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In this work, we perform experimental and numerical investigations on the dynamics of camphor-infused discs, well-established as active particles in their behavior. Our analysis focuses on examining the individual dynamics of these discs within a confined circular domain, revealing that they exhibit characteristics akin to active chiral particles. To characterize this behavior effectively, we introduce a methodology for estimating key model parameter values from our experiments, including linear velocity, angular velocity, and angular noise intensity. To validate our findings, we compare our experimental results with numerical simulations of the model. Our results demonstrate a striking phenomenon associated with camphor-infused discs: a pronounced accumulation of particles along the boundary. This intriguing observation suggests the occurrence of an attractive interaction between the active particles and the boundary, resulting in a kind of adsorption effect. The latter results in the confinement of the camphor disc along the Petri dish wall, which we refer to as sliding dynamics. We empirically determine the velocity of the particle along the Petri dish wall as well as its fluctuations, properties whose behavior notably deviates from the bulk dynamics.
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The morphological analysis of patterns in dried droplets has allowed the generation of efficient techniques for the detection of molecules of medical interest. However, the effectiveness of this method to reveal the coexistence of macromolecules of the same species, but different conformational states, is still unknown. To address this problem, we present an experimental study on pattern formation in dried droplets of bovine serum albumin (BSA), in folded and unfolded conformational states, in saline solution (NaCl). Folded proteins produce a well-defined coffee ring and crystal patterns all over the dry droplet. Depending on the NaCl concentration, the crystals can be small, large, elongated, entangled, or dense. Optical microscopy reveals that the relative concentration of unfolded proteins determines the morphological characteristics of deposits. At a low relative concentration of unfolded proteins (above 2%), small amorphous aggregates emerge in the deposits, while at high concentrations (above 16%), the "eye-like pattern", a large aggregate surrounded by a uniform coating, is produced. The radial intensity profile, the mean pixel intensity, and the entropy make it possible to characterize the patterns in dried droplets. We prove that it is possible to achieve 100% accuracy in identifying 4% of unfolded BSA contained in a protein solution.
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Albúmina Sérica Bovina , Cloruro de SodioRESUMEN
The quality control of medicines guarantees the effectiveness of treatments for diseases. We explore the use of texture analysis of patterns in dried droplets as a tool to readily detect both impurities and changes in drug concentration. Four types of medicines associated with different routes of administration were analyzed: Methotrexate, Ciprofloxacin, Clonazepam, and Budesonide. We use NaCl and a hot substrate at 63 ∘C to promote aggregate formation and to reduce droplet drying time. Depending on the medicine, optical microscopy reveals different complex aggregates such as circular to oval splatters, fern-like islands, crown shapes, crown needle-like and bump-like patterns as well as dendritic branched and star-like crystals. We use some physical features of the stains (as the stain diameter and superficial area) and gray level co-occurrence matrix (GLCM) to characterize patterns of dried droplets. Finally, we show that structural analysis of stains can achieve 95% accuracy in identifying medicines with 30% water dilution, while it achieves 99% accuracy in detecting drugs with 10% other substances.
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Preparaciones Farmacéuticas , Cloruro de Sodio , Desecación , Control de Calidad , AguaRESUMEN
ABSTRACT: Combat casualty care can be complicated by transport times exceeding the "golden hour," with intervention and resuscitation limited to what the medic can carry. Pharmaceutical albumin comes highly saturated with nonesterified fatty acids (NEFAs). We recently showed that treatment with 25% bovine serum albumin (BSA) loaded with oleic acid, but not NEFA-free BSA, improved survival for hours after severe hemorrhage and often eliminated the need for resuscitation in rats. However, it was unknown whether pharmaceutical albumin, derived from human sources and loaded with caprylic acid (CA), would have the same benefits. We compared adjunct treatment with oleic acid-saturated BSA, CA-saturated BSA, pharmaceutical human serum albumin, or a no-albumin control in a similar rat hemorrhagic shock model to determine whether the three NEFA-albumin groups provided the same benefits relative to control. We found almost no significant differences among the NEFA-albumin groups in any measure. Mortality in controls was too low to allow for detection of improvement in survival, but NEFA-albumin groups had significantly improved hemodynamics, lactate clearance, and greatly reduced fluid requirements compared with controls. Contrary to expectations of "dehydration," 25% albumins shifted little additional fluid into the vasculature. Rather, they restored protein to the autotransfusion fluid. Nonesterified fatty acids-albumin did not worsen lung permeability, but we observed a loss of circulating protein suggesting it may have increased overall vascular permeability. Our findings suggest that, though imperfect, 25% human serum albumin could be a solution for resuscitation in austere conditions requiring prolonged field care.
