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Mendoza-Halliday, Major et al., 2024 ("The Paper")1 advocates a local field potential (LFP)-based approach to functional identification of cortical layers during "laminar" (simultaneous recordings from all cortical layers) multielectrode recordings in nonhuman primates (NHPs). The Paper describes a "ubiquitous spectrolaminar motif" in the primate neocortex: 1) 75-150 Hz power peaks in the supragranular layers, 2) 10-19 Hz power peaks in the infragranular layers and 3) the crossing point of their laminar power gradients identifies Layer 4 (L4). Identification of L4 is critical in general, but especially for The Paper as the "motif" discovery is couched within a framework whose central hypothesis is that gamma activity originates in the supragranular layers and reflects feedforward activity, while alpha-beta activity originates in the infragranular layers and reflects feedback activity. In an impressive scientific effort, The Paper analyzed laminar data from 14 cortical areas in 2 prior macaque studies and compared them to marmoset, mouse, and human data to further bolster the canonical nature of the motif. Identification of such canonical principles of brain operation is clearly a topic of broad scientific interest. Similarly, a reliable online method for L4 identification would be of broad scientific value for the rapidly increasing use of laminar recordings using numerous evolving technologies. Despite The Paper's strengths, and its potential for scientific impact, a series of concerns that are fundamental to the analysis and interpretation of laminar activity profile data in general, and local field potential (LFP) signals in particular, led us to question its conclusions. We thus evaluated the generality of The Paper's methods and findings using new sets of data comprised of stimulus-evoked laminar response profiles from primary and higher-order auditory cortices (A1 and belt cortex), and primary visual cortex (V1). The rationale for using these areas as a test bed for new methods is that their laminar anatomy and physiology have already been extensively characterized by prior studies, and there is general agreement across laboratories on key matters like L4 identification. Our analyses indicate that The Paper's findings do not generalize well to any of these cortical areas. In particular, we find The Paper's methods for L4 identification to be unreliable. Moreover, both methodological and statistical concerns, outlined below and in the supplement, question the stated prevalence of the motif in The Paper's published dataset. After summarizing our findings and related broader concerns, we briefly critique the evidence from biophysical modeling studies cited to support The Paper's conclusions. While our findings are at odds with the proposition of a ubiquitous spectrolaminar motif in the primate neocortex, The Paper already has, and will continue to spark debate and further experimentation. Hopefully this countervailing presentation will lead to robust collegial efforts to define optimal strategies for applying laminar recording methods in future studies.
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INTRODUCTION: Wilms' tumor (WT) is the most frequent renal tumor in childhood. Therapeutic management progression has increased survival rates, and as a result, long-term adverse effects. MATERIALS AND METHODS: A descriptive retrospective study of a case series from 1977 to 2023 was carried out. The characteristics of the treatments received and the adverse effects listed on medical records were analyzed via phone surveys. RESULTS: 50 patients (25 boys-25 girls) with a mean age of 3.6 years (3 months-11 years) at diagnosis were included. Most of them (94%) were treated according to the protocol established by the European standards of pediatric oncology, which are characterized by the use of neoadjuvant chemotherapy. In one patient, the American treatment scheme was followed. The most common drugs used were vincristine and actinomycin D (78%). Only 12 patients (28%) received anthracyclines. Unilateral nephrectomy was the most frequent surgical technique (84%). Renal disorders were the most common (46%). However, the occurrence of second neoplasias (9%) and reproductive disorders (8% between boys and girls) had a greater impact on patients' quality of life. Multiple - cardiac (23%), endocrine (26%), and pulmonary (15%) - disorders associated with the treatments received were reported. CONCLUSIONS: WT treatment has an impact on health. Adequate and rigorous surgery, close follow-up, and limiting chemotherapy doses and radiation exposure can minimize long-term sequels.
