COVIDGR Dataset and COVID-SDNet Methodology for Predicting COVID-19 Based on Chest X-Ray Images.

Currently, Coronavirus disease (COVID-19), one of the most infectious diseases in the 21st century, is diagnosed using RT-PCR testing, CT scans and/or Chest X-Ray (CXR) images. CT (Computed Tomography) scanners and RT-PCR testing are not available in most medical centers and hence in many cases CXR images become the most time/cost effective tool for assisting clinicians in making decisions. Deep learning neural networks have a great potential for building COVID-19 triage systems and detecting COVID-19 patients, especially patients with low severity. Unfortunately, current databases do not allow building such systems as they are highly heterogeneous and biased towards severe cases. This article is three-fold: (i) we demystify the high sensitivities achieved by most recent COVID-19 classification models, (ii) under a close collaboration with Hospital Universitario Clínico San Cecilio, Granada, Spain, we built COVIDGR-1.0, a homogeneous and balanced database that includes all levels of severity, from normal with Positive RT-PCR, Mild, Moderate to Severe. COVIDGR-1.0 contains 426 positive and 426 negative PA (PosteroAnterior) CXR views and (iii) we propose COVID Smart Data based Network (COVID-SDNet) methodology for improving the generalization capacity of COVID-classification models. Our approach reaches good and stable results with an accuracy of [Formula: see text], [Formula: see text], [Formula: see text] in severe, moderate and mild COVID-19 severity levels. Our approach could help in the early detection of COVID-19. COVIDGR-1.0 along with the severity level labels are available to the scientific community through this link https://dasci.es/es/transferencia/open-data/covidgr/.

Choline induces opposite changes in pyramidal neuron excitability and synaptic transmission through a nicotinic receptor-independent process in hippocampal slices.

Choline is present at cholinergic synapses as a product of acetylcholine degradation. In addition, it is considered a selective agonist for α5 and α7 nicotinic acetylcholine receptors (nAChRs). In this study, we determined how choline affects action potentials and excitatory synaptic transmission using extracellular and intracellular recording techniques in CA1 area of hippocampal slices obtained from both mice and rats. Choline caused a reversible depression of evoked field excitatory postsynaptic potentials (fEPSPs) in a concentration-dependent manner that was not affected by α7 nAChR antagonists. Moreover, this choline-induced effect was not mimicked by either selective agonists or allosteric modulators of α7 nAChRs. Additionally, this choline-mediated effect was not prevented by either selective antagonists of GABA receptors or hemicholinium, a choline uptake inhibitor. The paired pulse facilitation paradigm, which detects whether a substance affects presynaptic release of glutamate, was not modified by choline. On the other hand, choline induced a robust increase of population spike evoked by orthodromic stimulation but did not modify that evoked by antidromic stimulation. We also found that choline impaired recurrent inhibition recorded in the pyramidal cell layer through a mechanism independent of α7 nAChR activation. These choline-mediated effects on fEPSP and population spike observed in rat slices were completely reproduced in slices obtained from α7 nAChR knockout mice, which reinforces our conclusion that choline modulates synaptic transmission and neuronal excitability by a mechanism independent of nicotinic receptor activation.

Laceración de mucosa labial por incrustación de anzuelo de pescador: un accidente poco frecuente / Labial mucosa laceration by embedding fishhook: a rare accident

Describir un caso de laceración de mucosa labial por incrustaci6n de anzuelo de pescar en lactante mayor, resaltando la terapéutica de remoción, que es un accidente poco frecuente Reporte de caso: Paciente lactante mayor masculino, de un año de edad, que acude a la Unidad de Odontopediatria del Hospital Universitario de Maracaibo por presentar objeto punzo-penetrante compatible con anzuelo de pescar en zona de mucosa vestibular del labio inferior. Bajo anestesia local, se realiza asepsia de la zona, se retira el objeto con técnica retrograda y sineresis de los tejidos con sutura reabsorbible. Se dieron indicaciones al representante de la terapia farmacológica a administrar. Conclusión: los traumatismos son la principal causa de urgencia en el área de odontopediatria, debemos conocer los procedimientos necesarios que incluyen la correcta anamnesis y la elaboraci6n de historia clínica correspondiente para seleccionar el tratamiento más adecuado para el tipo de accidente que se presente, considerando el uso de antibióticos y la aplicación de vacuna toxoide...

