Erythrocyte antigens and antibodies in the Chilean population.

Chile does not have a national registry of immunohematologic test results; there are no data on the prevalence of erythrocyte antigens and the frequency of antibodies in this population. Therefore, foreign references are used for decision-making. In this study, a standard questionnaire was used in 74 laboratories of public and private establishments. The information from tests conducted in 2015 was requested: ABO and D typing, antibody detection, antibody identification, and erythrocyte phenotype. Prevalence for the ABO-D phenotypes were obtained at the country level (D+ [94.4%] and D- [5.5%]) and differ from those recorded in the white population (85% and 15%, respectively). Positive antibody detection results were found in 0.4 and 1.3 percent of blood donors and patients, respectively; the main specificities were anti-Lea, -E, and -D in donors and anti-D, -E, and -K in patients. Inconclusive results were observed in ABO-D typing and antibody identification in donors and patients; these samples were referred to immunohematology reference laboratories for resolution. From this study, it was possible to estimate the prevalence of erythrocyte antigens and the frequency of antibodies at the national level, and this step allows us to characterize Chile's population of blood donors and transfusion recipients and to compare the results and frequencies with other populations or countries.Chile does not have a national registry of immunohematologic test results; there are no data on the prevalence of erythrocyte antigens and the frequency of antibodies in this population. Therefore, foreign references are used for decision-making. In this study, a standard questionnaire was used in 74 laboratories of public and private establishments. The information from tests conducted in 2015 was requested: ABO and D typing, antibody detection, antibody identification, and erythrocyte phenotype. Prevalence for the ABO-D phenotypes were obtained at the country level (D+ [94.4%] and D­ [5.5%]) and differ from those recorded in the white population (85% and 15%, respectively). Positive antibody detection results were found in 0.4 and 1.3 percent of blood donors and patients, respectively; the main specificities were anti-Lea, -E, and -D in donors and anti-D, -E, and -K in patients. Inconclusive results were observed in ABO-D typing and antibody identification in donors and patients; these samples were referred to immunohematology reference laboratories for resolution. From this study, it was possible to estimate the prevalence of erythrocyte antigens and the frequency of antibodies at the national level, and this step allows us to characterize Chile's population of blood donors and transfusion recipients and to compare the results and frequencies with other populations or countries.

Ultrafast carbon nanotubes growth on recycled carbon fibers and their evaluation on interfacial shear strength in reinforced composites.

The global demand for products manufactured with carbon fibers (CFs) has increased in recent years; however, the waste generated at the end of the product lifetime has also increased. In this research, the impact of the addition of carbon nanotubes (CNTs) on the interlaminated resistance of recycled carbon fibers (RCFs) was studied. In this work, a recycling process of the composite material was applied via thermolysis to obtain the CFs, followed by the growth of CNTs on their surface using the Poptube technique. The recycling temperature were 500 °C and 700 °C; and ferrocene and polypyrrole were used to grow CNTs on CFs surface. CNTs were verified by Raman spectroscopy and scanning electron microscopy (SEM). Finally, to determine the interlaminar resistance, a double cantilever beam (DCB) test was performed. The results indicate that with Poptube technique, CNTs can be grown on RCFs using both impregnations. Thermolysis recycling process at 500 °C allowed CFs without resin residues and without visible damage. The DCB tests showed a decrease in the fracture resistance in mode I loading of 34.9% for the polypyrrole samples and 29.3% for the ferrocene samples compared with the virgin carbon fibers (VCFs) samples with a resistance of 1052.5 J/m2.

Renal Transplantation in Second-Level Private Hospitals in the State of Mexico.

