Proportionate universalism intervention is effective for tackling nutritional social gradient in adolescents: the PRALIMAP-INÈS mixed randomised trial.

OBJECTIVE: This study aimed to investigate the effectiveness of proportionate universalism intervention to reduce the slope of the nutritional social gradient in adolescents. STUDY DESIGN: A mixed (experimental and quasi-experimental) multicentre trial. METHODS: Data from 985 adolescents of the PRALIMAP-INÈS trial (North-eastern France, 2012-2015) were analysed. For this, adolescents were split into five social classes according to the Family Affluence Scale: Highly Less Advantaged (H.L.Ad; n = 33), Less Advantaged (L.Ad; n = 155), Intermediate (Int; n = 404), Advantaged (Ad; n = 324) and Highly Advantaged (H.Ad; n = 69). The overweight care management was a standard care for all and a strengthened one adapted to the social class of adolescents. The main outcome was the 1-year change of the body mass index z-score (BMIz) slope. Other nutritional outcomes were BMI, ΔBMIp95 (BMI minus 95th percentile of the WHO reference), %BMIp95 (percent of 95th percentile of the WHO reference), leisure-time sport, consumption of fruits and vegetables and consumption of sugary foods and drinks. RESULTS: The inclusion data confirmed a weight social gradient expressed by a significant BMIz linear regression coefficient (ß = -0.09 [-0.14 to -0.04], P < 0.0001). The higher the social class, the lower the BMIz. The 1-year BMIz linear regression coefficient was -0.07 [-0.12 to -0.02], corresponding to a significant weight social gradient reduction of 23.3% (ß = 0.021 [0.001 to 0.041]; P = 0.04). Consistent results were found for other nutritional outcomes. CONCLUSIONS: PRALIMAP-INÈS shows that proportionate universalism intervention is effective to reduce the adolescents' nutritional social gradient and suggests that equitable health programmes and policies are a realistic goal.

A strain rate dependent model with decreasing Young's Modulus for cortical human bone.

In the existing literature, some studies have observed an increase in the elastic modulus of human cortical bone with strain rate, which has been described as a consequence of the viscoelastic properties of the bone. However, these results contradict the findings of other studies, in which an independence or decrease of the elastic modulus with strain rate is observed, which could be explained by other non-viscoelastic mechanisms. This research studies the dynamic behavior of human cortical bone specimens and investigates their mechanical properties . A full and objective strain rate dependent model is proposed and used to describe the experimental results obtained from uniaxial tensile tests of twenty-one human rib cortical bone specimens from twelve male post mortem human subjects (average age of 68.5 ± 12.3 years). In addition, a general discussion of some families of viscoelastic models is given and the caution with which they should be used when dealing with complex materials such as bone. The main experimental finding is that in the range of strain rate analyzed (ε̇=0.10-0.60), there is a significant decrease in Young's modulus (E≈ 18 GPa forε̇=0.10s-1andE≈ 8 GPa forε̇=0.50s-1), which is not of viscoelastic origin. Moreover, the most frequently used viscoelastic models analyzed in this study predict how the elastic modulus should not vary markedly with strain rate for small strains. In fact, the observed behavior seems related to the findings of other researchers who observed that the microcraking damage depends on the strain rate in the same sense found in our work. This allows us to interpret the qualitative results as a consequence of the microcracking that takes place within the cortical bone, and not related to viscoelastic effects.

Simulación Mediante Elemento Finito de Sistemas Intramedulares Telescópicos para Rehabilitación de Pacientes con Osteogénesis Imperfecta / Simulation by Finite Element Method of Intramedullary Telescopic Systems for Rehabilitation of Patients with Osteogenesis Imperfecta

Resumen En el trabajo se plantea el análisis de diferentes geometrías para un dispositivo intramedular, las cuales ayudan a reducir y evitar la migración, deformación y rotura del implante en tejido óseo afectado con Osteogénesis Imperfecta (OI). Se realizaron diseños en CAD de diferentes prototipos, donde se analizan las propiedades mecánicas en el alma del dispositivo, así como en las roscas distal y proximal de los implantes macho y hembra. Asimismo, se obtuvieron modelos 3D de huesos de un infante afectado con OI para realizar simulaciones mediante elemento finito de la interacción entre el hueso y el dispositivo intramedular. Los resultados muestran que los prototipos propuestos disminuyen la deformación del dispositivo, así como el aumento en la rigidez de la relación hueso-prótesis. Asimismo, las roscas generaron un menor esfuerzo en la unión con el hueso, lo que prevé un menor daño al tejido óseo. El trabajo se limitó al análisis numérico del rediseño de implantes telescópicos intramedulares para afectados con OI. Concluyendo que la geometría semicircular 3/4 de caña, otorga un óptimo resultado en las pruebas realizadas, al tiempo que las roscas ACME proveen una mejor sujeción en las epífisis distal y proximal de los huesos largos.

