El polimorfismo de un solo nucleótido rs1800795 en el gen IL6 no está asociado con el glaucoma primario de ángulo abierto en la población mexicana / The rs1800795 single nucleotide polymorphism in the IL6 gene is not associated with primary open angle glaucoma in Mexican population

Objetivo La interleucina 6 (IL-6) es una citoquina proinflamatoria con efectos pleiotrópicos que se ha relacionado con el glaucoma primario de ángulo abierto (GPAA) debido a su efecto particular de protección de las células ganglionares de la retina (CGR) contra la apoptosis. Se han asociado diferentes polimorfismos de un solo nucleótido (PSN) con el GPAA. El objetivo de este estudio fue determinar si existe una asociación entre el PSN de IL-6 rs1800795 (−174 G>C) y un mayor riesgo de padecer GPAA en la población mexicana occidental. Métodos Se incluyeron 165 pacientes mestizos mexicanos no emparentados con GPAA y 108 sujetos de control. Se extrajo el ADN genómico de los leucocitos y se purificó, seguido de la genotipificación y la amplificación por reacción en cadena de la polimerasa (PCR) con sondas TaqMan® Biosystem®. Se evaluó la diversidad alélica y genotípica entre los casos y los sujetos de control. Resultados No hubo asociación estadísticamente significativa entre las frecuencias alélicas y genotípicas, ni con modelos de asociación genética dominante ni recesiva (p>0,05). Conclusiones Aunque existe un papel de la IL6 en la fisiopatología del GPAA, nuestros resultados descartan la asociación entre la IL-6 y el PSN rs1800795 mostrando no ser un índice de mayor riesgo de GPAA en la población mexicana (AU)

Purpose Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (−174 G>C) SNP and a higher risk for POAG is present in western Mexican population. Methods One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. Results There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (P>.05). Conclusion Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population (AU)

The rs1800795 single nucleotide polymorphism in the IL6 gene is not associated with primary open angle glaucoma in Mexican population.

PURPOSE: Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (-174 G>C) SNP and a higher risk for POAG is present in western Mexican population. METHODS: One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. RESULTS: There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (p > 0.05). CONCLUSION: Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population.

Thoroughbred stallion fertility is significantly associated with FKBP6 genotype but not with inbreeding or the contribution of a leading sire.

This is a follow-up study to validate the previously detected association of the FKBP6 gene with stallion subfertility. Using a select cohort of 150 Thoroughbred stallions with detailed breeding records, we confirm significant association (P < 0.0001) between low per-cycle pregnancy rates (≤50%) and a combined A/A-A/A genotype of SNPs chr13:11 353 372G>A and chr13:11 353 436A>C in FKBP6 exon 5. We also show that stallion subfertility and the combined genotype A/A-A/A are not associated with the level of genetic diversity based on 12 autosomal microsatellite markers, or with pedigree-based inbreeding rate, or the extent of contribution of a leading Thoroughbred sire, Northern Dancer, in a stallion's pedigree. We develop a TaqMan allelic discrimination assay for the two SNPs to facilitate accurate and high-throughput genotyping. We determine allele, genotype and combined genotype frequencies of FKBP6 exon 5 SNPs in a global cohort of 518 Thoroughbreds (76% stallions or geldings and 24% mares) and show that the frequency of the A/A-A/A genotype is 4%. Because there is no similar association between the FKBP6 exon 5 genotype and stallion subfertility in Hanoverians, we suggest that the two SNPs are not causative but rather tagging a breed-specific haplotype with genetic variants unique to Thoroughbreds. Further WGS-based research is needed to identify the molecular causes underlying the observed genotype-phenotype association in Thoroughbred stallions.

eSalud en servicios de salud públicos en México: estudio de caso / E-Health in Public Health Services in Mexico: Case Study