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Hemodinámica , Resucitación , Albúmina Sérica , Choque Hemorrágico , Animales , Ratas , Resucitación/métodos , Humanos , Hemodinámica/efectos de los fármacos , Choque Hemorrágico/terapia , Choque Hemorrágico/tratamiento farmacológico , Masculino , Albúmina Sérica/uso terapéutico , Ratas Sprague-Dawley , Modelos Animales de Enfermedad , Heridas y Lesiones/terapia , Heridas y Lesiones/tratamiento farmacológico , Albúmina Sérica Humana , Albúmina Sérica Bovina , Ácido Oléico , Ácidos Grasos no Esterificados/sangre , Caprilatos/farmacología , Servicios Médicos de Urgencia , Hemorragia/tratamiento farmacológico , Hemorragia/terapiaRESUMEN
The analysis of structures in dried droplets has made it possible to detect the presence and conformational state of macromolecules in relevant biofluids. Therefore, the implementation of novel drying strategies for pattern formation could facilitate the identification of biomarkers for the diagnosis of pathologies. We present an experimental study of patterns formed by evaporating water-diluted blood droplets on a vertical surface. Three significant morphological features were observed in vertical droplet deposits: (1) The highest concentration of non-volatile molecules is consistently deposited in the lower part of the droplet, regardless of erythrocyte concentration. (2) The central region of deposits decreases rapidly with hematocrit; (3) At high erythrocyte concentrations (36-40% HCT), a broad coating of blood serum is produced in the upper part of the deposit. These findings are supported by the radial intensity profile, the relative thickness of the crown, the aspect ratio of the deformation, the relative area of the central region, and the Entropy of the Gray Level Co-occurrence Matrix Entropy (GLCM). Moreover, we explore the pattern formation during the drying of vertical blood drops. We found that hematocrit concentration has a significant impact on droplet drying dynamics. Finally, we conducted a proof-of-concept test to investigate the impact of vertical droplet evaporation on blood droplets with varying lipid concentrations. The results revealed that it is possible to differentiate between deposits with normal, slightly elevated, and moderately elevated lipid levels using only the naked eye.
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Lípidos , Agua , Agua/químicaRESUMEN
BACKGROUND: Glioblastoma (GB) is a malignant brain tumour that is challenging to treat, often relapsing even after aggressive therapy. Evaluating therapy response relies on magnetic resonance imaging (MRI) following the Response Assessment in Neuro-Oncology (RANO) criteria. However, early assessment is hindered by phenomena such as pseudoprogression and pseudoresponse. Magnetic resonance spectroscopy (MRS/MRSI) provides metabolomics information but is underutilised due to a lack of familiarity and standardisation. METHODS: This study explores the potential of spectroscopic imaging (MRSI) in combination with several machine learning approaches, including one-dimensional convolutional neural networks (1D-CNNs), to improve therapy response assessment. Preclinical GB (GL261-bearing mice) were studied for method optimisation and validation. RESULTS: The proposed 1D-CNN models successfully identify different regions of tumours sampled by MRSI, i.e., normal brain (N), control/unresponsive tumour (T), and tumour responding to treatment (R). Class activation maps using Grad-CAM enabled the study of the key areas relevant to the models, providing model explainability. The generated colour-coded maps showing the N, T and R regions were highly accurate (according to Dice scores) when compared against ground truth and outperformed our previous method. CONCLUSIONS: The proposed methodology may provide new and better opportunities for therapy response assessment, potentially providing earlier hints of tumour relapsing stages.