BACKGROUND: Kidney transplantation (KT) is the replacement therapy of choice in patients with end-stage renal disease (ESRD). Here we show a cohort of kidney transplant recipients from the period of May 1994 to May 2016 in 2 2nd-level private hospitals from the city of Toluca in the state of Mexico. METHODS: We checked the clinical files of all the patients that received KT in the period of study. RESULTS: We report 25 KT: 23 performed in Sanatorio Toluca and 2 in Sanatorio Florencia; 16 (64%) male and 9 (26%) female; mean age 36.03 ± 15.9 years (range, 10-66); 19 (76%) hemodialysis and 9 (24%) continuous ambulatory peritoneal dialysis before KT; ESRD etiology unknown in 16 (64%), diabetes in 5 (20%), IgA nephropathy in 2 (8%), and other in 2 (8%); living donors in 13 (52%) and deceased donors in 12 (48%); blood group 0+ in 18 (72%), A+ in 5 (20%), and B+ in 2 (8%); 21 (84%) with 0 and 4 (16%) with 1 HLA mismatch; and delayed graft function in 8 (32%), of which 7 were from deceased donors and 1 from a living donor. All 25 (100%) had a functional kidney at 1 year of follow-up. Immunosuppression regime consisted of multitarget maintenance therapy in all 25 (100%): cyclosporine in 18 (72%) and tacrolimus in 7 (28%). We used only methylprednisolone (MTP) as induction therapy. There were only 2 cases (8%) of acute rejection during the 1st 6 months of follow-up, and both responded to treatment with MTP. CONCLUSIONS: KT is the treatment of choice for patients with ESRD. The obtained results using only an MTP induction regime are satisfactory, with graft and patient survivals of 100% in the 1st year of follow-up.

Declaración de Sant Joan d’Alacant en defensa del acceso abierto a las publicaciones científicas, del Grupo de Editores de Revistas Españolas sobre Ciencias de la Salud (GERECS) / Declaration of Sant Joan d'Alacant in defense of open access to the scientific publications, from the publishers of Spanish journals group on (GERECS) health sciences

No disponible

Goal-Directed fluid therapy with closed-loop assistance during moderate risk surgery using noninvasive cardiac output monitoring: A pilot study.

BACKGROUND: Goal directed fluid therapy (GDFT) has been shown to improve outcomes in moderate to high-risk surgery. However, most of the present GDFT protocols based on cardiac output optimization use invasive devices and the protocols may require significant practitioner attention and intervention to apply them accurately. The aim of this prospective pilot study was to evaluate the clinical feasibility of GDFT using a closed-loop fluid administration system with a non-invasive cardiac output monitoring device (Nexfin™, BMEYE, Amsterdam, Netherlands). METHODS: Patients scheduled for elective moderate risk surgery under general anaesthesia were enrolled. The primary anaesthesia team managing the case selected GDFT targets using the controller interface and all patients received a baseline 3 ml kg(-1) h(-1) crystalloid infusion. Colloid solutions were delivered by the closed-loop system for intravascular volume expansion using data from the Nexfin™ monitor. Compliance with GDFT management was defined as acceptable when a patient spent more than 85% of the surgery time in a preload independent state (defined as pulse pressure variation <13%) or when average cardiac index during surgery was >2.5 litre min(-1) m(-2). RESULTS: A total of 13 patients were included in the study group. All patients met the established criteria for delivery of GDFT for greater than 85% of case time. The median length of stay in the hospital was 5 [3-6] days. CONCLUSION: In this pilot study, GDFT management using the closed-loop fluid administration system with a non-invasive CO monitoring device was feasible and maintained a high rate of protocol compliance. CLINICAL TRIAL REGISTRATION: NCT02020863.

Biodesulfurization of dibenzothiophene and gas oil using a bioreactor containing a catalytic bed with Rhodococcus rhodochrous immobilized on silica.

Biodesulfurization (BDS) in a bioreactor packed with a catalytic bed of silica containing immobilized Rhodococcus rhodochrous was studied. Various bed lengths and support particle sizes were evaluated for BDS of dibenzothiophene (DBT) and gas oil. The sulfur-containing substrates were introduced separately into the bioreactor at different feed flows. Higher removal of sulfur from DBT and gas oil was achieved with a long bed, lower substrate flow, and larger sizes of immobilization particles. The packed bed bioreactor containing metabolic active cells was recycled and maintained BDS activity.

First closed-loop goal directed fluid therapy during surgery: a pilot study.

OBJECTIVE: Intraoperative haemodynamic optimization based on fluid management and stroke volume optimization (Goal Directed Fluid Therapy [GDFT]) can improve patients' postoperative outcome. We have described a closed-loop fluid management system based on stroke volume variation and stroke volume monitoring. The goal of this system is to apply GDFT protocols automatically. After conducting simulation, engineering, and animal studies the present report describes the first use of this system in the clinical setting. STUDY DESIGN: Prospective pilot study. PATIENTS: Patients undergoing major surgery. METHODS: Twelve patients at two institutions had intraoperative GDFT delivered by closed-loop controller under the direction of an anaesthesiologist. Compliance with GDFT management was defined as acceptable when a patient spent more than 85% of the surgery time in a preload independent state (defined as stroke volume variation<13%), or when average cardiac index during the case was superior or equal to 2.5l/min/m(2). RESULTS: Closed-loop GDFT was completed in 12 patients. Median surgery time was 447 [309-483] min and blood loss was 200 [100-1000] ml. Average cardiac index was 3.2±0.8l/min/m(2) and on average patients spent 91% (76 to 100%) of the surgery time in a preload independent state. Twelve of 12 patients met the criteria for compliance with intraoperative GDFT management. CONCLUSION: Intraoperative GDFT delivered by closed-loop system under anaesthesiologist guidance allowed to obtain targeted objectives in 91% of surgery time. This approach may provide a way to ensure consistent high-quality delivery of fluid administration and compliance with perioperative goal directed therapy.

