Evaluation of chronic diarrhea in patients newly diagnosed with HIV infection through the FilmArray® gastrointestinal panel.

INTRODUCTION: The treatment and diagnosis of chronic diarrhea in the immunocompromised patient depends on the ability to rapidly detect the etiologic agents. AIMS: Our aim was to evaluate the results of the FilmArray® gastrointestinal panel in patients newly diagnosed with HIV infection that presented with chronic diarrhea. MATERIAL AND METHODS: Utilizing nonprobability consecutive convenience sampling, 24 patients were included that underwent molecular testing for the simultaneous detection of 22 pathogens. RESULTS: In 24 HIV-infected patients with chronic diarrhea, enteropathogen bacteria were detected in 69% of the cases, parasites in 18%, and viruses in 13%. Enteropathogenic Escherichia coli and enteroaggregative Escherichia coli were the main bacteria identified, Giardia lamblia was found in 25%, and norovirus was the most frequent viral agent. The median number of infectious agents per patient was three (range of 0 to 7). The biologic agents not identified through the FilmArray® method were tuberculosis and fungi. CONCLUSIONS: Several infectious agents were simultaneously detected through the FilmArray® gastrointestinal panel in patients with HIV infection and chronic diarrhea.

Exposure of Calophyllum antillanum seeds to liquid nitrogen delays seedling emergence and decreases leaf anthraquinones.

BACKGROUND: Trees within the Calophyllum genus are multi-use trees that produce valuable wood, phytochemicals with a range of biological activities, and seed oil as a source of biodiesel. As a consequence of climate change, there is a need to develop strategies to preserve valuable plant genetic resources. Cryopreservation represents the most suitable option for the long-term storage of germplasm with minimal space and maintenance requirements. OBJECTIVE: To determine appropriate methods to cryopreserve seeds of Calophyllum antillanum and maintain secondary compound production. MATERIALS AND METHODS: Seeds at a moisture content of 6% were used to evaluate two treatments: seeds immersed in liquid nitrogen and control seeds. Biosynthetic pathway efficiency was assessed post-cryo by determining anthraquinone contents in roots, stems and leaves following 30 and 75 d of seedling growth. RESULTS: The results indicated that exposure to liquid nitrogen delayed germination and seedling emergence for a period of up to 45 d after seed sowing. By 60 d of cultivation, no significant differences in plant growth were observed for cryostored and control seeds. The levels of anthraquinones, which were also measured in seeds and seedlings, were lower in plants regenerated from cryostored seeds following 30 d of growth, but there were no differences in roots and stems by 75 d of growth. Furthermore, the difference in leaf anthraquinone levels for cryopreserved and control seeds at 75 d was much smaller than at 30 d. CONCLUSION: The low initial anthraquinone levels in emerging seedlings correlated with the initial slow growth of cryopreserved seeds.

Cryopreservation of seeds of the highly valued tropical timber species Swietenia mahagoni.

BACKGROUND: Swietenia mahagoni wood is one of the most valuable in world trade and, as a result, natural populations have been decimated due to unsustainable harvesting. The decline in natural population levels is being exacerbated by climate change. In order to ensure the preservation of valuable genotypes, there is an urgent need to develop strategies to conserve the genetic diversity present within this species. At present, cryopreservation is the most viable option for the long-term storage of plant germplasm, particularly for long-lived species which are challenging to maintain in the field. OBJECTIVE: To cryopreserve intact seeds of S. mahagoni, with the dual goal of retaining the biosynthetic capacity of plants, which is critical since this species is highly valued for medicinal purposes. MATERIALS AND METHODS: Seeds at a moisture content of 6% were immersed in liquid nitrogen (LN) before warming and recovery. Plantlet establishment and growth were assessed over a period of 70 days and anthraquinone synthesis was determined in roots, stems and leaves. RESULTS: The results showed an initial lag in the germination rate of cryopreserved seeds compared with control seeds; however, this difference disappeared over time. The lag in seedling emergence observed in cryostored seeds was also evident in the plant characteristics measured following 30 days of culture when all plant parameters measured were significantly higher in plants produced from control than cryostored seeds. However, after 70 days of growth, these differences were no longer apparent. Anthraquinone levels were also initially lower (at 30 days) in plants regenerated from cryopreserved seeds than those from control seeds, however, this difference was substantially reduced by 70 days thereby indicating the ability of these plants to accumulate secondary metabolites, albeit at a reduced rate, during the early stages of development. CONCLUSION: In S. mahagoni, the delay in anthraquinone production in plants regenerated from cryostored seeds during the early stages of development may have occurred as a consequence of the preferential allocation of resources towards the initiation of recovery processes in response to the stresses imposed by cryopreservation. Once the stresses were overcome and plant growth resumed, resources could be directed to secondary processes such as anthraquinone synthesis. doi.org/10.54680/fr22610110412.

