Association of the chemical composition and nutritional value of forage resources in Colombia with methane emissions by enteric fermentation.

In the livestock sector, strategies are available to mitigate gas emissions, such as methane, one of the alternatives that have shown potential correspondence to changes in the composition of the diet. The main aim of this study was to analyze the influence of methane emissions with data on enteric fermentation obtained from the Electronic Data Gathering, Analysis, and Retrieval (EDGAR) database and based on forecasts of methane emissions by enteric fermentation with an autoregressive integrated moving average (ARIMA) model and the application of statistical tests to identify the association between methane emissions from enteric fermentation and the variables of the chemical composition and nutritional value of forage resources in Colombia. The results reported positive correlations between methane emissions and the variables ash content, ethereal extract, neutral detergent fiber (NDF), and acid detergent fiber (ADF) and negative correlations between methane emissions and the variables percentage of unstructured carbohydrates, total digestible nutrients (TDN), digestibility of dry matter, metabolizable energy (MERuminants), net maintenance energy (NEm), net energy gain (NEg), and net lactation energy (NEI). The variables with the most significant influence on the reduction of methane emissions by enteric fermentation are the percentage of unstructured carbohydrates and the percentage of starch. In conclusion, the analysis of variance and the correlations between the chemical composition and the nutritive value of forage resources in Colombia help to understand the influence of diet variables on methane emissions of a particular family and with it in the application of strategies of mitigation.

Airborne particulate matter integral assessment in Magdalena department, Colombia: Patterns, health impact, and policy management.

The relevance of atmospheric particulate matter (PM) to health and the environment is widely known. Long-term studies are necessary for understanding current and future trends in air quality management. This study aimed to assess the long-term PM concentration in the Magdalena department (Colombia). It focused on the following aspects: i) spatiotemporal patterns, ii) correlation with meteorology, iii) compliance with standards, iv) temporal trends over time, v) impact on health, and vi) impact of policy management. Fifteen stations from 2003 to 2021 were analyzed. Spearman-Rho and Mann-Kendall methods were used to correlate concentration with meteorology. The temporal and five-year moving trends were determined, and the trend magnitude was calculated using Teil-Sen. Acute respiratory infection odd ratios and risk of cancer associated with PM concentration were used to assess the impact on health. The study found that the maximum PM10 concentration was 194.5 µg/m3, and the minimum was 3 µg/m3. In all stations, a negative correlation was observed between PM10 and atmospheric water content, while the wind speed and temperature showed a positive correlation. The global trends indicated an increasing value, with five fluctuations in five-year moving trends, consistent with PM sources and socio-economic behavior. PM concentrations were found to comply with national standard; however, the results showed a potential impact on population health. The management regulation had a limited impact on increasing concentration. Considering that national regulations tend to converge towards WHO standards, the study area must create a management program to ensure compliance.

Postmortem Brain Imaging in Alzheimer's Disease and Related Dementias: The South Texas Alzheimer's Disease Research Center Repository.

BACKGROUND: Neuroimaging bears the promise of providing new biomarkers that could refine the diagnosis of dementia. Still, obtaining the pathology data required to validate the relationship between neuroimaging markers and neurological changes is challenging. Existing data repositories are focused on a single pathology, are too small, or do not precisely match neuroimaging and pathology findings. OBJECTIVE: The new data repository introduced in this work, the South Texas Alzheimer's Disease research center repository, was designed to address these limitations. Our repository covers a broad diversity of dementias, spans a wide age range, and was specifically designed to draw exact correspondences between neuroimaging and pathology data. METHODS: Using four different MRI sequences, we are reaching a sample size that allows for validating multimodal neuroimaging biomarkers and studying comorbid conditions. Our imaging protocol was designed to capture markers of cerebrovascular disease and related lesions. Quantification of these lesions is currently underway with MRI-guided histopathological examination. RESULTS: A total of 139 postmortem brains (70 females) with mean age of 77.9 years were collected, with 71 brains fully analyzed. Of these, only 3% showed evidence of AD-only pathology and 76% had high prevalence of multiple pathologies contributing to clinical diagnosis. CONCLUSION: This repository has a significant (and increasing) sample size consisting of a wide range of neurodegenerative disorders and employs advanced imaging protocols and MRI-guided histopathological analysis to help disentangle the effects of comorbid disorders to refine diagnosis, prognosis and better understand neurodegenerative disorders.