INTRODUCCION: El tumor de Wilms (TW) es el tumor renal más frecuente en la infancia. La evolución del manejo terapéutico ha incrementado la tasa de supervivencia y como consecuencia, los efectos secundarios a largo plazo. MATERIAL Y METODOS: Realizamos un estudio retrospectivo descriptivo a partir de una serie de casos entre 1977 y 2023. Estudiamos las características de los tratamientos recibidos y los efectos secundarios que constan en su historia clínica y a través de cuestionarios telefónicos. RESULTADOS: Localizamos 50 pacientes (25 hombres-25 mujeres) con edad media al diagnóstico de 3,6 años (3 meses-11 años). La mayoría fueron tratados según protocolo vigente de las guías europeas de oncología pediátrica (94%) caracterizadas por el uso de quimioterapia neoadyuvante. En un paciente Se siguió el esquema americano de tratamiento. Los fármacos más utilizados fueron vincristina y actinomicina D (78%); solo 12 pacientes (28%) recibieron antraciclinas. La nefrectomía unilateral fue la técnica quirúrgica más empleada (84%). Las alteraciones renales fueron las más frecuentes (46%). Sin embargo, la aparición de segundas neoplasias (9%) y aquellas alteraciones relacionadas con la reproducción (8% entre hombres y mujeres) suponen un mayor impacto en la calidad de vida de los pacientes. Se describen múltiples alteraciones: cardíacas (23%), endocrinas (26%) o pulmonares (15%) relacionadas con los tratamientos recibidos. CONCLUSIONES: El tratamiento del TW afecta a la salud general. Una cirugía adecuada y rigurosa, limitar las dosis de quimioterapia, minimizar la exposición a la radiación y un seguimiento estrecho puede minimizar las secuelas a largo plazo.
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Neoplasias Renales , Nefrectomía , Tumor de Wilms , Humanos , Tumor de Wilms/tratamiento farmacológico , Tumor de Wilms/terapia , Masculino , Estudios Retrospectivos , Femenino , Neoplasias Renales/terapia , Neoplasias Renales/tratamiento farmacológico , Lactante , Preescolar , Niño , Nefrectomía/métodos , Calidad de Vida , Terapia Neoadyuvante/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Factores de Tiempo , Neoplasias Primarias Secundarias , Tasa de Supervivencia , Dactinomicina/administración & dosificación , Dactinomicina/uso terapéuticoRESUMEN
OBJECTIVE: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. MATERIALS AND METHODS: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged <16 years. Thus, 21 cases in adults (mean age, 57 years) were analyzed. RESULTS: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumours were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). CONCLUSIONS: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its aetiology and therapeutic management.
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Intususcepción , Adulto , Humanos , Persona de Mediana Edad , Intususcepción/diagnóstico por imagen , Intususcepción/etiología , Intususcepción/terapia , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Dolor Abdominal , HospitalesRESUMEN
This study focuses on the radiolysis (up to 36 kGy) of guanine and adenine (nitrogenous bases) adsorbed in hectorite and attapulgite to highlight the potential role of clays as protective agents against ionizing radiation in prebiotic processes. In this framework, the study investigated the nitrogenous bases' behavior in two types of systems: a) aqueous suspension of adenine-clay systems and b) guanine-clay systems in the solid state. This research utilized spectroscopic and chromatographic techniques for its analytical purposes. Regardless of the reaction medium conditions, the results reveal that nitrogenous bases are stable under ionizing irradiation when adsorbed on both clays.
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OBJECTIVE: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. MATERIALS AND METHODS: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged<16 years. Thus, 21 cases in adults (mean age, 57 y) were analyzed. RESULTS: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumors were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). CONCLUSIONS: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its etiology and therapeutic management.
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The abiotic synthesis of histidine under experimental prebiotic conditions has proven to be chemically promising and plausible. Within this context, the present results suggest that histidine amino acid may function as a simple prebiotic catalyst able to enhance amino acid polymerization. This work describes an experimental and computational approach to the self-assembly and stabilization of DL-histidine on mineral surfaces using antigorite ((Mg, Fe)3Si2O5(OH)4), pyrite (FeS2), and aragonite (CaCO3) as representative minerals of prebiotic scenarios, such as meteorites, and subaerial and submarine hydrothermal systems. Experimental results were obtained through polarized-light microscopy, IR spectroscopy (ATR-FTIR), and differential scanning calorimetry (DSC). Molecular dynamics was performed through computational simulations with the MM + method in HyperChem software. IR spectra suggest the presence of peptide bonds in the antigorite-histidine and aragonite-histidine assemblages with the presence of amide I and amide II vibration bands. The FTIR second derivative inspection supports this observation. Moreover, DSC data shows histidine stabilization in the presence of antigorite and aragonite by changes in histidine thermodynamic properties, particularly an increase in histidine decomposition temperature (272ºC in antigorite and 275ºC in aragonite). Results from molecular dynamics are consistent with DSC data, suggesting an antigorite-histidine closer interaction with decreased molecular distances (cca. 5.5 Å) between the amino acid and the crystal surface. On the whole, the experimental and computational outcomes support the role of mineral surfaces in prebiotic chemical evolution as enhancers of organic stability.