Abstract In this work we propose the analysis of different geometries for an intramedullary device, which help to reduce and avoid the migration, deformation and rupture of the implant in bone tissue affected with Osteogenesis Imperfecta (OI). Designs of different prototypes were made in CAD, where the mechanical properties in the device's soul are analyzed, as well as in the distal and proximal threads of the male and female implants. Likewise, 3D bone models of an affected infant with OI were obtained to perform finite element simulations of the interaction between the bone and the intramedullary device. The results show that the prototypes proposed decrease the strain of the device, as well as the increase in the stiffnes of the bone-prosthesis relationship. Also, the threads generated less stress in the union with the bone, which provides less damage to the bone tissue. The work was limited to the numerical analysis of the redesign of intramedullary telescopic implants for patients with OI. Concluding that the semicircular geometry 3/4 of cane, gives an optimal result in the tests carried out, while the ACME threads provide a better subjection in the distal and proximal epiphyses of the long bones.

Numerical Low-Back Booster Analysis on a 6-Year-Old Infant during a Frontal Crash Test.

This work studies descriptively the Head Injury Criterion (HIC) and Chest Severity Index (CSI), with a finite element model of the Hybrid III dummy type, for six-year-old subjects in a frontal vehicular collision, using the low-back booster (LBB) passive safety system. The vehicle seats and the passive safety systems were modelled in CAD (computer aided design) software. Then, the elements were analysed by the finite element method (FEM) in LS-DYNA® software. The boundary conditions were established for each study, according to the regulations established by the Federal Motor Vehicle Safety Standard (FMVSS), following the FMVSS 213 standard. The numerical simulations were performed during an interval of 120 ms and recording results every 1 ms. In order to analyse the efficiency of the system, the restraint performance of the LBB system is compared with the restraint configuration of the vehicle safety belt (VSB) only. The obtained injury criteria with the LBB system shows its ability to protect children in a frontal collision. The analyses allow obtaining the deceleration values to which the dummy head and chest was subjected. Of the studies herein performed, Study I: VSB obtained a HIC36 of 730.4 and CSI of 315.5, while Study II: LBB obtained a HIC36 of 554.3 and CSI of 281.9. The outcome shows that the restraint efficiency of each studied case differs. Used materials, the attachment system of the LBB, and the belt restraint system properly placed over the infant trunk are the main factors reducing the injury criteria rate.

Frontal crashworthiness characterisation of a vehicle segment using curve comparison metrics.

The objective of this work is to propose a methodology for the characterization of the collision behaviour and crashworthiness of a segment of vehicles, by selecting the vehicle that best represents that group. It would be useful in the development of deformable barriers, to be used in crash tests intended to study vehicle compatibility, as well as for the definition of the representative standard pulses used in numerical simulations or component testing. The characterisation and selection of representative vehicles is based on the objective comparison of the occupant compartment acceleration and barrier force pulses, obtained during crash tests, by using appropriate comparison metrics. This method is complemented with another one, based exclusively on the comparison of a few characteristic parameters of crash behaviour obtained from the previous curves. The method has been applied to different vehicle groups, using test data from a sample of vehicles. During this application, the performance of several metrics usually employed in the validation of simulation models have been analysed, and the most efficient ones have been selected for the task. The methodology finally defined is useful for vehicle segment characterization, taken into account aspects of crash behaviour related to the shape of the curves, difficult to represent by simple numerical parameters, and it may be tuned in future works when applied to larger and different samples.

[Implementation of a best practice guideline for the prevention of falls: Perception among hospitalized patients and its caregivers]. / Implantación de una guía de buenas prácticas para la prevención de caídas: percepción de los pacientes hospitalizados y sus cuidadores.

