[Septic shock originating from a pulmonary focus caused by Pasteurella multocida. Report of one case]. / Shock séptico de foco respiratorio por Pasteurella multocida en un paciente inmunocompetente. Caso Clínico.

Pasteurella multocida is a gram-negative coccobacillus bacterium found as a commensal in the oropharynx of domestic animals such as cats and dogs and some farm animals. Soft tissue infections and occasionally bacteremia in immunocompromised patients with direct contact with animals are described. We report a 61 year old male with a history of scratches and close contact with domestic cats, with a septic shock originating from a pulmonary focus, requiring mechanical ventilation and vasopressors. Blood cultures disclosed the presence of Pasteurella multocida. He responded successfully to antimicrobials.

Shock séptico de foco respiratorio por Pasteurella multocida en un paciente inmunocompetente. Caso Clínico / Septic shock originating from a pulmonary focus caused by Pasteurella multocida. Report of one case

Pasteurella multocida is a gram-negative coccobacillus bacterium found as a commensal in the oropharynx of domestic animals such as cats and dogs and some farm animals. Soft tissue infections and occasionally bacteremia in immunocompromised patients with direct contact with animals are described. We report a 61 year old male with a history of scratches and close contact with domestic cats, with a septic shock originating from a pulmonary focus, requiring mechanical ventilation and vasopressors. Blood cultures disclosed the presence of Pasteurella multocida. He responded successfully to antimicrobials.

Improving bitter pit prediction by the use of X-ray fluorescence (XRF): A new approach by multivariate classification.

Bitter pit (BP) is one of the most relevant post-harvest disorders for apple industry worldwide, which is often related to calcium (Ca) deficiency at the calyx end of the fruit. Its occurrence takes place along with an imbalance with other minerals, such as potassium (K). Although the K/Ca ratio is considered a valuable indicator of BP, a high variability in the levels of these elements occurs within the fruit, between fruits of the same plant, and between plants and orchards. Prediction systems based on the content of elements in fruit have a high variability because they are determined in samples composed of various fruits. With X-ray fluorescence (XRF) spectrometry, it is possible to characterize non-destructively the signal intensity for several mineral elements at a given position in individual fruit and thus, the complete signal of the mineral composition can be used to perform a predictive model to determine the incidence of bitter pit. Therefore, it was hypothesized that using a multivariate modeling approach, other elements beyond the K and Ca could be found that could improve the current clutter prediction capability. Two studies were carried out: on the first one an experiment was conducted to determine the K/Ca and the whole spectrum using XRF of a balanced sample of affected and non-affected 'Granny Smith' apples. On the second study apples of three cultivars ('Granny Smith', 'Brookfield' and 'Fuji'), were harvested from two commercial orchards to evaluate the use of XRF to predict BP. With data from the first study a multivariate classification system was trained (balanced database of healthy and BP fruit, consisting in 176 from each group) and then the model was applied on the second study to fruit from two orchards with a history of BP. Results show that when dimensionality reduction was performed on the XRF spectra (1.5 - 8 KeV) of 'Granny Smith' apples, comparing fruit with and without BP, along with K and Ca, four other elements (i.e., Cl, Si, P, and S) were found to be deterministic. However, the PCA revealed that the classification between samples (BP vs. non-BP fruit) was not possible by univariate analysis (individual elements or the K/Ca ratio).Therefore, a multivariate classification approach was applied, and the classification measures (sensitivity, specificity, and balanced precision) of the PLS-DA models for all cultivars evaluated ('Granny Smith', 'Fuji' and 'Brookfield') on the full training samples and with both validation procedures (Venetian and Monte Carlo), ranged from 0.76 to 0.92. The results of this work indicate that using this technology at the individual fruit level is essential to understand the factors that determine this disorder and can improve BP prediction of intact fruit.

Modelo estadístico para predecir el puntaje de desarrollo psicomotor de niños de 4 a 5 años de edad en función del nivel socioeconómico: Proposal of a statistical model to predict the score of psychomotor development of children 4 to 5 years according to socioeconomic level / Proposal of a statistical model to predict the score of psychomotor development of children 4 to 5 years according to socioeconomic level

Introducción: estudios recientes enfatizan la importancia de examinar el efecto del nivel socioeconómico sobre el desarrollo psicomotor infantil, en tal sentido las investigaciones informan que el nivel económico y el ambiente sociocultural en que se desenvuelve el niño son fundamentales para favorecer un normal desarrollo en la infancia Objetivos: proponer un modelo estadístico para predecir el puntaje de desarrollo psicomotor de niños y niñas de 4 a 5 años de edad en función del nivel socioeconómico. Metodología: se evaluó el desarrollo psicomotor a una muestra de 228 niños y niñas por medio de la aplicación de la batería TEPSI. Para determinar el nivel socioeconómico se aplicó una encuesta sociodemográfica a los padres y apoderados. Se efectuó un análisis correlacional bivariado no paramétrico, además se realizaron pruebas ANOVA de un factor, finalmente para modelar se efectuó un análisis de regresión múltiple. Resultados: los resultados reportaron que el nivel educacional del jefe de hogar y el ingreso per cápita correlacionan significativamente con el desarrollo psicomotor. Conclusiones: en cuanto a los modelos, se informa que fue posible diseñar tres modelos. El primero permite predecir un 4,2% del puntaje en el desarrollo psicomotor en función de la variable ingreso per cápita. El segundo modelo es capaz de predecir en un 11% el puntaje del lenguaje en base al variable ingreso per cápita. Por último, el tercer modelo, con bajo valor predictor (2,2%), permite predecir el puntaje de la coordinación en función del nivel educacional del jefe de hogar.