Mediastinitis descendente en el contexto de la angina de Ludwig. Artículo de revisión / Descending mediastinitis in the context of Ludwig's Angina. Article review

Introducción: la mediastinitis se define como el proceso inflamatorio usualmente infeccioso del tejido conectivo mediastinal y los órganos que este rodea. Específicamente, la mediastinitis descendente corresponde a una complicación rara por infección de los espacios profundos del cuello, la orofaringe o la cavidad oral, que se extiende a través de los espacios fasciales del cuello y los diseca. De forma infrecuente, esta patología puede originarse a partir de la parotiditis, las infecciones de la piel del cuello o la epiglotitis. También, de manera menos frecuente, puede generarse en el contexto de un traumatismo del cuello o la cavidad oral. En este estudio se pretende llamar la atención, en particular, sobre los aspectos que involucran al especialista otorrinolaringólogo en el manejo de los pacientes con infecciones profundas del cuello y su rol en el diagnóstico y tratamiento eficaz de la mediastinitis descendente, como la principal causa de mortalidad en estos casos. Metodología: se llevó a cabo una búsqueda con las palabras clave "Airway" "Ludwig's angina" en PubMed, no se efectuó filtración por fecha ni tipo de estudio. Se encontró un total de 147 artículos. Se realizó lectura de los resúmenes por los autores y se seleccionaron 50. Se realizó lectura crítica del texto completo de los 50 artículos resultantes de la búsqueda y se extrajo la información relevante. Conclusión: esta patología de marcada severidad conlleva a un aumento significativo de la mortalidad. Su tratamiento, aunque permanece controversial en ciertas circunstancias, debe ser agresivo y oportuno, con un enfoque en el rol del otorrinolaringólogo en 4 pilares de tratamiento: el drenaje quirúrgico, la antibioticoterapia de amplio espectro, el soporte hemodinámico y la seguridad de la vía aérea.

Introduction: Mediastinitis is defined as the usually infectious inflammatory process of the mediastinal connective tissue and the organs it surrounds. Specifically, descending mediastinitis corresponds to a rare complication, an infection of deep spaces of the neck, oropharynx, or oral cavity, which extends through the facial spaces of the neck, dissecting. Less frequent, this pathology can originate from parotiditis, skin infections of the neck or epiglottitis. Also, less frequent it can be generated in the context of trauma to the neck or oral cavity. This study intends to draw attention to the aspects that involve the ENT specialist in the management of patients with deep neck infections and their role in the diagnosis and effective treatment of descending mediastinitis as the main cause of mortality in these patients. Methodology: A search was carried out with the keywords "Airway" "Ludwig's angina" in PubMed, no filtering was performed by date or type of study, finding a total of 147 articles, abstracts were read by the authors, selecting 50. A critical reading of the 50 articles full texts is carried out and the relevant information is extracted. Conclusion: This pathology of marked severity, carries a significant increase in mortality and its treatment, although it remains controversial in certain circumstances, it must be aggressive and timely, focusing the role of the otorhinolaryngologist on 4 pillars of treatment: surgical drainage, antibiotic therapy, hemodynamic support, and airway safety.

Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.

BACKGROUND: The cutaneous manifestations of COVID-19 disease are poorly characterized. OBJECTIVES: To describe the cutaneous manifestations of COVID-19 disease and to relate them to other clinical findings. METHODS: We carried out a nationwide case collection survey of images and clinical data. Using a consensus we described five clinical patterns. We later described the association of these patterns with patient demographics, the timing in relation to symptoms of the disease, the severity and the prognosis. RESULTS: The lesions may be classified as acral areas of erythema with vesicles or pustules (pseudo-chilblain) (19%), other vesicular eruptions (9%), urticarial lesions (19%), maculopapular eruptions (47%) and livedo or necrosis (6%). Vesicular eruptions appear early in the course of the disease (15% before other symptoms). The pseudo-chilblain pattern frequently appears late in the evolution of the COVID-19 disease (59% after other symptoms), while the rest tend to appear with other symptoms of COVID-19. The severity of COVID-19 shows a gradient from less severe disease in acral lesions to more severe in the latter groups. The results are similar for confirmed and suspected cases, in terms of both clinical and epidemiological findings. Alternative diagnoses are discussed but seem unlikely for the most specific patterns (pseudo-chilblain and vesicular). CONCLUSIONS: We provide a description of the cutaneous manifestations associated with COVID-19 infection. These may help clinicians approach patients with the disease and recognize cases presenting with few symptoms. What is already known about this topic? Previous descriptions of cutaneous manifestations of COVID-19 were case reports and mostly lacked illustrations. What does this study add? We describe a large, representative sample of patients with unexplained skin manifestations and a diagnosis of COVID-19, using a consensus method to define morphological patterns associated with COVID-19. We describe five clinical patterns associated with different patient demographics, timing and prognosis, and provide illustrations of these patterns to allow for easy recognition.

