ABSTRACT
Every fungal cell is encapsulated in a cell wall, essential for cell viability, morphogenesis, and pathogenesis. Most knowledge of the cell wall composition in fungi has focused on ascomycetes, especially human pathogens, but considerably less is known about early divergent fungal groups, such as species in the Zoopagomycota and Mucoromycota phyla. To shed light on evolutionary changes in the fungal cell wall, we studied the monosaccharide composition of the cell wall of 18 species including early diverging fungi and species in the Basidiomycota and Ascomycota phyla with a focus on those with pathogenic lifestyles and interactions with plants. Our data revealed that chitin is the most characteristic component of the fungal cell wall, and was found to be in a higher proportion in the early divergent groups. The Mucoromycota species possess few glucans, but instead have other monosaccharides such as fucose and glucuronic acid that are almost exclusively found in their cell walls. Additionally, we observed that hexoses (glucose, mannose and galactose) accumulate in much higher proportions in species belonging to Dikarya. Our data demonstrate a clear relationship between phylogenetic position and fungal cell wall carbohydrate composition and lay the foundation for a better understanding of their evolution and their role in plant interactions.
ABSTRACT
BACKGROUND: Tracheostomy is one of the most frequent techniques in intensive care units (ICU). Fiberoptic bronchoscopy (FB) is a safety measure when performing a percutaneous dilatational tracheostomy (PDT), but the controversy surrounding the routine use of FB as part of the procedure remains open. National surveys in some European countries showed that the use of FB is non-standardized. Retrospective studies have not shown a significant difference in complications between procedures performed with or without a bronchoscope. International guidelines have not been able to establish recommendations regarding the use of FB in PDT due to lack of evidence. DESIGN: This is a multicenter (three centers at the time of publishing this paper) randomized controlled clinical trial to examine the safety of percutaneous tracheostomy using FB. We will include all consecutive adult patients admitted to the ICU in whom percutaneous tracheostomy for prolonged mechanical ventilation is indicated and with no exclusion criteria for using FB. Eligible patients will be randomly assigned to receive blind PDT or PDT under endoscopic guidance. All procedures will be performed by experienced intensivists in PDT and FB. A Data Safety and Monitoring Board (DSMB) will monitor the trial. The primary outcome is the incidence of perioperative complications. DISCUSSION: FB is a safe technique when performing PDT although its use is not universally accepted in all ICUs as a routine practice. Should PDT be monitored routinely with endoscopic guidance? This study will assess the role of FB monitoring during PDT. TRIAL REGISTRATION: ClinicalTrials.gov NCT04265625. Registered on February 11, 2020.
Subject(s)
Bronchoscopy , Tracheostomy , Adult , Bronchoscopy/adverse effects , Dilatation/adverse effects , Europe , Humans , Multicenter Studies as Topic , Randomized Controlled Trials as Topic , Retrospective Studies , Tracheostomy/adverse effectsABSTRACT
Background: The incidence of surgical site infection (SSI) in breast surgery has been higher than expected, considering this is a clean surgical procedure. Few studies have reported an incidence of less than 5.0% and most publications report an incidence of between 10.2% and 30.0%. Objective: To estimate the incidence, associated factors and interval free from infection at 30 days postsurgery in women who underwent oncological and reconstructive breast surgery. Methods: Prospective cohort study of women with breast cancer who underwent conservative or radical breast surgery at a reference medical center in Medellín, Colombia. The outcomes were SSI and time to the event. The survival analysis of freedom from infection was performed using the Kaplan Meier method and the Cox proportional hazard model for multivariate analysis. Results: Of the 308 consecutive surgical breast oncology procedures performed, 161 (52.3%) were quadrantectomies and 147 (47.7%) were mastectomies, with an SSI incidence of 16.2% (50 cases). The associated risk factors were seroma-hematoma, which occurred in 79 (25.6%) cases, hazard ratio (HR) 2.7 (95% CI 1.5-4.9); and the presence of drainage devices, HR 5.6 (95% CI 2.2-14.3). The median time to the development of SSI was 16 days. Conclusion: Our study shows that the presence of postoperative seroma-hematoma and long-term drainage device use were independent risk factors for SSI in oncological breast surgery. (c) 2016 ACIN. Published by Elsevier Espana,˜ S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Antecedentes: La incidencia de infección del sitio operatorio (ISO) en cirugía de mama ha sido mayor de lo esperado, considerando este como un procedimiento quirúrgico limpio. Pocos estudios han reportado una incidencia menor del 5,0% y la mayoría de publicaciones la ubican entre 10,2 y 30,0%. Objetivo: Estimar la incidencia, los factores asociados y el intervalo libre de infección a 30 días, en las mujeres que se sometieron a cirugía oncológica y reconstructiva de mama. Métodos: Estudio de cohorte prospectivo en mujeres con cáncer de mama, que se sometieron a cirugía de mama conservadora o radical en un centro médico de referencia de Medellín, Colombia. Los resultados fueron infección del sitio operatorio y tiempo al evento. El análisis de supervivencia libre de infección se realizó con el método de Kaplan Meier y el modelo multivariado de riesgos proporcionales de Cox. Resultados: Seguimiento a 308 procedimientos quirúrgicos oncológicos de mama consecutivos; 161 (52,3%) fueron cuadrantectomías y 147 (47,7%) mastectomías, con una incidencia de ISO de 16,2% (50 casos). Los factores de riesgo asociados fueron: seroma-hematoma 79 (25,6%), HR 2,7 (IC 95%: 1,5; 4,9) y la presencia de dispositivos de drenaje, HR 5,6 (IC 95% 2,2; 14,3). El tiempo medio para el desarrollo de SSI fue de 16 días. Conclusión: Nuestro estudio mostró que la presencia de seroma hematoma posoperatorios y el uso extendido de dispositivos de drenaje fueron factores independientes para la presentación de infección del sitio operatorio en cirugía oncológica de mama.
