Healthy Life Habits in Caregivers of Children in Vulnerable Populations: A Cluster Analysis.

Intervention programs aimed at mitigating the effects of chronic noncommunicable disease (CNDs) focus on promoting healthy lifestyle habits (HLH), especially in the early stages of life. Because of this, different typologies of caregivers have been identified according to HLH during middle childhood and adolescence. However, the available studies have focused on aspects such as nutrition, physical activity, and rest, ignoring other HLHs that are equally important for children's well-being. Likewise, few studies address HLH during the first five years of life and how caregivers affect children's health. In a sample of 544 caregivers of children aged zero to five years from low-income Colombian communities, we established a typology of attitudes toward different HLHs. The results indicate the presence of three clusters that grouped caregivers with (1) positive attitudes toward all HLHs, (2) toward some HLHs, and (3) relatively low positive attitudes toward all HLHs. Membership in clusters with less positive attitudes toward HLHs was also found to be associated with low educational levels and living in rural areas. This study detected profiles of caregivers who may have unhealthy lifestyles, so the results would allow social workers to design differential interventions on HLHs in non-industrialized countries.

Structure-function of type I and III interferons.

Type I and type III interferons (IFNs) are major components in activating the innate immune response. Common to both are two distinct receptor chains (IFNAR1/IFNAR2 and IFNLR1/IL10R2), which form ternary complexes upon binding their respective ligands. This results in close proximity of the intracellularly associated kinases JAK1 and TYK2, which cross phosphorylate each other, the associated receptor chains, and signal transducer and activator of transcriptions, with the latter activating IFN-stimulated genes. While there are clear similarities in the biological responses toward type I and type III IFNs, differences have been found in their tropism, tuning of activity, and induction of the immune response. Here, we focus on how these differences are embedded in the structure/function relations of these two systems in light of the recent progress that provides in-depth information on the structural assembly of these receptors and their functional implications and how these differ between the mouse and human systems.

Structural insights into the formation of repulsive netrin guidance complexes.

Netrins dictate attractive and repulsive responses during axon growth and cell migration, where the presence of the receptor Uncoordinated-5 (UNC-5) on target cells results in repulsion. Here, we showed that UNC-5 is a heparin-binding protein, determined its structure bound to a heparin fragment, and could modulate UNC-5-heparin affinity using a directed evolution platform or structure-based rational design. We demonstrated that UNC-5 and UNC-6/netrin form a large, stable, and rigid complex in the presence of heparin, and heparin and UNC-5 exclude the attractive UNC-40/DCC receptor from binding to UNC-6/netrin to a large extent. Caenorhabditis elegans with a heparin-binding-deficient UNC-5 fail to establish proper gonad morphology due to abrogated cell migration, which relies on repulsive UNC-5 signaling in response to UNC-6. Combining UNC-5 mutations targeting heparin and UNC-6/netrin contacts results in complete cell migration and axon guidance defects. Our findings establish repulsive netrin responses to be mediated through a glycosaminoglycan-regulated macromolecular complex.

Massive Pulmonary Embolism Related to a Patient With Heart Failure Secondary to Stress Cardiomyopathy: A Case Report.

Venous thromboembolism (VTE) is a common disease, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE). It is the third most common cardiovascular disorder, affecting predominantly the male elderly population. Stress cardiomyopathy (SC) is a transitorily cardiovascular condition produced after an emotional or physical trigger, and it features signs and symptoms of acute coronary syndrome. Its pathophysiological mechanisms remain unclear, and SC has also been related to critical complications such as heart failure, arrhythmias, left ventricular outflow obstruction, and thromboembolic events. This case report highlights the association of PE and SC that might play a pathophysiological role.

A Single Transradial Guiding Catheter in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Door-to-Balloon Optimized Strategy.