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Evolución Química , Histidina , Aminoácidos , MineralesRESUMEN
Despite the medical importance of sandflies as vectors (Diptera: Phlebotominae) of Leishmania spp., immature stages of phlebotomine sandflies have never been found in the wild in Mexico. In the present investigation, we sought to identify specific microhabitats associated with the presence of sandfly immature stages. Field work was conducted in 11 localities of the Yucatan Peninsula and we collected soil samples from each site during two periods (November 2007 to April 2008, November 2008). Soil samples were transported to our base camp and were processed using the Berlese's funnels. We processed a total 242 soil samples with an average weight of 362 ± (SD) 317 gr. From these samples, we were able to recover 51 phlebotomine larvae in five different microhabitats and largest number was obtained from mammal burrows (88%) and from tree-buttresses of Brosimium alicastrum (Berg) (6%). We identified larval microhabitat for Brumptomyia hamata (Fairchild & Hertig) and those specimens provided the material to describe for the first time the fourth instar larva. We also include information of a larval microhabitat of Lutzomyia cruciata (Coquillett). In addition, we recorded a total of 4872 arthropods from 15 taxa in all those soil samples in which sandfly larvae were found, being Collembola (76%) and Acari (10%) the most abundant.
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Phlebotomus , Psychodidae , Animales , Insectos Vectores , Larva , MéxicoRESUMEN
Spinal muscular atrophy (SMA) is an autosomal recessive disease caused by homozygous deletions or loss-of-function mutations in SMN1, which result in a degeneration of motor neurons in the spinal cord and brain stem. Even without a randomized placebo-controlled trial, salbutamol has been offered to patients with SMA in the neuromuscular clinics of most of hospitals for many years. We describe the response to salbutamol in 48 patients with SMA type II who were not taking any other medication. We investigate the changes over an eighteen-month period in motor functional scales and we analyze side effects and subjective response to treatment. Our results suggest that oral administration of salbutamol might be helpful in the maintenance of motor function in patients with SMA type II. An apparent beneficial effect was observed in functional scales of children under the age of 6, especially during the first 6 months of therapy. The majority of patients of all ages referred some kind of subjective positive effect associated with therapy intake. Salbutamol seemed safe and was well tolerated without serious side effects.
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Agonistas Adrenérgicos beta/efectos adversos , Agonistas Adrenérgicos beta/uso terapéutico , Albuterol/efectos adversos , Albuterol/uso terapéutico , Atrofias Musculares Espinales de la Infancia/tratamiento farmacológico , Adolescente , Edad de Inicio , Niño , Preescolar , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Estudios Longitudinales , Masculino , Movimiento , Procedimientos Ortopédicos/estadística & datos numéricos , Estudios Prospectivos , Escoliosis/etiología , Atrofias Musculares Espinales de la Infancia/fisiopatología , Resultado del Tratamiento , Adulto JovenRESUMEN
Streblidae are ectoparasites exclusive to bats and feed only on their blood. Studies on ectoparasite fauna have increased our ecological knowledge of the parasitic relationship between streblids and their bat hosts. We evaluate assemblages of phyllostomid bats and their ectoparasitic flies in three scenarios with different types of anthropogenic use: pine-oak forest, avocado orchards, and an urban park during an annual cycle in the highlands of Michoacan, Mexico. We recorded a total of 325 bats belonging to nine species in three subfamilies: Glossophaginae, Desmodontinae, and Stenodermatinae, and obtained 225 bat flies belonging to seven species. The nectivorous bat Anoura geoffroyi Gray, 1838, had the highest prevalence of infestation and the hematophagous bat Desmodus rotundus (É. Geoffroy, 1810) was the host with the highest mean parasite abundance and mean intensity. Aspidoptera delatorrei Wenzel, 1966, Megistopoda proxima (Séguy, 1926), Paratrichobius longicrus (Miranda Ribeiro, 1907), Trichobius brennani Wenzel, 1966, and T. parasiticus Gervais, 1844, are new records for the state of Michoacan reported in this study.
