Prior influenza vaccine is not a risk factor for bacterial coinfection in patients admitted to the ICU due to severe influenza.

OBJECTIVE: To determine whether the prior usage of the flu vaccine is a risk factor for bacterial co-infection in patients with severe influenza. DESIGN: This was a retrospective observational cohort study of subjects admitted to the ICU. A propensity score matching, and logistic regression adjusted for potential confounders were carried out to evaluate the association between prior influenza vaccination and bacterial co-infection. SETTINGS: 184 ICUs in Spain due to severe influenza. PATIENTS: Patients included in the Spanish prospective flu registry. INTERVENTIONS: Flu vaccine prior to the hospital admission. RESULTS: A total of 4175 subjects were included in the study. 489 (11.7%) received the flu vaccine prior to develop influenza infection. Prior vaccinated patients were older 71 [61-78], and predominantly male 65.4%, with at least one comorbid condition 88.5%. Prior vaccination was not associated with bacterial co-infection in the logistic regression model (OR: 1.017; 95%CI 0.803-1.288; p=0.885). After matching, the average treatment effect of prior influenza vaccine on bacterial co-infection was not statistically significant when assessed by propensity score matching (p=0.87), nearest neighbor matching (p=0.59) and inverse probability weighting (p=0.99). CONCLUSIONS: No association was identified between prior influenza vaccine and bacterial coinfection in patients admitted to the ICU due to severe influenza. Post influenza vaccination studies are necessary to continue evaluating the possible benefits.

Prior influenza vaccine is not a risk factor for bacterial coinfection in patients admitted to the ICU due to severe influenza.

OBJECTIVE: To determine whether the prior usage of the flu vaccine is a risk factor for bacterial co-infection in patients with severe influenza. DESIGN: This was a retrospective observational cohort study of subjects admitted to the ICU. A propensity score matching, and logistic regression adjusted for potential confounders were carried out to evaluate the association between prior influenza vaccination and bacterial co-infection. SETTINGS: 184 ICUs in Spain due to severe influenza. PATIENTS: Patients included in the Spanish prospective flu registry. INTERVENTIONS: Flu vaccine prior to the hospital admission. RESULTS: A total of 4175 subjects were included in the study. 489 (11.7%) received the flu vaccine prior to develop influenza infection. Prior vaccinated patients were older 71 [61-78], and predominantly male 65.4%, with at least one comorbid condition 88.5%. Prior vaccination was not associated with bacterial co-infection in the logistic regression model (OR: 1.017; 95%CI 0.803-1.288; p=0.885). After matching, the average treatment effect of prior influenza vaccine on bacterial co-infection was not statistically significant when assessed by propensity score matching (p=0.87), nearest neighbor matching (p=0.59) and inverse probability weighting (p=0.99). CONCLUSIONS: No association was identified between prior influenza vaccine and bacterial coinfection in patients admitted to the ICU due to severe influenza. Post influenza vaccination studies are necessary to continue evaluating the possible benefits.

ΔNp73 status in peritoneal and ovarian dissemination of appendicular adenocarcinoids (goblet cells).

INTRODUCTION: Goblet cell carcinoma (GCC) is an appendicular neoplasia representing less than 5% of all appendicular tumors, found in 0.3-0.9% of the appendectomies, 35-58% of all appendicular neoplasms, and less than 14% of malign appendix tumors. The most frequent clinical presentation is abdominal pain associated with a picture of acute appendicitis. MATERIALS AND METHODS: We present 3 clinical cases of appendix GCC, 2 subjected to cytoreductory surgery plus intraperitoneal hyperthermic chemotherapy and a third, who is currently receiving neoadjuvant treatment with a good response to chemotherapy and who will be offered the same treatment as the first two patients. Given the unpredictable behavior of these tumors, the use of molecular markers could help us to predict their behavior and prognosis. In this context, the TP73 gene would make an interesting putative marker. ∆Np73 has been described as overexpressed in a great variety of tumor types including colon cancer and this up-regulation is associated with a poor prognosis. To evidence its role in this malignancy, we evaluate here the status of ∆Np73 in the primary tumor and normal counterpart tissues, in the metastatic implants and in healthy areas of the peritoneum from the appendicular GCC patients. In addition, we checked the expression levels of this p73 variant in the tumor and normal tissue of 26 patients with colon cancer. RESULTS: Remarkably, 2 patients showed significant ∆Np73 down-regulation in both the primary tumor and the implants. Case 1 presented a fourfold decrease of levels in the primary tumor and 20-fold decrease in the implants. Case 2 showed a seven- and fourfold down-regulation in the primary tumor and implants, respectively. However, Case 3 showed an up-regulation of 53- and threefold in the primary tumor and implants, respectively. CONCLUSION: Goblet cell carcinoma of the appendix is very rate. It tends to seed throughout the peritoneum, making aggressive surgical cytoreduction and chemotherapy viable treatment options. Investigation into the molecular basis of these tumors may improve the diagnosis, prognosis and therapeutic decisions regarding these patients. ∆Np73 seems a good candidate for further analysis in longer series.