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Objetivo: Diseñar un instrumento para medir la adopción del rol del cuidador familiar en la administración de medicamentos en personas con enfermedad crónica y establecer tanto su validez de contenido como facial. Método: Estudio metodológico que incluyó tres fases: diseño del instrumento, determinación de la validez de contenido con 9 expertos y determinación de la validez facial mediante entrevistas cognitivas a 14 cuidadores y juicios de 30 cuidadores de adultos con enfermedades crónicas. Resultados: Se obtuvo un cuestionario conformado por 32 ítems distribuidos en 3 dimensiones denominadas labores, organización y respuesta ante el rol. El instrumento presentó una adecuada validez de contenido dado que todos los ítems superaron el CVI mínimo de 0,58, mientras que para la escala total fue de 0,97. Por su parte, la validez facial mostró que la claridad fue del 99,6%, la comprensión fue del 98,4% y la precisión fue del 96,9%. Conclusión: El instrumento Adopción del rol en la administración de medicamentos mide de forma lógica el constructo y los ítems que lo conforman representan adecuadamente sus dominios.
Objective: To design an instrument to measure the adoption of the role of the family caregiver in the administration of medications in people with chronic disease and to establish both its content and facial validity. Method: Methodological study that included three phases: design of the instrument, determination of content validity with 9 experts and determination of facial validity through cognitive interviews with 14 caregivers and judgments of 30 caregivers of adults with chronic diseases. Results: A questionnaire made up of 32 items distributed in 3 dimensions called tasks, organization and response to the role was obtained. The instrument presented adequate content validity since all the items exceeded the minimum CVI of 0.58, while for the total scale it was 0.97. For its part, facial validity showed that clarity was 99.6%, comprehension was 98.4%, and precision was 96.9%. Conclusion: The instrument Adoption of the role in drug administration logically measures the construct and the items that comprise it adequately represent its domains.
Objetivo: Projetar um instrumento para medir a adoção do papel do cuidador da família na administração de medicamentos em pessoas com doenças crônicas e estabelecer tanto seu conteúdo quanto sua validade facial. Método: Estudo metodológico que incluiu três fases: desen do instrumento, determinação da validade do conteúdo com 9 especialistas e determinação da validade do rosto através de entrevistas cognitivas com 14 cuidadores e julgamentos de 30 cuidadores de adultos cronicamente doentes. Resultados: Foi obtido um questionário composto de 32 itens distribuídos em 3 dimensões chamadas trabalho, organização e resposta ao papel. O instrumento mostrou validade de conteúdo adequada, dado que todos os itens excederam o CVI mínimo de 0,58, enquanto que para a escala total foi de 0,97. A validade facial mostrou que a clareza era 99,6%, a compreensão era 98,4% e a precisão era 96,9%. Conclusão: O instrumento de adoção do papel da Administração de Medicamentos medelogicamente a construção e seus itens representam adequadamente seus domínios.
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Preparaciones Farmacéuticas , Estudio de Validación , Enfermedad Crónica , Cuidadores , PlanificaciónRESUMEN
In 2009, a common set of questions addressing handwashing behavior was introduced into nationally representative Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), providing large amounts of comparable data from numerous countries worldwide. The objective of this analysis is to describe global handwashing patterns using two proxy indicators for handwashing behavior from 51 DHS and MICS surveys conducted in 2010-2013: availability of soap anywhere in the dwelling and access to a handwashing place with soap and water. Data were also examined across geographic regions, wealth quintiles, and rural versus urban settings. We found large disparities for both indicators across regions, and even among countries within the same World Health Organization region. Within countries, households in lower wealth quintiles and in rural areas were less likely to have soap anywhere in the dwelling and at designated handwashing locations than households in higher wealth quintiles and urban areas. In addition, disparities existed among various geographic regions within countries. This analysis demonstrates the need to promote access to handwashing materials and placement at handwashing locations in the dwelling, particularly in poorer, rural areas where children are more vulnerable to handwashing-preventable syndromes such as pneumonia and diarrhea.