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Quirópteros/parasitología , Dípteros/clasificación , Interacciones Huésped-Parásitos , Animales , Dípteros/anatomía & histología , Dípteros/fisiología , Femenino , Masculino , MéxicoRESUMEN
Biomimetic simulation permits neuroscientists to better understand the complex neuronal dynamics of the brain. Embedding a biomimetic simulation in a closed-loop neuroprosthesis, which can read and write signals from the brain, will permit applications for amelioration of motor, psychiatric, and memory-related brain disorders. Biomimetic neuroprostheses require real-time adaptation to changes in the external environment, thus constituting an example of a dynamic data-driven application system. As model fidelity increases, so does the number of parameters and the complexity of finding appropriate parameter configurations. Instead of adapting synaptic weights via machine learning, we employed major biological learning methods: spike-timing dependent plasticity and reinforcement learning. We optimized the learning metaparameters using evolutionary algorithms, which were implemented in parallel and which used an island model approach to obtain sufficient speed. We employed these methods to train a cortical spiking model to utilize macaque brain activity, indicating a selected target, to drive a virtual musculoskeletal arm with realistic anatomical and biomechanical properties to reach to that target. The optimized system was able to reproduce macaque data from a comparable experimental motor task. These techniques can be used to efficiently tune the parameters of multiscale systems, linking realistic neuronal dynamics to behavior, and thus providing a useful tool for neuroscience and neuroprosthetics.
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HPV-based screening provides greater protection against cervical cancer (CC) than cytology-based strategies. Currently, several molecular diagnostic assays for the detection of human papillomavirus (HPV) are available. In this study, we analyzed 5 different HPV testing and genotyping techniques (Hybrid Capture 2 [HC2; Qiagen, Hilden, Germany], AnyplexTMII HPV28 [Anyplex; Seegene, Seoul, Korea], Linear Array [Roche, Branchburg, NJ, USA], GP5+/6+ PCR-EIA-RH [Labo Bio-medical Products, Rijswijk, The Netherlands] and CLART2 [Genomica, Madrid, Spain]) in 295 women referred to the hospital Colposcopy Clinic from 2007 to 2008 due to positive HPV test results or an abnormal Pap test. DNA extraction for HPV genotyping was performed in cervical sample specimens after Pap test and HPV detection by HC2. The inclusion criteria were: (1) adequate cervical sampling with sufficient material for the Pap test and HPV detection and genotyping, and (2) colposcopically-directed biopsy and/or endocervical curettage. HC2 showed the highest sensitivity for high-grade squamous intraepithelial lesion and CC (HSIL+) detection (96.1%), but all the HPV genotyping tests showed a higher specificity. (Anyplex 86.8%; Linear Array 86.0%; GP5+/6+ 78.8%; CLART2 76.5%). The agreement between HC2 results and the other techniques was similar: 82.4%, kappa=0.650 for Anyplex; 83.4%, kappa=0.670 for Linear Array, 79.93%, kappa=0.609 for GP5+/6+ and 82.4%, kappa=0.654 for CLART2. HPV 16 and/or 18 infection was a risk factor for underlying HSIL+ in the univariate analysis. Anyplex showed the highest risk of underlying HSIL+ after positive HPV 16 and/or 18 tests (OR 31.1; 95% CI 12.1-80.0).
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Cuello del Útero/virología , Enfermedades de los Genitales Femeninos/diagnóstico , Técnicas de Genotipaje , Técnicas de Diagnóstico Molecular/métodos , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Adolescente , Adulto , Anciano , Biopsia , Cuello del Útero/patología , Detección Precoz del Cáncer/métodos , Femenino , Enfermedades de los Genitales Femeninos/epidemiología , Enfermedades de los Genitales Femeninos/virología , Genotipo , Papillomavirus Humano 16/genética , Papillomavirus Humano 16/aislamiento & purificación , Humanos , Tamizaje Masivo , Persona de Mediana Edad , Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Juego de Reactivos para Diagnóstico , Sensibilidad y Especificidad , España/epidemiología , Lesiones Intraepiteliales Escamosas de Cuello Uterino/diagnóstico , Lesiones Intraepiteliales Escamosas de Cuello Uterino/virología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología , Adulto JovenRESUMEN
We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid Community, Valencian Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV coinfection, and treatment details were recorded. We included 48595 chronically HCV-infected patients with the following characteristics: median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was 66.9% GT1 (24.9% subtype 1a and 37.9% subtype 1b), 2.8% GT2, 17.3% GT3, 11.4% GT4 and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, nonparenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns. We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV coinfection and within geographical areas and epidemiological groups.