El presente trabajo tiene el objetivo de explorar el desarrollo de las tecnologías de la información y comunicación (componentes de eSalud) en servicios de salud públicos de México, así como indagar sobre los facilitadores y barreras para su implementación. Se realizó un estudio de caso en el Instituto de Servicios de Salud del Estado de Aguascalientes utilizando un abordaje mixto de tipo concurrente y de predominancia cualitativa que incluyó observación no participante, entrevistas semiestructuradas y un cuestionario dirigido al personal médico. A través del estudio, se identifican diversas oportunidades de mejora en cuanto al acceso y desarrollo de las tecnologías de la información y comunicación; también se identifican diversas barreras para su implementación factibles de superarse. En cuanto a las limitaciones del estudio, se reconoce la exploración de perspectivas sólo desde la oferta de servicios. En lo que respecta a la originalidad, destaca la investigación integral de diferentes componentes de eSalud. Se concluye que es necesario fortalecer las políticas de las tecnologías de información y comunicación dirigidas al sector salud con el fin de optimizar su desarrollo e implementación

The purpose of this work is to explore the development of the Information and Communication Technologies (e-Health components) in public health services of Mexico, as well as to inquire into the enablers and barriers to its implementation. A case study was conducted at the Instituto de Servicios de Salud del Estado de Aguascalientes using a mixed approach of concurrent type and qualitative predominance that included non-participant observation, semi-structured interviews and a questionnaire addressed to medical staff. Through the study, diverse improvement opportunities for the access and development of the Information and Communication Technologies were identified; diverse barriers to its implementation were also. The study has the limitation of taking only the services offer perspectives. The originality of this study is the comprehensive research of e-Health components. It is concluded that it is necessary to strengthen the Information and Communication Technologies policies focused to the health sector in order to optimize its development and implementation

Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ).

BACKGROUND: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.

[Clinical and socio-demographic profile of neurosyphilis: a retrospective study in a reference centre in Colombia]. / Perfil clinico y sociodemografico de la neurosifilis: estudio retrospectivo en un centro de referencia de Colombia.

INTRODUCTION: Neurosyphilis is the Treponema pallidum infection of the central nervous system and can occur at any time after the initial infection. In the 21st century, the incidence of neurosyphilis has increased in the post-antibiotic era. The highest rates of neurosyphilis are from low-income countries and the published studies are limited. AIM: To determine the clinical and sociodemographic characteristics of neurosyphilis patients in a tertiary care center in Pereira, Colombia. PATIENTS AND METHODS: Retrospective study of diagnosed neurosyphilis patients in a tertiary care center in Pereira, Colombia, between 2012 to 2017. The diagnosis was established based on serologic treponemal tests, VDRL in CSF, and CSF analysis. Sociodemographic, clinical, and laboratory parameters variables were obtained. RESULTS: Sixteen patients were included, 11 with definitive neurosyphilis and 5 with probable neurosyphilis. The median age was 59.50 ± 13.78 years. Men accounted for 75% (n = 12) of the patients. Four patients were (25%) HIV-infected. All the patients had positive peripheral FTA-ABS and 11 had reactive VDRL in CSF. The most frequent form was late neurosyphilis (62.5%), being general paralysis the most common. The most frequently clinical manifestations were neuropsychiatric alterations (46.9%), predominantly disorientation, behavioral changes, and cognitive impairment, followed by motor changes (36.7%). CONCLUSIONS: Late neurosyphilis was the most prevalent form, predominantly neuropsychiatric alterations. Only a quarter of patients presented HIV coinfection.

TITLE: Perfil clinico y sociodemografico de la neurosifilis: estudio retrospectivo en un centro de referencia de Colombia.Introduccion. La neurosifilis es causada por Treponema pallidum y puede afectar al sistema nervioso central en cualquier momento de la infeccion. Desde inicios de este siglo, su incidencia ha ido en aumento, aun en la era postantibiotica. En paises en vias de desarrollo, el problema tiene mayor magnitud y los estudios son escasos. Objetivo. Describir las caracteristicas de la poblacion con neurosifilis en un hospital de tercer nivel de Pereira, Colombia. Pacientes y metodos. Estudio descriptivo de corte transversal de pacientes con neurosifilis que acudieron a un centro de tercer nivel de Pereira, Colombia, entre 2012 y 2017. Los criterios diagnosticos se basaron en las siguientes variables: prueba treponemica en sangre, VDRL y analisis citoquimico del liquido cefalorraquideo. Se consideraron variables sociodemograficas, clinicas y de laboratorio. Resultados. Se incluyo a 16 pacientes, 11 con neurosifilis definitiva y cinco con neurosifilis probable, con una edad media de 59,5 ± 13,78 años. El 75% (n = 12) de los casos eran hombres. La coinfeccion por virus de la inmunodeficiencia humana fue del 25%. Todos los pacientes tenian FTA-ABS positivo en sangre y 11 presentaron VDRL reactiva en el liquido cefalorraquideo. La forma mas frecuente de neurosifilis fue la tardia (62,5%), y predomino la paralisis general. Las manifestaciones clinicas mas frecuentes fueron las alteraciones neuropsiquiatricas (46,9%), con predominio de la desorientacion, los cambios en el comportamiento y el deterioro cognitivo, seguidos de las alteraciones motoras (36,7%). Conclusiones. La neurosifilis tardia fue la presentacion mas prevalente, caracterizada por manifestaciones neuropsiquiatricas. Una cuarta parte de los pacientes presentaba infeccion por virus de la inmunodeficiencia humana.