OBJECTIVE: To analyze the influence that the implementation of a fall prevention Best Practice Guideline (BPG) could have on the perception of patients and their caregivers about the utility of the activities implemented, about the care provided during admission and the adherence (the level of follow-up) to the recommendations received at discharge. MATERIAL AND METHOD: Design. Quasi-experimental study. Patients >65 years admitted≥48h to the Medical Area of the General Hospital of Albacete. SAMPLE: 104 subjects (consecutive sampling January-March 2013). Experimental group (EG). Patients admitted to BPG implementation units. Control group (CG). Usual care units. VARIABLES: Sociodemographic characteristics; previous and during admission falls, cognitive status (Pfeiffer); independence in daily life activities (ADLs); satisfaction with care and information provided, utility perceived, adherence to recommendations at discharge. DATA SOURCES: Interview and clinical history. Statistical analysis (SPSS 15.0). Descriptive and bivariant. Relative Risk. CI95%. RESULTS: 104 patients, EG 46.2% (48) and CG 53.8% (56). Women 51.9%, average age 79.9 years (s.d.=7.8). Pfeiffer 4,3 (s.d.=3.7). Previous falls 31.1%. In process, 1 fall in each group. There were statistically significant differences between EG/CG: age, cognitive status and independence in ADLs. In the EG was higher the percentage of perception about the usefulness of the recommendations to prevent falls (P<.001), greater adherence to them (P=0.0002), and to be very or quite satisfied with the information (P<.00004) and care received (P=.002). CONCLUSION: To implement recommendations according to an Evidence-based BPG to prevent falls in older people has shown, in users and caregivers, greater satisfaction, better perception of its usefulness and greater adherence to the recommendations.

DNA microarray analysis of the cyanotroph Pseudomonas pseudoalcaligenes CECT5344 in response to nitrogen starvation, cyanide and a jewelry wastewater.

Pseudomonas pseudoalcaligenes CECT5344 is an alkaliphilic bacterium that can use cyanide as nitrogen source for growth, becoming a suitable candidate to be applied in biological treatment of cyanide-containing wastewaters. The assessment of the whole genome sequence of the strain CECT5344 has allowed the generation of DNA microarrays to analyze the response to different nitrogen sources. The mRNA of P. pseudoalcaligenes CECT5344 cells grown under nitrogen limiting conditions showed considerable changes when compared against the transcripts from cells grown with ammonium; up-regulated genes were, among others, the glnK gene encoding the nitrogen regulatory protein PII, the two-component ntrBC system involved in global nitrogen regulation, and the ammonium transporter-encoding amtB gene. The protein coding transcripts of P. pseudoalcaligenes CECT5344 cells grown with sodium cyanide or an industrial jewelry wastewater that contains high concentration of cyanide and metals like iron, copper and zinc, were also compared against the transcripts of cells grown with ammonium as nitrogen source. This analysis revealed the induction by cyanide and the cyanide-rich wastewater of four nitrilase-encoding genes, including the nitC gene that is essential for cyanide assimilation, the cyanase cynS gene involved in cyanate assimilation, the cioAB genes required for the cyanide-insensitive respiration, and the ahpC gene coding for an alkyl-hydroperoxide reductase that could be related with iron homeostasis and oxidative stress. The nitC and cynS genes were also induced in cells grown under nitrogen starvation conditions. In cells grown with the jewelry wastewater, a malate quinone:oxidoreductase mqoB gene and several genes coding for metal extrusion systems were specifically induced.

Análisis morfométrico de hepatoesteatosis microvesicular alcohólica de ratas / Morphometric analysis of alcoholic microvesicular hepatic steatosis in rats

