Utilization of an immunochromatographic lateral flow assay for rapid detection of carbapenemase production in gram negative bacilli.

BACKGROUND: Rapid detection of carbapenemase production in gram negative bacilli has important treatment considerations. OBJECTIVE: We evaluated a lateral flow assay (LFA) for carbapenemase production compared with molecular detection of 5 (blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48) carbapenemase genes. METHODS: A total of 218 carbapenem nonsusceptible strains, including species of Enterobacterales, Pseudomonas aeruginosa isolated from clinical cultures were tested using the Cepheid Xpert Carba-R assay and the NG Biotech Carba-5 lateral flow immunoassay. RESULTS: Overall agreement with LFA was 98.2% with accuracy for each target >99% compared with polymerase chain reaction. Results were available within 15 minutes compared with 1 hour for molecular detection. CONCLUSION: The use of accurate, rapid diagnostics compliments antimicrobial stewardship programs.

Relationship between Quality of Life and the Complexity of Default Mode Network in Resting State Functional Magnetic Resonance Image in Down Syndrome.

BACKGROUND: The study of the Default Mode Network (DMN) has been shown to be sensitive for the recognition of connectivity patterns between the brain areas involved in this network. It has been hypothesized that the connectivity patterns in this network are related to different cognitive states. PURPOSE: In this study, we explored the relationship that can be estimated between these functional connectivity patterns of the DMN with the Quality-of-Life levels in people with Down syndrome, since no relevant data has been provided for this population. METHODS: 22 young people with Down syndrome were evaluated; they were given a large evaluation battery that included the Spanish adaptation of the Personal Outcome Scale (POS). Likewise, fMRI sequences were obtained on a 3T resonator. For each subject, the DMN functional connectivity network was studied by estimating the indicators of complexity networks. The variability obtained in the Down syndrome group was studied by taking into account the Quality-of-Life distribution. RESULTS: There is a negative correlation between the complexity of the connectivity networks and the Quality-of-Life values. CONCLUSIONS: The results are interpreted as evidence that, even at rest, connectivity levels are detected as already shown in the community population and that less intense connectivity levels correlate with higher levels of Quality of Life in people with Down syndrome.

A Mixed-Methods Study to Examine the Role of Psychosocial Stress and Air Pollution on Hypertension in Mexican-Origin Hispanics.

PURPOSE: Independent and combined effects of air pollution and psychosocial stressors on hypertension, a risk factor for cardiovascular disease, among Hispanics are not well studied. METHODS: We administered a pilot-tested questionnaire on individual- and neighborhood-level psychosocial stressors, developed with community input, to nearly 2500 individuals from the MD Anderson Cancer Center cohort of Mexican-Americans. We used data from local air quality monitors to estimate individual exposures to ozone (O3) and fine particulate matter (PM2.5) for the 12-month period preceding enrollment using inverse distance interpolation. We applied logistic regression models to examine relationships between exposures to psychosocial stressors and air pollution with prevalent hypertension and used stratified analyses to examine the interacting effects of these two exposures on hypertension. RESULTS: There was a positive association between prevalent hypertension and a high frequency of feeling anxious or depressed (prevalence odds ratio (POR) = 1.36, 95% CI [1.06-1.75]) and experiencing aches and pains (POR = 1.29, 95% CI [1.01-1.64]). The odds of having hypertension were also elevated among those worrying about their own health (POR = 1.65, 95% CI [1.30-2.06]) or about not having enough money (POR = 1.27, 95% CI [1.01-1.6]). We observed an inverse association between O3 and hypertension. There was no interaction between psychosocial stressors and O3 on hypertension. CONCLUSION: Our findings add to the evidence of a positive association between individual and family stressors on hypertension among Hispanics and other racial/ethnic groups. Contrary to previous studies reporting positive associations, our results suggest that long-term exposure to O3 may be inversely related to prevalent hypertension.

Empathy, schizophrenia and violence: a systematic review.

BACKGROUND: A small but significant association between schizophrenia and violence is open to a number of explanations. Impaired empathy has been associated with schizophrenia, and with violence in the general population. Our aim was to conduct a systematic review of any research into relationships between schizophrenia, empathy and violence. METHODS: The electronic databases Medline, Psychinfo, Embase, Cochrane and DARE were searched using combinations of terms for schizophrenia, empathy and violence, as were selected journals and reference lists of relevant articles. Selection of studies and data extraction was done by each of us, blind to the other. RESULTS: Six studies were identified, but sample selection, research procedures and empathy, illness and violence measures differed sufficiently between them that only descriptive analysis was possible. Apart from one single case study, sample sizes were between 24 (12 violent) and 116 (35 violent). A component of emotional empathy (emotion recognition) was measured in three of the studies, all of which showed some specific dysfunctional recognition related to violence. Cognitive empathy was measured in three studies, two linking impairments to violence and one not. Emotional responsiveness was measured in one study and no association with violence was found. CONCLUSION: Although evidence is inconclusive on empathy impairment as a mediator of violence by people with chronic psychosis, it's likely relevance is most apparent in the better controlled studies. Larger scale studies are indicated with rigorous control for comorbidities.

Myeloperoxidase is an early biomarker of inflammation and cardiovascular risk in prepubertal obese children.