Synchronization of complex networks of identical and nonidentical chaotic systems via model-matching control.

In this work, a synchronization scheme for networks of complex systems is presented. The proposed synchronization scheme uses a control law obtained with some definitions from graph theory and solving the Model-Matching Problem for complex networks. In particular, Rössler, Chen, Lorenz and Lü chaotic systems are used as complex chaotic systems into complex networks. Particular cases with regular and irregular networks of six identical chaotic systems are implemented, with some well-known topologies as star and ring small-world, and tree topologies. Highlighting, the obtained control law is applied to synchronize an irregular network of six different chaotic systems in a tree topology. The usefulness and advantages of the proposed synchronization scheme are highlighted performing numerical simulations of the chaotic complex networks.

Cuidados enfermeros paliativos en urología / No disponible

Raramente encontramos casos de pacientes que requieran cuidados paliativos en una unidad quirúrgica de Urología. Presentamos un caso tratado en nuestro hospital y el plan de cuidados enfermero personalizado desarrollado para esta situación de últimos días, priorizando la humanización de la asistencia. Elaboramos un plan de cuidados enfermero personalizado con taxonomía NANDA, NIC y NOC, usando registros validados de enfermería. Muchas actividades y resultados esperados se repiten o solapan en los distintos diagnósticos enfermeros planteados. Prima la humanización de la asistencia y favorecer una muerte digna. No hay bibliografía suficiente de pacientes paliativos en unidades quirúrgicas. La enfermera es pieza clave en los cuidados paliativos y fundamental para plantear la limitación del esfuerzo terapéutico

Very rarely we find cases of patients who require palliative care in the surgical unit of urology. We present a case treated in our hospital and the personalized nursing care plan for the patient's situation during the last days, prioritising humanization of assistance. A personalized nursing care plan was created with NANDA, NIC and NOC, using valid records of nursing. Many tasks and expected outcome are repeated or they overlap with one another in the different nursing diagnoses. There is not enough bibliography of palliative care in surgical units. The nurse is the key of palliative care and is essential upon the limitation of therapeutic efforts

Relationship between tumor-associated immune infiltrate and p16 staining over clinicopathological features in acral lentiginous melanoma.

PURPOSE: This study aims to evaluate the association between composition of tumor-infiltrating lymphocytes (TIL) and expression of p16 in acral lentiginous melanoma (ALM), and their impact on prognosis. MATERIALS AND METHODS: A cohort of 148 surgical pathology specimens of ALM was studied. TIL were evaluated by immunohistochemical detection of CD3 and CD8, along with CD20, CD4, CD68, and CD163 in a subset of 43 cases. p16 protein expression was also investigated in all the cases. RESULTS: The median age was 66 years, median Breslow thickness was 6.0 mm, grade III TIL was found in 28.4% and lymph nodes were involved in 54.2%. Breslow thickness (p < 0.001), stage I-II (p < 0.001), negative lymph nodes (p < 0.001) and < 10% p16 (p = 0.01) were associated with longer survival. Grade III of TIL was associated with thinner Breslow thickness (p = 0.008) and lower mitosis (p = 0.047). A higher density of CD3 TIL was associated with male gender (p = 0.008), thinner Breslow thickness (p = 0.047), negative lymph node (p = 0.031), early stage (p = 0.046), and p16 nuclear expression of > 10% (p = 0.045). Higher CD8 TIL was associated with > p16 (p = 0.03). Survival analysis found that longer survival had a trend to be associated with high TIL (p = 0.090). Levels of CD3+ and CD8+ cells were correlated with those of CD4+, CD20+, CD68+ and CD163+ immune cells. CONCLUSIONS: Higher levels of TIL tend to be associated with better overall survival in ALM. Loss of expression of p16 is associated with lower levels of CD3+ and CD8+ TIL, indicating a probable relationship between p16 and TIL immune response in ALM .

