Minería de datos para la evaluación del riesgo de malignidad en pacientes con nódulos tiroideos con estudio citológico Bethesda IV / Risk of malignancy evaluation through data mining technic in patients with thyroid nodules with cytology study Bethesda IV

Introducción: en el campo de la salud, cada decisión representa datos, y las técnicas de minería de datos han empezado a ser una metodología prometedora para el análisis de esta información, especialmente en el diseño de los modelos predictivos. Métodos: estudio observacional analítico de pacientes mayores de 15 años, con reporte de punción de aspiración con aguja fina con estudio Bethesda IV, sometidos a manejo quirúrgico en el Hospital de San José de Bogotá. Los datos recogidos de los pacientes se incluyeron en tres grupos: la información sociodemográfica y clínica, los hallazgos en la citología y los reportes de la ecografía. Se realizó el análisis mediante Naive-Bayes, árbol de decisión y redes neuronales. Se usó la herramienta Weka versión 3.8.2. Resultados: de los 427 pacientes, 195 tuvieron resultados de patología de carcinoma de tiroides (45,6 %). Se evidenciaron mejores resultados usando la validación cruzada (10 fold) comparado con partición (66 %), la técnica de Bayes tuvo mejores resultados de clasificación correcta (91,1 %), comparado con la técnica de árbol (87,8 %) y la red neuronal (88,2 %). Conclusiones: el uso de la técnica de Naive Bayes muestra una importante exactitud para determinar la predicción de riesgo de malignidad en los pacientes con estudio citológico Bethesda IV, lo cual permitiría orientar de forma adecuada el manejo quirúrgico de los pacientes

Introduction: In the health field, each decision represents data, and data mining techniques have begun to be a promising methodology for the analysis of this information, especially in the design of predictive models. Methods: Analytical observational study; patients older than 15 years with a report of Bethesda IV after a fine needle aspiration biopsy that undergoing surgical management at the Hospital de San José in Bogotá. The data collected from those patients were included in three groups: sociodemographic-clinical information, cytology findings, and ultrasound reports. Analysis was performed using three technics: Naive Bayes, decision trees, and neural networks. Weka tool version 3.8.2 was used. Results: 195 patients out of 427, had a thyroid carcinoma pathology (45.6%). Better results were evidenced using cross-validation (10 fold) compared with a partition (66%), the Bayes technique had better results of correct classification (91.1%), than the tree technique (87.8%) and neural network (88.2%). Conclusions: The use of the Naive Bayes technique shows an important accuracy to determine the prediction of risk of malignancy in patients with a Bethesda IV cytological study, which would allow an adequate guide to the surgical management of patients.

A Randomized Phase I Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Recombinant Erwinia Asparaginase (JZP-458) in Healthy Adult Volunteers.

L-asparaginase has been an important component of acute lymphoblastic leukemia (ALL) therapy for over 40 years, and is standard therapy during ALL induction and consolidation treatment. L-asparaginases are immunogenic and can induce hypersensitivity reactions; inability to receive asparaginase has been associated with poor patient outcomes. There are L-asparaginases of varied bacterial origins, with the most commonly used being Escherichia coli (E. coli); therefore, to ensure that patients who develop hypersensitivity to E. coli-derived asparaginases receive an adequate therapeutic course, alternative preparations are warranted. JZP-458 is a recombinant Erwinia asparaginase produced using a novel Pseudomonas fluorescens expression platform that yields an enzyme with no immunologic cross-reactivity to E. coli-derived asparaginases. To evaluate the safety, tolerability, and pharmacokinetics (PK) of a single dose of JZP-458, a randomized, single-center, open-label, phase I study was conducted with JZP-458 given via i.m. injection or i.v. infusion to healthy adult volunteers. At the highest doses tested for each route of administration (i.e., 25 mg/m2 i.m. and 37.5 mg/m2 i.v.), JZP-458 achieved serum asparaginase activity (SAA) levels ≥ 0.1 IU/mL at 72 hours postdose for 100% of volunteers. Bioavailability for i.m. JZP-458 was estimated at 36.8% based on SAA data. All dose levels were well-tolerated, with no unanticipated adverse events (AEs), no serious AEs, and no grade 3 or higher AEs. Based on PK and safety data, the recommended JZP-458 starting dose for the pivotal phase II/III study in adult and pediatric patients is 25 mg/m2 i.m. and 37.5 mg/m2 i.v. on a Monday/Wednesday/Friday dosing schedule.