Background Acute coronary syndrome (ACS) is the leading cause of morbidity and mortality worldwide. The different reperfusion strategies have evolved over the years, and efforts have been directed to reduce its complications. Among these strategies, the one that has shown the best results is percutaneous coronary intervention, which has significantly improved the survival and prognosis of these patients; however, this procedure is not free of complications since multiple factors are involved. Among them is the time of patient care from the time of diagnosis until the coronary reperfusion therapy is performed. Methodology In this study, we describe the experience in our center with the 6-French Ikari Left guide catheter as a strategy of radial angiography-angioplasty with a single catheter to reduce the care times of patients with acute ST-elevation myocardial infarction (STEMI) in our center and compare it with the series reported by other international centers since. To establish an alternative to the usual approach that consists of the use of Judkins catheters, diagnosis, and guiding. Results Our study showed a success rate for diagnostic angiography and percutaneous coronary intervention (PCI) with the 6- French Ikari Left catheter comparable to those obtained in other centers, even with lower complication rates than the usual approach with Judkins' Catheters. Conclusions The use of the 6-French Ikari Left catheter demonstrated shorter needle-device time and compared to other international series, it was shown to be shorter and related to shorter fluoroscopy time. Our study has a small sample and only included a highly selected population, which represents a limitation. This study is vulnerable to the different practices of the operators, with involvement in procedure time and use of contrast volume.

[Effect of weight gain on the development of gestational diabetes]. / Efecto de la ganancia ponderal en el desarrollo de diabetes gestacional.

Background: Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second or third trimester of pregnancy. Assessing the weight gain in each pregnant women's appointment is a common task of primary care during their visit. However, the implications of this increase in weight for the development of GDM are unknown. Objective: Evaluate if the greater than expected weight gain (HEWG) in pregnancy is a risk factor for the development of GDM. Methods: Analytical, observational, longitudinal, retrolective study, which included pregnant women between 15 and 40 years of age with complete follow-up of the preg-nancy with > 2 prenatal check-ups, somatometry and complete medical history was made. During follow-up, the GPME was determined. Odds ratio (OR) and 95% confi-dence intervals (95% CI) were calculated. Variables with significance were entered into a multiple logistic regression model (MLR), where the dependent variable was DMG. The sample size calculation was for convenience. Results: 1000 pregnant women with a median age of 28 years were included. In the MLR The pre-gestational body mass index (BMI) with overweight had an RM of 1.3 (95% CI 0.86-1.98), BMI with obesity an OR of 2.57 (95% CI 1.6-4.14), the HEWG during pregnancy had an OR 1.14 95% CI (0.71-1.81), Age> 30 years shows an RM of 2.24 (95% CI 1.55-3.25). Conclusions: HEWG during pregnancy is not an independent risk factor for the devel-opment of GDM. The main ones are age> 30 years and pre-gestational obesity.

Introducción: la diabetes mellitus gestacional (DMG) se refiere a la diabetes diagnosti-cada a partir del segundo trimestre del embarazo. Evaluar el incremento de peso de mu-jeres embarazadas es una labor habitual en la consulta del primer nivel de atención. Sin embargo, se desconocen las implicaciones que tiene este incremento ponderal para el desarrollo de DMG. Objetivo: evaluar si la ganancia ponderal mayor a la esperada (GPME) en el embarazo es factor de riesgo para el desarrollo de DMG. Métodos: estudio analítico, observacional, longitudinal, retrolectivo, que incluyó a em-barazadas de 15 a 40 años con seguimiento completo del embarazo con más de dos consultas de control prenatal, somatometría e historia clínica completa. Durante el se-guimiento se determinó la GPME. Se calculó razón de momios (RM) e intervalos de confianza del 95% (IC95%). Las variables con significancia se ingresaron a un modelo de regresión logística múltiple (RLM), en donde la variable de desenlace fue DMG. Resultados: se incluyeron a 1000 embarazadas con mediana de edad de 28 años. En la RLM el índice de masa corporal (IMC) pre-gestacional con sobrepeso tuvo una RM de 1.3 (IC95%: 0.86-1.98), IMC con obesidad una RM de 2.57 (IC95%: 1.6-4.14), la GPME durante el embarazo tuvo una RM de 1.14 (IC95%: 0.71-1.81) y la edad > 30 años una RM de 2.24 (IC95%: 1.55-3.25). Conclusiones: la GPME durante el embarazo no es un factor de riesgo independiente para el desarrollo de DMG. Los principales son la edad >30 años y la obesidad preges-tacional.

Molecular analysis of the type III interferon complex and its applications in protein engineering.