Healthcare accreditation as trigger of organisational change: The view of professionals.

BACKGROUND: Healthcare accreditation seeks to promote the organisational change in healthcare organisations from an approach that values the level of progress achieved through a validated reference framework. The aim of this paper is to analyse the role played by accreditation through the experience perceived by health professionals during the process of self-assessment and external evaluation, taking into account three dimensions of analysis: focus on the patient, internal organisation and leadership, and impact on the clinical aspects of healthcare. MATERIAL AND METHODS: Design: Semi-structured interviews with key informants from clinical management units (CMU) within the Andalusian Health System (Spain). PARTICIPANTS: The key informants in each CMU were the clinical leader, the head of nursing and two health professionals (doctors and nurses). A qualitative research protocol was employed to conduct the semi-structured interviews (n=52 interviews) with physicians and nurses, in order to analyse their experience with the accreditation process. RESULTS: The analysis identified four main outcomes related to the accreditation process perceived by professionals: (1) A benchmarking conceptualisation of the process; (2) Improvements in patient-centred care, quality of clinical records, and organisational culture of the units; (3) Improvement of patient safety culture; (4) As negative outcomes, a slight perception of bureaucratisation and standardisation of the clinical practice. CONCLUSIONS: The described initiative of accreditation process in Andalusia (Spain) is widely perceived as positive by health professionals since it fosters the organisational change, although it also has a slightly negative bureaucratisation effect on clinical practice.

Alterations in circulating lymphoid cell populations in systemic small vessel vasculitis are non-specific manifestations of renal injury.

Innate lymphocyte populations, such as innate lymphoid cells (ILCs), γδ T cells, invariant natural killer T (iNK T) cells and mucosal-associated invariant T (MAIT) cells are emerging as important effectors of innate immunity and are involved in various inflammatory and autoimmune diseases. The aim of this study was to assess the frequencies and absolute numbers of innate lymphocytes as well as conventional lymphocytes and monocytes in peripheral blood from a cohort of anti-neutrophil cytoplasm autoantibody (ANCA)-associated vasculitis (AAV) patients. Thirty-eight AAV patients and 24 healthy and disease controls were included in the study. Patients with AAV were sampled both with and without immunosuppressive treatment, and in the setting of both active disease and remission. The frequencies of MAIT and ILC2 cells were significantly lower in patients with AAV and in the disease control group compared to healthy controls. These reductions in the AAV patients remained during remission. B cell count and frequencies were significantly lower in AAV in remission compared to patients with active disease and disease controls. Despite the strong T helper type 2 (Th) preponderance of eosinophilic granulomatosis with polyangiitis, we did not observe increased ILC2 frequency in this cohort of patients. The frequencies of other cell types were similar in all groups studied. Reductions in circulating ILC2 and MAIT cells reported previously in patients with AAV are not specific for AAV, but are more likely to be due to non-specific manifestations of renal impairment and chronic illness. Reduction in B cell numbers in AAV patients experiencing remission is probably therapy-related.