Un total de 24 ratas hembras de 4 meses de vida con peso aproximado de 250 gramos fueron divididas en dos grupos de animales rotulados como A y B. El grupo A se mantuvo con pellet y agua ad libitum sirviendo como controles mientras que el grupo B conservaba el pellet y recibía una solución de alcohol 40% disuelto en agua lo cual derivó en una esteatosis alcohólica multivesicular. Ambos grupos se mantuvieron en estas condiciones por 60 días. Posteriormente las ratas fueron sacrificadas y se extrajeron muestras tanto de hígado normal-control como de hígado graso para enseguida ser procesadas para microscopía electrónica de transmisión. De hepatocitos normales y esteatósicos se obtuvieron microfotografías electrónicas de transmisión con aumentos finales de 9.500X, las cuales fueron sometidas a estudios morfométricos para determinar fracciones volumétricas de los siguientes componentes celulares: Retículo endoplasmático rugoso, mitocondrias, inclusiones lipídicas y de glicógeno, eu y heterocromatina. De igual manera se cuantificaron las áreas celulares y nucleares. Del análisis de los resultados entre hepatocitos normales y alcohólicos se visualiza que existen notables diferencias en todos los componentes celulares cuantificados. Se concluye que los efectos de la ingesta diaria de alcohol provoca en los hepatocitos una esteatosis microvesicular que genera una drástica transformación en su ultraestructura y en su morfología, situación que se traduciría, por ende, en una variación funcional, representando de esta manera el efecto que esta droga provoca en los hepatocitos.

A total of 24 female rats, aged 4 months and weighing approximately 250 g, were divided into two groups, called A and B. The group A animals were kept on pellets and water ad libitum and served as controls, while group B animals were fed pellets and given a solution of 40% alcohol dissolved in water, leading to alcoholic multivesicular steatosis. Both groups were kept under these conditions for 60 days. The rats were then euthanized and samples of normal-control and fatty liver were taken and processed for examination by transmission electron microscope. Transmission electron microscope microphotographs of normal and steatotic hepatocytes were obtained with final magnification of 9,500 X. They were subjected to morphometric studies to determine the volumetric fractions of the following cell components: Rough Endoplasmic Reticulum, mitochondria, lipid and glycogen inclusions, and eu- and heterochromatin. In addition, the cell and nucleus areas were quantified and the nucleo cytoplasmic ratio of each cell type was determined. Analysis of the results between normal and alcoholic hepatocytes shows that noticeable differences exist in all the cell components quantified. It is concluded that the effects of the daily consumption of alcohol provoke microvesicular steatosis in the hepatocytes, generating a drastic transformation of their ultrastructure and morphology. This finally leads to functional variations, representing the effects produced by this drug in the hepatocytes.

Efecto de estimulaciones infrarrojas sobre hepatoesteatosis microvesicular alcohólica de ratas / Infrared laser effect on alcoholic rat hepatic microvesicular steatosis

24 ratas hembras de 4 meses de vida con peso aproximado de 250 gramos fueron divididas en dos grupos de animales, A y B. Ambos grupos se mantuvieron con pellet y solución de alcohol 40% durante 60 días generándoseles una hepatoesteatosis microvesicular. Los hígados de los animales pertenecientes al grupo B fueron estimulados con láser infrarrojo 6 J/cm2 durante 15 días consecutivos. Posteriormente, las ratas fueron sacrificadas y se extrajeron muestras de hígado y luego procesadas para microscopía electrónica de transmisión. De ambos tipos celulares se obtuvieron microfotografías electrónicas de transmisión con aumentos finales de 8.500 X, las cuales fueron sometidas a estudios morfométricos para determinar fracciones volumétricas de los siguientes componentes celulares: Retículo endoplasmático rugoso (RER), mitocondrias, inclusiones lipídicas y de glicógeno, eu y heterocromatina. De igual manera se cuantificaron las áreas celulares y nucleares. Del análisis de los resultados entre hepatocitos esteatósicos e irradiados se visualiza que existen diferencias en todos los componentes celulares cuantificados y se concluye que los efectos de la estimulación infrarroja con dosis de 6 J/cm2 provoca en los hepatocitos con esteatosis microvesicular transformación en su ultraestructura y en su morfología, fundamentalmente en la disminución acentuada de las infiltraciones lipídicas hasta en un 80% situación que se traduciría, en una variación funcional, representando de esta manera un efecto evidente que estas inducciones infrarrojas generan.

