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1.
J Clin Rheumatol ; 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38809130

RESUMEN

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease that affects different areas of the patient's body. Patient education and health literacy is essential for them to participate actively in follow-up. OBJECTIVES: The aim of this study was to assess differences between clinimetric measurements done by a medical team and patient-reported outcome measures (PROMs) in RA and understand the impact of patient education strategies in order to identify differences between RA assessment methods. METHODS: This is a longitudinal cohort study. It included adult patients with RA and access to digital tools. These were divided into 3 groups by type of education. Group 1 included patients who participated in a multicomponent RA educational program. Group 2 did not have this multicomponent RA education. Group 3 did not receive any education. The 3 groups performed PROMs. Disease activity scales, functional class, and quality of life were measured. Univariate and bivariate analysis (χ2 and Wilcoxon for paired data) were done. RESULTS: Twenty-eight patients were included in group 1, 26 in group 2, and 37 in group 3. All were women. In group 1, there were no significant differences in clinimetrics between the medical team and patient's PROMs except for fatigue. In group 2 and group 3, significant differences were found. The RAPID3 and PAS variables did not show significant differences when analyzed by intervention subgroups. CONCLUSIONS: This study shows no differences between clinimetrics/PROMs for patients with a high-level education on RA and physicians. On the other hand, when patient did not have any RA education, the clinimetric results differed from physician measurement.

2.
Environ Monit Assess ; 195(12): 1480, 2023 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-37968519

RESUMEN

Besides direct mortality, wind farms also affect aerial fauna by modifying their communities, reducing species diversity and richness through disturbance. During three consecutive years, we used mist nets and acoustic recorders, and conducted carcass searches, to characterize the assemblage of bat species and to estimate bat mortality at two nearby wind farms sited <5 km apart in a highly biodiverse region. We asked whether the diversity, richness and evenness of the assemblages varied yearly, predicting it would decrease through time. Richness and evenness did not change, but the diversity of species recorded acoustically, 96% being aerial insectivores, was significantly lower the third year. We estimate 4 - 15.7 fatalities/MW/year by wind farm, with 63% of species found as carcasses being aerial insectivores. We found >40% of dissimilarity in the species composition of bat assemblages between wind farms despite the short distance between them, with species turnover accounting for more than half of the dissimilarity every year. Similarly, species turnover accounted for >15% of the dissimilarity in the composition of the assemblage of live bats (captured and recorded acoustically) and the assemblage obtained through carcass searches. Our findings suggest that nearby wind farms impact bat communities differentially and aerial insectivores disproportionally. Long term, multi-method surveys are needed to characterize bat communities in highly diverse regions and to evaluate the post-construction effects that wind farms have on them.


Asunto(s)
Quirópteros , Animales , Fuentes Generadoras de Energía , Monitoreo del Ambiente , Viento , Granjas
3.
Front Oncol ; 13: 1304662, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38250553

RESUMEN

Introduction: The decisive key to disease-free survival in B-cell precursor acute lymphoblastic leukemia in children, is the combination of diagnostic timeliness and treatment efficacy, guided by accurate patient risk stratification. Implementation of standardized and high-precision diagnostic/prognostic systems is particularly important in the most marginalized geographic areas in Mexico, where high numbers of the pediatric population resides and the highest relapse and early death rates due to acute leukemias are recorded even in those cases diagnosed as standard risk. Methods: By using a multidimensional and integrated analysis of the immunophenotype of leukemic cells, the immunological context and the tumor microenvironment, this study aim to capture the snapshot of acute leukemia at disease debut of a cohort of Mexican children from vulnerable regions in Puebla, Oaxaca and Tlaxcala and its potential use in risk stratification. Results and discussion: Our findings highlight the existence of a distinct profile of ProB-ALL in children older than 10 years, which is associated with a six-fold increase in the risk of developing measurable residual disease (MRD). Along with the absence of CD34+ seminal cells for normal hematopoiesis, this ProB-ALL subtype exhibited several characteristics related to poor prognosis, including the high expression level of myeloid lineage markers such as MPO and CD33, as well as upregulation of CD19, CD34, CD24, CD20 and nuTdT. In contrast, it showed a trend towards decreased expression of CD9, CD81, CD123, CD13, CD15 and CD21. Of note, the mesenchymal stromal cell compartment constituting their leukemic niche in the bone marrow, displayed characteristics of potential suppressive microenvironment, such as the expression of Gal9 and IDO1, and the absence of the chemokine CXCL11. Accordingly, adaptive immunity components were poorly represented. Taken together, our results suggest, for the first time, that a biologically distinct subtype of ProB-ALL emerges in vulnerable adolescents, with a high risk of developing MRD. Rigorous research on potential enhancing factors, environmental or lifestyle, is crucial for its detection and prevention. The use of the reported profile for early risk stratification is suggested.

4.
Gac Med Mex ; 158(M3): M1-M48, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35350063

RESUMEN

Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.


La leucemia mieloide aguda (LMA) comprende un grupo heterogéneo de neoplasias de células hematopoyéticas de linaje mieloide que surgen de la expansión clonal de sus precursores en la médula ósea, interfiriendo con la diferenciación celular, lo que conlleva a un síndrome de falla medular. La LMA es una consecuencia de cambios genéticos y epigenéticos (mutaciones puntuales, rearreglos de genes, deleciones, amplificaciones y arreglos en cambios epigenéticos que influyen en la expression del gen) en las células hematopoyéticas precursoras, la cual crea una clona de células anormales que son capaces de proliferar, pero no se pueden diferenciar en células hematopoyéticas maduras ni sufrir una muerte celular programada. El diagnostic requiere más del 20% de blastos mieloides en médula ósea y ciertas anormalidades citogénicas. El tratamiento dependerá de la edad, comorbilidades, riesgo citogenético entre las más frecuentes.