Neospora caninum serostatus in dairy cattle of the Northern plains of Antioquia, Colombia / Estudio serológico de Neospora caninum en ganado de leche del altiplano Norte de Antioquia, Colombia

ABSTRACT Objectives. To determine Neospora caninum seroprevalence in nonvaccinated dairy cattle from the Northern plains of Antioquia. Materials and methods. A cross-sectional study was conducted to determine the prevalence of neosporosis in a major dairy area of Colombia. Blood samples were collected from 1003 dairy cattle in 29 herds located in the municipality of San Pedro de los Milagros, in Antioquia. N. caninum antibody levels were measured by an enzymatic immunoassay (ELISA) and the results classified as positive or negative. Results. Seropositive cattle were observed in all herds, with a prevalence ranging from 7 to 97% and a mean (±S.E) of 37.1% (±4.2). The distribution of seropositive animals by age groups of <1, 1-2, 2-3 and ≥3 years old was 25.5, 30.3, 46.1 and 39.1%, respectively. Conclusions. There is a high seroprevalence of N. caninum in the main dairy cattle area of Antioquia. The large variation among herds suggests the presence of mayor risk factors whose identification would be essential to establish control programs. Considering that any seropositive cow has a greater risk to abort than uninfected mates, future studies should address the epidemiology of abortions that can be attributed to neosporosis and the type of control strategies that could be implemented.

RESUMEN Objetivos . Determinar la seroprevalencia de Neospora caninum en ganado lechero sin vacunar del altiplano Norte de Antioquia. Materiales y métodos . Se realizó un estudio transversal para determinar la prevalencia de neosporosis en bovinos de la principal zona lechera antioqueña. En Mayo-Junio del 2014 se recolectaron muestras de sangre de 1003 bovinos en 29 hatos ubicados en el municipio de San Pedro de los Milagros, en Antioquia. Los niveles de anticuerpos de N. caninum se midieron mediante un kit de inmunoensayo enzimático (ELISA) y los resultados se clasificaron como positivos o negativos. Resultados. Se observaron bovinos seropositivos en todos los hatos, con una prevalencia entre el 7 y 97%, y una media (±SE) del 37.1% (±4.2). La distribución de los animales seropositivos por grupos de <1, 1-2, 2-3 y ≥3 años de edad fue del 25.5, 30.3, 46.1 y 39.1%, respectivamente. Conclusiones. Se detectó una alta tasa de seroprevalencia de N. caninum en la principal zona de ganado lechero de Antioquia. La gran variación entre hatos apunta a que existen factores de riesgo cuya identificación sería esencial a la hora de instaurar programas de control. En vista de que cualquier vaca seropositiva tiene un mayor riesgo de abortar que congéneres no infectados, los próximos estudios deberían abordar la epidemiología de abortos atribuible a neosporosis previo a establecer cualquier plan de control.

Neonatal exposure to amphetamine alters social affiliation and central dopamine activity in adult male prairie voles.

The prairie vole (Microtus ochrogaster) is a socially monogamous rodent species that forms pair bonds after mating. Recent data have shown that amphetamine (AMPH) is rewarding to prairie voles as it induces conditioned place preferences. Further, repeated treatment with AMPH impairs social bonding in adult prairie voles through a central dopamine (DA)-dependent mechanism. The present study examined the effects of neonatal exposure to AMPH on behavior and central DA activity in adult male prairie voles. Our data show that neonatal exposure to AMPH makes voles less social in an affiliation test during adulthood, but does not affect animals' locomotor activity and anxiety-like behavior. Neonatal exposure to AMPH also increases the levels of tyrosine hydroxylase (TH) and DA transporter (DAT) mRNA expression in the ventral tegmental area (VTA) in the brain, indicating an increase in central DA activity. As DA has been implicated in AMPH effects on behavioral and cognitive functions, altered DA activity in the vole brain may contribute to the observed changes in social behavior.

Analyzing redox balance in a synthetic yeast platform to improve utilization of brown macroalgae as feedstock.

Macroalgae have high potential to be an efficient, and sustainable feedstock for the production of biofuels and other more valuable chemicals. Attempts have been made to enable the co-fermentation of alginate and mannitol by Saccharomyces cerevisiae to unlock the full potential of this marine biomass. However, the efficient use of the sugars derived from macroalgae depends on the equilibrium of cofactors derived from the alginate and mannitol catabolic pathways. There are a number of strong metabolic limitations that have to be tackled before this bioconversion can be carried out efficiently by engineered yeast cells. An analysis of the redox balance during ethanol fermentation from alginate and mannitol by Saccharomyces cerevisiae using metabolic engineering tools was carried out. To represent the strain designed for conversion of macroalgae carbohydrates to ethanol, a context-specific model was derived from the available yeast genome-scale metabolic reconstructions. Flux balance analysis and dynamic simulations were used to determine the flux distributions. The model indicates that ethanol production is determined by the activity of 4-deoxy-l-erythro-5-hexoseulose uronate (DEHU) reductase (DehR) and its preferences for NADH or NADPH which influences strongly the flow of cellular resources. Different scenarios were explored to determine the equilibrium between NAD(H) and NADP(H) that will lead to increased ethanol yields on mannitol and DEHU under anaerobic conditions. When rates of mannitol dehydrogenase and DehRNADH tend to be close to a ratio in the range 1-1.6, high growth rates and ethanol yields were predicted. The analysis shows a number of metabolic limitations that are not easily identified through experimental procedures such as quantifying the impact of the cofactor preference by DEHU reductase in the system, the low flux into the alginate catabolic pathway, and a detailed analysis of the redox balance. These results show that production of ethanol and other chemicals can be optimized if a redox balance is achieved. A possible methodology to achieve this balance is presented. This paper shows how metabolic engineering tools are essential to comprehend and overcome this limitation.