To describe a case of labial mucosa laceration by embedding fishhook in an infant, highlighting the therapeutic removal, because it is a rare accident. We present a case of a 5 year old boy, who attended the Operative Dental Service of the National Institute of Child Health, because he had a crown fracture previously treated in maxillary incisor. The treatment consisted in making an anterior telescopic maintainer to supply this deficiency. Case report: Patient male infant, of one year old, who came to the Dentistry Unit of the University Hospital of Maracaibo by daggersharp object file compatible with fishhook in area buccal mucosa of the lip. Under local anesthesia, antisepsis of the area is performed; the object with technical and syneresis retrograde tissue with absorbable suture is removed. Instructions were given to the representative of the drug therapy administered. Conclusion: Injuries are the leading cause of emergency in the area of dentistry, we must know the necessary procedures including correct history and the development of corresponding clinical history to select the must know the necessary procedures including correct history and the development of corresponding clinical history to select the most appropriate treatment for the type of accident that is present, considering the antibiotics and applying toxoid vaccine...

Isolation of cholesterol- and deoxycholate-degrading bacteria from soil samples: evidence of a common pathway.

Nineteen different steroid-degrading bacteria were isolated from soil samples by using selective media containing either cholesterol or deoxycholate as sole carbon source. Strains that assimilated cholesterol (17 COL strains) were gram-positive, belonging to the genera Gordonia, Tsukamurella, and Rhodococcus, and grew on media containing other steroids but were unable to use deoxycholate as sole carbon source. Surprisingly, some of the COL strains unable to grow using deoxycholate as sole carbon source were able to catabolize other bile salts (e.g., cholate). Conversely, strains able to grow using deoxycholate as the sole carbon source (two DOC isolates) were gram-negative, belonging to the genus Pseudomonas, and were unable to catabolize cholesterol and other sterols. COL and DOC were included into the corresponding taxonomic groups based on their morphology (cells and colonies), metabolic properties (kind of substrates that support bacterial growth), and genetic sequences (16S rDNA and rpoB). Additionally, different DOC21 Tn5 insertion mutants have been obtained. These mutants have been classified into two different groups: (1) those affected in the catabolism of bile salts but that, as wild type, can grow in other steroids and (2) those unable to grow in media containing any of the steroids tested. The identification of the insertion point of Tn5 in one of the mutants belonging to the second group (DOC21 Mut1) revealed that the gene knocked-out encodes an A-ring meta-cleavage dioxygenase needed for steroid catabolism.

Emerging trends in candidemia: a higher incidence but a similar outcome.

The clinical presentation and outcome of candidemia has changed in recent years. We compared two 5-year periods (2000-2004 and 2005-2009) in a single institution. We recorded 419 candidemia episodes during the study period (124 in the first period and 295 in the second period). We observed a significant increase in the number of cases per 1000 admissions per year, from 0.57 in 2000 to 1.52 in 2009 (χ(2) LT <0.001). Candida albicans was the most frequently isolated species (42.2%), followed by Candida parapsilosis (34.4%) and Candida glabrata (12.9%). In the second period, episodes were associated with higher comorbidity and were more commonly nosocomial, with a more frequent catheter-related source and an increased rate of C. glabrata infection. No significant differences were observed in susceptibility by species during the study period. According to multivariate analysis, the independent factors associated with higher mortality were shock, age >50 years, elevated comorbidity score (Charlson index >6), and source of candidemia other than catheter. In contrast to the increase in comorbid conditions observed in recent years, mortality remained similar during both periods (~37% during the first month). This finding could be attributed to a significant increase in catheter-related candidemia and better outcome, as well as to a potential improvement in the management of antifungal therapy in recent years.

[Anesthesia awareness]. / Awareness, consecuencias de una experiencia estresante.

Anesthesia awareness, or "unintended intra-operative awareness" occurs during general anesthesia, on the operating table, when a patient has not had enough general anesthetic or analgesic to prevent consciousness or waking up during surgery. According to international studies its global incidence ranges from 0.1 to 0.2%. Its impact on people can be as severe as other traumatic experiences such as natural disasters, violent fights or sexual abuse. The prevalence of symptoms compatible with post traumatic stress disorder can be as high as 50%, after experiencing the awareness phenomenon. This paper reviews the main issues of the awareness phenomenon.