24 four-month-old female rats weighing approximately 250 grams were divided into two groups labeled A and B. Both groups were fed pellets and a 40% alcohol solution for 60 days, which caused a microvesicular hepatic steatosis. The livers of the animals in Group B were stimulated with 6 J/cm2 of infrared laser for 15 consecutive days. The rats were then sacrificed and samples of both steatosic liver and liver stimulated with infrared inductions were extracted for immediate processing via transmission electron microscopy.From both cell types transmission electron microphotographs were obtained at magnifications of 9500 X; these were subjected to morphometric studies to determine volumetric fractions of the following cell components: rough endoplasmic reticulum (RER), mitochondria, lipid and glycogen inclusions, euchromatin and heterochromatin. Likewise, cell and nuclear areas were quantified. Analysis of the results between steatosic and radiated hepatocytes revealed notable differences in all the cell components quantified. It is concluded that the effects of infrared stimulation with a dose of 6 J/cm2 brings about in the steatosic hepatocytes a microvesicular transformation in their ultrastructure and morphology, fundamentally in the considerable decrease in lipid infiltrations to 80%, which ultimately translates into a functional variation, thus representing an obvious impact produced by these infrared inductions.

[We and zinc]. / Nosotros y el cinc.

Nutrition is the basis of human physiological processes. Inadequate nutrition can lead to dysfunction in the metabolic chain links. One of the most important micronutrients is zinc, as evidenced by its wide range of carriers in the body. Zinc intake has a large margin in the current world population, may be 7 mg/d in the UK, reaching 15 mg/d in the U.S., although of course, the RDA's are set according to age, sex , physiological status (pregnancy, lactation, etc..), or disease. It is known that zinc is essential for the structure and function as well as DNA and enzymes, coenzymes, hormones and so on. Life is short, zinc, since the most rapidly absorbed and is transferred to tanks where it is stored, so the amount available zinc in the blood cannot be the amount "real". In this work we have done a mini-review of the passage of zinc by the body trying since their intake to their tour of the blood in both healthy and sick people.

Persistencia de los efectos del láser infrarrojo 6 J/cm² en hepatocitos de rata / Persistence of the effects of 6 J/cm2 infrared laser in rat hepatocytes

Hígados de ratas Sprague Dawley fueron irradiados con dosis diarias de 6 J/cm2 emitida por el láser AsGa equivalente a 904 nm durante 15 días De estos animales previamente anestesiados fueron sacrificados transcurridos 5, 10, 30, 45 y 60 días post irradiación para posteriormente obtener quirúrgicamente muestras de hígado y ser procesadas para microscopía electrónica de transmisión, aplicando técnicas morfométricas utilizando aumentos de 8.500 X con especial énfasis en cuantificar fracciones volumétricas de componentes celulares con el objetivo de precisar la duración de las estimulaciones infrarrojas. El análisis de los resultados entre hepatocitos controles e irradiados con dosis de 6 J/cm2 y tiempo de estimulación infrarroja revela que existen marcadas diferencias entre las fracciones volumétricas de componentes celulares determinantes de funcionalidad celular e involucrados en síntesis proteica, cuantificación que demuestra claramente que el efecto del láser infrarrojo persiste hasta los 30 días post estimulación, evidenciándose modificaciones de organelos que revelan alta funcionalidad, mientras que sobre este tiempo es observada una notable inhibición de dicha funcionalidad, concluyéndose entonces que los efectos de radiación infrarroja persisten en tiempos precisos provocando en los hepatocitos una drástica transformación en sus componentes y por ende en su funcionalidad. en estas células de elevado metabolismo.

Livers of Sprague Dawley rats were irradiated with daily doses of 6 J/cm2 emitted by a laser AsGa, equivalent to 904 nm during 15 days. Experiment animals were anaesthetised and killed after 5, 10, 30, 45 and 60 days post irradiation, in order to obtain samples of liver by surgery. These were processed for transmission electron microscopy, and morphometric techniques were applied using 8,500 X magnification with special emphasis on measuring the volumetric fractions of cell components in order to determine the duration of infrared stimulation. Analysis of the results between control hepatocytes and those irradiated with doses of 6 J/cm2 and by period after infra-red stimulation revealed the existence of marked differences between the volumetric fractions of cell components which determine cell function or are involved in protein synthesis. The measurements show clearly that the effect of the infrared laser persists up to 30 days post stimulation, with evidence of modifications of organelles revealing high functioning, while after 30 days a notable inhibition of this functioning is observed. It is therefore concluded that the effects of infrared radiation persist for precise times, provoking a drastic transformation in hepatocyte components, and thus the functioning of these high-metabolism cells.