Pattern of Tuber melanosporum extramatrical mycelium expansion over a 20-year chronosequence in Quercus ilex-truffle orchards.

Successful cultivation of black truffle (Tuber melanosporum) requires a long-term investment and the maintenance of the symbiosis throughout its preproductive and productive years. Monitoring the symbiosis over time is challenging, as it requires methods that can detect the belowground proliferation of the fungus associated with its host tree. In this study, we used a chronosequence design to study the expansion pattern of this fungus as the host tree grows. We hypothesize that this expansion can be estimated by monitoring T. melanosporum DNA from soil beneath host trees of different ages (3, 5, 7, 10, 14, and 20 years old) and at different distances from the trunk of the trees (40, 100, and 200 cm). We also wished to evaluate the presences of Tuber brumale and Tuber indicum, potentially problematic truffle species, in these plantations. To detect the mycelium of T. melanosporum in these soils, we extracted DNA and performed polymerase chain reaction (PCR) with Tuber species-specific primers, and to estimate DNA amount, we measured relative band intensities from the amplicons in agarose gels. Both age and distance were related to T. melanosporum DNA quantity, which was more abundant in the oldest age classes, reaching a plateau in 5-7 years. At 40 cm from the tree, there were no differences in T. melanosporum DNA amounts in orchards of different ages, but at 100 and 200 cm, younger orchards had less T. melanosporum DNA. We did not detect DNA from T. brumale or T. indicum in any of our samples.

Early psychological care of the French victims of the Costa Concordia shipwreck.

Most of the French passengers who survived the shipwreck of the cruise ship Costa Concordia were repatriatedfrom Italy to Marseille, one of the stopovers of the cruise. The shipwreck happened during the nightof 13th-14th January 2012 and entailed the forced evacuation of 4195 passengers and crewmembers.Thirty-two persons died and 2 others are still reported missing. The massive and unexpected inflow of402 French citizens in the port of Marseille required the quick setting up of welcome facilities, not only tosolve logistical problems, but also to address psychological and sometimes even medical problems. ThePrehospital Psychological Emergency Service (CUMP) and the Prehospital Emergency Medical Service(SAMU) of Marseille examined 196 persons in total, and were able to avoid a great number of emergencyadmissions deemed necessary because of difficult psychological situations (death, missing or lost persons,acute stress). The objective of this report is to rapidly present the emergency committee as a whole andto describe in more detail the work that the CUMP accomplished during the 36 hours necessary to takecharge of the majority of the French passengers of the Costa Concordia.

Efecto del ácido linoléico sobre la producción de las prostaglandinas PGF2α y PGE2 en células endometriales / Linoleic acid effect on PGF2a and PGE2 prostaglandin production in endometrial cells

Objetivo. Evaluar el efecto in vitro del ácido linoléico sobre la producción de PGF2α y PGE2 en células endometriales epiteliales bovinas (CEEP). Materiales y métodos. Se cultivaron CEEP aisladas de tejido uterino y se suplementaron con AL a diferentes concentraciones (1 μM, 10 μM, 100 μM), oxitocina (OT) (0.1 μM) e interferón trofoectodérmico bovino (bINT-τ) (50 ng/ml). Se cuantificó la PGF2α y PGE2 a distintos tiempos (12, 24 y 36h). En el control, la PGF2α en el sobrenadante aumentó en el tiempo de cultivo y fue 1.2 veces mayor que la producción de PGE2. Resultados. El ácido linoléico disminuyó la concentración de PGF2α (p<0.05) en el sobrenadante, y no afectó (p>0.05) la producción de PGE2. El efecto conjunto de AL y OT sobre la producción de PGF2α difirió para cada uno de los tiempos; el ácido linoléico inhibió parcialmente el efecto estimulante de la OT sobre la producción de PGE2, el efecto conjunto del AL y el bINT-τ aumentó (p<0.05) esta inhibición hasta la hora 24. Conclusiones. El ácido linoléico afecta negativamente la concentración de PGF2α en el sobrenadante a través del tiempo. Respecto a la PGE2 se concluye que el ácido linoléico por sí solo no afecta la concentración en el sobrenadante.

