failed to replicate the relevant protective effects in relation to oxidative phosphorylation or the mitochondrial membrane ischemia/reperfusion injury. Whether or not MB was combined with laser treatment, it was shown to be efficient in reducing oxidative stress. In relation to alanine aminotransferase enzymes, whether or not laser treatment was combined with MB had a protective effect on the hepatic lesion, whereas in relation to aspartate aminotransferase enzymes only laser treatment was able to provide this protection.

Coffea arabica and C. canephora discrimination in roasted and ground coffee from reference material candidates by real-time PCR.

To produce specific desirable coffee blends, Coffea arabica and C. canephora are mixed each other, in some cases to suit consumer preference, but in others to reduce production costs. In this scenario, the aim of this work was to evaluate standard candidate reference materials (RMc) for analysis of different blends of roasted and ground coffee. For this purpose, we analyzed different percentages of C. arabica and C. canephora (100:0; 50:50; 25:75; and 0:100, respectively). These RMc samples were developed in a previous study with green coffee beans submitted to medium roasting. In this work, coffee species differentiation (C. arabica and C. canephora) was analyzed by real-time PCR, using specific primers previously developed, called ARA primers. The RMc material with 100% C. canephora did not present amplification, in contrast with the samples containing C. arabica, which all presented amplification. These results indicate the specificity of ARA primers for C. arabica and that the detection system assay can be used as a promising molecular tool to identify and quantify percentages of C. arabica in different coffee blends.

Ventilation-induced changes correlate to pulmonary vascular response and VEGF, VEGFR-1/2, and eNOS expression in the rat model of postnatal hypoxia.

Neonatal asphyxia occurs due to reduction in oxygen supply to vital organs in the newborn. Rapid restoration of oxygen to the lungs after a long period of asphyxia can cause lung injury and decline of respiratory function, which result from the activity of molecules that induce vascular changes in the lung such as nitric oxide (NO) and vascular endothelial growth factors (VEGF). In this study, we evaluated the pulmonary and vascular morphometry of rats submitted to the model of neonatal asphyxia and mechanical ventilation, their expression of pulmonary VEGF, VEGF receptors (VEGFR-1/VEGFR-2), and endothelial NO synthase (eNOS). Neonate Sprague-Dawley rats (CEUA #043/2011) were divided into four groups (n=8 each): control (C), control submitted to ventilation (CV), hypoxia (H), and hypoxia submitted to ventilation (HV). The fetuses were harvested at 21.5 days of gestation. The morphometric variables measured were body weight (BW), total lung weight (TLW), left lung weight (LLW), and TLW/BW ratio. Pulmonary vascular measurements, VEGFR-1, VEGFR-2, VEGF, and eNOS immunohistochemistry were performed. The morphometric analysis showed decreased TLW and TLW/BW ratio in HV compared to C and H (P<0.005). Immunohistochemistry showed increased VEGFR-2/VEGF and decreased VEGFR-1 expression in H (P<0.05) and lower eNOS expression in H and HV. Median wall thickness was increased in H, and the expression of VEGFR-1, VEGFR-2, VEGF, and eNOS was altered, especially in neonates undergoing H and HV. These data suggested the occurrence of arteriolar wall changes mediated by NO and VEGF signaling in neonatal hypoxia.

Enfermedad Pulmonar Obstructiva Crónica en el Siglo XXI - Optimismo basado en evidencia / Chronic Obstructive Pulmonary Disease in the 21st Century - Evidence-based optimism

There are increasingly more data on the prevalence and distribution of Chronic Obstructive Pulmonary Disease (COPD) from around the world. COPD is predicted to be the third most frequent cause of death in the world by 2020. COPD is mainly caused by chronic tobacco smoking, which induces important changes in both the airways and lung parenchyma. COPD is a progressive, disabling condition that ultimately ends in respiratory failure and death. Is a multicomponent disease, there is evidence that systemic inflammation and extrapulmonary effects are also common in COPD, although the association between systemic inflammation and systemic manifestations of COPD is still not entirely clear. COPD has been associated with a nihilistic attitude. On the basis of current evidence, this nihilistic attitude is totally unjustified. The disease must be viewed through the lens of a new paradigm: COPD is not only preventable but also treatable. The past decade has witnessed great progress in COPD research. New drugs have been developed and tested and a growing base of scientific evidence now documents the efficacy of various therapies for symptoms and exacerbations. It is clear that many patients with COPD can benefit from aggressive management, with a decrease in the frequency of hospitalizations and improvements in symptoms and quality of life. In addition, basic and clinical scientists have now identified cells, mechanisms, and molecules that appear to play key roles in disease pathogenesis. Additional novel treatments are on the horizon and the advent of newer and more effective therapies will lead to a decline in the contribution of this disease to poor world health. The good news about COPD is to increase awareness of the disease. COPD is now viewed under a new paradigm as preventable and treatable.