Cognitive errors detected in anaesthesiology: a literature review and pilot study.

BACKGROUND: Cognitive errors are thought-process errors, or thinking mistakes, which lead to incorrect diagnoses, treatments, or both. This psychology of decision-making has received little formal attention in anaesthesiology literature, although it is widely appreciated in other safety cultures, such as aviation, and other medical specialities. We sought to identify which types of cognitive errors are most important in anaesthesiology. METHODS: This study consisted of two parts. First, we created a cognitive error catalogue specific to anaesthesiology practice using a literature review, modified Delphi method with experts, and a survey of academic faculty. In the second part, we observed for those cognitive errors during resident physician management of simulated anaesthesiology emergencies. RESULTS: Of >30 described cognitive errors, the modified Delphi method yielded 14 key items experts felt were most important and prevalent in anaesthesiology practice (Table 1). Faculty survey responses narrowed this to a 'top 10' catalogue consisting of anchoring, availability bias, premature closure, feedback bias, framing effect, confirmation bias, omission bias, commission bias, overconfidence, and sunk costs (Table 2). Nine types of cognitive errors were selected for observation during simulated emergency management. Seven of those nine types of cognitive errors occurred in >50% of observed emergencies (Table 3). CONCLUSIONS: Cognitive errors are thought to contribute significantly to medical mishaps. We identified cognitive errors specific to anaesthesiology practice. Understanding the key types of cognitive errors specific to anaesthesiology is the first step towards training in metacognition and de-biasing strategies, which may improve patient safety.

Retención de orina en un paciente inmunocompetente: mielitis transversa aguda / Urinary retention in immunocompetent patient: acute transverse myelitis

La diabetes MODY-5 es un tipo de diabetes monogenica infrecuente, causada por mutación en el gen del factor de transcripción nuclear hepático 1-beta (HNF-1¦Â). Esta mutación puede ser de tipo puntual o bien corresponder a delecciones grandes, y a su vez, puede aparecer de novo por mutación espontanea o bien ser transmitida de forma hereditaria con caracter autosomicodominante. Está asociada con un alto riesgo de complicaciones microvasculares de aparición temprana en las personas afectas, así como con alteraciones renales características del tipo quistes y anomalías del tracto genital, que estan presentes incluso antes del nacimiento. Por ello, está justificado hacer pruebas de detección para las mutaciones de HNF-1 en diabíticos no obesos, sobre todo, cuando existen alteraciones renales o genitales asociadas, sin tener en cuenta los antecedentes familiares (AU)

MODY-5 diabetes is an infrequent type of monogenic diabetes, caused by mutation in the gene of the nuclear hepatic transcription factor 1-beta (HNF-1¦Â).This mutation can be of a momentary type or it might correspond to big deletions, and, in its turn, it can appear due to spontaneous de novo mutation or it can be transmitted by hereditary with an autosomal dominant character. It is associated with a high risk of microvascular complications that appear early in affected people, as well as with characteristic renal alterations of the cyst type, and anomalies of the genital tract, which are present even before birth. That is why it is justified to carry out detection tests for HNF-1¦Â mutations in non-obese diabetics, above all when there are associated renal or genital alterations, without consideration of family antecedents (AU)

[Urinary retention in immunocompetent patient: acute transverse myelitis]. / Retención de orina en un paciente inmunocompetente: mielitis transversa aguda.

A heterogeneous group of diseases is included under the term acute transverse myelitis (ATM); these have the common factor of producing an inflammatory focal injury of the spinal cord in an acute form. Understanding of ATM is being constantly improved with the arrival of new diagnostic techniques and theories about its immune origin. Responsibility for making an early diagnosis lies primarily in the field of primary care and must always be based on the completion of a detailed clinical report together with a thorough neurological examination. Once detected, correct handling of the clinical situation will require an urgent referral to a hospital for evaluation and treatment at an early stage by multidisciplinary teams. Early intervention in many of these diseases is vital, because it improves the prognosis of these patients and significantly reduces injuries.

