Generation of Variability in Chrysodeixis includens Nucleopolyhedrovirus (ChinNPV): The Role of a Single Variant.

The mechanisms generating variability in viruses are diverse. Variability allows baculoviruses to evolve with their host and with changes in their environment. We examined the role of one genetic variant of Chrysodeixis includens nucleopolyhedrovirus (ChinNPV) and its contribution to the variability of the virus under laboratory conditions. A mixture of natural isolates (ChinNPV-Mex1) contained two genetic variants that dominated over other variants in individual larvae that consumed high (ChinNPV-K) and low (ChinNPV-E) concentrations of inoculum. Studies on the ChinNPV-K variant indicated that it was capable of generating novel variation in a concentration-dependent manner. In cell culture, cells inoculated with high concentrations of ChinNPV-K produced OBs with the ChinNPV-K REN profile, whereas a high diversity of ChinNPV variants was recovered following plaque purification of low concentrations of ChinNPV-K virion inoculum. Interestingly, the ChinNPV-K variant could not be recovered from plaques derived from low concentration inocula originating from budded virions or occlusion-derived virions of ChinNPV-K. Genome sequencing revealed marked differences between ChinNPV-K and ChinNPV-E, with high variation in the ChinNPV-K genome, mostly due to single nucleotide polymorphisms. We conclude that ChinNPV-K is an unstable genetic variant that is responsible for generating much of the detected variability in the natural ChinNPV isolates used in this study.

Synergy of Lepidopteran Nucleopolyhedroviruses AcMNPV and SpliNPV with Insecticides.

The joint use of baculoviruses and synthetic insecticides for integrated pest management requires the study of the additive, synergistic or antagonistic effects among them on pest mortality. Droplet bioassays were conducted with Autographa californica multiple nucleopolyhedrovirus (AcMNPV), Spodoptera littoralis nucleopolyhedrovirus (SpliNPV) and seven insecticides (azadirachtin, Bacillus thuringiensis, cyantraniliprole, emamectin, metaflumizone, methoxyfenozide and spinetoram) on Spodoptera exigua and Spodoptera littoralis. The lethal concentrations LC50 and LC95 were calculated through probit regressions. Then, the sequential feeding of insecticides and nucleopolyhedroviruses was studied. Larvae were provided with the LC50 of one insecticide, followed by the LC50 of one nucleopolyhedrovirus 24 h later. The inverse order was also conducted. The insecticide LC50 and LC95 were higher for S. littoralis than for S. exigua. AcMNPV showed greater toxicity on S. exigua than SpliNPV on S. littoralis. Emamectin showed synergy with AcMNPV when the chemical was applied first, and metaflumizone and AcMNPV were synergistic regardless of the order of application, both from the first day of evaluation. SpliNPV was synergistic with azadirachtin and emamectin when it was applied first, but synergy was reached after 12-13 days. Excellent control is possible with the LC50 of azadirachtin, emamectin and metaflumizone in combination with nucleopolyhedroviruses, and merits further study as a means of controlling lepidopteran pests.

Diaphragmatic Ultrasonography, a Novel Approach in Critical Care: A Proposal for a New Weaning Index.

The evaluation of the diaphragm in critically ill patients is simple and noninvasive and has shown good repeatability. The aim of the study was to generate a predictive index for successful weaning (ULDIMex) from invasive mechanical ventilation (IMV) based on an ultrasonographic diaphragmatic assessment before performing a spontaneous breathing test. We recruited patients who required IMV and who were candidates for weaning from ventilation. The measurement of diaphragmatic excursion and time during inspiration and expiration was obtained with a 3- to 5-MHz probe in the M mode. Using the formula (a + b)c/2, the value for the ULDIMex was obtained to evaluate its impact on predicting the successful weaning of IMV, where a is the time during the inspiratory phase, b is the time during expiration, and c is the diaphragmatic excursion during the inspiratory phase, which corresponds to the highest point of the curve from the baseline. We recruited 114 patients, of whom 86 (76%) were successfully weaned from IMV. The patients who were successfully weaned from the IMV had a cutoff value greater than 4.06 cm/s for the ULDIMex index, with a sensitivity of 92.8% (95% confidence interval, 76.5-99.1), specificity of 63.9% (95% confidence interval, 52.9-74.0), positive predictive value of 45.6%, and negative predictive value of 96.5%. The ULDIMex index demonstrated a good level of discrimination for successful weaning prediction. Considering the excellent negative likelihood ratio of the ULDIMex index of greater than 4.06, this index may be considered before performing an spontaneous breathing test to identify critically ill adult patients who will extubate successfully.