OBJECTIVE: Obesity is associated with a state of chronic low-grade inflammation. Myeloperoxidase (MPO) plays an important role in the initiation and progression of acute and chronic inflammatory diseases, such as cardiovascular disease (CVD). The objectives of the current study were to evaluate plasma MPO levels in prepubertal obese children and to determine whether MPO could be an early biomarker of inflammation and CVD risk. RESEARCH DESIGN AND METHODS: In a prospective multicenter case-control study paired by age and sex of 446 Caucasian prepubertal children ages 6-12 years, 223 normal-weight and 223 obese children were recruited. Blood pressure, waist circumference, weight, and height were measured. In addition to MPO, glucose, insulin, metabolic lipid parameters, oxidized low-density lipoproteins, adiponectin, leptin, resistin, C-reactive protein (CRP), interleukin 6, tumor necrosis factor α, matrix metalloproteinase-9 (MMP-9), and plasminogen activator inhibitor 1 were determined. RESULTS: We found that MPO was elevated in prepubertal obese children and that this enzyme was associated with such proinflammatory and cardiovascular risk biomarkers as CRP, MMP-9, and resistin. Insulin resistance calculated by the homeostatic assessment model was the best predictor of MPO. CONCLUSIONS: MPO is an early biomarker of inflammation associated with CVD risk in obese children at the prepubertal age.

Trastorno bipolar en la infancia de causa orgánica / Childhood Bipolar Disorder due to organic causes

La búsqueda de las bases orgánicas de las enfermedades mentales es uno de los objetivos históricos de la psiquiatría. Frente a otros supuestos etiológicos de difícil verificación, la constatación de bases orgánicas acerca a la psiquiatría al resto de las especialidades médicas. Dicha disfunción puede ser primaria (si afecta al cerebro de manera directa o selectiva) o secundaria (si la disfunción afecta a diversos órganos o sistemas, entre ellos el cerebro). La comunicación de Casos Clínicos en los que se evidencia la conexión entre el substrato lesional y la expresión psicopatológica puede resultar ilustrativa y, en ocasiones, orientar futuras investigaciones. Presentamos dos Casos Clínicos de sintomatología sugerente de Trastorno Bipolar en la infancia, secundarios ambos a causa orgánica

The search for organic bases of mental illnesses is one of the central goals of psychiatry. Unlike other etiological hypotheses hard to verify, the search for organic bases brings psychiatry closer to other medical specialities. Such dysfunction may be primary (if it affects the brain directly or selectively) or secondary (if the dysfunction concerns various organs or systems including the brain). Reporting clinical cases in which there are clear connections between substrate damage and psychopathological expression can be illuminating, and occasionally a guide for future research. Two cases are presented with symptoms suggestive of childhood bipolar disorder, both due to organic causes

A theoretical study of the low-lying excited states of thieno[3,4-b]pyrazine.

The low-lying electronic excited states of thieno[3,4-b]pyrazine have been studied using the multiconfigurational second-order perturbation CASPT2 theory with extended atomic natural orbital basis sets. The CASPT2 results allow for a full interpretation of the electronic absorption and emission spectra and provide valuable information for the rationalization of the experimental data. The nature, position, and intensity of the spectral bands have been analyzed in detail. A preliminary comparative study of the ground-state geometry of thieno[3,4-b]pyrazine has been performed at the coupled cluster single and doubles and density functional theory levels using a variety of correlation-consistent basis sets. Thieno[3,4-b]pyrazine exhibits a polyene-like structure in the ground state due to the bond localization in the pyrazine moiety. An aromatization of the pyrazine unit is predicted for the lowest-energy electronic excited states.

[Updates in hemodialysis]. / Actualizaciones en hemodiálisis.

One of the topics of most concern for nephrologists today is how to reduce the mortality of our patients and we try to have markers to help us know which patients are at greatest risk. Cardiovascular disease is one of the main causes of morbidity and mortality in patients with chronic kidney disease. Oxidative stress, inflammation and endothelial dysfunction have been recognized as nontraditional cardiovascular risk factors, but they are achieving growing importance. On the other hand, quality management systems are being applied on an increasing basis in routine clinical practice, demonstrating that the way of working in the center may be a key factor in the results obtained.

Regulación de la temperatura del recién nacido después del baño / Temperature regulation of the newborn following bath

Este estudio se realizó en una Unidad de Recién Nacidos y tiene como propósito identificar los cambios significativos en la temperatura corporal del recién nacido después del baño de acuerdo con diferentes temperaturas ambientales. Participaron 15 recién nacidos con pesos entre 2000 y 4000 gramos, hospitalizados en el área de cunas, a quienes se les realizó baño diario durante cuatro días consecutivos en un horario previamente establecido y después se controló la temperatura central y del ambiente en periodos predeterminados. Los resultados muestran que no hay diferencias significativas entre las cifras halladas en la mañana y en la noche. Al evaluar el cambio de la temperatura del recién nacido, durante el tiempo de observación (0min a 60min), se encontró, a los 5 minutos del baño, un descenso de la temperatura estadísticamente significativo (P<0,01), rangos: 27 C- 36,8 C, temperatura media: 33,47 C (DE=5). Conclusión: la temperatura ambiente sí influye en la termorregulación de los recién nacidos después del baño