Type III interferons (IFNλs) are cytokines with critical roles in the immune system and are attractive therapeutic candidates due to their tissue-specific activity. Despite entering several clinical trials, results have demonstrated limited efficacy and potency, partially attributed to low-affinity protein-protein interactions (PPIs) responsible for receptor complex formation. Subsequently, structural studies of the native IFNλ signaling complexes remain inaccessible. While protein engineering can overcome affinity limitations, tools to investigate low-affinity systems like these remain limited. To provide insights into previous efforts to strengthen the PPIs within this complex, we perform a molecular analysis of the extracellular ternary complexes of IFNλ3 using both computational and experimental approaches. We first use molecular simulations and modeling to quantify differences in PPIs and residue strain fluctuations, generate detailed free energy landscapes, and reveal structural differences between an engineered, high-affinity complex, and a model of the wild-type, low-affinity complex. This analysis illuminates distinct behaviors of these ligands, yielding mechanistic insights into IFNλ complex formation. We then apply these computational techniques in protein engineering and design by utilizing simulation data to identify hotspots of interaction to rationally engineer the native cytokine-receptor complex for increased stability. These simulations are then validated by experimental techniques, showing that a single mutation at a computationally predicted site of interaction between the two receptors increases PPIs and improves complex formation for all IFNλs. This study highlights the power of molecular dynamics simulations for protein engineering and design as applied to the IFNλ family but also presents a potential tool for analysis and engineering of other systems with low-affinity PPIs.

Psychometric properties of a Spanish translation of the Functionality Appreciation Scale (FAS) in adults from Colombia.

The 7-item Functionality Appreciation Scale (FAS) measures the extent of an individual's appreciation of their body for what it can do and is capable of doing. Although the FAS has been widely used in diverse linguistic contexts, it has not been previously translated into Spanish. Here, we examined the psychometric properties of a novel Spanish translation of the FAS in Colombian adults. A total of 1420 university students from Colombia (804 women, 616 men) completed the FAS, as well as additional validated measures. Exploratory and confirmatory factor analyses in separate subsamples supported a unidimensional model of FAS scores. The FAS evidenced scalar invariance across gender identity, with men having significantly higher FAS scores than women (Cohen's d = 0.18). FAS scores were also found to have adequate composite reliability, as well as adequate convergent (significant associations with body appreciation, appearance evaluation, and eating disorder psychopathology) and concurrent validity (significant associations with self-esteem, life satisfaction, and gratitude). Functionality appreciation incrementally predicted life satisfaction in women, but not in men. Overall, these results suggest that the Spanish FAS is a psychometrically valid and reliable tool for the assessment of functionality appreciation in university-aged populations from Colombia.

What a difference a year makes: Objective rest/activity patterns, circadian phase markers, and sleep quality before and during the COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic led to numerous changes in sleep duration, quality, and timing. The goal of this study was to examine objective and self-reported changes in sleep and circadian timing before and during the pandemic. METHODS: Data were utilized from an ongoing longitudinal study of sleep and circadian timing with assessments at baseline and 1-year follow-up. Participants had baseline assessment between 2019 and March 2020 (before pandemic) and 12-month follow-up between September 2020 and March 2021 (during pandemic). Participants completed 7 days of wrist actigraphy, self-report questionnaires, and laboratory-collected circadian phase assessment (dim light melatonin onset). RESULTS: Actigraphy and questionnaire data were available for 18 participants (11 women and 7 men, Mean = 38.8 years, SD = 11.8). Dim light melatonin onset was available for 11 participants. Participants demonstrated statistically significant decreases in sleep efficiency (Mean = -4.11%, SD = 3.22, P = .001), worse scores on Patient-Reported Outcome Measurement Information System sleep disturbance scale (Mean increase = 4.48, SD = 6.87, P = .017), and sleep end time delay (Mean = 22.4 mins, SD = 44.4 mins, P = .046). Chronotype was significantly correlated with change in dim light melatonin onset (r = 0.649, P = .031). This suggests that a later chronotype is associated with a greater delay in dim light melatonin onset. There were also non-significant increases in total sleep time (Mean = 12.4 mins, SD = 44.4 mins, P = .255), later dim light melatonin onset (Mean = 25.2 mins, SD = 1.15 hrs, P = .295), and earlier sleep start time (Mean = 11.4 mins, SD = 48 mins, P = .322). CONCLUSION: Our data demonstrate objective and self-reported changes to sleep during the COVID-19 pandemic. Future studies should look at whether some individuals will require intervention to phase advance sleep when returning to previous routines such as returning to office and school settings.

Pseudo-Normalization of the T-wave During Stress and Its Relationship With Myocardial Ischemia: Evaluation by Myocardial Perfusion Single Photon Emission Computed Tomography (SPECT).