Awareness, consecuencias de una experiencia estresante: [revisión] / Anesthesia awareness: [review]

Anesthesia awareness, or "unintended intra-operative awareness" occurs during general anesthesia, on the operating table, when a patient has not had enough general anesthetic or analgesic to prevent consciousness or waking up during surgery. According to international studies its global incidence ranges from 0.1 to 0.2 percent. Its impact on people can be as severe as other traumatic experiences such as natural disasters, violent fights or sexual abuse. The prevalence of symptoms compatible with post traumatic stress disorder can be as high as 50 percent, after experiencing the awareness phenomenon. This paper reviews the main issues of the awareness phenomenon.

Nuestra experiencia en el hiperaldosteronismo primario / Our experience in primary hiperaldos dosteronism

Objetivo: Analizar las formas de presentación, características clínicas, diagnóstico y tratamiento de los pacientes diagnosticados de hiperaldosteronismo primario (HA1º) en la consulta externa de nefrología desde su apertura. Método: Se realizó un estudio retrospectivo revisando todas las historias clínicas de pacientes diagnosticados de HA1º desde 1981-2005. Resultados: Se diagnosticaron un total de 35 pacientes con una edad media de 50 años con predominio de varones (82%). El motivo principal de inicio de estudio de HA1º fue la hipertensión arterial (HTA) rebelde, seguido de hipertensión más hipopotasemia(34%). Dieciséis casos eran adenomas (7 adenomas clásicos y 9 renino-dependientes) y 14 hiperplasias (10 hiperplasias bilaterales y 4 hiperplasias adrenales primarias). Cinco casos fueron excluidos del estudio por encontrarse en el momento de realización del estudio pendientes de pruebas complementarias. Para diagnóstico de localización la prueba que mostró más concordancia con el diagnóstico final fue la gammgrafía I-131colesterol seguida de la RMN y la TAC. En 8 casos se realizó muestreo venoso suprarrenal. Fueron intervenidos 10 de los 16 adenomas con resultado de normalización de cifras tensionales sin tratamiento en el 60% de ellos. El resto de los casos se encuentran en tratamiento con espironolactona con adecuado control tensional. El efecto adverso más frecuente fue la ginecomastia. Conclusión: En contra de lo publicado en la literatura, en nuestra serie observamos un claro predominio de varones. Obtuvimos una similar incidencia de adenomas e hiperplasias. La forma de presentación más frecuente fue la hipertensión arterial rebelde al tratamiento. La opción quirúrgica de los adenomas no significa un resultado curativo, pero sí un mejor controlde las cifras tensionales con menos fármacos y una disminución de los niveles de aldosterona con el consiguiente descenso de la toxicidad miocárdica y vascular (AU)

Aims: The aim of this paper is to analyze the ways of appearance, clinical characteristics, diagnosis and treatment related to patients suffering from primary hyperaldosteronism (HA1º) in external nephrology consultation since their opening. Methodology: A retrospective study was carried out, checking out all HA1º diagnosed patients of clinicalrecords from 1981-2005. Results: 35 patients were diagnosed,with an average age of 50 and a predominance of men (82%). The main reason for starting the HA1º study was persistent hypertension; other reasons were hypertension and hypopotassemia (34%). Sixteen of the cases were adenomas (7 classic adenomas and 9 renin-dependents) and fourteen of them were hyperplasia (10 bilateral hyperplasias and 4 primary adrenals hyperplasia). Five cases were excluded because they were waiting for complementary tests. For location diagnosis, gammagrafía I-131cholesterol was the test showing more agreement with final diagnosis, and then RMN and TAC. In eight of the cases, an adrenal vein sampling was made. Ten of sixteen adenomas suffered a surgery performance. The result showed standardization of tensional levels, without any treatment in 60% of the cases. The rest of them are currently treated with spironolactone under an appropriate tensionalcontrol. Gynecomastia was the most usual adverse effect found. Conclusion: Contrary to other published papers, we found out a male predominance in our database. A similar incidence of adenomas e hyperplasias was obtained. The most usual way of appearance was persistent hypertension to treatment. Adenomas surgery does not implyhealing results, though it achieves a better tensional levels control, using less drugs and diminishing aldosterone levels. It implies a descent in myocardic and vascular toxicity (AU)

[Hierarchical clustering analysis to detect associations between clinical and pathological features of gastric tumors and hypermethylation of suppressor genes]. / Identificación de asociaciones clínico-patológicas e hipermetilación de genes supresores de tumores en cáncer gástrico difuso a través de análisis de Hierarchical clustering.