Validation of a Spanish version of the EuroPrevall Food Allergy Quality of Life Questionnaire-Parental Form.

BACKGROUND: Food allergy can have a major impact on quality of life of children and their parents. Questionnaires have been developed to measure the impact of this disorder. We aimed to validate the EuroPrevall questionnaire on Food Allergy-Quality of Life Questionnaire, Parent Form (FAQLQ-PF) and the Food Allergy Independent Measure (FAIM), translated into Spanish. METHODS: The internal consistency of the FAQLQ-PF and the FAIM, translated into Spanish (Spain) and completed by the parents of 74 children with IgE-mediated food allergy, were evaluated with Cronbach's alpha. To test construct validity of the FAQLQ-PF, its correlation with the FAIM was also calculated. To assess their discriminant validity, we compared the values of both depending on the number of offending foods and for children with and without anaphylaxis. RESULTS: The values of Cronbach's alpha for the three domains in the FAQLQ-PF were over 0.9. The value of alpha for FAIM questions was below 0.6, which was attributed to the wording of one question. When this question was removed, alpha increased to over 0.70. There was a significant correlation between the FAQLQ-PF score and the FAIM. There were significantly poorer FAQLQ-PF scores in children with more food allergies and worse FAIM in those who had had anaphylaxis. CONCLUSIONS: The Spanish version of the FAQLQ-PF had a good internal consistency, good construct validity and validity to discriminate patients with more food allergies and anaphylaxis. It can be used as a tool to evaluate and monitor the quality of life in families with food allergic children.

Análisis retrospectivo de pacientes con traqueostomía nueva en 2010-2011 / Retrospective analysis of patients with a new tracheostomy in 2010-2011

Estudio descriptivo y retrospectivo realizado durante el período 2010-2011. Se incluyeron en el estudio los pacientes que se internaron en el CIM 62 del hospital Garrahan con traqueostomía realizada durante dicha internación. Se registraron 88 pacientes. La mayoría de ellos (85%) presentaban alguna Enfermedad de Base previa a la realización de la traqueostomía, siendo la enfermedad neurológica la más frecuente. El principal motivo de realización de traqueostomía fue el fracaso en la extubación/ARM prolongada. Los pacientes presentaron una estancia media de internación de 35 días posteriores a la realización de la traqueostomía. Actualmente se está desarrollando un Programa de Entrenamiento en el manejo de la traqueostomía con el objetivo de agilizar su egreso (AU)

A retrospective descriptive study was conducted over the period 2010-2011. Patients admitted to CIM 62 of hospital Garrahan who required a tracheostomy during their hospital stay were included in the study. Overall, 88 patients were included. The majority (85%) presented with some underlying disease, most frequently a neurological disorder, previous to the tracheostomy, The main reason for tracheostomy was extubation failure/prolonged MV. Mean hospital stay before tracheostomy was 35 days. Currently a training program for tracheostomy placement is being developed to streamline discharge (AU)

Primer caso de tratamiento ex utero intraparto realizado por vía vaginal en un feto con síndrome de obstrucción congénita de la vía aérea superior / The first case of exutero intrapartum treatment performed using the vaginal route in a fetus with congenital high airway obstruction syndrome