[SciELO: A cooperative project for the dissemination of science]. / SciELO: un proyecto cooperativo para la difusión de la ciencia.

The article describes the SciELO (Scientific Electronic Library Online) model for the electronic publication and dissemination of scientific journals, its origin and evolution, methodology, components, services and potential, and its implantation in Spain. It consists of thirteen participant countries with eight certified web portals, with another 5 under development and another two thematic ones. In February 2009 Scielo.org had 611 magazines and 195,789 articles of which 46% were about health sciences. Spain became a project member in 1999 and launched the SciELO web portal in 2001, as well as 4 magazines. It currently has 39 titles in the field of Health Sciences; one of which is the Revista Española de Sanidad Penitenciaria, which joined the project in 2007 and which currently has 6 issues from 2007 and 2008 available. This makes it one of the most important open access initiatives existing. The report concludes by stating that the SciELO model contributes to the development of research and science by offering an effective and efficient method of promoting and increasing the dissemination of scientific publications in Latin America.

SciELO: un proyecto cooperativo para la difusión de la ciencia / Scielo: a cooperative project for the dissemination os science

Se describe el modelo SciELO (Scientific Electronic Library Online) para la publicación y difusión electrónica de revistascientíficas, su origen y evolución, su metodología, componentes, servicios y potencialidades, así como su implantación enEspaña. Con 13 países participantes que suponen 8 portales certificados y 5 portales en desarrollo, más dos portales temáticos,en febrero de 2009 SciELO.org recogía 611 revistas y 195.789 artículos, de los cuales el 46% eran de Ciencias de la Salud,lo que lo convierte en una de las iniciativas de acceso abierto más importantes de cuantas existen. España se une al proyectoen 1999 y lanzó su portal «SciELO España» en 2001, con 4 revistas. En la actualidad incluye 39 títulos del área de Cienciasde la Salud, entre ellos la Revista Española de Sanidad Penitenciaria que se ha incorporado a la colección en 2007 y tieneaccesibles 6 números correspondientes a los años 2007 y 2008. Se concluye afirmando que el modelo SciELO contribuye aldesarrollo de la investigación y la ciencia, ofreciendo una solución eficiente y eficaz para impulsar y aumentar la difusión delas publicaciones científicas del área iberoamericana (AU)

The article describes the SciELO (Scientific Electronic Library Online) model for the electronic publication and disseminationof scientific journals, its origin and evolution, methodology, components, services and potential, and its implantationin Spain. It consists of thirteen participant countries with eight certified web portals, with another 5 under developmentand another two thematic ones. In February 2009 Scielo.org had 611 magazines and 195,789 articles of which 46% were abouthealth sciences. Spain became a project member in 1999 and launched the SciELO web portal in 2001, as well as 4 magazines.It currently has 39 titles in the field of Health Sciences; one of which is the Revista Española de Sanidad Penitenciaria,which joined the project in 2007 and which currently has 6 issues from 2007 and 2008 available. This makes it one of themost important open access initiatives existing. The report concludes by stating that the SciELO model contributes to thedevelopment of research and science by offering an effective and efficient method of promoting and increasing the disseminationof scientific publications in Latin America (AU)

Posthemipelvectomy hernia.

We report the case of a white male who underwent a classic hemipelvectomy due to a femur fibrosarcoma with inguinal metastases, which 33 years later, developed into a posthemipelvectomy hernia in the amputation stump that impaired the use of his Canadian prosthesis. The hernia was repaired with a polypropylene mesh in a subaponeurotic position. A seroma was drained in the postoperative and it was only 2 months after the operation that he could use his prosthesis with any difficulty. A year after the operation, the hernia had not recurred. Only seven similar cases have been published, and there are only four cases with details of their correction, two with a mesh as was our case, and the rest with a primary suture of the aponeurotic borders. A brief review of the bibliography is given on this subject.

[Bibliometric analysis of the Spanish Journal of Chemotherapy (1996-2000)]. / Análisis bibliométrico de la Revista Española de Quimioterapia (1996-2000).