Objective: Evaluate the in vitro effect of AL on the production of PGF2a and PGE2 in bovine epithelial endometrial cells (CEEP). Materials and methods. Isolated CEEP were cultured and supplemented with AL at different concentrations (1μM, 10μM, 100μM), oxytocin (OT) (0.1 μM) and bovine interferon (BINT-τ) (50 ng / ml). PGF2a and PGE2 were quantified as response variables at different times. In the control, the concentration of PGF2a in the supernatant increased over time and was 1.2 times greater than the production of PGE2. Results. AL reduced the concentration of PGF2a (p <0.05) in the supernatant, and did not affect (p> 0.05) the production of PGE2. The combined effect of LA and OT in the production of PGF2a is different in time, LA partially inhibited the stimulatory effect of OT in the production of PGE2, the joint effect of LA and BINT-τ increased (p<0.05) when this inhibition at 24h. Conclusions. LA alone negatively affects the concentration in the supernatant of PGE2 in time. Regarding PGE2 , LA alone does not affect the concentration in the supernatant.

Phenylpropiophenone derivatives as potential anticancer agents: synthesis, biological evaluation and quantitative structure-activity relationship study.

Series of twelve chalcone and propafenone derivatives has been synthesized and evaluated for anticancer activities against HeLa, Fem-X, PC-3, MCF-7, LS174 and K562 cell lines. The 2D-QSAR and 3D-QSAR studies were performed for all compounds with cytotoxic activities against each cancer cell line. Partial least squares (PLS) regression has been applied for selection of the most relevant molecular descriptors and QSAR models building. Predictive potentials of the created 2D-QSAR and 3D-QSAR models for each cell line were compared, by use of leave-one-out cross-validation and external validation, and optimal QSAR models for each cancer cell line were selected. The QSAR studies have selected the most significant molecular descriptors and pharmacophores of the chalcone and propafenone derivatives and proposed structures of novel chalcone and propafenone derivatives with enhanced anticancer activity on the HeLa, Fem-X, PC-3, MCF-7, LS174 and K562 cells.

The treatment with an anti-glycosaminoglycan antibody reduces aortic oxidative stress in a rabbit model of atherosclerosis.

Retained low-density lipoproteins (LDL) by arterial glycosaminoglycans (GAG) are more susceptible to reactive oxygen species-mediated oxidation, contributing to oxidative stress and atherosclerosis. Recently, we reported the properties of the chimeric mouse/human monoclonal antibody chP3R99-LALA to bind sulfated GAG, to inhibit LDL-chondroitin sulfate binding, and to avoid LDL oxidation in vitro. Here, we hypothesized that chP3R99-LALA treatment might reduce aortic oxidative stress in a therapeutic setting. Redox biomarkers and serum lipids were determined by spectrophotometric methods. Subcutaneous administration of five doses (100 µg) of chP3R99-LALA, after Lipofundin administration (2 mL/kg/day, i.v.) during 8 days, reduced atherosclerotic lesion development, which was not associated with a serum lipid modulation. In contrast, the treatment with chP3R99-LALA reduced (p < 0.05) malondialdehyde and protein oxidation, induced a restoration of reduced glutathione level, of the superoxide dismutase and catalase activities and of endothelial nitric oxide level. Thus, the antiatherogenic effect of chP3R99-LALA treatment seems to be associated with a reduction of aortic oxidative stress. These results contribute in understanding the molecular mechanisms associated with chP3R99-LALA atheroprotection and support the use of anti-GAG antibody-based immunotherapy as a potential tool to treat the atherosclerosis.