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Actitud Frente a la Salud , Desinfección de las Manos , Conductas Relacionadas con la Salud , Encuestas Epidemiológicas , Jabones , Demografía , Geografía , Conocimientos, Actitudes y Práctica en Salud , Humanos , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios , Población Urbana/estadística & datos numéricos , Abastecimiento de AguaRESUMEN
RESUMEN Introducción: La aplicación de la medicina regenerativa personalizada en el proceso de cicatrización del paciente quemado es hoy una realidad. Las plaquetas han cambiado su rol clásico en la hemostasia, al de fuentes de factores de crecimiento para la síntesis de nuevas proteínas, actividad microbicida, moduladora de la inflamación, favorecer la proliferación celular, la síntesis de matriz extracelular y efecto analgésico. Objetivo: Evaluar el plasma rico en plaquetas para la cicatrización de los pacientes con quemaduras dérmicas. Métodos: Se realizó un estudio experimental en pacientes con quemaduras dérmicas en el Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey de julio de 2018 hasta julio de 2020. De un universo de 200 pacientes, se seleccionaron dos grupos de tratamiento de 30 pacientes cada uno, grupo de estudio con plasma rico en plaquetas y grupo control con tratamiento convencional. Se realizó distribución homogénea de los grupos acorde a edad y sexo. Resultados: Desde la evaluación inicial a los cinco días se constató mayor porcentaje de cicatrización en el grupo con plasma rico en plaquetas, así como menor variación según la desviación estándar, el tiempo hasta la cicatrización completa fue menor en este grupo. La mayor parte de los pacientes no presentaron complicaciones. Las complicaciones halladas fueron locales. Conclusiones: El plasma rico en plaquetas garantizó una cicatrización más rápida en las quemaduras dérmicas.
ABSTARCT Introduction: The application of personalized regenerative medicine in the healing process of the burned patient is a reality now. Platelets have changed their classic role in hemostasis, to that of sources of growth factors for the synthesis of new proteins, microbicidal activity, modulator of inflammation, favoring cell proliferation, synthesis of extracellular matrix and analgesic effect. Objective: To evaluate platelet-rich plasma for the healing of patients with dermal burns. Methods: An experimental study was carried out in patients with dermal burns at the Manuel Ascunce Domenech University Hospital in Camagüey's province, from July 2018 to July 2020. From a universe of 200 patients, two treatment groups of 30 patients each one were selected, a study group with platelet rich plasma and a control group with conventional treatment. A homogeneous distribution of the groups was made according to age and sex. Results: From the initial evaluation at five days, a higher percentage of healing was observed in the group with platelet rich plasma, as well as a lower variation according to the standard deviation, the time to complete healing was lower in this group. Most of the patients did not present complications. The complications found were local. Conclusions: Platelet rich plasma guaranteed faster healing in dermal burns.
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In most Latin American countries there are significant numbers of missing people and forced disappearances, 68,000 alone currently in Colombia. Successful detection of shallow buried human remains by forensic search teams is difficult in varying terrain and climates. This research has created three simulated clandestine burial styles at two different depths commonly encountered in Latin America to gain knowledge of optimum forensic geophysics detection techniques. Repeated monitoring of the graves post-burial was undertaken by ground penetrating radar. Radar survey 2D profile results show reasonable detection of ½ clothed pig cadavers up to 19 weeks of burial, with decreasing confidence after this time. Simulated burials using skeletonized human remains were not able to be imaged after 19 weeks of burial, with beheaded and burnt human remains not being able to be detected throughout the survey period. Horizontal radar time slices showed good early results up to 19 weeks of burial as more area was covered and bi-directional surveys were collected, but these decreased in amplitude over time. Deeper burials were all harder to image than shallower ones. Analysis of excavated soil found soil moisture content almost double compared to those reported from temperate climate studies. Vegetation variations over the simulated graves were also noted which would provide promising indicators for grave detection.