El síndrome de obstrucción congénita de la vía aérea superior (CHAOS), es una condición infrecuente que causa asfixia o muerte perinatal inmediata, de no mediar una estrategia terapéutica que permita permeabilizar la vía aérea del paciente durante el nacimiento. El diagnóstico prenatal, es fundamental para delinear estrategias de tratamiento perinatal con el fin de minimizar la morbimortalidad de niños con anomalías congénitas. El tratamiento ex-útero intraparto (EXIT) es el procedimiento de elección. Clásicamente se realiza mediante una cesárea programada, manteniendo el soporte fetal a través de la circulación útero-placentaria. Se requiere un equipo altamente calificado y un trabajo coordinado para concretar el procedimiento en estas condiciones. Objetivo: El objetivo es reportar un caso de Síndrome de CHAOS, en el que se realizó un procedimiento EXIT en un niño nacido por parto vaginal, con la participación de un equipo multidisciplinario de profesionales de dos Instituciones Públicas de la Ciudad de Buenos Aires, en el marco de un Programa Conjunto de Diagnóstico y Tratamiento Fetal (AU)

Congenital high airway obstruction syndrome (CHAOS) is a rare entity causing perinatal asphyxia or immediate death if no therapeutic strategy is undertaken to correct airway patency at birth. Prenatal diagnosis is essential to plan perinatal strategies to decrease morbidity and mortality in children with congenital anomalies. The exutero intrapartum treatment (EXIT) is the procedure of choice. Classically, a programmed cesarean section is performed while the fetus is maintained on uteroplacental circulation. A highly trained team is required in the coordinated effort to perform the procedure. Aim: The aim of this study was to report on a case of CHAOS managed with an EXIT procedure in a child born through vaginal delivery performed by a multidisciplinary team of professionals belonging to two public institutions of the city of Buenos Aires in the framework of the Joint Program of Fetal Diagnosis and Treatment (AU)

Effect of ß-lactoglobulin A and B whey protein variants on cheese yield potential of a model milk system.

Cheese yield mainly depends on the amount and proportion of milk constituents; however, genetic variants of the proteins present in milk may also have an important effect. The objective of this research was to study the effect of the variants A and B of ß-lactoglobulin (LG) on cheese yield using a model system consisting of skim milk powder fortified with different levels of a mixture containing α-lactalbumin and ß-LG genetic variants (A, B, or A-B) in a 1:2 ratio. Fortified milk samples were subjected to pasteurization at 65 °C for 30 min. Miniature cheeses were made by acidifying (pH=5.9) fortified milk and incubating with rennet for 1h at 32 °C. The clot formed was cut, centrifuged at 2,600 × g for 30 min at 20 °C and drained for determining cheese yield. Cheese-yielding capacity was expressed as actual yield (grams of cheese curd per 100g of milk) and dry weight yield (grams of dried cheese curd per 100g of milk). Free-zone capillary electrophoresis was used for determining ß-LG A or B recovery in the curd during rennet-induced coagulation. The presence of ß-LG variant B resulted in a significantly higher actual and dried weight cheese yield than when A or A-B were present at levels ≤ 0.675% of whey protein (WP) addition. Results of free-zone capillary electrophoresis allowed us to infer that ß-LG B associates with the casein micelles during renneting, as shown by an increase in the recovery of this variant in the curd when ß-LG B was added up to a maximum at 0.45% (equivalent to 0.675% WP). In general, actual or dried weight cheese yield increased as WP addition was increased from 0.225 to 0.675%. However, when WP addition ranged from 0.675 to 0.90%, a drastic drop in cheese yield was observed. This behavior may be because an increase in the aggregation of casein micelles with a concomitant inclusion of whey protein in the gel occurs at low levels of WP addition, whereas once the association of WP with the casein micelles reach a saturation point at addition levels higher than 0.675%, rearrangements of the gel network result in larger whey expulsion and syneresis. This knowledge is expected to be useful to maximize cheese yield and optimize processing conditions during cheese and cheese analogs manufacturing.

Intracytoplasmic sperm injection (ICSI) in small ruminants.