Prognostic implications of residual disease tumor-infiltrating lymphocytes and residual cancer burden in triple-negative breast cancer patients after neoadjuvant chemotherapy.

BACKGROUND: For primary triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy (NAC), higher pretreatment tumor-infiltrating lymphocytes (TILs) correlates with increased pathologic complete response (pCR) rates, and improved survival. We evaluated the added prognostic value of residual disease (RD) TILs to residual cancer burden (RCB) in predicting survival post-NAC. PATIENTS AND METHODS: We combined four TNBC NAC patient cohorts who did not achieve pCR. RD TILs were investigated for associations with recurrence-free survival (RFS), and overall survival (OS) using Cox models with stromal TILs as a continuous variable (per 10% increment). The likelihood ratio test was used to evaluate added prognostic value of RD TILs. RESULTS: A total of 375 RD TNBC samples were evaluable for TILs and RCB. The median age was 50 years, with 62% receiving anthracycline/taxane chemotherapy. The RCB class after NAC was 11%, 50%, and 39% for I, II, and III, respectively. The median RD TIL level was 20% (IQR 10-40). There was a positive correlation between RD TIL levels and CD8+ T-cell density (ρ = 0.41). TIL levels were significantly lower with increasing post-NAC tumor (P = 0.005), nodal stage (P = 0.032), but did not differ by RCB class (P = 0.84). Higher RD TILs were significantly associated with improved RFS (HR: 0.86; 95% CI 0.79-0.92; P < 0.001), and improved OS (HR: 0.87; 95% CI 0.80-0.94; P < 0.001), and remained significant predictors in multivariate analysis (RFS P = 0.032; OS P = 0.038 for OS). RD TILs added significant prognostic value to multivariate models including RCB class (P < 0.001 for RFS; P = 0.021 for OS). The positive prognostic effect of RD TILs significantly differed by RCB class for RFS (PInt=0.003) and OS (PInt=0.008) with a greater magnitude of positive effect observed for RCB class II than class III. CONCLUSIONS: TIL levels in TNBC RD are significantly associated with improved RFS and OS and add further prognostic information to RCB class, particularly in RCB class II.

Tumor infiltrating lymphocytes in acral lentiginous melanoma: a study of a large cohort of cases from Latin America.

PURPOSE: Acral lentiginous melanoma (ALM) is a poor prognosis subtype and is the most prevalent in non-Caucasian populations. The presence of tumor infiltrating lymphocytes (TILs) has been associated with poor prognosis in melanoma. A large cohort of ALM cases was studied to determine status of TIL and its association with outcome. METHODS: All patients with cutaneous melanoma presenting from 2005 to 2012 at Instituto Nacional de Enfermedades Neoplasicas in Peru were retrospectively identified. Clinicopathological information was obtained from the medical charts. A prospective evaluation of TIL was performed. Analysis of association between ALM and clinicopathological features including TIL as well as survival analysis compared the outcome of ALM to whole group and extremity NALM was performed. RESULTS: 537 ALM from a total of 824 cutaneous melanoma cases were studied. Older age (p = 0.022), higher Breslow (p = 0.008) and ulceration (p < 0.001) were found to be more frequent in ALM. Acral had worse overall survival (OS) compared with the whole group (p = 0.04). Clinical stage (CS) I-II patients had a median OS of 5.3 (95% CI 4.3-6.2) for ALM and 9.2 (95% CI 5.0-7.0) for extremity NALM (p = 0.016). Grade 0 (absence of TIL), I, II and III were found in 7.5, 34.5, 32.1, and 25.9%, respectively. Lower TIL grade was associated with larger tumor size (p = 0.003), higher Breslow (p = 0.001), higher Clark level (p = 0.007), higher CS (p = 0.002), extremity location (p = 0.048), histological subtype ALM (p = 0.024) and better OS (p = 0.001). CONCLUSIONS: ALM is highly prevalent in Peru and carries poor outcome. Lower TIL levels were associated with poor outcome and ALM.