Prognostication of Survival Outcomes in Patients Diagnosed with Glioblastoma.

OBJECTIVE: Glioblastoma multiforme (GBM) is an aggressive primary brain tumor with dismal survival. This study aims to examine the prognostic value of primary tumor sites and race on survival outcomes. METHODS: Patient data obtained from the Scott and White Hospital Brain Tumor Registry (1976-2013) were stratified according to sex, age, race, primary tumor site, vital status, and survival. RESULTS: Of the 645 patients, 580 (89.9%) were diagnosed with GBM not otherwise specified (GBM NOS), 57 (8.8%) with GBM, and 8 (1.2%) with giant-cell GBM. Most were male (53.5%), aged 50 years or older (78.7%). The white population had the highest GBM prevalence (87.1%) and the lowest overall survival versus all other race groups (6.6% vs. 30.1%; P < 0.01). The black population had a relatively low prevalence of GBM (5.9%) and the greatest overall survival versus all others (47.4% vs. 7.3%; P < 0.01). Primary tumor sites located in the temporal (25.8% vs. 20.2%; P = 0.03), occipital (8.1% vs. 2.9%; P = 0.05), and parietal lobes (24.2% vs. 20.8%; P = 0.05) had a greater occurrence in surviving individuals. The overall survival for men versus women was (62.9% vs. 37.1%; P = 0.12). CONCLUSIONS: Black racial background and temporal, occipital, or parietal primary tumor sites are suggestive of positive survival outcomes. Conversely, white racial background with primary tumor sites in the brain overlapping and NOS areas seem to be associated with negative outcomes and decreased survival. Thus, racial background and primary tumor site may be useful prognostic factors in patients with GBM.

Análisis retrospectivo de las características y utilización de los recursos de salud en pacientes con cáncer de próstata resistente a la castración metastásico tratados con Enzalutamida o Acetato de Abiraterona en Colombia / Retrospective Analysis of the Characteristics and Utilization of Health Resources in Patients with Castration Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate in Colombia

Objetivo Describir las características demográficas, clínicas, los recursos de salud utilizados y los costos directos del tratamiento del cáncer de próstata resistente a la castración metastásico (CPRCm), tratados con enzalutamida o acetato de abiraterona en Colombia. Métodos Mediante un estudio de corte transversal se analizaron datos de utilización de servicios de una EPS (entidad promotora de salud) colombiana. Para ello, se identificaron los pacientes que durante el 1 de julio de 2016 y 30 de junio de 2017 (fecha índice) presentaron registro de uso de enzalutamida o acetato de abiraterona y se confirmaron sus antecedentes de castración química o quirúrgica (6 meses previos a la fecha índice). Se establecieron las frecuencias de uso de servicios en dicha población y se extrajo el consumo reportado asociado a consultas (urgencias, consulta externa), procedimientos y medicamentos en el periodo de análisis. Los costos se organizaron por categorías y se reportaron en pesos colombianos (COP) 2016. Resultados se identificaron 161 pacientes con CPRCm con edad media de 77 años, se determinó que el departamento colombiano con más población de CPRCm en esta cohorte fue el Valle del Cauca, que 98,1% de los pacientes pertenecen al régimen contributivo y que 1,9% al subsidiado. El cálculo de la supervivencia con el índice de comorbilidad de Charlson mostró que esos pacientes tendrían una tasa de supervivencia de 0% a 10 años. Las comorbilidades más frecuentes encontradas fueron hipertensión, diabetes mellitus, insuficiencia renal y otras patologías tumorales relacionadas. El costo total de manejo de un paciente con CPRCm, que recibe de manera continua durante 12 meses abiraterona o enzalutamida es promedio $131.942.292 COP año. Esa cifra incluye tanto el uso de servicios como el consumo de medicamentos, y ese último representa cerca del 90% del costo. Conclusiones los pacientes con cáncer en estadio metastásico se caracterizan por presentar alta demanda de medicamentos, laboratorios, imágenes diagnósticas, visitas ambulatorias e ingresos hospitalarios. Debido a que es una muestra pequeña de pacientes, se requiere desarrollar una valoración posterior que permita corroborar los hallazgos encontrados en este estudio retrospectivo.