Recovery of aerobic and anaerobic bacteria from patients with acute appendicitis using blood culture bottles / Recuperación de bacterias aerobias y anaerobias de pacientes con apendicitis aguda mediante botellas de hemocultivo

Introduction: Acute appendicitis is the first cause of acute abdomen, however, there is a little information about the associated bacteria and its sensibility profile. Objetive: To identify and to determine the resistance pattern of aerobic and anaerobic bacteria isolated in periapendicular fluid cultures taken in patients with acute appendicitis and to establish the proportions of isolates according to the clinical phase. Materials and methods: A descriptive and prospective study was undertaken at the Hospital Universitario de San José (Bogotá, Colombia) of patients older than sixteen years of age, undergoing an open appendectomy. A sample of periappendiceal fluid was taken, which was deposited directly into aerobic and anaerobic blood culture bottles. Results: One hundred and fifty-four patients were included. The overall positivity of cultures was 87% (n=1344); 77% (n=118) for aerobes and 51% (n=79) for anaerobes. The proportion of positive cultures was lower in the uncomplicated appendicitis cases as compared to the complicated ones (80% (66/83) vs. 95%(67/71), p = 0.003). The microorganisms isolated most frequently were: Escherichia coli (53%) (n=84); Bacteroides spp. (25%) (n=25); Propionibacterium acnes (21%) (n=21); coagulase negative Staphylococci (17%) (n=27); Enterococcus spp. (11%) (n=15), and Fusobacterium spp. (11%) (n=11). The sensitivity of E. coli to ampicillin/sulbactam was 30%. The sensitivity of Bacteroides spp. to clindamycin and ampicillin/sulbactam was 91%. All anaerobe isolates were sensitive to piperacillin/tazobactam, ertapenem, meropenem and metronidazole. Conclusions: Intraoperative cultures in acute appendicits are relevant in order to determine the local epidemiological pattern and to establish prophylactic and therapeutic antibiotics for this pathology; direct inoculation in blood culture bottles allows a high recovery of microorganisms.

Introduccción. La apendicitis aguda es la primera causa de abdomen agudo; sin embargo, poco se conoce sobre las bacterias asociadas y su perfil de sensibilidad. Objetivo. Identificar y determinar el patrón de resistencia de las bacterias aerobias y anaerobias aisladas en cultivo de líquido periapendicular tomado de los pacientes con apendicitis aguda, y establecer la proporción de bacterias según la fase clínica. Materiales y métodos. Se llevó a cabo un estudio descriptivo y prospectivo en el Hospital Universitario de San José de Bogotá (Colombia), en pacientes mayores de 16 años sometidos a apendicectomía abierta. Se tomaron muestras de líquido periapendicular, las cuales se sembraron directamente en botellas de hemocultivos para aerobios y anaerobios. Resultados. Se incluyeron 154 pacientes. Del total de cultivos, el 87 % (n=134) fueron positivos: 77 % (n=118) para aerobios y 51 % (n=79) para anaerobios. La proporción de cultivos positivos fue inferior en los casos de apendicitis no complicada, en comparación con aquellos de apendicitis complicada (80 % (66/83) Vs. 95 % (67/71); p=0,003). Los microorganismos aislados con mayor frecuencia fueron: Escherichia coli (53 %) (n=84), Bacteroides sp. (25 %) (n=25), Propionibacterium acnes (21 %) (n=21), Staphylococci coagulasa negativo (17 %) (n=27), Enterococcus sp. (10 %) (n=15) y Fusobacterium sp. (11 %) (n=11). La sensibilidad de E. coli a la amplicilina sulbactam fue de 30 %. La sensibilidad de Bacteroides spp. a la clindamicina y la ampicilina sulbactam fue de 91 %. El 100 % de los anaerobios fueron sensibles a piperacilina tazobactam, ertapenem, meropenem y metronidazol. Conclusiones. Los cultivos intraoperatorios son pertinentes en la apendicitis para determinar el patrón epidemiológico local, y establecer los antibióticos profilácticos y terapéuticos para esta enfermedad. Su siembra directa en botellas de hemocultivo permite una gran recuperación de microorganismos.