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Entierro , Plantas , Radar , Animales , Botánica , Cadáver , Colombia , Ciencias Forenses , Fenómenos Geológicos , Humanos , PorcinosRESUMEN
Se exponen las recomendaciones sobre la atención de los recién nacidos en Cuba, hijos de madres con diagnóstico de COVID -19. Se expresan las orientaciones generales sobre la organización de los servicios para el cuidado de los pacientes, los principales aspectos relacionados con la atención en el momento del nacimiento, la alimentación, las características clínicas descritas en esta etapa de la vida, los estudios complementarios que se deberán realizar para el diagnóstico, el tratamiento, los criterios de egreso y el seguimiento. Los autores reunieron la poca evidencia científica existente sobre la infección por coronavirus en la etapa neonatal y de acuerdo con el Grupo Nacional de Neonatología del Ministerio de Salud Pública, se proponen estas recomendaciones, adaptadas a las características de la atención neonatal en Cuba, con el objetivo de orientar las conductas a seguir en los recién nacidos con sospecha o diagnóstico confirmado de COVID-19. Estas recomendaciones están basadas en las publicaciones científicas disponible y sujetas a cambios por la revisión periódica de estas publicaciones, ya que se trata de una infección de reciente aparición, sobre la cual aún existe muy poca información para esta etapa temprana de la vida, como puede ser un caso confirmado de solo 36 horas de vida. Se espera que todo el personal involucrado en la atención de recién nacidos con sospecha o confirmados de infección por SARS- Cov- 2 analicen e incorporen estas recomendaciones en el cuidado y vigilancia de sus pacientes(AU)
In this work are presented recommendations on the care of newborns who are children of mothers diagnosed with COVID-19 in Cuba, and are expressed the general guidelines on the organization of the services for patients care, the main aspects related with the care in the birth moment, feeding related aspects, clinical characteristics described in this stage of life, complementary studies that must be conducted for diagnosis, the treatment to be used, and discharge and follow up criteria. The autors collected poor existent scientific evidence on the infection by coronavirus in the neonatal stage, and jointly with the National Group of Neonatology of the Ministry of Public Health are proposing these recommendations which are adapted to the characteristics of the neonatal care in Cuba with the aim of guiding the behaviours to implement in the attention to newborns suspected or with confirmed diagnosis of COVID-19.These recommendations are based in the available scientific publications and they are subject to changes since this is an emerging infection and there is scarse information of its presence in the earliest stages of life like it can be a confirmed case of just 36 hours of life. It is expected that all the personnel involved in the attention of newborns suspected or confirmed with infection by SARS-Cov-2 can analyze and add these recommendations to the care and surveillance of their patients(AU)
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Humanos , Recién Nacido , Atención , Organización Mundial de la Salud , Cuidados Posteriores , Vigilancia en Desastres , Síndrome Respiratorio Agudo Grave , InfeccionesRESUMEN
During the past several years, trauma resuscitation in human patients has evolved from decreased use of crystalloids to increased use of blood products. Of high interest is the role of platelets in trauma resuscitation. Because conducting prehos- pital resuscitation in human trauma patients is very difficult, swine are often the animal model of choice for such studies because their coagulation and hemodynamic systems are similar to those in humans. However, consistent production of sufficient swine platelets for such studies has not previously been achieved. We developed a method for producing swine platelets by using standard human techniques and equipment. We assessed pH, pO2, pCO2, lactate, thromboelastography, and platelet aggregation over 5 d of storage to determine whether the swine platelet product met the American Association of Blood Banks (AABB) standards for transfusion. Swine platelets met AABB standards at 24 h but not at later time points. In addition, we fluorescently labeled nonautologous platelets and then measured their percentage recovery over 5 h (the time used in subsequent experimental studies) when transfused into a recipient pig. We showed that 80% of the platelets stored for 24 h remained in the circulation and increased the recipient pigs' thromboelastographic responses, indicating that the platelets were viable and active. Therefore, swine platelets stored for 24 h by using standard human products met the AABB criteria and were functional.