Objective describe the demographic, clinical characteristics, the health resources utilization and the direct costs of patients with metastatic castration-resistant prostate cancer (CPRCm) treated with Enzalutamide or Abiraterone Acetate in Colombia. Methods Through a descriptive retrospective analysis through the database of a Colombian health insurer, patients were identified who, during July 1st, 2016 and June 30th, 2017 (index date) were dispensed with enzalutamide or abiraterone acetate, medical history of chemical or surgical castration was confirmed (6 months prior to the index date). The frequencies of use of services in this population were established and the reported consumption associated with consultations (emergencies, outpatient consultation), procedures and medications in the period of analysis were extracted. The costs were organized by categories and were reported according to Colombian pesos (COP) 2016. Results In a cohort of 161 patients with CPRCm with an average age of 77 years, it was determined that Valle del Cauca is the Colombian department with the largest CPRCm population in this cohort. 98.1% of the patients belong to the contributory regimen and 1.9% to the subsidized. The calculation of the patient's survival with the Charlson Comorbidity Index (CCI) showed a 0% survival rate at 10 years and most frequent comorbidities were hypertension, diabetes mellitus, renal failure and other related tumor pathologies. The total cost of managing a patient with CPRCm, who receives continuous abiraterone or enzalutamide for 12 months on average is $ 131,942,292 COP per year, this figure includes both the use of services and the consumption of medications; the latter represents ∼90% of cost. onclusions These patients were characterized by being large demander of health services, namely, medicines, laboratories, images, outpatient visits and inpatient admission. Due to it is a small sample of patients, is necessary to develop a posterior evaluation to corroborate the findings found in this retrospective analysis.

Sepsis por escherichia coli de inicio infrecuente en paciente con linfoma de células T y NK / Sepsis By Escherichia Coli Of Uncommon Starting In Patient With T And NK Cell Lymphoma

La sepsis se da en presencia de un foco infeccioso; en este caso por Escherichia coli (E.coli), las cuales poseen toxinas que pueden causar daños severos en la funcionalidad y morfología del organismo, viéndose empeorado en pacientes con enfermedades que afecten al sistema inmunitario; como es este caso en presencia de neoplasia hematológica. Paciente femenina de 42 años , con diagnóstico de Linfoma no Hodgkin de células T-NK presenta una placa necrótica en el paladar, temperatura por encima de 38°C, frecuencia respiratoria superando las 20 respiraciones por minutos y frecuencia cardíaca superando los 90 latidos por minuto, al examen de cultivo faríngeo positivo a E.coli, urocultivo negativo, confirmando punto partida infeccioso faríngeo; tratada con amikacina vía endovenosa durante 7 días con buena respuesta a la antibioticoterapia . Se reporta un caso infrecuente por este tipo de bacteria en zona bucal y revisión del tema.

Sepsis occurs in the presence of an infectious focus; in this case by Escherichia coli (E. coli), that toxins can cause severe damage to the organism's functionality and morphology, being worsened in patients with diseases that affect the immune system; as is this case in the presence of hematological malignancy. A 42-year-old female patient with a diagnosis of T-NK non-Hodgkin lymphoma presented with a necrotic plaque on the palate, temperature above 38 ° C, respiratory rate exceeding 20 breaths per minute, and heart rate exceeding 90 beats per minute. , on examination of a positive pharyngeal culture for E. coli, negative urine culture, confirming a pharyngeal infectious starting point; Treat with amikacin endovenously for 7 days with good response to antibiotic therapy. An infrequent case is reported for this type of bacteria in the oral area and a review of the subject.

Simultaneous Erb's and Klumpke's palsy: Case report.