Alkaline cyanide degradation by Pseudomonas pseudoalcaligenes CECT5344 in a batch reactor. Influence of pH.

Water containing cyanide was biologically detoxified with the bacterial strain Pseudomonas pseudoalcaligenes CECT5344 in a batch reactor. Volatilization of toxic hydrogen cyanide (HCN) was avoided by using an alkaline medium for the treatment. The operational procedure was optimized to assess cyanide biodegradation at variable pH values and dissolved oxygen concentrations. Using an initial pH of 10 without subsequent adjustment allowed total cyanide to be consumed at a mean rate of approximately 2.81 mg CN(-) L(-1) O.D.(-1) h(-1); however, these conditions posed a high risk of HCN formation. Cyanide consumption was found to be pH-dependent. Thus, no bacterial growth was observed with a controlled pH of 10; on the other hand, pH 9.5 allowed up to 2.31 mg CN(-) L(-1) O.D.(-1) h(-1) to be converted. The combination of a high pH and a low dissolved oxygen saturation (10%) minimized the release of HCN. This study contributes new basic knowledge about this biological treatment, which constitutes an effective alternative to available physico-chemical methods for the purification of wastewater containing cyanide or cyano-metal complexes.

Acute iliac artery thrombosis and pulsatile femoral and popliteal veins in the same extremity: a case report.

Systemic venous pressure is elevated in right heart failure, and this elevation may be reflected in pulsatile venous flow when there is significant tricuspid regurgitation. The presence of this systolic reversed flow in the femoral and popliteal veins may result in major difficulties for diagnosis and treatment. We report the case of a patient with signs and symptoms of acute ischemia of the right lower limb with palpable pulse in the groin and popliteal fossa. Tricuspid regurgitation was suspected by clinical examination, and Doppler ultrasonographic examination of the extremity revealed pulsatile flow in the femoral and popliteal veins while the iliac arterial axis was occluded. A preoperative angiogram revealed an underlying iliac artery thrombosis, which was successfully treated.

[Intravenous colistin in the treatment of infections due to pan-resistant Gram negative bacilli]. / Colistín en infecciones nosocomiales por bacilos gramnegativos pan-resistentes.

UNLABELLED: Emergence of panresistant gram negative bacilli has lead to the progressive reintroduction of intravenous colistin. AIM: To describe the clinical experience observed with this compound. METHODOLOGY: A retrospective analysis was performed for all treatments lasting >/= 48 hours. Medical records were analyzed to obtain clinical parameters and microbiological data, evaluate clinical response and evolution until discharge. MAIN RESULTS: 24 treatments lasting >/= 48 hours were applied between June 2005 and September 2006. Intravenous colistin was indicated to treat cases of ventilator-associated (VA) pneumonia (n = 10; 41.7%), abscess or collections (12.5%), bloodstream infections, non-VA pneumonia or urinary tract infections (4.2% each one, respectively). Treatment was initiated on average at 3.2 days (+/- 2.85) from diagnosis of infection. All courses were microbiologically-guided, and involved P. aeruginosa or A. baumannii isolates. Susceptibility was evaluated by E-test in 11 isolates (MIC90 3.6 nicrog/mL, range 0.38 to 4 microg/mL). One isolate was resistant to colistin (9%). A favorable response was observed in 12 treatments (50%) with a relapse in 5 cases (41.7%). Being treated for pneumonia was the only factor associated to failure, (p = 0.04) Eradication was documented in 8 cases (33.3%) and persistence in 11 (45.8%). In 5 cases a microbiological follow-up was not available. Survival at time of discharge was 45.5%. (n = 10) None of the treatment courses was associated with nefrotoxicity. CONCLUSIONS: Intravenous colistin is a safe compound useful to treat various nosocomial infections due to pan-resistant gram negative bacilli. Nonetheless, its clinical efficacy is limited, especially among patients treated for nosocomial pneumonia.