Improved Antiviral Activity of a Polyamide Against High-Risk Human Papillomavirus Via N-Terminal Guanidinium Substitution.

We report the synthesis of two novel pyrrole-imidazole polyamides with N-terminal guanidinium or tetramethylguanidinium groups and evaluate their antiviral activity against three cancer-causing human papillomavirus strains. Introduction of guanidinium improves antiviral activity when compared to an unsubstituted analog, especially in IC90 values. These substitutions change DNA-binding preferences, while binding affinity remains unchanged.

In situ spectroscopic characterization of a solution-phase X-type ligand exchange at colloidal lead sulphide quantum dot surfaces.

We employed quantitative NMR spectroscopy and spectrophotometric absorbance titration to study a quantum dot X-type ligand exchange reaction. We find that the exchange is highly cooperative, where at low extents of exchange the change in free energy of the reaction, ΔGXC, is ∼11 kJ mol-1 while at higher extents of exchange ΔGXC saturates to ∼-4 kJ mol-1. A modified Fowler binding isotherm is developed to describe the reaction.

The Corticospinal Tract in Huntington's Disease.

Huntington's disease (HD) is characterized by progressive motor impairment. Therefore, the connectivity of the corticospinal tract (CST), which is the main white matter (WM) pathway that conducts motor impulses from the primary motor cortex to the spinal cord, merits particular attention. WM abnormalities have already been shown in presymptomatic (Pre-HD) and symptomatic HD subjects using magnetic resonance imaging (MRI). In the present study, we examined CST microstructure using diffusion tensor imaging (DTI)-based tractography in 30-direction DTI data collected from 100 subjects: Pre-HD subjects (n = 25), HD patients (n = 25) and control subjects (n = 50), and T2*-weighted (iron sensitive) imaging. Results show decreased fractional anisotropy (FA) and increased axial (AD), and radial diffusivity (RD) in the bilateral CST of HD patients. Pre-HD subjects had elevated iron in the left CST, regionally localized between the brainstem and thalamus. CAG repeat length in conjunction with age, as well as motor (UHDRS) assessment were correlated with CST FA, AD, and RD both in Pre-HD and HD. In the presymptomatic phase, increased iron in the inferior portion supports the "dying back" hypothesis that axonal damage advances in a retrograde fashion. Furthermore, early iron alteration may cause a high level of toxicity, which may contribute to further damage.

Determinación de plomo en lápices labiales de diferentes marcas comercializados en Lima / Determination of plumb in lip pencils of different commercial marks in Lima

Objetivo: Determinar la presencia de plomo en los lápices labiales de diferentes marcas que se expenden en la ciudad de Lima. Material y Método: Se utilizó 24 lápices labiales de cinco marcas comerciales operantes en Perú, procedentes del centro comercial Capón en Lima. La presencia de plomo se determinó por el método de espectrofotometría de absorción atómica con horno de grafito. Para la validación estadística, se determinó la media y la desviación estándar. Resultados: Se encontró mayor contenido de plomo en las marcas LAL-04-YHBC (3,02 ppm), LAL-05-BALOE (2,10 ppm), LAL- 02-RW (1,55 ppm) y LAL-03-VCYH (1,22 ppm); contrastada con una marca poco conocida,de código LAL-01-CHOCO PLUSII en la que no se detectó plomo. Conclusiones: De los lápices labiales estudiados, cuatro de ellos superaron los valores permisibles de plomo (0,1 ppm), que es un valor referencial para caramelos.

Objective: To determine the presence of lead in lipsticks from different brands that are sold in the city of Lima. Material and Methods: 24 lipsticks of five different trademarks were used, from the shopping center in Lima Capon. The presence of lead was determined by the method of atomic absorption spectrophotometry with graphite furnace. For statistical validation, the mean and standard deviation was determined. Results: The highest lead content was found in the LAL -04 - YHBC (3.02 ppm) , LAL -05 - BALOE (2.10 ppm) , LAL -02 -RW (1.55 ppm) and LAL -03 marks - VCYH (1.22 ppm ) ; contrasted with a little known brand , LAL -01- CHOCO PLUSII code where no lead was detected. Conclusions: Of the studied lipsticks, four exceeded the permissible values of lead (0.1 ppm), which is a reference value for candy.