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Genotipo , Hepacivirus/clasificación , Hepacivirus/genética , Hepatitis C Crónica/epidemiología , Hepatitis C Crónica/virología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Epidemiológicos , Femenino , Técnicas de Genotipaje , Hepacivirus/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Epidemiología Molecular , Filogeografía , Prevalencia , Estudios Retrospectivos , España/epidemiologíaRESUMEN
The present study presents morphological and chaetotaxic descriptions of the immature stages of Lutzomyia (Tricholateralis) cruciata (Coquillett), a probable vector of leishmaniasis in Mexico. The egg exochorion is consistent with the species already known as Lu. (Tricholaterialis), but different from the Lu. cruciata egg of Chiapas, Mexico. The fourth instar larva of Lu. (Tricholateralis) cruciata possesses a novel antenna, combining morphological characteristics of categories 2 and 3 for neotropical sandflies. Differences between the chaetotaxy of first and fourth instar larvae of Lu. cruciata with those of Lu. (Lutzomyia) and Lu. (Tricholaterlis) are compared and discussed. This is the first time in which the chaetotaxy and morphology of pupa of a species belonging to Lutzomyia (Tricholateralis) sensu Galati have been described, and we recorded for the first time the anterior prothorax setae, which was previously only considered for Old World species.
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Psychodidae/anatomía & histología , Animales , México , Psychodidae/crecimiento & desarrollo , PupaRESUMEN
Meloidogyne ethiopica, an aggressive nematode, causes significant economic losses to Vitis crops. Rootstocks can successfully manage phytoparasitic nematodes. However, no studies exist on M. ethiopica-resistant rootstocks under field conditions. This study assessed the resistance of six Vitis rootstocks to M. ethiopica under field and greenhouse conditions. The number of galls and eggs in vine roots, quantity of second stage juveniles and males in 250 ml of soil, root weight, and shoot weight were determined for the Harmony, SO4, 101-14 MG, 110R, 3309C, and Kober 5BB rootstocks, and the own-root Chardonnay variety as a control. In the field, Harmony, SO4, 101-14 MG, Kober 5BB, and 110R were highly resistant to nematode parasitism and reproduction. In turn, 3309C was the least resistant rootstock. In the greenhouse, all rootstocks similarly limited M. ethiopica attack and reproduction. In both conditions, Chardonnay was the most susceptible vine to nematode attack, with high quantities of galls, eggs, and nematode reproduction. In conclusion, most of the evaluated rootstocks reduced M. ethiopica parasitism. Harmony, SO4, 101-14 MG, 110R, and Kober 5BB rootstocks are options for vineyard use, with final selection dependent on winegrower requirements.
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Introducción: el Dengue es una enfermedad infecciosa, sistémica y dinámica. Es una sola enfermedad, con diferentes presentaciones clínicasy evolución impredecible. Se hizo endémica en Paraguay desde el año 2002; el objetivo de este trabajo es determinar las características clínicas y epidemiológicas de la epidemia de diciembre de2012 a febrero de 2013. Materiales y Métodos: Diseño descriptivo, retrospectivo, transversal. Fueron incluidos pacientes que desarrollaron criterios de casos probables de Dengue que consultaron al Servicio de Urgencias del Hospital de Clínicas. 1037 pacientes cumplían los criterios de inclusión. Resultados: La frecuencia de casos de Dengue fuedel 14%. La edad promedio fue de 37,7 ± 16,3. El56% era del sexo femenino. El 87% de los pacientes provenían del departamento Central. El mes de mayor número de casos con 48% fue febrero. El83% de los pacientes fue tratado de forma ambulatoria. El promedio de días de internación fue de 2,39 ± 1,65. Sólo el 20% de los pacientes presentó algún tipo de comorbilidad. La fiebre estuvo presente en el 99,3% de los pacientes. El 20% de los pacientes tenía signos de alarma al momento de laconsulta. La presión de pulso promedio fue 40,4± 12,1 La frecuencia cardiaca media fue de 93,8± 17,3. Promedio de hematocrito fue 42,2 ± 5,07.Promedio de plaquetas fue 111.500 ± 79972,1. Promediode leucocitos 4561 ± 3717. Se registró unóbito. Conclusión: Este trabajo muestra las diferentesaristas de una de las epidemias más importantes desarrollada a nivel país.