Background The T-wave alterations are suggestive of ischemia, among them there is the pseudo-normalization (positivization of the T-wave, previously negative, during stress exercise). Myocardial single photon emission computed tomography (SPECT) at rest and stress is usually performed with Technetium 99 (Tc-99), which has high sensitivity and specificity for the detection of ischemic heart disease. In this study, we decided to investigate the patients who pseudo-normalized the T-wave in the stress test to correlate with the existence of ischemia diagnosed by myocardial perfusion study, specifically myocardial SPECT in perfusion and rest with Tc-99. Methodology T - wave pseudo-normalization patients who underwent a myocardial perfusion SPECT between January 2018 and June 2019 were included in this retrospective study. We analyzed 81 patients: 50 patients with pseudo-normalization of T-waves and 31 patients, as a control group, without pseudo-normalization. A descriptive analysis of the quantitative variables was performed using Student's t-test or Mann-Whitney U test, and for the qualitative variables, the χ2 test or Fisher's exact test was performed. Results The degree of ischemia according to the presence or absence of pseudo-normalization of the T-wave. The pseudo-normalization of the T-wave in the group without ischemia (48.4% vs. 36%), for the mild degree the proportions were the same (38.7% vs. 38%), the moderate degree it was slightly higher in the pseudo-normalization of the T-wave (9.7% vs. 18%) and severe (3.2% vs. 6%). Conclusions In this study, the relationship between pseudo-normalization of the T waveform and ischemia, predominantly moderate to severe, was demonstrated. However, it was not statistically significant due to the size of the sample studied.

Split crest con colocación simultánea de implantes en sector anterior: reporte de un caso / Split crest with simultaneous placement of implants in the anterior sector: a case report

La pérdida ósea en el sector anterior, ya sea por un defecto horizontal, vertical o combinado, actualmente es un desafío, no sólo por la integración del implante, sino por la estética involucrada. Entre las técnicas de regeneración ósea que permiten solucionar estos defectos, cabe destacar la técnica de expansión de crestas. Se presenta el caso de una paciente de 58 años con reborde atrófico, que se sometió a la expansión de crestas con colocación simultánea de implantes en sector anterior, con xenoinjerto previo a técnica de expansión de crestas con piezoeléctrico, colocación simultánea de implantes Narrow Connection SLActive Straumann. Se logró ganancia ósea y estabilidad primaria de los implantes, sin complicaciones. En escenarios seleccionados, la técnica de expansión de crestas de manera predecible permite ganancia de hueso horizontal adecuada, el éxito de los implantes con tasa de supervivencia y mínimas complicaciones intra y postoperatorias (AU)

Bone loss in the anterior sector, both a horizontal, vertical or combined defect is a challenge today; not only for the integration of the implant but also the aesthetic involved. There are techniques of bone regeneration that help us to solve this type of defects, among them we should highlight the crest expansion technique. We present the case of a 58-year-old patient with atrophic flange, who underwent the expansion of crests with simultaneous placement of implants in the anterior sector, with xenograft prior to the piezoelectric crest expansion technique, Simultaneous placement of Narrow Connection SLActive Straumann implants, bone gain and primary stability of the implants were obtained, without complications. In selected scenarios, the crest expansion technique could be considered a predictable approach that demonstrates a high implant survival rate, adequate horizontal bone gain, and minimal intra- and postoperative complications (AU)

Coronary Artery Disease in Systemic Lupus Erythematosus: What Do the Facts Say?

Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect any organ with a predisposition for women of reproductive age. It is related to a higher risk of cardiovascular events, increasing it up to 50 times in young people, and 30% of deaths are attributed to coronary artery disease. The risk of developing cardiovascular disease in SLE is related not only to traditional cardiovascular risks factors such as advanced age, hypertension, dyslipidemia, and diabetes but also to disease-specific factors, such as degree of activity, autoantibodies, organ damage, and treatment. Accelerated atherosclerosis is one of the main contributors to pathogenesis. Manifestations range from angina to acute myocardial infarction and sudden death. Markers have been studied for the detection of subclinical disease and stratification of these patients, as well as different treatment options to improve the cardiovascular prognosis of the disease.

Recent and future perspectives on engineering interferons and other cytokines as therapeutics.