MRI measures of corpus callosum iron and myelin in early Huntington's disease.

Increased iron in subcortical gray matter (GM) structures of patients with Huntington's disease (HD) has been suggested as a causal factor in neuronal degeneration. But how iron content is related to white matter (WM) changes in HD is still unknown. For example, it is not clear whether WM changes share the same physiopathology (i.e. iron accumulation) with GM or whether there is a different mechanism. The present study used MRI to examine iron content in premanifest gene carriers (PreHD, n = 25) and in early HD patients (n = 25) compared with healthy controls (n = 50). 3T MRI acquisitions included high resolution 3D T1, EPI sequences for diffusion tensor imaging (DTI) as an indirect measure of tissue integrity, and T2*-weighted gradient echo-planar imaging for MR-based relaxometry (R2*), which provides an indirect measure of ferritin/iron deposition in the brain. Myelin breakdown starts in the PreHD stage, but there is no difference in iron content values. Iron content reduction manifests later, in the early HD stage, in which we found a lower R2* parameter value in the isthmus. The WM iron reduction in HD is temporally well-defined (no iron differences in PreHD subjects and iron differences only in early HD patients). Iron level in callosal WM may be regarded as a marker of disease state, as iron does not differentiate PreHD subjects from controls but distinguishes between PreHD and HD.

Impact of carbapenem resistance on clinical and economic outcomes among patients with Acinetobacter baumannii infection in Colombia.

Acinetobacter baumannii is a major cause of healthcare-associated infection, often affecting critically ill patients. The purpose of the study was to examine the associations of carbapenem resistance with mortality, length of hospital stay and hospital costs among patients infected with A. baumannii in intensive-care units (ICUs) in Colombia. A prospective, multicentre cohort study was conducted among 165 patients with A. baumannii infection admitted to ICUs between April 2006 and April 2010. Patients with carbapenem-resistant A. baumannii had higher risk of 30-day mortality than patients with carbapenem-susceptible A. baumannii in the univariate analysis (unadjusted hazard ratio = 2.12; 95% CI 1.14-3.95; p 0.018). However, carbapenem resistance was not significantly associated with risk of mortality (adjusted hazard ratio = 1.45; 95% CI 0.74-2.87; p 0.28) after adjusting for APACHE II score and other confounding factors. We did not find a significant difference in length of stay in ICU after the onset of infection between the two groups in the multivariate analysis (adjusted mean = 13.1 days versus 10.5 days; p 0.14). The average total cost of hospitalization among patients with carbapenem-resistant A. baumannii was significantly higher than that among patients with carbapenem-susceptible A. baumannii in the multivariate analysis (adjusted cost; US$ 11 359 versus US$ 7049; p <0.001). Carbapenem resistance was not significantly associated with mortality, though we are unable to rule out an increased risk due to the limited sample size. Carbapenem resistance was associated with an additional cost of hospitalization.

Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis.

Acinetobacter baumannii has emerged as a major cause of healthcare-associated infections. Controversy exists as to whether antimicrobial resistance increases the risk of mortality. We conducted a systematic review and meta-analysis to examine this association. We searched MEDLINE and EMBASE databases up to May 2013 to identify studies comparing mortality in patients with carbapenem-resistant A. baumannii (CRAB) vs. carbapenem-susceptible A. baumannii (CSAB). A random-effects model was used to pool Odds Ratios (OR). Heterogeneity was examined using I(2). We included 16 observational studies. There were 850 reported deaths (33%) among the 2546 patients. Patients with CRAB had a significantly higher risk of mortality than patients with CSAB in the pooled analysis of crude effect estimates (crude OR = 2.22; 95% CI = 1.66, 2.98), although substantial heterogeneity was evident (heterogeneity I(2) = 55%). The association remained significant in the pooled adjusted OR of 10 studies. Studies reported that patients with CRAB compared to patients with CSAB were more likely to have severe underlying illness and also to receive inappropriate empirical antimicrobial treatment, which increases the risk of mortality. Our study suggests that carbapenem resistance may increase the risk of mortality in patients with A. baumannii infection. However, cautious interpretation is required because of the residual confounding factors and inadequate sample size in most studies.