Introduction: assessment by beneficiaries of social programs is needed to evaluate their managementand impact, mainly of nutritional programs .Objective: To determine the practices, acceptability and the perception of the of childrens caretakers who are beneficiaries of the Integral Nutritiona Food Program-INFP in 2 hospitals of the Central department of Paraguay. Methodology: Cross-sectional, observational and descriptive design. 125 childrens caretakers wereinterviewed. Results: The caretakers scholarship average was of 9±3 years. The manipulation and the storage ofthe PANI milk were adapted to 85.2% and to 95.3% respectively; 59.4% was improperly prepared, mainly due to incorrect dilution (34.2%) and becausethey did not respect the preparation steps (31.6%). 99.2% consumes 2 or more times/day and 51.6% combines it with other foods. 75.8% and 83.6% consider that the milks taste and smell isgood and 9.4 % reported some discomfort regardingits consumption. 43% of the childrens caretakers expressed that they like the milk a lot and 40.6 % love it the 90.6% thought the program was very important. Conclusion: The handling of INFPs milk is adequate however, strengthening of caretakers skills regarding its preparation is required. There is anexcellent acceptability and perception of the program.
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Humanos , Masculino , Femenino , Niño , Niño , Programas y Políticas de Nutrición y Alimentación , ParaguayRESUMEN
BACKGROUND: Chronic diseases have become a main cause of morbidity and mortality provoking function loss in organs. Quality of life is poor and expensive with replacement therapy. Transplantation offers a higher survival rate and a better life; however, the donation rate in Mexico is low, making it important to know the opinion of the population. METHODS: Six hundred forty-two people in Guanajuato, Mexico, (>15 years old) were enrolled. Demographic characteristics, education, religion, organ donation, and transplantation attitudes were evaluated. RESULTS: Donation attitudes in life or death were: very willing to donation (82.8% vs 61.5%), refuse to donate (12.7% vs 29.4%), and undecided (4.5% vs 9.1%). Reasons for donation were: altruism (63%), being useful to someone (28.6%), and empathy (7.1%). Negative causes were: personal beliefs (35.6%), fear (23.7%), and ignorance or "I don't know the recipient" (18.5%). Finally, 94.5% of the population is willing to receive a transplant if they need it. CONCLUSIONS: Guanajuato has a high tendency to donate their own organs, but less to donate from a family member. Refusal to donate has originated from lack/misinformation that people received from health professionals. Although most people are willing to donate, this is not reflected in donation rates. To be able to make this intention reality, we must create educational models for health care personnel that will allow them to transmit proper information to the population.
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Actitud , Familia/psicología , Trasplante de Órganos/psicología , Obtención de Tejidos y Órganos/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Adulto JovenRESUMEN
The main inclicator of iodine nutritional status of salt for human con-sumption is the urinary concentration of iodine, which is useful in monitoring universal levels in salt. Paraguay has suffered deficiency in salt with highprevalence of goiter in thepopulation reaching48.6%. In 2000, results of the ThyroidMobileproject in Latin America showed a goiter prevalence of 17% but 79.6% of the consumed iodized salt was adequate in paraguayan households (more than 15 ppm of iodine). The average values of iodine urinary concentration in 4487 scholars was 437 µg/L, 30% of the average value was between the ideal of 100 to 199 µg/L and 46.1% were above 300 mg/L, with risk of excess iodine. Urinary concentration of iodine during pregnancy was measure for the first time in Paraguay in 200 women; the average was 484 µg/L but diabetes and hypothyroidism during pregnancy was observe in 50% of them. Objective: Determine iodine concentration in urine of the school population in 17 departments of the country and measure the levels of iodine in urine in 200 pregnant women from 15-37 years of age and their levels of glycaemia, and thyroid TSH. Methods: During the years, 2006 and 2007 were evaluated 4487 school randomized, in a probabilistic sample, 3198 in rural areas and 1,289 in urban areas; casual urine samples was collected to determine iodine content. The urinary concentration of iodine in two hundredpregnant women, concentration of iodine in salt, and levels of glycaemia and TSH were also included in the present study All candidates agreed with the informed consent under the ethics rules. Results: These data showed by comparing the levels of iodine in urine concentration in more than adequate and excessive level but this last was markedly elevated (93.8%). The median level greater than 300 µg/L was observed in 100% of the 4,487 urine samples, while the median urinary iodine levels of300-500 µg/L was 91.3% and above 500 was 9.7%. These levels showed the risk of developing thyroid autoimmune diseases. In 200 pregnancy women the average of urine concentration of iodine was 498 pcg/L, subclinical and clinical hypothyroidism and gestational diabetes was 50% of both. Conclu-sion: To obtain normal median urinary iodine levels is necessary to decrease the amount of iodine in salt. The main recommendation is to insist on adequate monitoring of iodized salt consumption. Also continue surveillance and monitoring in sentinel sites reporting the importance of adequate iodine intake of the population especially in pregnant women that also need to be warm about the diabetes during pregnancy but also a regimen is necessary to keep them within the normal levels of glycemia. The subclinical hypothyroidism has been also studied in the same patients.