As crucial mediators and regulators of our immune system, cytokines are involved in a broad range of biological processes and are implicated in various disease pathologies. The field of cytokine therapeutics has gained much momentum from the maturation of conventional protein engineering methodologies such as structure-based designs and/or directed evolution, which is further aided by the advent of in silico protein designs and characterization. Just within the past 5 years, there has been an explosion of proof-of-concept, preclinical, and clinical studies that utilize an armory of protein engineering methods to develop cytokine-based drugs. Here, we highlight the key engineering strategies undertaken by recent studies that aim to improve the pharmacodynamic and pharmacokinetic profile of interferons and other cytokines as therapeutics.

Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia / Factores de riesgo para infecciones asociadas a la atención en salud por gérmenes productores de BLEE en una unidad de cuidados intensivos de un hospital público en Bogotá D.C., Colombia

Abstract Introduction: Extended spectrum beta-lactamases (ESBL) produced by gram-negative bacteria have been associated with increased hospital morbidity and mortality, longer hospital stays, use of carbapenems, and higher health care costs. Few studies have assessed the risk factors for infection by ESBL-producing germs in intensive care units (ICU). Objective: To determine the risk factors for healthcare-associated infections (HAIs) by ESBL-producing Klebsiella pneumoniae and Escherichia coli in an ICU of a public tertiary care hospital and to assess the impact of this type of infection on mortality. Materials and methods: A case-control study with a 1:2 ratio (97 cases and 194 controls) was conducted in critically ill patients admitted to the ICU of a public tertiary care hospital in Bogotá D.C. (Colombia) between January 2016 and December 2019, and in which a HAI by ESBL-producing K. pneumoniae or E. coli (cases: n=97) or K. pneumoniae or E. coli with a normal antibiotic resistance pattern (controls: n=194) was documented. Bivariate analyses were performed using the chi-squared and the Mann-Whitney U tests. A logistic regression model was used in the multivariate analysis, and a two-tailed test was performed with the p-values obtained in the bivariate analyses. Results: ESBL-producing K. pneumoniae and E. coli isolates were identified in 57 (58.76%) and 40 (41.24%) patients, respectively. These isolates were obtained mainly from urine samples (30,92%), followed by peritoneal fluid (27.80%). In the multivariate analysis, the presence of urinary tract infection on admission to the ICU was identified as a risk factor (OR=5.63, 95%CI: 1.918-16.53;; p=0.002). The mortality rate was 28.17% (26.29% in the controls and 31.95% in the cases), but no significant difference was observed between groups (p=0.311). Conclusion: Urinary tract infection on admission to the ICU was a risk factor for HAIs by ESBL-producing K. pneumoniae or E. coli. Furthermore, no significant difference was observed between cases and controls in terms of mortality.

Resumen Introducción. Las betalactamasas de espectro extendido (BLEE) producidas por gérmenes gram negativos se han asociado con aumento de la morbilidad y mortalidad hospitalaria, mayor estancia hospitalaria, uso de carbapenémicos y mayores costos de atención en salud. Existen pocos trabajos que evalúen los factores de riesgo para infección por gérmenes productores de BLEE en unidades de cuidado intensivo (UCI). Objetivo. Determinar los factores de riesgo para el desarrollo de infecciones asociadas a la atención en salud (IAAS) por Klebsiella pneumoniae y Escherichia coli productoras de BLEE en una UCI de un hospital público de tercer nivel de atención y evaluar el impacto de este tipo de infección en la mortalidad. Materiales y métodos. Estudio de casos y controles con relación 1:2 realizado en pacientes críticamente enfermos admitidos entre enero de 2016 y diciembre de 2019 a la UCI de un hospital público de tercer nivel de Bogotá D.C., Colombia, y en los que se documentó una IAAS por K. pneumoniae o E. coli productoras de BLEE (casos; n=97) y por K. pneumoniae o E. coli con fenotipo de resistencia natural (controles; n=194). Se realizaron análisis bivariados mediante las pruebas de chi-cuadrado y U de Mann-Whitney. En el análisis multivariado se usó un modelo de regresión logística, con una prueba de dos colas con los valores p obtenidos en los análisis bivariados. Resultados. Se identificaron aislamientos de K. pneumoniae y de E. coli productoras de BLEE en 57 (58,76%) y 40 (41,24%) de los casos, respectivamente y estos aislamientos se obtuvieron principalmente de muestras de orina (30.92%), seguido de líquido peritoneal (27.83%). En el análisis multivariado, la presencia de infección de vías urinarias al ingreso a UCI fue identificada como factor de riesgo (OR=5.63, IC95%:1.918-16.527; p=0,002). La tasa de mortalidad fue del 28.17% (26.29% en los controles y 31.95% en los casos), pero no se observó una diferencia significativa entre grupos (p=0.311). Conclusión. La infección de vías urinarias al ingreso a la UCI fue un factor de riesgo para la IAAS por K. pneumoniae o E. coli productoras de BLEE. Además, no se observó una diferencia significativa entre los casos y controles en términos de mortalidad.