Soluciones aportadas por Atención Primaria para abordar los riesgos relacionados con la seguridad del paciente / Patient safety risks in primary health care: identification and prevention of adverse events

Objetivo. Conocer si existen estrategias de identificación proactiva de riesgos para la seguridad del paciente, los riesgos potenciales identificados por los profesionales y las soluciones aportadas para evitar su aparición. Material y métodos. Estudio descriptivo retrospectivo de unidades clínicas de Atención Primaria (AP) en proceso de acreditación por la Agencia de Calidad Sanitaria de Andalucía (ACSA). Entre junio de 2010 y junio de 2011 se evaluaron 61 unidades de AP. Se ha analizado si estas unidades utilizaron una metodología para la identificación y priorización de riesgos, los riesgos potenciales identificados y las soluciones aportadas. Los riesgos y soluciones se clasificaron en 8 categorías (medicación, infección, diagnóstico, gestión, accidentes de los pacientes, comunicación, cuidados, equipamiento médico). La información se obtuvo de la aplicación informática que da soporte a los procesos de acreditación (ME_joraC). Resultados. El 47,5% de las unidades utilizaron herramientas para el análisis proactivo de riesgos. Los riesgos potenciales identificados más frecuentemente fueron los relacionados con la medicación (100%) y la infección (89,6%). Las principales soluciones estaban relacionadas con la elaboración de protocolos para la revisión de medicamentos, formación en técnica de higiene de manos, soluciones hidroalcohólicas e intervenciones con polimedicados. Conclusiones. Una proporción importante de los eventos adversos producidos en el medio sanitario son evitables, por lo que es necesario establecer estrategias preventivas. Este estudio pone de manifiesto las soluciones aportadas para evitar que los riesgos potenciales identificados ocurran, así como riesgos para la seguridad del paciente no encontrados en otros estudios (relacionados con el uso de dispositivos médicos/equipamiento) (AU)

Objective. To determine whether there are pro-active strategies for identifying risks to patient safety, the potential risks identified by the professionals, and the solutions to prevent their occurrence. Materials and methods. A descriptive-retrospective study was conducted on Primary Health Care units in the process of accreditation. This work was performed at the Andalusian Agency for Health Care Quality through the analysis of primary healthcare units assessed. A total of 61 Primary healthcare units were assessed between June 2010 to June 2011. The main measurements were methods for identifying and prioritising risks, prioritised risks, and solutions provided by the Primary Health Care units. The risks and solutions were classified into 8 categories (medication, infection, diagnosis, management, patient accidents, communication, care, medical devices/equipment). The data were obtained in our computer application for the accreditation process (Me_joraC). Results. Just under half (47.5%) of the healthcare units used tools for proactive analysis of patient safety risks. The risks identified most often were related to medication (100%), and infection (89.6%). The main solutions identified were related to protocols for medication review, hand hygiene training, alcohol-based hand-wash solutions, and interventions on patients on polypharmacy. Conclusions. A large proportion of adverse events that occur in health care are preventable, thus it is necessary to establish preventive strategies. This study shows the solutions for Primary Health Care units to prevent adverse events, and other patient safety risks not found in other studies (related to the use of medical devices/equipment) (AU)

Medidas para garantizar la confidencialidad de los datos en unidades clínicas en el marco de la acreditación de calidad en Andalucía / Measures to ensure data confidentiality in Clinical Units in order to achieve quality accreditation in Andalusia

Objetivo. Analizar las medidas implantadas en las unidades clínicas para garantizar la confidencialidad de la información sanitaria de los ciudadanos y que han sido validadas como adecuadas por un equipo de evaluadores de la Agencia de Calidad Sanitaria de Andalucía. Material y métodos. Estudio descriptivo retrospectivo de 272 unidades clínicas en proceso de acreditación por la Agencia de Calidad Sanitaria de Andalucía evaluadas entre enero de 2003 y diciembre de 2010. Se han analizado las medidas evaluadas adecuadas para garantizar la confidencialidad, estableciendo categorías tras análisis de los registros de la aplicación que da soporte a los procesos de certificación (ME_joraC). Resultados. Se identificaron espacios de mejora en cuanto a la custodia de los registros clínicos (64,1%) y al control interno de la aplicación de las medidas de seguridad de la información (19,6%). Principalmente, las soluciones implantadas en las unidades clínicas han sido de carácter tecnológico (28,5%). Se aportaron también con frecuencia soluciones relacionadas con la implantación (17,9%) y difusión (22,3%) de protocolos de uso de la historia clínica. Conclusiones. Los procesos de certificación facilitan la identificación de espacios de mejora y la implantación de medidas de garantía de la confidencialidad. Las soluciones tecnológicas que dan respuesta a las necesidades planteadas por la digitalización de los registros clínicos, así como la implantación efectiva de protocolos y la monitorización de la adherencia a estos protocolos mediante autoevaluaciones concentran la mayoría de los esfuerzos por garantizar la confidencialidad. Además, se fomenta la implicación y responsabilidad de los profesionales sobre este tema (AU)