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Plaquetas/fisiología , Plaquetoferesis , Porcinos , Animales , Bancos de Sangre , Coagulación Sanguínea , Humanos , Masculino , Modelos Animales , Transfusión de Plaquetas , TromboelastografíaRESUMEN
In the acute care setting, both the tracings and numeric outputs (R time, angle, and MA) of thrombelastography (TEG) may be used to inform treatment decisions. The objective was to determine the sensitivity of TEG to isolated changes in platelet count, hematocrit and fibrinogen concentration in human blood. As pigs have a similar coagulation system, we also compared the responses of the pig blood. Eight volunteers (>18âyears of age, no anticoagulation or nonsteroidal anti-inflammatory therapy, not pregnant) were enrolled into this study. Four female anesthetized donor pigs were instrumented percutaneously with a catheter for blood collection. All blood was collected into sodium citrate. The concentration of each component (platelets, fibrinogen, and red blood cells) was changed while keeping the other components constant by use of centrifugation or preparation of each individual's plasma into platelet poor plasma, platelet rich plasma, cryoprecipitate, purified washed platelets, and packed red blood cells as appropriate. TEG (Haemoscope) analysis was performed and compared with the patients' whole blood diluted with lactated Ringer's solution. We demonstrated that the major factor affecting the MA and angle was the platelet count. In fact, reducing platelets alone resulted in TEG profiles and parameters that were similar to lactated Ringer's dilution profiles. Swine blood responses were parallel to that of human blood, although there were offsets especially of TEG-R and angle that confirmed that the swine are hypercoagulable compared with humans. Superficially similar TEG tracing patterns can be produced by divergent mechanisms associated with altered concentrations of blood components.
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Coagulación Sanguínea/fisiología , Plaquetas/citología , Eritrocitos/citología , Fibrinógeno/metabolismo , Adulto , Animales , Anticoagulantes/química , Plaquetas/fisiología , Células Cultivadas , Citratos/química , Recuento de Eritrocitos , Eritrocitos/fisiología , Femenino , Hematócrito , Humanos , Soluciones Isotónicas , Masculino , Recuento de Plaquetas , Plasma Rico en Plaquetas/química , Lactato de Ringer , Citrato de Sodio , Porcinos , Tromboelastografía/veterinariaRESUMEN
Fundamentación: la reducción de costos sin afectar la calidad de la atención al paciente quemado requiere la implementación de nuevas estrategias de trabajo. Objetivo: evaluar la necrectomía precoz con autoinjerto de piel inmediato en el tratamiento del paciente quemado. Métodos: se realizó un estudio analítico de casos y control en el paciente con quemaduras dérmicas profundas e hipodérmicas en el Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey, en el periodo septiembre 2010 a septiembre 2015. El estudio comprendió a 64 pacientes, de ellos la mitad fue intervenido de forma quirúrgica con necrectomía precoz con autoinjerto de piel inmediato en los cinco primeros días posquemadura y la otra parte con necrectomía entre los 19 a 21 días posquemadura con autoinjerto de piel en el mismo tiempo quirúrgico o posterior. Resultados: más del doble de los casos intervenidos de forma quirúrgica fueron del sexo masculino, el grupo de estudio mostró nueve veces más probabilidad de egreso hospitalario temprano, veintiuna veces más probabilidad de en solo una sesión quirúrgica obtener la cobertura cutánea definitiva y tres veces menos riesgo de complicaciones. Conclusión: la necrectomía precoz con autoinjerto de piel inmediato resulta una intervención quirúrgica ventajosa dada la posibilidad de cobertura cutánea definitiva en un solo tiempo quirúrgico, con egreso hospitalario temprano e incidencia baja de complicaciones.
Background: the reduction of costs without affecting the quality from the attention to the burn patient requires the implementation of new work strategies. Objective: to evaluate precocious necrectomy with immediate skin graft in the treatment of the burn patient. Methods: an analytic study of cases and control in the patient with deep and hypodermic dermal burns was conducted at Manuel Ascunce Domenech hospital in Camagüey, from September 2010 to September 2015. The study was composed of 64 patients. From them, 32 underwent surgery with precocious necrectomy with immediate skin graft in the first five days after the burn and the other part with necrectomy among the 19 to 21 days after the burn with skin graft in the same surgical or later time. Results: more than double the cases intervened surgically were males, the study group showed nine times more probability of early hospital discharge, twenty-one times more probability of in alone a surgical session to obtain the definitive cutaneous covering and three times less risk of complications. Conclusions: the precocious necrectomy with immediate skin graft is an advantageous surgical intervention given the possibility of definitive cutaneous covering in a single surgical time, with early hospital discharge and low incidence of complications.