BACKGROUND: Methylation is an inactivation mechanism for tumor suppressor genes, that can have important clinical implications. AIM: To analyze the methylation status of 11 tumor suppressor genes in pathological samples of diffuse gastric cancer. MATERIAL AND METHODS: Eighty three patients with diffuse gastric cancer with information about survival and infection with Epstein Barr virus, were studied. DNA was extracted from pathological slides and the methylation status of genes p14, p15, p16, APC, p73, FHIT, E-cadherin, SEMA3B, BRCA-1, MINT-2 y MGMT, was studied using sodium bisulphite modification and polymerase chain reaction. Results were grouped according to the methylation index or Hierarchical clustering (TIGR MultiExperiment Viewer). RESULTS: Three genes had a high frequency of methylation (FHIT, BRCA1, APC), four had an intermediate frequency (p15, MGMT, p14, MINT2) and four had a low frequency (p16, p73, E-cadherin, SEMA3B). The methylation index had no association with clinical or pathological features of tumors or patients survival. Hierarchical clustering generated two clusters. One grouped clinical and pathological features with FHIT, BRCA1, and APC and the other grouped the other eight genes and Epstein Barr virus infection. Two significant associations were found, between APC and survival and p16/p14 and Epstein Barr virus infection. CONCLUSIONS: Hierarchical clustering is a tool that identifies associations between clinical and pathological features of tumors and methylation of tumor suppressor genes.

Identificación de asociaciones clínico-patológicas e hipermetilación de genes supresores de tumores en cáncer gástrico difuso a través de análisis de Hierarchical clustering / Hierarchical clustering analysis to detect associations between clinical and pathological features of gastric tumors and hypermethylation of suppressor genes

Background:Methylation is an inactivation mechanism for tumor suppressor genes, that can have important clinical implications. Aim: To analyze the methylation status of 11 tumor suppressor genes in pathological samples of diffuse gastric cancer. Material and methods: Eighty three patients with diffuse gastric cancer with information about survival and infection with Epstein Barr virus, were studied. DNA was extracted from pathological slides and the methylation status of genes p14, p15, p16, APC, p73, FHIT, E-caderin, SEMA3B, BRCA-1, MINT-2 y MGMT, was studied using sodium bisulphite modification and polymerase chain reaction. Results were grouped according to the methylation index or Hierarchical clustering (TIGR MultiExperiment Viewer). Results: Three genes had a high frequency of methylation (FHIT, BRCA1, APC), four had an intermediate frequency (p15, MGMT, p14, MINT2) and four had a low frequency (p16, p73, E-cadherin, SEMA3B). The methylation index had no association with clinical or pathological features of tumors or patients survival. Hierarchical clustering generated two clusters. One grouped clinical and pathological features with FHIT, BRCA1, and APC and the other grouped the other eight genes and Epstein Barr virus infection. Two significant associations were found, between APC and survival and p16/p14 and Epstein Barr virus infection. Conclusions: Hierarchical clustering is a tool that identifies associations between clinical and pathological features of tumors and methylation of tumor suppressor genes.

[Our experience in primary hyperaldosteronism]. / Nuestra experiencia en el hiperaldosteronismo primario.