Introduction: recent studies emphasize the importance of examining the effect of socioeconomic status on child psychomotor development. In this sense, research conducted reports that the level of economic and cultural environment child operate in, are crucial for facilitating their normal development. Objectives: the study proposes a statistical model to predict the psychomotor development score of children from 4 to 5 years of age depending on the socio-economic level. Methodology: psychomotor development was evaluated in a sample made up of 228 boys and girls through the application of the psychomotor development test (TEPSI). A demographic survey was applied to parents and guardians to determine their socio-economic level. A non-parametric bivariate correlational analysis was performed, and a single factor ANOVA tests were carried out. Last, a multiple regression analysis was made for modelling purposes. Results: the results reported that the educational level of the head of household and the per capita income is significantly correlated with the psychomotor development. Conclusions: as to models, the possibility of designing three models is reported. The first one allows predicting 4.2 % of the psychomotor development score based on the per capita income variable. The second model is able to predict 11% of the language score based on the per capita income variable. Last, the third model, with low predictive value (2.2 %), enables predicting the coordination score, based on the educational level of the head of household.

Importance of Legionella pneumophila in the etiology of severe community-acquired pneumonia in Santiago, Chile.

BACKGROUND: In US and European literature, Legionella pneumophila is reported as an important etiologic agent of severe community-acquired pneumonia (CAP), but in Chile this information is lacking. The aim of this study was to determine the incidence and identify predictors of severe CAP caused by L pneumophila in Santiago, Chile. METHODS: A multicenter, prospective clinical study lasting 18 months was conducted; it included all adult patients with severe CAP admitted to the ICUs of four hospitals in Santiago. We excluded patients who were immunocompromised, had been hospitalized in the previous 4 weeks, or presented with another disease during their hospitalization. All data for the diagnosis of severe CAP were registered, and urinary antigens for L pneumophila serogroup 1 were determined. RESULTS: A total of 104 patients with severe CAP were included (mean ± SD age, 58.3 ± 19.3 years; men, 64.4%; APACHE (Acute Physiology and Chronic Health Evaluation) II score, 16.7 ± 6.3; Sepsis-related Organ Failure Assessment score, 6.1 ± 3.2; Pitt Bacteremia Score, 3.4 ± 2.5; Pao2/Fio2, 170.8 ± 87.1). An etiologic agent was identified in 62 patients (59.6%), with the most frequent being Streptococcus pneumoniae (27 patients [26%]) and L pneumophila (nine patients [8.6%]). Logistic regression analysis showed that a plasma sodium level of ≤ 130 mEq/L was an independent predictor for L pneumophila severe CAP (OR, 11.3; 95% CI, 2.5-50.5; P = .002). Global mortality was 26% and 33% for L pneumophila. The Pitt bacteremia score and pneumonia score index were the best predictors of mortality. CONCLUSIONS: We found that in Santiago, L pneumophila was second to S pneumoniae as the etiologic agent of severe CAP. Severe hyponatremia at admission appears to be an indicator for L pneumophila etiology in severe CAP.

Estimating the lung burden from exposure to aerosols of depleted uranium.

Following exposure to aerosols of depleted uranium (DU), biological samples show the presence of a synthetic mixture of natural uranium and DU. By partitioning the uranium in the 24-h urine sample along the isotopic fractions of natural uranium and DU, one can study the kinetics of these subpopulations independently. A linear model is developed to estimate the lung burden of DU from measurements of DU in 24-h urine samples, years after inhalational exposure to aerosols of DU. This model takes into account the intracellular dissolution of the retained particles and the precipitation of a significant fraction of the dissolved DU as insoluble uranyl phosphates.

Nicotinamide protected first-phase insulin response (FPIR) and prevented clinical disease in first-degree relatives of type-1 diabetics.

BACKGROUND: After a study of ICA prevalence among relatives of Type-1 diabetics (DM1) in Santiago, Chile, parents of those who tested positive asked us to go on forward with an intervention study. METHODS: We had screened 1021 relatives, of which 30 had shown ICA > or = 20 JDF units (2.9%). Among the 26/30 who participated in the intervention study, the baseline screening showed normal glucose tolerance in all, and the first-phase insulin response (FPIR) was normal in 24/26 individuals, which were randomized into Nicotinamide (n = 12; oral Nicotinamide, 1200 mg m(-2) day(-1)) and Placebo (n = 12) groups. The FPIRs and ICAs were monitored yearly. Compliance was monitored by urine Nicotinamide. RESULTS: The 1.5, 3.0 and 5-year life-table estimates of keeping the FPIR > or = 10th centile were, for Nicotinamide group 100% in all time points, and for Placebo these were 90.0% (c.i. = 100-71.4), 72.0% (c.i. = 100-37.1) and 0.0% (c.i. = 0.0-0.0) (p = 0.0091). The 5-year life-table estimates of remaining diabetes-free were 100% for Nicotinamide and 62.5% for Placebo (p = 0.0483). No adverse effects were observed. CONCLUSIONS: Oral Nicotinamide protected beta-cell function and prevented clinical disease in ICA-positive first-degree relatives of type-1 diabetes.

La evaluación estadística en los estudios casos-control

Se realiza una discusión de los diseños, análisis y técnicas asociadas a los estudios observacionales del tipo caso-control para resolver el problema de la integración de los métodos estadísticos relacionados con dichos estudios, ya que se crea un sistema automatizado en microcumputadoras compatibles IBM que facilita el análisis de la inferencia causal de factores de riesgo, con respuestas hasta tricotómicas (AU)