Materiales bioactivos para restauraciones directas en dientes posteriores / Bioactive materials for direct restorations in posterior teeth

Se trata de paciente femenino de 22 años de edad, en quien se realizó una restauración en un molar siguiendo la filosofía de mínima intervención desde el diagnóstico hasta la obturación con un material bioactivo. Los objetivos del tratamiento fueron devolver la funcionalidad y estética de dicho molar, pero sobre todo brindar una protección a largo plazo mediante la liberación y recarga de iones de calcio, fosfato y flúor proporcionado por el material bioactivo (AU)

t is about a female patient of twenty-two years, in which a restoration was made in a molar following the philosophy of minimal intervention from diagnosis to filling with a bioactive material. The objectives of the treatment were to restore the functionality and aesthetics, but mainly to provide long-term protection through the release and recharge of calcium, phosphate and fluoride ions provided by the bioactive material used (AU)

A new challenge for dental education: Generation Z / Un nuevo reto para la educación odontológica: Generación Z

Abstract A new cohort, known as ''Generation Z'', is nowadays studying Health Careers. These students were born between 1996 and 2012, and currently at year 2022, have between 18 and 26 years. It is necessary to comprehend their characteristics and behaviors, for a better understanding of how they learn, what do they expect from education and how to improve their academic development and potential. Generation Z is considered as the most diverse, and it requires a closer mentorship from teachers, who must be ready to help students to manage their time and resources efficiently. It is worth mentioning that Gen Z information about their professional performance is still preliminary, because they are currently studying their University programs. Thus, it will be interesting to further analyze the behavior of Generation Z in Dental Education.

Abstract Una nueva cohorte generacional, conocida como ''Generación Z'', se encuentra estudiando las Licenciaturas en el área de la Salud. Estos estudiantes nacieron entre los años de 1996 y 2012, y actualmente al año 2022, tienen entre 18 y 26 años. Es necesario comprender sus características y sus conductas, para tener un mejor entendimiento de cómo aprenden, qué esperan de la educación, y cómo se podría mejorar su desarrollo académico y su potencial. La Generación Z es conocida como la más diversa, y requiere de una mentoría cercana por parte de los profesores, quienes deben estar listos para ayudar a los estudiantes a manejar el tiempo y los recursos eficientemente. Es importante mencionar que la información referente al desempeño profesional de la Generación Z es aún preliminar, dado que actualmente están cursando sus programas universitarios. Por tanto, será interesante seguir analizando el comportamiento de la Generación Z en la Educación Odontológica.

Resistencia antibiótica de Escherichia coli, según producción de beta lactamasas de espectro extendido, en urocultivos. Hospital III-1. Chiclayo, Perú 2020

Objetivo: determinar la resistencia antibiótica de Echerichia coli, en urocultivos, según produccion de BLEE, en pacientes hospitalizados. El estudio: Diseño descriptivo - retrospectivo. La identificación bacteriana se hizo con VITEK XL, la susceptibilidad, con las pautas del CLSI M100. 30 edicion. Hallazgos. E. coli BLEE positivo, presento resistencia de 0% a: Meropenem, ertapenem, tigeciclina y colistina. Piperacilina/tazobactam, nitrofurantoina, imipenem, amicacina con 16.7%, 6.2%, 5% y 1% respectivamente. E. Coli BLEE negativo, presento resistencia de 0% a: cefotaxima, cefuroxime, tigeciclina y piperacilina/tazobactam. Ceftriaxona, cefepime, gentamicina, cefazolina, ceftazidima, nitrofurantoina, meropenem, amicacina, imipenem y ertapenem con 14.7%, 13%, 13%, 10.7%, 9.7%, 9.1%, 9.1%, 8%, 5%, 2.7%, respectivamente. Conclusion: Meropenen, ertapenem, tigeciclina, colestina, piperacilina/tazobactam, nitrofurantoina, amicacina y imipenem, con resistencia menor de 20%, fueron los mismos, para E. coli BLEE positivo, y E. coli, sin considerar la produccion de BLEE.