Genetic Variability of Chrysodeixis Includens Nucleopolyhedrovirus (ChinNPV) and the Insecticidal Characteristics of Selected Genotypic Variants.

Genetic variation in baculoviruses is recognized as a key factor, not only due to the influence of such variation on pathogen transmission and virulence traits, but also because genetic variants can form the basis for novel biological insecticides. In this study, we examined the genetic variability of Chrysodeixis includens nucleopolyhedrovirus (ChinNPV) present in field isolates obtained from virus-killed larvae. Different ChinNPV strains were identified by restriction endonuclease analysis, from which genetic variants were isolated by plaque assay. Biological characterization studies were based on pathogenicity, median time to death (MTD), and viral occlusion body (OB) production (OBs/larva). Nine different isolates were obtained from eleven virus-killed larvae collected from fields of soybean in Mexico. An equimolar mixture of these isolates, named ChinNPV-Mex1, showed good insecticidal properties and yielded 23 genetic variants by plaque assay, one of which (ChinNPV-R) caused the highest mortality in second instars of C. includens. Five of these variants were selected: ChinNPV-F, ChinNPV-J, ChinNPV-K, ChinNPV-R, and ChinNPV-V. No differences in median time to death were found between them, while ChinNPV-F, ChinNPV-K, ChinNPV-R and ChinNPV-V were more productive than ChinNPV-J and the original mixture of field isolates ChinNPV-Mex1. These results demonstrate the high variability present in natural populations of this virus and support the use of these new genetic variants as promising active substances for baculovirus-based bioinsecticides.

Pulmonary Ultrasound: A New Era in Critical Care Medicine.

Pulmonary ultrasonography is a complementary study that is easy to perform at the patient bedside with no need to transfer the patient to special areas. The technique provides information with high sensitivity and specificity for different pathologies. Pulmonary ultrasonography is a very important diagnostic tool in the assessment of lung, pleural, and chest wall diseases. Pulmonary ultrasound provides low-cost analysis, easy real-time reproduction, and safety, all of which have made it a beneficial tool in the diagnostic arsenal available to medical personnel. The purpose of this review was to describe the usefulness of pulmonary ultrasound in critical areas.

Standardization of Sonographic Diaphragm Thickness Evaluations in Healthy Volunteers.

BACKGROUND: B-mode ultrasound can be used to measure diaphragm thickness at the zone of apposition. We believe it is necessary to develop normal values for diaphragm thickness at rest in a large group of healthy subjects and compare them with international results. METHODS: Ultrasound measurements of diaphragm thickness at expiratory rest were taken in 109 healthy individuals, with results stratified by sex, body mass index, and thorax circumference. The following methods were used for analysis and interpretation. Multivariable databases with descriptive statistical analyses were made. The Pearson chi-square test was used to evaluate the distribution between variables. Additionally, mean and SD values were calculated. For standardization, the data were separated by sex within a 95% CI, and we calculated a Z test. A 95% CI was also constructed for proportion analyses. RESULTS: One hundred nine healthy volunteers were included in the study, and the correlation between the body mass index and thorax circumference values with a Pearson chi-square test resulted in an r = 0.69. Additionally, the average value of diaphragmatic thickness was 0.19 ± 0.04 cm (95% CI 0.17-0.20 cm) for men and 0.14 ± 0.03 cm (95% CI 0.13-0.15 cm) for women (P = .001). There was no relation between body mass index thorax circumference, and diaphragmatic thickness. CONCLUSION: Real-time ultrasound of the diaphragm is a simple, inexpensive, and portable imaging technique that can provide qualitative anatomical information. The findings in this study show that sonographic diaphragm evaluations can be applied to the general population.

Oral anticoagulation and self-management: analysis of the factors that determine the feasibility of using self-testing and self-management in primary care.

BACKGROUND: The skills of patients on oral anticoagulants are critical for achieving good outcomes with this treatment. Self-management, or the capacity of patients to control their INR level and adjust their treatment, is an effective strategy of treatment. Capacity of patients to self manage is determined by a range of factors. The identification of these factors would improve the design of self management programmes and in turn increase the number of patients able to self-manage. The objective of our study is to identify those factors that determine the ability of patients on oral anticoagulant therapy to achieve self-management of their treatment. DESIGN: This will be a three year quasi- experimental prospective study with a control group. 333 patients on anticoagulant therapy from five health centres of the Basque Health Service are to be followed up for a period of six months each after the intervention, to assess their ability to self-test and self-manage. The intervention will consist of a patient training programme involving the provision of information and practical training concerning their condition and its treatment, as well as how to use a portable blood coagulation monitoring device and adjust their anticoagulant dose. DISCUSSION: The ease-of-use of this technique lead us to believe that self-management is feasible and will represent an innovative advance that should have a substantial impact on the quality of life of this patients and their families as well as on the health care provision systems. TRIAL REGISTRATION: Osakidetza Protocol Record ISCIII-11/02285, Oral anticoagulation and self-management, ClinicalTrials.gov Identifier: NCT01878539.