Small ruminants are an important component of the global production systems of meat and wool, and their reproductive biology is well known. However, the incorporation of assisted reproduction techniques (ART) in the production systems of small ruminants is not as well developed as for other domestic species. Normally, production systems that incorporate ARTs are restricted to artificial insemination or in vivo embryo transfer. Intracytoplasmic sperm injection (ICSI) is one of the ARTs techniques reported for small ruminants and consists of the injection of spermatozoa inside an oocyte, bypassing the natural process of sperm-oocyte interaction. In goats and sheep, there are few live births by ICSI reported, with no reports from other species of small ruminants. Currently, there has not been intensive research about ICSI in small ruminants. However, ICSI has potentially important applications in animal production systems, primarily its use with semen of valued animals, with epididymal sperm, in the fertilization of prepubertal or cryopreserved oocytes. Other applications include more advanced techniques, such as transgenic-ICSI or its combination with spermatogonial transplantation. In this article, we review the "state of the art" of this technique in small ruminants including its historical development, research needs for its improvement and future applications.

The trypanocidal activity of the alkaloid oliverine involves inhibition of DNA synthesis.

The Trypanosoma cruzi parasite is an etiologic agent of the American trypanosomiasis called Chagas disease. This pathology affects more than 24 million persons and represents one of the most important public health problems in Latin America. Taking into account this, it is necessary the search of new antitrypanosomal agents that show a major level of efficacy and minor indexes of toxicity in affected patients. Vast source of them are the natural products from plants with enormous structural diversity. A particular type of these compounds is represented by aporphinoid alkaloids. In our experiments, anonaine (2), oliverine (3) and guatterine (5) displayed antitrypanosomal activity. The compound 3 showed the most important activity with an IC50 = 12.00 ± 0.36 μM. Its mechanism of action may include inhibition of DNA synthesis.

Screening nutricional: inclusión en la primera fase del Proceso de Atención de Enfermería / Nutritional screening: inclusion in first stage of the Process of Attention of Infirmary

La identificación del riesgo nutricional en pacientes hospitalizados puede realizarse con técnicas de tamizaje o screening nutricional (SN) de sencilla aplicación. Este estudio tuvo por objetivo valorar la importancia de la inclusión del test de SN en la primera fase del Proceso de Atención de Enfermería (PAE) en pacientes con Accidente Cerebro Vascular (ACV), internados en la Unidad de Terapia Intensiva (UTI) del Hospital San Juan Bautista de Catamarca. Se realizaron mediciones antropométricas directas e indirectas, se aplicó el test de SN para adultos (NRS 2000) de la Sociedad Americana de Nutrición Enteral y Parenteral (ASPEN) y se analizaron sus ítems.

A novel icetexane diterpene, 5-epi-icetexone from Salvia gilliessi is active against Trypanosoma cruzi.

In this work the effect of a novel compound, 5-epi-icetexone (ICTX) obtained from Salvia gilliessi Benth. (Labiatae), is studied on cultured epimastigotes of Trypanosoma cruzi (Tulahuen). It was found that the compound exerts an antiproliferative effect on the parasites at concentrations between 2.8 and 4.2 microM, and similar sensitivity in other strains (Dm28c, CL-Brener and Y-strain). The compound was deleterious at concentrations higher than 4.2 microM, with an estimated IC50 of 6.5+/-0.75 microM, but with low cytotoxicity to mammalian cells. These effects were irreversible, even at short times of exposure to the drug. In solution, ICTX showed to be stable for at least 96 h at 29 degrees C. With cytostatic dose a little percentage of parasites was resistant to the action of ICTX, and they continued growing although with different kinetic. By electron transmission microscopy, at dose of 4.2 microM an external vesiculization was observed on the first day of exposure to the compound, but the parasite cytoplasm became plenty of vacuoles and exhibited nuclear disorganization from the second day of exposure. It was concluded that ICTX is active against T. cruzi and may act by multiple mechanisms. In future, this novel icetexane diterpene may be a good candidate for therapeutic use against Chagas' disease.