Mapping nerve deficits during a physical exam after trauma to the upper extremity can help determine not only if the brachial plexus was injured but also which nerve roots were involved. A 28-year-old male presented with simultaneous signs and symptoms of Erb's (C5) and Klumpke's (C8, T1) palsy, with sparing of the C6 and C7 roots. The patient presented several months ago to his local emergency room with shortness of breath, which was determined to be caused by left diaphragmatic paralysis through clinical and radiographical evidence. However, the etiology of the current nerve dysfunction in the upper extremity remained unknown. With persistent questioning and establishing the patient's trust in the caregivers, it was revealed that the patient had attempted suicidal hanging. We describe the clinical features and the likely mechanism of injury leading to this previously unreported combination of brachial plexus injuries. The unique injuries to this patient's brachial plexus can be explained by the sequence of events during the attempted suicidal hanging. The upper brachial plexus was injured during the initial moments where the neck was excessively stretched and the lower brachial plexus was injured due to the patient reaching up and holding himself by his arm for an extended period of time.

Estimación de los costos directos de los eventos coronarios en Colombia / Estimation of the direct costs of coronary events in Colombia

Resumen Objetivo: estimar los costos de atención en salud relacionados con los pacientes que desarrollan eventos coronarios asociados a factores de riesgo (hipertensión, diabetes e hipercolesterolemia), así como el costo de acuerdo con el tiempo de evolución luego de dicho evento, en el contexto colombiano. Métodos: se llevó a cabo un estudio retrospectivo descriptivo a través de las bases de datos de suficiencia UPC de dos aseguradoras de salud colombianas, en las cuales se identificaron los pacientes que, durante el año 2014, presentaron algún evento coronario y se confirmaron sus antecedentes médicos (factores de riesgo) en la base del año 2013. Se estableció la tasa de presentación de eventos coronarios en la población y se extrajo el consumo reportado asociado a los procedimientos practicados durante un periodo de un año. Los costos se organizaron por categorías en diferentes cortes de tiempo desde la presentación del evento. Resultados: se encontraron 2.103 pacientes con eventos coronarios de los cuales, como antecedente médico, 583 presentaban hipertensión arterial, 354 dislipidemia y 198 diabetes. El costo total promedio al año del evento coronario fue de COP$23.454.569,95, sin factor de riesgo diagnosticado previamente fue de COP$23.848.023,32 y con antecedentes médicos tratados fue de COP$17.040.335,95, COP$22.075.708,19 y COP$28.825.710,71 para dislipidemia, hipertensión arterial y diabetes, respectivamente. Conclusiones: un paciente sin diagnóstico temprano de enfermedades o factores de riesgo cardiovascular, al momento de presentar un evento coronario, tiene mayor costo en el manejo terapéutico del evento que aquel diagnosticado previamente y que recibe tratamiento para ello.

Abstract Objective: To estimate the health care costs associated with patients that develop coronary events associated with risk factors (hypertension, diabetes, and hypercholesterolaemia), as well as the cost as regards the time of onset after such event, in the Colombian context. Methods: A retrospective, descriptive study was conducted using the Per-capita Payment Unit (UPC) sufficiency databases of two Colombian insurance companies. Patients were identified that presented with a cardiac event during the year 2014, and their medical history was confirmed (risk factors). The rate of presenting with coronary events in the population was established and the reported costs associated with the procedures practiced during a one-year period were extracted. The costs were organised by categories into different time cut-offs from the presentation of the event. Results: A total of 2,103 patients were found with coronary events, of which 583 had arterial hypertension, 354 with dyslipidaemia, and 198 patients with diabetes, as medical history. The total average cost a year of the coronary event was (COP$23,454,569.95), with no previously diagnosed risk it was (COP$23,848,023.32), and with a treated medical history it was (COP$17,040,335.95), (COP$22,075,708.19) and (COP$28,825,710.71) for dyslipidaemia, arterial hypertension, and diabetes, respectively. Conclusions: A patient without an early diagnosis of cardiovascular diseases or risk factors, on presenting with a coronary event, incurs higher costs in the therapeutic management of the event than one previously diagnosed and receives treatment for it.