Recuperación de bacterias aerobias y anaerobias de pacientes con apendicitis aguda mediante botellas de hemocultivo / Recovery of aerobic and anaerobic bacteria from patients with acute appendicitis using blood culture bottles

Introducción. La apendicitis aguda es la primera causa de abdomen agudo; sin embargo, poco se conoce sobre las bacterias asociadas y su perfil de sensibilidad. Objetivo. Identificar y determinar el patrón de resistencia de las bacterias aerobias y anaerobias aisladas en cultivo de líquido periapendicular tomado de los pacientes con apendicitis aguda, y establecer la proporción de bacterias según la fase clínica. Materiales y métodos. Se llevó a cabo un estudio descriptivo y prospectivo en el Hospital Universitario de San José de Bogotá (Colombia), en pacientes mayores de 16 años sometidos a apendicectomía abierta. Se tomaron muestras de líquido periapendicular, las cuales se sembraron directamente en botellas de hemocultivos para aerobios y anaerobios. Resultados. Se incluyeron 154 pacientes. Del total de cultivos, el 87 % (n=134) fueron positivos: 77 % (n=118) para aerobios y 51 % (n=79) para anaerobios. La proporción de cultivos positivos fue inferior en los casos de apendicitis no complicada, en comparación con aquellos de apendicitis complicada (80 % (66/83) Vs. 95 % (67/71); p=0,003). Los microorganismos aislados con mayor frecuencia fueron: Escherichia coli (53 %) (n=84), Bacteroides sp. (25 %) (n=25), Propionibacterium acnes (21 %) (n=21), Staphylococci coagulasa negativo (17 %) (n=27), Enterococcus sp. (10 %) (n=15) y Fusobacterium sp. (11 %) (n=11). La sensibilidad de E. coli a la amplicilina sulbactam fue de 30 %. La sensibilidad de Bacteroides spp. a la clindamicina y la ampicilina sulbactam fue de 91 %. El 100 % de los anaerobios fueron sensibles a piperacilina tazobactam, ertapenem, meropenem y metronidazol. Conclusiones. Los cultivos intraoperatorios son pertinentes en la apendicitis para determinar el patrón epidemiológico local, y establecer los antibióticos profilácticos y terapéuticos para esta enfermedad. Su siembra directa en botellas de hemocultivo permite una gran recuperación de microorganismos.

Introduction: Acute appendicitis is the first cause of acute abdomen, however, there is a little information about the associated bacteria and its sensibility profile. Objetive: To identify and to determine the resistance pattern of aerobic and anaerobic bacteria isolated in periapendicular fluid cultures taken in patients with acute appendicitis and to establish the proportions of isolates according to the clinical phase. Materials and methods: A descriptive and prospective study was undertaken at the Hospital Universitario de San José (Bogotá, Colombia) of patients older than sixteen years of age, undergoing an open appendectomy. A sample of periappendiceal fluid was taken, which was deposited directly into aerobic and anaerobic blood culture bottles. Results: One hundred and fifty-four patients were included. The overall positivity of cultures was 87% (n=1344); 77% (n=118) for aerobes and 51% (n=79) for anaerobes. The proportion of positive cultures was lower in the uncomplicated appendicitis cases as compared to the complicated ones (80% (66/83) vs. 95%(67/71), p = 0.003). The microorganisms isolated most frequently were: Escherichia coli (53%) (n=84); Bacteroides spp. (25%) (n=25); Propionibacterium acnes (21%) (n=21); coagulase negative Staphylococci (17%) (n=27); Enterococcus spp. (11%) (n=15), and Fusobacterium spp. (11%) (n=11). The sensitivity of E.coli to ampicillin/sulbactam was 30%. The sensitivity of Bacteroides spp. to clindamycin and ampicillin/sulbactam was 91%. All anaerobe isolates were sensitive to piperacillin/tazobactam, ertapenem, meropenem and metronidazole. Conclusions: Intraoperative cultures in acute appendicits are relevant in order to determine the local epidemiological pattern and to establish prophylactic and therapeutic antibiotics for this pathology; direct inoculation in blood culture bottles allows a high recovery of microorganisms.