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In this work we investigate multistability in the lac operon of Escherichia coli when it is induced by a mixture of lactose and the non-metabolizable thiomethyl galactoside (TMG). In accordance with previously published experimental results and computer simulations, our simulations predict that: (1) when the system is induced by TMG, the system shows a discernible bistable behavior while, (2) when the system is induced by lactose, bistability does not disappear but excessively high concentrations of lactose would be required to observe it. Finally, our simulation results predict that when a mixture of lactose and TMG is used, the bistability region in the extracellular glucose concentration vs. extracellular lactose concentration parameter space changes in such a way that the model predictions regarding bistability could be tested experimentally. These experiments could help to solve a recent controversy regarding the existence of bistability in the lac operon under natural conditions.
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INTRODUCCIÓN: la sepsis neonatal grave se produce en 0,5 a 8,0 de cada 1 000 nacidos vivos, y es la causa más común de muerte neonatal. OBJETIVO: caracterizar la sepsis neonatal grave en los pacientes ingresados en el servicio de Neonatología del Hospital Universitario Ginecoobstétrico "Mariana Grajales", de Santa Clara, durante los años 2011-2012. MÉTODOS: se realizó un estudio observacional, descriptivo, de tipo transversal, con elementos de enfoque cualitativo y cuantitativo. El universo de estudio quedó conformado por el total de recién nacidos con sepsis neonatal grave (105 neonatos), lo que coincidió con la muestra. Las variables perinatales seleccionadas fueron: total de nacidos vivos, ingresos en terapia neonatal (con sepsis y con sepsis graves), edad gestacional, clasificación de la sepsis, microorganismos aislados, estudios microbiológicos y tasa por 1 000 nacidos vivos por infección. RESULTADOS: de los 145 neonatos con diagnóstico de sepsis, 105 de ellos evolucionaron con sepsis grave (72,4 %). Se comprobó que 70 pacientes del total nacieron pretérminos, que representó el 66,6 %; y 74 niños presentaron sepsis generalizada adquirida confirmada. Fue más frecuente el aislamiento del Staphylococcus coagulasa negativo. CONCLUSIONES: más de la mitad de los neonatos con sepsis se comportaron como una sepsis grave. La prematuridad se relacionó estrechamente con esta entidad en la etapa neonatal. La sepsis generalizada adquirida fue la más frecuente. Más de la mitad de los hemocultivos fueron positivos, y los microorganismos más frecuentes fueron el Staphylococcus coagulasa negativo y la Candida.
INTRODUCTION: severe neonatal sepsis occurs in 0.5 to 8 per 1 000 livebirths and is the common cause of neonatal death. OBJECTIVE: to characterize the severe neonatal sepsis in patients admitted to the neonatology service of "Mariana Grajales" university gynecological and obstetric hospital located in Santa Clara during 2011 and 2012. METHODS: observational, descriptive and cross-sectional study was conducted, using quantitative and qualitative-focused elements. The universe of study was the total number of newborns with severe neonatal sepsis (105 neonates), which agreed with the sample. The selected perinatal variables included total number of livebirths, admissions to neonatal therapy service (with sepsis and severe sepsis), gestational age, classification of sepsis, isolated microorganisms, microbiological studies and infection rate per 1 000 livebirths. RESULTS: of 145 neonates with sepsis diagnosis, 105 progressed into severe sepsis (72.4 %). It was confirmed that 70 patients were preterm born, accounting for 66.6 % and 74 children presented with confirmed acquired generalized sepsis. The most isolated agent was negative Staphylococcus coagulase. CONCLUSIONS: half of neonates with sepsis behaved as if they had severe sepsis. Prematurity was closely related to this entity at the neonatal phase. Acquired generalized sepsis was the most common. More than 50 % of the hemocultures were positive and the most frequent ones were negative Staphylococcus coagulase and Candida.