ABSTRAC Objective: to determine the antibiotic resistance of Echerichia coli, in urine cultures, according to ESBL production, in hospitalized patients. The study: Descriptive-retrospective design. Bacterial identification was done with VITEK XL, susceptibility, with the CLSI M100 guidelines. 30 edition. Findings: E. coli ESBL positive, presented 0% resistance to: Meropenem, ertapenem, tigecycline and colistin. Piperacillin/tazobactam, nitrofurantoin, imipenem, amikacin with 16.7%, 6.2%, 5% and 1% respectively. E. Coli ESBL negative, presented 0% resistance to: cefotaxime, cefuroxime, tigecycline and piperacillin/tazobactam. Ceftriaxone, cefepime, gentamicin, cefazolin, ceftazidime, nitrofurantoin, meropenem, amikacin, imipenem, and ertapenem with 14.7%, 13%, 13%, 10.7%, 9.7%, 9.1%, 9.1%, 8%, 5%, 2.7%, respectively. Conclusion: Meropenen, ertapenem, tigecycline, cholesterol, piperacillin/tazobactam, nitrofurantoin, amikacin and imipenem, with less than 20% resistance, were the same for ESBL-positive E. coli, and E. coli, without considering ESBL production.

Acute heart failure due to a giant left atrial myxoma: a case report.

Background: Cardiac myxomas are the most common primary benign tumour of the heart. Most of them occur between the 4th and 6th decade of life, are most frequent in the woman, and most frequently localized in the left atrium. Case summary: We present a case of a 41-year-old female who presented with a history of left-sided heart failure. A left atrial mass of 87 × 88 × 65 mm was documented by cardiac magnetic resonance. She was taken to surgical resection of the mass. Histopathologic findings were diagnostic of cardiac myxoma. Generally, myxomas that are bigger than 6 cm are associated with the worst prognosis. Discussion: Primary cardiac tumours are mostly benign, being in 50% of the cases a cardiac myxoma. The rest of them correspond to papillary fibroelastoma (26%), fibromas (6%), lipomas (4%), and others including calcified tumours, haemangiomas, teratomas, cysts, and rhabdomyomas. Our clinical case illustrates an unusual and rare presentation of cardiac myxoma with a double mitral lesion.

Day-to-day intrapersonal variability in mobility patterns and association with perceived stress: A cross-sectional study using GPS from 122 individuals in three European cities.

Many aspects of our life are related to our mobility patterns and individuals can exhibit strong tendencies towards routine in their daily lives. Intrapersonal day-to-day variability in mobility patterns has been associated with mental health outcomes. The study aims were: (a) calculate intrapersonal day-to-day variability in mobility metrics for three cities; (b) explore interpersonal variability in mobility metrics by sex, season and city, and (c) describe intrapersonal variability in mobility and their association with perceived stress. Data came from the Physical Activity through Sustainable Transport Approaches (PASTA) project, 122 eligible adults wore location measurement devices over 7-consecutive days, on three occasions during 2015 (Antwerp: 41, Barcelona: 41, London: 40). Participants completed the Short Form Perceived Stress Scale (PSS-4). Day-to-day variability in mobility was explored via six mobility metrics using distance of GPS point from home (meters:m), distance travelled between consecutive GPS points (m) and energy expenditure (metabolic equivalents:METs) of each GPS point collected (n = 3,372,919). A Kruskal-Wallis H test determined whether the median daily mobility metrics differed by city, sex and season. Variance in correlation quantified day-to-day intrapersonal variability in mobility. Levene's tests or Kruskal-Wallis tests were applied to assess intrapersonal variability in mobility and perceived stress. There were differences in daily distance travelled, maximum distance from home and METS between individuals by sex, season and, for proportion of time at home also, by city. Intrapersonal variability across all mobility metrics were highly correlated; individuals had daily routines and largely stuck to them. We did not observe any association between stress and mobility. Individuals are habitual in their daily mobility patterns. This is useful for estimating environmental exposures and in fuelling simulation studies.