Diabetes mellitus: acciones de prevención primaria y secundaria en Atención Primaria de la Salud / Primary and secundary prevention at the Health Primary Attention level

El presente trabajo describe acciones de prevención primaria y secundaria desarrolladas en el área de cobertura de los Centros de Salud del departamento Capital-Catamarca, en el marco del Proyecto "Monitoreo de Diabetes Mellitus por Areas Programáticas" (Sede CyT-U.N.Ca), articulado con la Dirección de Atención Primaria de la Salud - Ministro de Salud de la provincia, durante el período 2001-2004. Las mismas se ejecutaron por etapas: 1º- Implementación de un Programa de Capacitación en Diabetes Mellitus para el personal operativo del primer nivel de atención. 2º- Caracterización epidemiológica de pacientes diagnosticados. 3º- Identificación de individuos con factores de riesgo. 4º- Implementación de Cursos de Educación Diabetológica a pacientes y familiares (AU)

Diabetes mellitus: acciones de prevención primaria y secundaria en Atención Primaria de la Salud / Primary and secundary prevention at the Health Primary Attention level

El presente trabajo describe acciones de prevención primaria y secundaria desarrolladas en el área de cobertura de los Centros de Salud del departamento Capital-Catamarca, en el marco del Proyecto "Monitoreo de Diabetes Mellitus por Areas Programáticas" (Sede CyT-U.N.Ca), articulado con la Dirección de Atención Primaria de la Salud - Ministro de Salud de la provincia, durante el período 2001-2004. Las mismas se ejecutaron por etapas: 1°- Implementación de un Programa de Capacitación en Diabetes Mellitus para el personal operativo del primer nivel de atención. 2°- Caracterización epidemiológica de pacientes diagnosticados. 3°- Identificación de individuos con factores de riesgo. 4°- Implementación de Cursos de Educación Diabetológica a pacientes y familiares

Capacitación del personal del primer nivel de atención como estrategia de prevención y control de la diabetes mellitus / Training to the performing staff

En este artículo se muestra la experiencia desarrollada en la provincia de Catamarca durante la ejecución del Programa de Capacitación en Diabetes Mellitus destinado al personal operativo del primer Nivel de Atención (AU)

Capacitación del personal del primer nivel de atención como estrategia de prevención y control de la diabetes mellitus / Training to the performing staff

En este artículo se muestra la experiencia desarrollada en la provincia de Catamarca durante la ejecución del Programa de Capacitación en Diabetes Mellitus destinado al personal operativo del primer Nivel de Atención

Effect of pulmonary perfusion on the slopes of single-breath test of CO2.

The objective of this study was to evaluate the effects of lung perfusion on the slopes of phases II (S(II)) and III (S(III)) of a single-breath test of CO(2) (SBT-CO(2)). Fourteen patients submitted to cardiac surgery were studied during weaning from cardiopulmonary bypass (CPB). Pump flow was decreased in 20% steps, from 100% (total CPB = 2.5 l.min(-1).m(-2)) to 0%. This maneuver resulted in a progressive and opposite increase in pulmonary blood flow (PBF) while maintaining ventilator settings constant. SBT-CO(2), respiratory, and hemodynamic variables remained unchanged before and after CPB, reflecting a constant condition at those stages. S(III) was similar before and after CPB (19.6 +/- 2.8 and 18.7 +/- 2.1 mmHg/l, respectively). S(III) was lowest during 20% PBF (8.6 +/- 1.9 mmHg/l) and increased in proportion to PBF until exit from CPB (15.6 +/- 2.2 mmHg/l; P < 0.05). Similarly, S(II) and the CO(2) area under the curve increased from 163 +/- 41 mmHg/l and 4.7 +/- 0.6 ml, respectively, at 20% PBF to 313 +/- 32 mmHg/l and 7.9 +/- 0.6 ml (P < 0.05) at CPB end. When S(II) and S(III) were normalized by the mean percent expired CO(2), they remained unchanged during the protocol. In summary, the changes in PBF affect the slopes of the SBT-CO(2). Normalizing S(II) and S(III) eliminated the effect of changes in the magnitude of PBF on the shape of the SBT-CO(2) curve.