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Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Mortalidad Infantil , Sepsis/diagnóstico , Sepsis/prevención & control , Epidemiología Descriptiva , Estudios Transversales , Estudios Observacionales como AsuntoRESUMEN
INTRODUCCIÓN: la presión positiva continua en la vía aérea en pacientes que respiran espontáneamente se define como CPAP (en inglés, de Continuous Positive Airways Pressure), y consiste en la modalidad de ventilación mecánica no invasiva más sencilla. OBJETIVO: caracterizar el uso de la presión positiva continua en la vía aérea nasal, en recién nacidos con dificultad respiratoria. MÉTODOS: se realizó un estudio observacional descriptivo transversal, que incluyó a los 149 recién nacidos que recibieron esta técnica ventilatoria, en el Hospital Provincial Universitario Ginecoobstétrico "Mariana Grajales", de Santa Clara, en los años 2012-2013. Se aplicó un instrumento confeccionado al efecto, que incluyó variables perinatales y neonatales Se analizaron variables como: edad gestacional, peso, vía del parto, diagnóstico, edad posnatal al inicio y tiempo del tratamiento, evolución clínica, gasométrica y/o radiológica. Se obtuvieron los datos del departamento de estadística, historias clínicas pediátricas y obstétricas, y los libros de registro de parto; así como, los registros de morbilidad y mortalidad continua del servicio. Para el análisis descriptivo de la muestra se utilizaron frecuencias absolutas y relativas según el tipo de información. RESULTADOS: el mayor porcentaje de los recién nacidos fueron pretérminos (83,2 %) y con peso inferior a 2 500 g. Se ventilaron en la primera hora de vida 78 neonatos, y la duración del tratamiento inferior a las 24 horas fue más frecuente. La principal indicación médica fue el edema pulmonar. CONCLUSIONES: la mayoría de los neonatos presentó una evolución clínica, gasométrica y/o radiológica satisfactoria.
INTRODUCTION: continuous positive airways pressure in patients who normally breathes (known as CPAP) is a simpler modality of noninvasive mechanical ventilation. OBJECTIVE: to characterize the use of the nasal continuous positive airways pressure in newborns with respiratory distress. METHODS: cross-sectional, descriptive and observational study of 149 newborns that were treated with this ventilation technique at "Mariana Grajales" provincial university gynecobstetric hospital in Santa Clara in 2012 and 2013. An instrument including perinatal and neonatal variables was particularly designed for this purpose. These variables covered gestational age, weight, delivery, diagnosis, postnatal age at the beginning of treatment and length of time, clinical progress, gasometric and/or radiological progress. The study used data from the statistical department in addition to pediatric and obstetric medical histories, delivery register books, and continuous morbidity and mortality records of the service. For statistical analysis of the sample, absolute and relative frequencies were used depending on the type of information. RESULTS: the highest percentage of newborns was preterm (83.2 %) weighing less than 2 500 g. Seventy eight neonates were ventilated during their first hour of life and the treatment mostly lasted less than 24 hours. The main medical indication for treatment was pulmonary edema. CONCLUSIONS: most of neonates had satisfactory clinical, gasometric and/or radiological progression.
Asunto(s)
Humanos , Recién Nacido , Respiración con Presión Positiva/métodos , Manejo de la Vía Aérea/métodos , Epidemiología Descriptiva , Estudios Transversales , Análisis Multivariante , Estudios Observacionales como AsuntoRESUMEN
Evaluar la producción de etanol a partir de cultivos lignocelulósicos, específicamente pastos de rápido crecimiento en la región, constituye una alternativa a la demanda de biocombustibles. En la presente investigación se seleccionó el pasto Maralfalfa (Pennisetum glaucum x Pennisetum purpureum) utilizando el pretratamiento con ácido sulfúrico diluido a diferentes temperaturas (110, 130, 150, 170 y 190 °C) y concentraciones de ácido (0.8, 1.2 y 2.0% (p/p)), seguido de un proceso de hidrólisis enzimática utilizando celulasas y celobiosas comerciales y un proceso de hidrólisis y fermentación simultanea. La máxima producción de etanol obtenido fue 117 mg etanol/ g biomasa pretratada a 190 °C y 1,2 %(p/p) de ácido sulfúrico. El líquido hidrolizado fue caracterizado calculando el porcentaje de glucosa, xilosa y lignina solubilizadas y degradadas durante el pretratamiento.
The goliath grass (Pennisetum glaucum x Pennisetum purpureum) was pretreated with different sulfuric acid concentrations (0.8, 1.2 y 2.0% (w/w)) from low to high temperatures (110, 130, 150, 170 y 190 °C) followed by enzymatic hydrolysis and SSF of remaining solids. The maximum yield was 117 mg of ethanol/g biomass to 190 °C and 1.2 % (w/w) of sulfuric acid.