El principal indicador del impacto de la yodación de la sal de consumo humano es la concentración urinaria de yodo la cual es útil en el monitoreo de la sal. En la encuesta del año 1988 realizada en el Paraguay, se alcanzó una prevalencia de bocio de 48,6% en la población escolar con un déficit de yodo en la sal, pero el año 2000 en el estudio del proyecto de Tiroides Móvil, se redujo por el método ecográfico a 17%. Ese mismo año la mediana de los niveles urinarios en niños escolares de 6-12 años fue 258 µg/L, considerando que 30% se encontraba entre el valor ideal de 100 a 199 µg/L y 46,1% sobre 300 µg/L, implicando un riesgo de exceso de yodo en dicha población con las posibles consecuencias de aparición tanto de hipo como de hipertiroidismo. El 93% presentó exceso de yodo en la sal y la mediana urinaria fue 437 ug/ mL. Un grupo de embarazadas han sido estudiadas en el Hospital San Pablo por primera vez en el Paraguay para la determinación de la yoduria, yodo en sal, diabetes gestacional, hipotiroidismo en el embarazo y sus valores antropométricos resultando un hipotiroidismo subclínico del 50% y diabetes gestacional del 50%. Objetivo: Determinar las yodurias en la población escolar de 6-12 años pre púber de ambos sexos en 17 departamentos del país y en una submuestra en embarazadas y también niveles de glicemia en el embarazo en un hospital de Asunción. Sujetos y Métodos: En el periodo del 2006-2007 fueron evaluados 4.487 escolares randomizados, en una muestra probabilística, 3.198 en el área rural y 1.289 en el área urbana con muestras en orina casual. El año 2015, doscientas embarazadas fueron estudiadas con muestras de glicemia en ayunas y 2 horas post prandial, dosaje de TSH, yodo en sal de 100 gramos de la sal de consumo en sus hogares y de orina para ver la concentración de yodo en sal y urinaria de yodo. Todos los candidatos fueron estudiados bajo consentimiento autorizado y de acuerdo a normas éticas. Resultados: Al comparar los niveles de yodo en orina en el nivel más que adecuado y el excesivo de la yoduria se vió que éste último nivel estaba marcadamente elevado (93.8%), que la mediana de los niveles mayores a 300 ug/L era del 100% del total de las 4.487 muestras de orina, mientras que la mediana de los niveles de yoduria entre 300-500 µg/L fue de 91,3% y por encima de 500 fue 9.7% lo cual implicó el riesgo de desarrollar enfermedades tiroideas autoinmunes. Las embarazadas presentaron una mediana urinaria de yodo 484 µg/L, diabetes gestacional e hipotiroidismo subclínico en 50%. Conclusión: Para normalizar los niveles de yoduria, es necesario disminuir la cantidad de yodo en la sal. La recomendación es insistir en el monitoreo de la adecuada yodación de las sales de consumo familiar y continuar con la vigilancia y el monitoreo constante en sitios centinelas divulgando la importancia de la adecuada ingesta de yodo a la población. Un régimen dietético a las embarazadas es necesario implementar en el primer trimestre del embarazo.
Asunto(s)
Humanos , Estudiantes , Glándula Tiroides , Glucemia , Estado Nutricional , Diabetes Gestacional , Mujeres Embarazadas , Hipotiroidismo , Yodo , Ingestión de AlimentosRESUMEN
PCR assays are nowadays between the most sensitive and reliable methods for screening and diagnosing sexually transmitted infections (STIs). The aim of this study was to analyze the reliability, accuracy, and usefulness of the new NG OligoGen kit in comparison with the cobas 4800 assay for the detection of Neisseria gonorrhoeae in clinical samples. A prospective study was designed for detection of N. gonorrhoeae including urine samples (n=152), rectal (n=80), endocervical (n=67), pharyngeal (n=41), and urethral swabs (n=5) that were sent from a regional STI clinic in Seville, Spain. Samples were collected from 255 (73.9%) men and 90 women. Sensitivity, specificity, positive and negative predicative values, and kappa value for N. gonorrhoeae detection using the NG OligoGen kit were 99.6%, 100%, 100%, 99.1%, and 0.99, respectively. Statistical data obtained in this study confirm the usefulness and reliable results of this new assay.