Colistín en infecciones nosocomiales por bacilos gramnegativos pan-resistentes / Intravenous colistin in the treatment of infections due to pan-resistant Gram negative bacilli

La emergencia de bacilos gramnegativos pan-resistentes ha obligado a la reutilización progresiva de colistín. Objetivo: Describir la experiencia clínica con este compuesto. Metodología: Se efectuó un análisis retrospectivo de todos los tratamientos con colistín endovenoso administrados por más de 48 horas, analizando datos clínicos, microbiológicos, la respuesta terapéutica y evolución hasta el egreso. Resultados: Se aplicaron 24 tratamientos entre junio de 2005 y septiembre de 2006. Colistín endovenoso fue utilizado en eventos de neumonía asociada a VM (n = 10; 41,7 por ciento), colecciones o abscesos (12,5 por ciento), bacteriemias, neumonía no asociada a VM e infección urinaria (4,2 por ciento cada una, respectivamente). El tratamiento fue iniciado en promedio a 3,2 (± 2,85) días desde el diagnóstico de infección. Todos los pacientes tenían infecciones por Pseudomonas aeruginosa o Acinetobacter baumannii. Se evaluó la susceptibilidad por E-test en once aislados (CIM90 3,6 µg/mL, rango 0,38 a 4 µg/mL). Una cepa (9 por ciento) presentó resistencia. Se observó una respuesta favorable en 50 por cientoo de los casos (n = 12) con recaída en cinco de estos casos (41,7 por ciento). El único factor asociado a fracaso fue la presencia de neumonía (p = 0,04). Se observó erradicación en ocho casos (33,3 por ciento) y persistencia en once (45,8 por ciento). En cinco casos el resultado microbiológico no fue evaluable. Sobrevivió a la hospitalización 45,5 por ciento de los pacientes (n = 10). No se observó nefrotoxicidad. Conclusiones: Colistín endovenoso es un compuesto seguro para el tratamiento de infecciones por bacilos gramnegativos pan-resistentes. Sin embargo, su eficacia terapéutica es limitada, especialmente, entre aquellos pacientes tratados por neumonía.

Emergence of panresistant gram negative bacilli has lead to the progressive reintroduction of intravenous colistin. Aim: To describe the clinical experience observed with this compound. Methodology: A retrospective analysis was performed for all treatments lasting ≥ 48 hours. Medical records were analyzed to obtain clinical parameters and microbiological data, evaluate clinical response and evolution until discharge. Main results: 24 treatments lasting ≥ 48 hours were applied between June 2005 and September 2006. Intravenous colistin was indicated to treat cases of ventilator-associated (VA) pneumonia (n = 10; 41.7 percent), abscess or collections (12.5 percent), bloodstream infections, non-VA pneumonia or urinary tract infections (4.2 percent each one, respectively). Treatment was initiated on average at 3.2 days (± 2.85) from diagnosis of infection. All courses were microbiologically-guided, and involved P. aeruginosa or A. baumannii isolates. Susceptibility was evaluated by E-test in 11 isolates (MIC90 3.6 µg/mL, range 0.38 to 4 µg/mL). One isolate was resistant to colistin (9 percent). A favorable response was observed in 12 treatments (50 percent) with a relapse in 5 cases (41.7 percent). Being treated for pneumonia was the only factor associated to failure, (p = 0.04) Eradication was documented in 8 cases (33.3 percent) and persistence in 11 (45.8 percent). In 5 cases a microbiological follow-up was not available. Survival at time of discharge was 45.5 percent. (n = 10) None of the treatment courses was associated with nefrotoxicity. Conclusions: Intravenous colistin is a safe compound useful to treat various nosocomial infections due to pan-resistant gram negative bacilli. Nonetheless, its clinical efficacy is limited, especially among patients treated for nosocomial pneumonia.

A PER/TIM/DBT interval timer for Drosophila's circadian clock.

Circadian rhythms in Drosophila are supported by a negative feedback loop, in which PERIOD (PER) and Timeless (TIM) shut down their own transcription as they translocate once a day from the cytoplasm of clock-containing cells to the nucleus. Period length is partially determined by an interval of cytoplasmic retention of the TIM and PER proteins. To study this process, we examined PER/TIM/Doubletime (DBT) physical interactions and nuclear translocation by imaging individual cultured Drosophila cells. Using live cell video microscopy and green fluorescent protein (GFP) tags, we observed dynamic patterns of stability and localization for DBT, PER, and TIM that resembled those previously found in vivo. These studies suggest that a cytoplasmic interval timer regulates nuclear translocation of these proteins. The cultured cell assay provides a potent system to study interactions among new and known genes involved in the generation of circadian behavior.