Subject(s)
Humans , Female , Adult , Middle Aged , Operating Rooms , Breast Neoplasms , Patient Care , Infections , Operating Rooms/standards , SepsisABSTRACT
Contexto: La mayoría de los estudios que soportan las guías actuales de manejo de la enfermedad VIH-SIDA han sido realizados en países desarrollados. Sin embargo, su aplicabilidad y efectividad de las terapias en países en vía de desarrollo puede variar, dado que al tener diferentes características socioeconómicas pueden modificarel resultado de la terapia. Objetivo: Medir la efectividad de la terapia HAART y los factores asociados con eléxito virológico al sexto mes de tratamiento. Diseño: Cohorte histórica.Sitio: Clínica pública ambulatoria para pacientes con VIH-SIDA en un paíssubdesarrollado (Medellín-Colombia). Mayo 1997 a mayo 2000. Pacientes: 340 pacientes naive, mayores de 13 años, todos iniciaron TerapiaAntirretroviral Altamente Activa (HAART). Medición: La variable dependiente fue la carga viral al sexto mes, categorizada mayor o menor de 500 copias/ml. El análisis univariado se realizó con la medición de la razón de disparidades (OR) para las variables categóricas y la t de student para las variables cuantitativas. La regresión logística se utilizó para identificar losfactores asociados ajustando por variables de confusión...
Context: Most studies supporting guidelines on HIV/AIDS have been conducted in developed countries. Nevertheless, their applicability on effectiveness of therapies may vary in developing countries, because of different socioeconomic characteristicswhich can affect therapy responses.Objective: To measure HAART effectiveness and factors associated with favorable virologic responses after six months of treatment. Study design: Historical Cohort. Place: Public Hospital with ambulatory service for HIV/AIDS patients in a developing country (Medellín, Colombia). May 1997 trough May 2000. Patients: 340 naive patients, over 13 years of age, which began HAART theraphy. Measurements: The dependent variable was the viral load after six months of therapy, classified as a result either over or below 500 copies/ml. Univariate analysiswas conducted using odds ratios for categorical variables and student t test for quantitative ones. Logistic regression was used in order to identify adjusted risk factors of confounding factors...
Subject(s)
Humans , Antiretroviral Therapy, Highly Active , HIV , Viral Load , Acquired Immunodeficiency SyndromeABSTRACT
Molecular dynamics simulations are reported for the four component nematic liquid crystal mixture E7, which is used commercially. We are able to show the growth of a nematic phase directly from an isotropic liquid over a 100 ns period for an all-atom model, and study orientational and dipole order within the nematic phase. The simulations show that the cyanoterphenyl component of the mixture, 5CT, is more ordered than the three cyanobiphenyl components. The simulations show also that both parallel and anti-parallel dipole correlation take place in E7 but that the strong anti-parallel dipole correlation is localised to particular arrangements of molecules. It is possible to identify two key preferred configurations for molecular pairs in the fluid, which explain the form of the dipole correlation function, g(1)(r).
ABSTRACT
We have performed molecular dynamics simulations of a 2,5-bis-(p-hydroxyphenyl)-1,3,4-oxadiazole mesogen (ODBP-Ph-C(7)) at a fully atomistic level for a range of temperatures within the region that has experimentally been assigned to a biaxial nematic phase. Analysis of the data shows that the simulated nematic phase is biaxial but that the degree of biaxiality is small. The simulations show also the formation of ferroelectric domains in the nematic where the molecular short axis is aligned with the oxadiazole dipoles parallel to each other. Removal of electrostatic interactions leads to destabilization of ferroelectric domains and destabilization of the biaxiality. An additional simulation shows the slow growth of a mesophase directly from the isotropic fluid over a period of approximately 50 ns. This is the first time this has been achieved within the framework of an all-atom model.
Subject(s)
Computer Simulation , Hot Temperature , Liquid Crystals/chemistry , Models, Molecular , Oxadiazoles/chemistrySubject(s)
Humans , Male , Adolescent , Abortion, Induced/statistics & numerical data , Pregnancy in Adolescence/statistics & numerical data , Cuba , Mexico , Canada , Brazil , United StatesSubject(s)
Humans , Male , Adolescent , Pregnancy in Adolescence/statistics & numerical data , Abortion, Induced/statistics & numerical data , United States , Brazil , Canada , Cuba , MexicoABSTRACT
A lo largo de estas páginas hemos discutido los grandes problemas que se debaten alrededor de la eutanasia.