Objective. To analyse the measures introduced by Health Care Units to ensure the confidentiality of health information on patients that been validated as adequate by an assessment team of the Agency for Healthcare Quality in Andalusia (Spain). Material and methods. A retrospective study was conducted on Health Care Units accredited by the Agency for Healthcare Quality in Andalusia. A total of 272 Health Care Units were evaluated between January 2003 and December 2010. We analysed the measures that were assessed as adequate to ensure the confidentiality of data by this team, establishing categories after analysing records of the application that supports the certification process (ME_joraC). Results. Using on- site surveys, areas of improvement were found in the safeguarding of medical records (64.1%) and the internal control of implementing the information security measure (19.6%). The measures introduced into the Health Care Services were mainly technological actions (28.5%), which were related to the increasing presence of electronic history. It also frequently provided solutions related to implementation (17.9%) and dissemination (22.3%) protocols for use of medical records. Conclusions. Accreditation processes help to identify areas for improvement and the introduction of procedures for ensure confidentiality of data in the healthcare system. Technological solutions that respond to the needs created by the computerisation of medical records, and the effective implementation of protocols and monitoring the adherence to these protocols using self-assessment, strengthen the efforts to ensure confidentiality. Furthermore, it promotes the involvement and responsibility of the professionals on this topic (AU)

Uso de la actividad colinesterasa para el diagnóstico de intoxicaciones por insecticidas organofosforados y carbamatos / Use of cholinesterase activity in the diagnosis of acute intoxications by organophosphorus and carbamate insecticides

Objetivo. La medición de la actividad colinesterasa (ChE) es una prueba rápida y económica que se emplea en el diagnóstico de intoxicaciones por insecticidas organofosforados y carbamatos. Como la interpretación por el laboratorio requiere valores de referencia para cada especie, en este estudio se establecieron las actividades de ChE normales en sangre, cerebro y retina de varias especies de animales domésticos mediante el método de Ellman. Materiales y métodos. Se obtuvieron encéfalos y globos oculares en el matadero central de Medellín, mientras que las muestras de sangre procedieron de animales remitidos al laboratorio de diagnóstico clínico de la Universidad de Antioquia. Resultados. Las medias (±D.E.) de actividad ChE sanguínea, expresada en µmoles de acetiltiocolina iodada hidrolizada/min/mL, fueron de 2.4± 0.2, 1.5±0.3, 1.9±0.3 y 2.5±0.2 para caninos, felinos, equinos y bovinos, respectivamente. En el encéfalo, la actividad ChE (µmol/min/g peso fresco), fue de 4.0±0.4, 5.4 ±0.3 y 4.9±0.3, en bovinos, porcinos y caninos, respectivamente. La retina bovina mostró una actividad de 21.7±2.45 µmol/min/g. Conclusiones. Los valores obtenidos coinciden ampliamente con los reportados por laboratorios certificados por la Asociación Americana de Laboratorios de Diagnostico Veterinarios (AAVLD), corroborando la buena reproducibilidad de la técnica y validando su uso como apoyo al diagnóstico de intoxicaciones por insecticidas inhibidores de la colinesterasa.

Objective. The measurement of cholinesterase activity (ChE) is a rapid and inexpensive test used in the diagnosis of intoxications by organophosphorus and carbamate insecticides. As the interpretation by laboratories entails reference values for each species, the present study was aimed to establish normal ChE activities in blood, brain and retina of several species of domestic animals by the use of the Ellman method. Materials and methods. Brains and eyeballs were obtained from Medellin's central slaughterhouse, while blood samples came from animals referred to the clinical diagnostic laboratory from the University of Antioquia. Results. The mean (± SD) of blood ChE activity, expressed as µmoles of iodide hydrolyzed acetylthiocholine/min/mL, were 2.4±0.2, 1.5±0.3, 1.9±0.3 and 2.5±0.2 for canines, felines, equines and bovines, respectively. In the brain, ChE activity (µmol/min/g wet weight) was 4.0±0.4, 5.4±0.3 and 4.9±0.3, in bovines, porcine, and canines, respectively. The bovine retina showed an activity of 21.7±2.45 µmol/min/g. Conclusions. The values obtained coincide with those reported by laboratories accredited by the American Association of Veterinary Diagnostic Laboratories (AAVLD), confirming its ease to reproduce the technique and validating its use to support the diagnosis of intoxications by cholinesterase inhibitors.