A bibliometric study of the output of Spanish scientific research into antimicrobial and antiparasitic chemotherapy was carried out, based on articles published in the Spanish Journal of Chemotherapy from 1996 to 2000. The 20 issues of the journal corresponding to the 5-year period studied were analyzed using the main indicators for bibliometry: article typology; output; Bradford's Law and Lotka's estimation; collaboration index; institutional origin; geographic location; subject; and advertising. The majority of the articles were original, and a small group of high-output authors and an appropriate level of contribution were identified. The greatest percentage of scientific output was from the autonomous regions of Madrid and Valencia. The majority of studies included in the analysis were hospital-based and the most researched topic was antimicrobial drugs. A reduction in the amount of advertising was noted.

Funciones de los equipos directivos de Atención Primaria del INSALUD de Madrid. Necesidades de formación / Function of the Primary Health Care directors of the INSALUD of Madrid. Needs of training

Objetivos: son escasos los estudios en los que se analizan las funciones de los equipos directivos de Atención Primaria y sus necesidades de formación, siendo los objetivos de este trabajo: a) analizar la dedicación a las distintas funciones de la gestión; b) conocer los atributos sociales requeridos para el desempeño de su rol; c) determinar las necesidades de formación en gestión y los métodos preferidos. Material y métodos: estudio descriptivo transversal, mediante cuestionario enviado por correo en noviembre de 1999. La población diana son 77 personas, que constituyen los equipos directivos de las gerencias de Atención Primaria de Madrid. Las variables estudiadas fueron: a) tiempo que dedica a cada una de las funciones de su puesto de trabajo y el que le gustaría dedicar; b) importancia para el desempeño de su rol de distintos atributos sociales; c) grado de formación sobre sus funciones; d) métodos de formación preferidos. Resultados : contestaron un 84,4 por ciento. La distribución del tiempo que dedican a las distintas funciones es: coordinación (26,3 por ciento), dirección (22 por ciento), organización (21,4 por ciento), planificación (15,8 por ciento) y evaluación (13,7 por ciento), y el orden deseado: planificación (23 por ciento), dirección (21,2 por ciento), coordinación (20,6 por ciento), organización (19,7 por ciento) y evaluación (16,4 por ciento). Se evidencia una aceptable concordancia (Coeficiente de Kendall W= 0,408) en el orden de importancia que conceden a los atributos personales. Sólo un 32,3 por ciento tienen una titulación para la gestión. Las necesidades de formación resultan poco homogéneas (W = 0,19). Si existe aceptable concordancia en los métodos de aprendizaje de preferencia (W= 0,408). Conclusiones: se confirma una ligera discordancia entre la realidad de la gestión y el ideal que de ella tienen los gestores. Las necesidades de formación resultan heterogéneas. La formación en la práctica diaria es el método preferido por los encuestados. (AU)

Plant meiosis: the means to 1N.

Meiosis is pivotal in the life history of plants. In addition to providing an opportunity for genetic reassortment, it marks the transition from diploid sporophyte to haploid gametophyte. Recent molecular data suggest that, like animals, plants possess a common set of genes (also conserved in eukaryotic microorganisms) responsible for meiotic recombination and chromosome segregation. However, unlike animals, plant meiocytes do not differentiate from a pool of primordial germ cells, but rather arise de novo from a germline formed from sub-epidermal cells in the anthers and ovules. Mutants defective in the specification of these reproductive cell lines and disrupted in different aspects of the meiotic process are beginning to reveal many features unique to plant meiosis.

Dominance between booby nestlings involves winner and loser effects.

Two-chick broods of the blue-footed booby, Sula nebouxii, ordinarily exhibit stable dominance-subordinance, with the senior (first-hatched) chick habitually aggressive and the junior one habitually submissive (Nelson 1978, The Sulidae: Gannets and Boobies. London: Oxford University Press). But are both the subordinate and the dominant chick affected in their agonistic tendencies by early social experience? To answer this, we permanently paired subordinate and dominant chicks, 2-3 weeks old, with singletons (chicks lacking experience with a nestmate) by cross-fostering. During the first 4 h after pairing, subordinate chicks were seven times less aggressive than singletons and twice as likely to be submissive; dominant chicks were six times as aggressive as singletons. Although most subordinates consistently lost agonistic encounters during the first 10 days after pairing, the proportion of dominants that won decreased progressively until, by day 6, only about half of dominant chicks were winning. Early social experience has a strong but reversable training effect on both subordinates and dominants. Training as a subordinate showed more persistent effects than training as a dominant, possibly in part because our testing situation perpetuated subordinate training and counteracted dominant training. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.