Experiencias de desempleo: un estudio de casos / Unemployment experience: case study

El trabajo informa sobre los resultados de un estudio de 34 casos sobre experiencias de desempleo en Chile. Del análisis de las experiencias se desprenden tres tipos de contribuciones para el conocimiento en la materia, la primera se refiere a la forma en que las personas viven el término del vínculo laboral con las empresas. La segunda, alude a los problemas que enfrenta la gente durante el proceso de desempleo y las estrategias que ocupan para sortearlos. La última, consiste en el hallazgo de cuatro tipos de transición que suelen estar presentes en las experiencias de desempleo. Los resultados del estudio muestran que la pérdida del trabajo es un evento que sacude con singular rudeza a las personas, en lo económico, en la identidad, en las relaciones familiares y en la salud mental. En el trabajo se hace ver el desamparo que aflige a los desempleados y se apela por una mayor solidaridad en el contexto de la sociedad chilena

­Quiénes fuman en un hospital general? Comentario clínico / Who smokes in a General Hospital? Clinical

Justificación y objetivo. El consumo de tabaco es un problema de salud pública. En los hospitales existe un grupo de trabajadores que fuman, debe investigarse quiénes son fumadores activos.Método. Se realizó una encuesta con preguntas cerradas a 659 trabajadores de un hospital general de tercer nivel para conocer la prevalencia del consumo de tabaco. Resultados. El hábito de fumar fue positivo en 184 personas y negativo en 475. La mayoría de los fumadores estaban casados y pertenecían a las áreas administrativa (53) y médica (46). El grado de escolaridad no fue un factor determinante para el consumo de tabaco. La edad de inicio más frecuente fue entre los 10 y 20 años. Las principales causas para el consumo de tabaco son la sensación de placer, la relajación y la necesidad de fumar. Conclusión. El principal lugar de consumo de tabaco es el área laboral, lo que ocasiona que 72 por ciento de la población encuestada que convive con los fumadores activos sea de fumadores pasivos. Por lo que se considera la importancia de tomar acciones para evitar el tabaquismo en áreas de trabajo y tener un hospital libre de humo de tabaco.

La pérdida del empleo y sus efectos en las personas / The unemployment and it effects on people

En el trabajo se presenta un marco teórico sobre los efectos que la pérdida del empleo tiene en las personas. El trabajo consta de tres secciones, en la primera se explica el desempleo en cuanto transición psico-social como resultado de la alteración que se produce en el espacio vital cuando se pierde el empleo. En la segunda sección se identifica el ciclo de transición del desempleo y sus distintas etapas, el cual revela un patrón común de reacciones en los individuos ante la pérdida del empleo. En la tercera sección se establecen hipótesis sobre la intervención de diversos factores y sus efectos en el comportamiento de personas que enfrentan el desempleo

La incorporación al desarrollo de las personas con discapacidad / Incorporation to the development of the persons with handicapped

Se presentan conceptos y tipos de discapacidad, así como algunas consideraciones sociales con objeto de sensibilizar a la sociedad para que haya una actitud positiva hacia dichas personas discapacitadas y puedan éstas incorporarse productivamente a la sociedad. Contenido: 1) Introducción. 2) El problema de la terminología. 3) Principales tipos de discapacidad: física (por poliomielitis, lesión medular, amputaciones), sensorial (ciegas, deficiencias visuales y auditivas, problemas de comunicación y en el lenguaje) e intelectual (retraso mental, síndrome de Down, parálisis cerebral). 3) El problema de la marginación. 5) Incorporación al desarrollo de las personas con discapacidad. 6) El principio de ingualdad. 7) Igualdad de oportunidades

Alimentación parenteral en niños: experiencia en un hospital de segundo nivel de atención / Parenteral nutrition in children: experience in second level hospital