Estudio fitoquímico, toxicidad aguda y efectos antiulceroso y antitumoral de los extractos acuoso, etanólico y metanólico de Capsicum pubescens, «Rocoto¼ / Phytochemical Study, Acute Toxicity and Anti-ulcerous and Anti-tumoral Effects of the Aqueous, Ethanolic and Methanolic Extracts of Capsicum pubescens, «Rocoto¼

Objetivo: Evaluar la composición química, la toxicidad aguda y los efectos antiulceroso y antitumoral de tres extractos de Capsicum pubescens (ROCOTO) en estudios preclínicos. Materiales y métodos: Estudio experimental preclínico, analítico. Utilizamos 50 ratas albinas machos para evaluar el efecto antiulceroso y 86 ratones albinos para evaluar el efecto antitumoral y la toxicidad aguda. El tamizado fitoquímico se realizó con el método de Ciulei. Para producir las úlceras gástricas usamos Indometacina como agente ulcerígeno. El efecto antitumoral de Capsicum pubescens, fue evaluado frente al sarcoma-180. La toxicidad aguda (DL-50) fue evaluada con dosis de 500, 1000, 2000, 10000 y 12000 mg/kg de peso de rocoto. Resultados: En el estudio fitoquímico, detectamos grasas, aceites, alcaloides, lactonas, coumarinas, triterpenos, esteroides, catequinas, resinas, azúcares reductores, fenoles y taninos, entre otros. Apreciamos reducción de las lesiones gástricas macroscópicas producidas por indometacina con los extractos acuoso y etanólico de rocoto, superiores a los de la ranitidina. No observamos mortalidad en los ratones hasta la dosis de 12,000 mg/kg de peso, del extracto metanólico de rocoto. El extracto metanólico de rocoto, mejoró la sobrevida de los ratones inoculados con sarcoma, cuando se administró preventivamente, siendo mayor el efecto a la dosis de 750 mg/kg. Conclusiones: Los extractos acuoso y etanólico de rocoto, presentaron propiedades gastroprotectoras, dosis dependiente, superiores a Ranitidina, y el extracto metanólico presentó efecto antitumoral frente al sarcoma-180, administrado preventivamente y es, prácticamente, atóxico según los criterios de Williams.

Factores de riesgo cardiovascular en síndrome metabólico / Cardiovascular risk factors in metabolic syndrome

El síndrome metabólico es un grupo de factores de riesgo para desarrollar evento coronario; alteración del metabolismo de la glucosa, diabetes, obesidad abdominal, dislipidemia e hipertensión forman parte de él. Seestima que una cuarta parte de la población adulta lo presenta, tienen dos veces de riesgo de morir y tresveces más riesgo de padecer algún evento coronario o evento Cerebrovascular comparado a quienes no lopresentan. También las personas tienen cinco veces más posibilidad de desarrollar diabetes tipo 2. Laspatologías que lo conforman, parecen tener una interrelación fisiopatológica, que las va uniendo. Laspoblaciones latinoamericanas presentan características que las hacen especialmente susceptibles a padecerestas patologías cardio-metabólicas. El reconocimiento de estas características en los pacientes tiene unaimportancia especial debido a que indica la necesidad de aplicar medidas activas para reducir el riesgo cardiovascular.

Metabolic syndrome is a group of the most dangerous risk factors for coronary event, alteration in glucosemetabolism; diabetes, abdominal obesity, dyslipidemia and hypertension are components of this. It isestimated that a quarter of the adult population has it, they have twice probabilities to die, three times as likelyto coronary event or Cerebrovascular event compared to those do not have it. Also people are five times morelikely at risk for type 2 Diabetes. The pathologies that comprise it seem to have a pathophysiologicalinterrelationship, which puts together. Latin American populations have characteristics that make themespecially susceptible to these cardiometabolic diseases. Recognition of these characteristics in patients isparticularly important because it indicates the need for active measures to reduce cardiovascular risk.