Complete genome sequencing and comparative genomic analysis of functionally diverse Lysinibacillus sphaericus III(3)7.

Lysinibacillus sphaericus III(3)7 is a native Colombian strain, the first one isolated from soil samples. This strain has shown high levels of pathogenic activity against Culex quinquefaciatus larvae in laboratory assays compared to other members of the same species. Using Pacific Biosciences sequencing technology we sequenced, annotated (de novo) and described the genome of strain III(3)7, achieving a complete genome sequence status. We then performed a comparative analysis between the newly sequenced genome and the ones previously reported for Colombian isolates L. sphaericus OT4b.31, CBAM5 and OT4b.25, with the inclusion of L. sphaericus C3-41 that has been used as a reference genome for most of previous genome sequencing projects. We concluded that L. sphaericus III(3)7 is highly similar with strain OT4b.25 and shares high levels of synteny with isolates CBAM5 and C3-41.

Complete Genome Sequence of the Larvicidal Bacterium Lysinibacillus sphaericus Strain OT4b.25.

Lysinibacillus sphaericus OT4b.25 is a native Colombian strain isolated from coleopteran larvae in an oak forest near Bogotá D.C.; this strain has shown high levels of pathogenic activity against Culex quinquefasciatus larvae in laboratory assays compared to that of other members of the same species. Using Pacific Biosciences sequencing technology, we propose a chromosomal contig of 4,665,775 bp that, according to comparative analysis, is highly similar to that of reference strain L. sphaericus C3-41.

Computational modeling and preliminary iroN, fepA, and cirA gene expression in Salmonella Enteritidis under iron-deficiency-induced conditions.

Salmonellosis outbreaks in Europe, the United States, and Latin America have been associated with contaminated food derivatives including meat from the poultry industry. Salmonella grown under iron-limiting conditions has the capability to increase concentration of several iron-regulated outer-membrane proteins to augment the acquisition of the metal. These proteins have been proved to have immunogenic properties. Our aim was to increase the relative expression of iroN, fepA, and cirA in Salmonella Enteritidis domestic strain. Furthermore, we proposed a 3-dimensional structure model for each protein to predict and locate antigenic peptides. Our eventual objective is to produce an effective vaccine against regional avian salmonellosis. Two simple factorial designs were carried out to discriminate between 2 nitrogen sources and determine chelating-agent addition timing to augment relative gene expression. Two antigenic peptides located at the external face of each protein and 2 typical domains of iron-regulated outer-membrane proteins, plug and TonB-dep-Rec, were identified from the 3-dimensional models. Tryptone was selected as the best nitrogen source based on growth rate (µx = 0.36 h(-1)) and biomass productivity (Px = 0.9 g•h(-1)•L(-1)) as determined by a general factorial design. Optimum timing for chelating agent addition was in the middle of the log phase, which allowed relative expressions at 4 h of culture. Increase in iroN, fepA, and cirA relative expression was favored by the length of log phase and the addition of chelating agent, which decreased chelating toxicity and enhanced cell growth rate.