Asunto(s)
Técnicas Bacteriológicas/métodos , Gonorrea/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Neisseria gonorrhoeae/aislamiento & purificación , Adulto , Femenino , Humanos , Masculino , Neisseria gonorrhoeae/genética , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y Especificidad , EspañaRESUMEN
The objective of this study was to analyse the characteristics of healthcare-associated febrile urinary tract infection (HCA-FUTI) compared to community-acquired FUTI (CA-FUTI) in men. An ambispective cross-sectional study in which we recorded clinical and microbiology data and outcomes from males with FUTI attended in the Emergency Department was carried out. A total of 479 males with FUTI, 162 (33.8%) HCA-FUTI and 317 (66.2%) CA-FUTI, were included. HCA-FUTI patients were older (p < 0.001), had higher Charlson scores (p < 0.001) and received previous antimicrobial treatment more frequently (p < 0.001) compared to CA-FUTI patients. HCA-FUTI was less likely caused by Escherichia coli (p < 0.001) and more frequently by Klebsiella spp. (p = 0.02), Enterobacter spp. (p < 0.001) and Pseudomonas aeruginosa (p < 0.001). Resistance to ceftriaxone (p = 0.006), gentamicin (p < 0.001), quinolones (p < 0.001), co-trimoxazole (p = 0.001) and fosfomycin (p = 0.009) was higher among E. coli strains isolated from males with HCA-FUTI and so was the prevalence of extended-spectrum beta-lactamase and AmpC E. coli and Klebsiella spp.-producing strains (p = 0.012). Inadequate antimicrobial treatment and all-cause in-hospital mortality was associated with HCA-FUTI (p < 0.001 and p = 0.004, respectively). Independent factors for mortality were severe sepsis or septic shock [odds ratio (OR) 29; 95% confidence interval (CI): 3.9-214] and cirrhosis (OR 23.7; 95% CI: 1.6-350.6). Male patients with HCA-FUTI have different clinical characteristics, outcomes and microbiological features compared to CA-FUTI patients. Previous contact with the healthcare system has to be taken into consideration when deciding the optimal antimicrobial treatment in males with FUTI.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/patología , Infección Hospitalaria/microbiología , Infección Hospitalaria/patología , Infecciones Urinarias/microbiología , Infecciones Urinarias/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacterias/clasificación , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Estudios Transversales , Farmacorresistencia Bacteriana , Humanos , Masculino , Persona de Mediana Edad , Análisis de Supervivencia , Resultado del Tratamiento , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Adulto Joven , beta-Lactamasas/análisisRESUMEN
PURPOSE: The aim of this study was to determine the presence of the new Swedish Chlamydia trachomatis (C. trachomatis) variant (nvCT) and the distribution of C. trachomatis ompA genotypes in three geographically distant regions of Spain. METHODS: The genotypes of strains causing 624 episodes of infection (January 2011-September 2012) were studied using a nested PCR that amplifies a fragment of the ompA gene, followed by sequencing. To detect nvCT, a real-time PCR was used that amplifies a fragment of the cryptic plasmid with a 377 base pair deletion, which identifies the nvCT. RESULTS AND CONCLUSION: The ompA genotype was identified in 565 (90.5%) episodes. Eleven genotypes were detected, of which nine were found in all three regions. Only one nvCT strain was detected (0.4%), despite the predominance of genotype E (41%). Other frequent genotypes were genotypes D (19%), F (13%), G (11 %), and J (7%). Genotype L2b, causing lymphogranuloma venereum, was detected in men who have sex with men (MSM) in all three regions. Genotypes E and F were more frequent in women and heterosexual men, and genotypes D, G, J and L2b in MSM. In men, the main factor causing differences in the distribution of C. trachomatis was sexual behavior (MSM versus heterosexual men), while the distribution of C. trachomatis genotypes was similar in women and heterosexual men.