Objetivo: revisar la experiencia de un hospital de segundo nivel de atención en el manejo de niños con alimentación parenteral total (APT). Método: se estudiaron los expedientes de 289 niños manejados con APT (200 recién nacidos, 52 lactantes, cinco preescolares, 17 escolares y 15 adolescentes). Se compararon los resultados con lo informado en centros de segundo y tercer nivel de atención. Resultados: ciento sesenta y tres fueron masculinos y 116 femeninos, En 225 al APT se indicó por problemas médicos y en 64, por quirúrgicos. En 239 casos no se presentaron complicaciones y en los 50 restantes hubo una o más de ellas; 45 niños presentaron 56 complicaciones metabólicas; 24 complicaciones relacionadas con el catéter, siete, colestasis; seis, infecciones y cuatro, acidosis respiratoria. 238 niños aumentaron de peso, 32 lo disminuyeron y 19 no presentaron cambios. Un recién nacido falleció por hipoglucemia secundaria y ruptura del catéter y 15 murieron por complicaciones no relacionadas con la aPT. Al comparar los resultados obtenidos con lo informado por otros autores se encontró que son muy semejantes. Conclusión: los resultados sugieren que el manejo de la APT en el segundo nivel de atención es tan seguro como en el tercer nivel

Derechos humanos. Legislación nacional y tratados internacionales / Human rights. National legislation and international treaties

Compilación acerca de los tratados y legislaciones elaboradas en materia de Derechos Humanos a nivel nacional e internacional, de tal manera que se conozca el panorama general acerca de los instrumentos existentes en la defensa de los derechos de la persona y su concepto, antecedentes históricos, características y otras disposiciones establecidas de acuerdo a los siguientes capítulos: I. Características e importancia de los instrumentos internacionales y su problemática en materia de Derechos Humanos II. Antecedentes históricos III. El Orden Jurídico Mexicano IV. Derechos de igualdad V. Derechos de libertad VI. Derecho a la vida, a la seguridad e integridad personal VII. Anexos

Efectos de la liofilización sobre cuatro actividades biológicas del veneno de Bothrops atrox (Serpentes: Viperidae) / Effects of lyophilization on four biological activities of Bothrops atrox venom (Serpentes: Viperidae)

Fresh venom was obtained by milking both sexes of adult Bothrops atrox snakes. Four biological activities were studied in both fresh and freeze dried venom: local hemorrhagic in guinea pig skin, proteolytic upon casein (caseinolytic), esterasic upon TAME and fibrinogen clotting activity. All activities were detected in fresh venom: Hemorrhagic (DHM = 0.93, DHR = 9.75 micrograms protein), caseinolytic (0.25 U kunitz/mg protein), esterasic (0.70 U/mg protein) and clotting activity (75.7 U NIH/mg protein). After freeze drying, all the biological activity of B. atrox venom enzymes decreased: hemorrhagic, caseinolytic and clotting activity in 50 and the esterasic activity only in 15. Our results show that lyophylization decreases several important biological activities in snake venom related to a decrease in the venom enzymatic activities.

Administración de los bienes de los pacientes mentales hospitalizados: legislación vigente en Chile y necesidades de cambio / Administration of possessions of mental inpatients

En resumen, pensamos que la legislación vigente es insuficiente e inadecuada para permitir una eficaz curaduría de los bienes de nuestros pacientes. Adolece de una falta de integración importante que hace necesario interpretar distintos textos para llevarla a feliz término. En contadas ocasiones es contradictoria, necesitando en esos casos una definición más clara, como por ejemplo en el asunto del cobro de parte de la pensión por parte de los establecimientos. Nos parece que los articulados correspondientes del Código Sanitario, más lo del Código Civil, deberían ser complementados por un reglamento claro y mas elaborado que el contenido en el Reglamento General de Insanos, texto que debiera revisarse, modificándose a la brevedad y que, en el tema que nos preocupa, debiera contener alguna de las ideas ya comentadas en este trabajo

Escorbuto y disfunción familiar / Scurvy and familiar dysfunction

Lactante masculino de 13 meses de edad con escorbuto, en quien las manifestaciones clínicas y radiográficas del padecimiento constituyeron la base para el diagnóstico. Se observaron: atrofia ósea cortical y esponjosa generalizada en fémures, línea de Fraenkel, línea de desmineralización y fracturas metafisiarias, hemorragias subperiósticas, espolones, así como rarefacción de los núcleos de crecimiento con halo de brillantez y luxación epifisiaria. Se hace énfasis en la fisiopatología y manifestación de las lesiones óseas; la importancia de la radiografía de los miembros inferiores para establecer el diagnóstico, dado que en la actualidad, casos tan avanzados como el que se describe no son los más frecuentes. En conjunto, al proceso carencial se le encontraron como causas, alteraciones profundas en la dinámica familiar que condicionaron la dieta inadecuada, con ausencia de ácido ascórbico y deprivación afectiva. Después de proporcionar tratamiento sustitutivo con ácido ascórbico, se observó mejoría clínica general y de las lesiones radiológicas que no requirieron manejo ortopédico especial. Fue necesario, además, instituir estimulación temprana, terapia afectiva y psicoterapia a la madre, a fin de lograr un tratamiento integral del paciente