Evaluacion del equilibrio durante la marcha a velocidad autoseleccionada en jovenes saludables, adultos mayores no caedores y adultos mayores con alto riesgo de caidas / Assessment of balance during gait at a self-elected speed in healthy youngsters, elderly persons who do not fall and elderly persons with a high risk of falls

Introduccion: el equilibrio depende de mantener la proyeccion del centro de masa corporal dentro de los limites de la base de sustentacion, pero su valoracion se realiza habitualmente en forma indirecta a traves de la variabilidad cinematica. Objetivos: analizar el equilibrio durante la marcha a velocidad autoseleccionada en tres poblaciones de sujetos utilizando diferentes abordajes. Material y metodo: los grupos analizados fueron: jovenes saludables, adultos mayores no caedores y adultos mayores caedores. Mediante analisis cinematico tridimensional se calculo: velocidad, variabilidad temporal, variabilidad angular de rodilla y el equilibrio duranteciclos de marcha. Para el calculo directo del equilibrio se definio una variable considerando la proyeccion del centro de masa corporal y la base de sustentacion. Los resultados de las variables cinematicas fueron comparados entre los grupos mediante ANOVA (alfa=0,05). Deigual forma se procedio con los valores medio, maximo y minimo de la estimacion directa del equilibrio entre grupos para las fases de apoyo simple y doble del ciclo. Resultados: la velocidad de ciclo fue similar entre los adultos mayores. En los jovenes saludables la variabilidad temporal del ciclo fue baja y la variabilidad angular de rodilla alta y estas variables no mostraron diferencias entre los grupos de adultos mayores. Durante tamla fase de apoyo simple los valores medio y minimo de equilibrio para el grupo de caedores fueron significativamente diferentes respecto a los demas grupos. Conclusiones: la estimacion directa del equilibrio durante la fase de apoyo simple surge como una potencial herramienta para la identificacion de individuos con riesgo de caida.

Introduction: balance depends on keeping the projection of the center of body mass within the limits of the support basis, although its assessment is usually performed by means of cinematic variability. Objectives: to analyse balance during gait at a selfelected speed in three populations using different approaches. Method: the groups analysed were: healthy youngsters, elderly who do not fall and elderly who fall. We calculated speed, time variability, angle variability of knee and balance during gait cycles through a tridimensional cinematic analysis. To directly calculate balance we defineda variable considering the projection of the center of body mass. Results of the cinematic variables were compared between groups using ANOVA (a=0,05). Similarly we compared average, maximum and minimum values ofthe direct balance estimation between groups for simple support and double cycle stages. Results: cycle speed was similar in elderly persons. Time variability of cycle was low and angle variability was high in healthy youngsters, while these variables evidenced no difference between the elderly persons groups. During the simple support stage average and minimum balance values for the group of people who fall were significantly different if compared to the other groups. Conclusions: direct estimation of balance during the simple support stage appears as a potential tool to identify individuals with a risk of falls.

Introdução: o equilibrio depende da manutenção da projeção do centro de massa corporea dentro dos limitesda base de apoio, mas sua avaliação é feita habitualmente de maneira indireta utilizando variabilidade cinematica. Objetivos: analisar o equilibrio durante a marcha em velocidade auto-selecionada em tres populações de pessoas utilizando diferentes abordagens. Material e metodo: os grupos analisados foram: jovens saudaveis, adultos idosos não caidores e adultos idosos caidores. Utilizando analise cinematica tridimensional foram calculadas a velocidade, a variabilidade temporal, avariabilidade angular do joelho e o equilibro durante os ciclos da marcha. Para fazer o calculo direto do equilibrio definiu-se uma variavel considerando a projeção do centro de massa corporea e a base de apoio. A comparação entre os resultados das variaveis sistematicas entre os grupos foi feita usando ANOVA (a=0,05) e tambem para comparar os valores minimo, medio e maximo da estimativa direta para as fases de apoio simples e duplo do ciclo. Resultados: a velocidade de ciclo foi similar entre os dois grupos de idosos. No grupo de jovens saudaveis a variabilidade temporal do ciclo foi baixa e a variabilidade angular do joelho alta e não se encontraram diferenças nessas variaveis entre os dois grupos de idosos. Durante a fase de apoio simples os valores medio e minimo de equilibrio para o grupo de caidores foram significativamente diferentes quando comparados com os outros grupos. Conclusões: a estimativa direta do equilibrio durante a fase de apoio simples pode ser uma ferramenta potencial para a identificação de individuos com risco de queda.