UNLABELLED: The aim of this paper is to analyze the ways of appearance, clinical characteristics, diagnosis and treatment related to patients suffering from primary hyperaldosteronism (HA1 masculine) in external nephrology consultation since their opening. METHODOLOGY: a retrospective study was carried out, checking out all HA1 masculine diagnosed patients of clinical records from 1981-2005. RESULTS: 35 patients were diagnosed, with an average age of 50 and a predominance of men (82%). The main reason for starting the HA1 masculine study was persistent hypertension; other reasons were hypertension and hypopotassemia (34%). Sixteen of the cases were adenomas (7 classic adenomas and 9 renin-dependents) and fourteen of them were hyperplasia (10 bilateral hyperplasias and 4 primary adrenals hyperplasia). Five cases were excluded because they were waiting for complementary tests. For location diagnosis, gammagrafía I131cholesterol was the test showing more agreement with final diagnosis, and then RMN and TAC. In eight of the cases, an adrenal vein sampling was made. Ten of sixteen adenomas suffered a surgery performance. The result showed standardization of tensional levels, without any treatment in 60% of the cases. The rest of them are currently treated with spironolactone under an appropriate tensional control. Gynecomastia was the most usual adverse effect found. CONCLUSION: Contrary to other published papers, we found out a male predominance in our database. A similar incidence of adenomas e hyperplasias was obtained. The most usual way of appearance was persistent hypertension to treatment. Adenomas surgery does not imply healing results, though it achieves a better tensional levels control, using less drugs and diminishing aldosterone levels. It implies a descent in myocardic and vascular toxicity.

Influence of nanoencapsulation on human skin transport of flufenamic acid.

The effect of the inclusion of flufenamic acid in poly(lactide-co-glycolide) nanoparticles on the transport of flufenamic acid into excised human skin was investigated. Penetration and permeation data were acquired using two different in vitro test systems: the Saarbrucken penetration model, where the skin acts as its own receptor medium, and the Franz diffusion cell, where the receptor medium is a buffer solution. For the stratum corneum, no differences were found between nanoencapsulated and free drug. Drug accumulation in the deeper skin layers and drug transport across human epidermis were slightly delayed for the nanoencapsulated drug compared to the free drug after shorter incubation times (<12 h). In contrast, after longer incubation times (>12 h), the nanoencapsulated drug showed a statistically significantly enhanced transport and accumulation (p < 0.05). Additionally, nanoencapsulated flufenamic acid was visualized by multiphoton fluorescence microscopy. Particles were found homogeneously distributed on the skin surface and within the dermatoglyphs, but no nanoparticles were detected within or between the corneocytes.

Potential use of a Yersinia ruckeri O1 auxotrophic aroA mutant as a live attenuated vaccine.

The aroA gene of Yersinia ruckeri, which encodes 5-enolpyruvylshikimate 3-phosphate synthase, was insertionally inactivated with a DNA fragment containing a kanamycin resistance determinant and reintroduced by allelic exchange into the chromosome of Y. ruckeri 21102 O1 by means of the suicide vector pIVET8. The Y. ruckeri aroA::Kan(r) mutant was highly attenuated when inoculated intraperitoneally into rainbow trout, with a 50% lethal dose of >5 x 10(7) CFU. The mutants were not recoverable from the internal organs 48 h post-inoculation or later. The vaccination of rainbow trout with the AroA mutant as a live vaccine conferred significant protection (relative percentage survival = 90%) against the pathogenic wild-type strain of Y. ruckeri.

Reconstrucción microquirúrgica de cabeza y cuello: revisión de dos años de experiencia en nuestro servicio

Introducción. La reconstrucción de los grandes defectos de cabeza y cuello, especialmente de tipo oncológico ha experimentado un avance considerable en los últimos años merced a la inclusión de las técnicas microquirúrgicas como elemento terapéutico básico. En la actualidad, la realización convencional de este tipo de técnicas es imprescindible en cualquier Servicio de Cirugía Maxilofacial que se ocupe de esta patología. Incluímos en este concepto servicios de reciente remodelación y en fase de expansión, como el del Complejo Hospitalario Juan Canalejo de La Coruña. Material y Método. En los dos últimos años se han realizado 67 reconstrucciones microquirúrgicas en nuestro Servicio. Presentamos nuestra experiencia al respecto, incidiendo en los resultados obtenidos hasta el momento, las complicaciones que nos hemos encontrado y la morbilidad en zonas donantes. Resultados. En nuestro Servicio, 59 de las 67 reconstrucciones han sido viables. Los resultados obtenidos, considerando la morbilidad asociada y la situación actual de nuestros pacientes, se pueden cataogar como satisfactorios. Conclusiones. La realización de reconstrucciones microquirúrgicas en grades defectos orofaciales debe constituir una actividad convencional en cualquier Servicio de Cirugía Maxilofacial. Las ventajas funcionales y estéticas que aportan estas técnicas justifican plenamente los costes que suponen (AU)

Microbial synthesis of poly(beta-hydroxyalkanoates) bearing phenyl groups from pseudomonas putida: chemical structure and characterization.

New poly(beta-hydroxyalkanoates) having aromatics groups (so-called PHPhAs) from a microbial origin have been characterized. These polymers were produced and accumulated as reserve materials when a beta-oxidation mutant of Pseudomonas putida U, disrupted in the gene that encodes the 3-ketoacyl-CoA thiolase (fadA), was cultured in a chemically defined medium containing different aromatic fatty acids (6-phenylhexanoic acid, 7-phenylheptanoic acid, a mixture of them, or 8-phenyloctanoic acid) as carbon sources. The polymers were extracted from the bacteria, purified and characterized by using (13)C nuclear magnetic resonance spectroscopy (NMR), gel permeation chromatography (GPC), and differential scanning calorimetry (DSC). Structural studies revealed that when 6-phenylhexanoic acid was added to the cultures, an homopolymer (poly-3-hydroxy-6-phenylhexanoate) was accumulated. The feeding with 8-phenyloctanoic acid and 7-phenylheptanoic acid leads to the formation of copolymers of the corresponding units with the n - 2 carbons formed after deacetylation, copoly(3-hydroxy-8-phenyloctanoate-3-hydroxy-6-phenylhexanoate) and copoly(3-hydroxy-7-phenylheptanoate-3-hydroxy-5-phenylvalerate), respectively. The mixture of 6-phenylhexanoic acid and 7-phenylheptanoic acid gave rise to the corresponding terpolymer, copoly(3-hydroxy-7-phenylheptanoate-3-hydroxy-6-phenylhexanoate-3-hydroxy-5-phenylvalerate). Studies on the chemical structure of these three polyesters revealed that they were true copolymers but not a mixture of homopolymers and that the different monomeric units were randomly incorporated in the macromolecular chains. Thermal behavior and molecular weight distribution were also discussed. These compounds had a dual attractive interest in function of (i) their broad use as biodegradable polymers and (ii) their possible biomedical applications.

Genetically engineered Pseudomonas: a factory of new bioplastics with broad applications.

New bioplastics containing aromatic or mixtures of aliphatic and aromatic monomers have been obtained using genetically engineered strains of Pseudomonas putida. The mutation (-) or deletion (Delta) of some of the genes involved in the beta-oxidation pathway (fadA(-), fadB(-) Delta fadA or Delta fad BA mutants) elicits a strong intracellular accumulation of unusual homo- or co-polymers that dramatically alter the morphology of these bacteria, as more than 90% of the cytoplasm is occupied by these macromolecules. The introduction of a blockade in the beta-oxidation pathway, or in other related catabolic routes, has allowed the synthesis of polymers other than those accumulated in the wild type (with regard to both monomer size and relative percentage), the accumulation of certain intermediates that are rapidly catabolized in the wild type and the accumulation in the culture broths of end catabolites that, as in the case of phenylacetic acid, phenylbutyric acid, trans-cinnamic acid or their derivatives, have important medical or pharmaceutical applications (antitumoral, analgesic, radiopotentiators, chemopreventive or antihelmintic). Furthermore, using one of these polyesters (poly 3-hydroxy-6-phenylhexanoate), we obtained polymeric microspheres that could be used as drug vehicles.

Hydrazinonaphthalene and azonaphthalene thrombopoietin mimics are nonpeptidyl promoters of megakaryocytopoiesis.

High-throughput screening for the induction of a luciferase reporter gene in a thrombopoietin (TPO)-responsive cell line resulted in the identification of 4-diazo-3-hydroxy-1-naphthalenesulfonic acids as TPO mimics. Modification of the core structure and adjustment of unwanted functionality resulted in the development of (5-oxo-1,5-dihydropyrazol-4-ylidene)hydrazines which exhibited efficacies equivalent to those of TPO in several cell-based assays designed to measure thrombopoietic activity. Furthermore, these compounds elicited biochemical responses in TPO-receptor-expressing cells similar to those in TPO itself, including kinase activation and protein phosphorylation. Potencies for the best compounds were high for such low molecular weight compounds (MW < 500) with EC(50) values in the region of 1-20 nM.