Asunto(s)
Leucemia Mieloide Aguda , Diferenciación Celular , Consenso , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/terapia , México
5.
Arana-Luna, Luara L.; Alvarado-Ibarra, Martha; Silva-Michel, Luis G.; Morales-Maravilla, Adrián; González-Rubio, María del C.; Chávez-Aguilar, Lénica A.; Tena-Iturralde, María Fernanda; Mojica-Balceras, Liliana; Zapata-Canto, Nidia; Galindo-Delgado, Patricia; Miranda-Madrazo, María Raquel; Morales-Hernández, Alba E.; Silva-Vera, Karina; Grimaldo-Gómez, Flavio A.; Hernández-Caballero, Álvaro; Bates-Martin, Ramón A.; Álvarez-Vera, José L.; Tepepa-Flores, Fredy; Teomitzi-Sánchez, Óscar; Fermín-Caminero, Denisse J.; Peña-Celaya, José A. de la; Salazar-Ramírez, Óscar; Flores-Villegas, Luz V.; Guerra-Alarcón, Lidia V.; Leyto-Cruz, Faustino; Inclán-Alarcón, Sergio I.; Milán-Salvatierra, Andrea I.; Ventura-Enríquez, Yanet; Pérez-Lozano, Uendy; Báez-Islas, Pamela E.; Tapia-Enríquez, Ana L.; Palma-Moreno, Orlando G.; Aguilar-Luévano, Jocelyn; Espinosa-Partida, Arturo; Pérez-Jacobo, Luis F.; Rojas-Castillejos, Flavio; Ruiz-Contreras, Josué I.; Loera-Fragoso, Sergio J.; Medina-Coral, Jesús E.; Acosta-Maldonado, Brenda L.; Soriano-Mercedes, Emely J.; Saucedo-Montes, Erick E.; Valero-Saldana, Luis M.; González-Prieto, Susana G.; Nava-Villegas, Lorena; Hernández-Colin, Ana K.; Hernández-Alcántara, Areli E.; Zárate-Rodríguez, Pedro A.; Ignacio-Ibarra, Gregorio; Meillón-García, Luis A.; Espinosa-Bautista, Karla A.; Ledesma de la Cruz, Cindy; Barbosa-Loría, Diego M.; García-Castillo, Carolina; Balderas-Delgado, Carolina; Cabrera-García, Álvaro; Pérez-Zúñiga, Juan M.; Hernández-Ruiz, Eleazar; Villela-Peña, Atenas; Gómez Cortés, Sue Cynthia; Romero-Rodelo, Hilda; Garzón-Velásquez, Katheryn B.; Serrano-Hernández, Cristina; Martínez-Ríos, Annel; Pedraza-Solís, María Luisa; Martínez-Coronel, Jorge A.; Narváez-Davalos, Iris M.; García-Camacho, Alinka S.; Merino-Pasaye, Laura E.; Aguilar-Andrade, Carolina; Aguirre-Domínguez, Juan A.; Guzmán-Mera, Pedro G.; Delgado-de la Rosa, Elizabeth; Flores López, Perla E.; González-Aguirre, Lilia L.; Ramírez-Alfaro, Edgar M.; Vera-Calderón, Heidi; Meza-Dávalos, María Lizeth; Murillo-Cruz, Juan; Pichardo-Cepín, Yayra M.; Ramírez-Romero, Eva F..
Gac. méd. Méx ; 158(spe): M1-M51, ene. 2022. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1375542

RESUMEN

resumen está disponible en el texto completo


Abstract Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.

6.
Rev. iberoam. micol ; 36(3): 139-141, jul.-sept. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-191402

RESUMEN

Background: Sertraline (SRT) is an antidepressant that has proven its activity in vitro against Cryptococcus, Coccidioides, Trichosporon and other fungi. Disseminated sporotrichosis, although rare, has a high mortality and its treatment is difficult and prolonged, often relying in combining two or more antifungals. Aims: In our study we evaluate the antifungal activity of SRT, alone and in combination with itraconazole (ITC), voriconazole (VRC) and amphotericin B (AMB), against 15 clinical isolates of Sporothrix schenckii. Methods: We used the broth microdilution method as described by the CLSI to test the susceptibility to antifungals, and the checkerboard microdilution method to evaluate drug interactions. Results: The minimum inhibitory concentration (MIC) with SRT was in the range of 4-8μg/ml, while for AMB, VRC and ITC were 0.5-4μg/ml, 0.5-8μg/ml and 0.125-2μg/ml, respectively. In addition, SRT showed synergy with ITC in one strain, mainly additivity with VRC, and indifference with AMB in others. Conclusions: The MIC values with SRT for the isolates studied show the potential role of this drug as an adjuvant in the treatment of sporotrichosis, especially in disseminated or complicated cases


Antecedentes: La sertralina (SRT) es un antidepresivo que ha demostrado actividad in vitro contra Cryptococcus, Coccidioides, Trichosporon y otros hongos. La esporotricosis diseminada, aunque rara, tiene una mortalidad elevada y su tratamiento es complicado, requiriendo, a menudo, la combinación de dos o más antifúngicos. Objetivos: En este estudio evaluamos la actividad antifúngica de SRT, sola y en combinación con itraconazol (ITC), voriconazol (VRC) y anfotericina B (AMB), frente a 15 aislamientos clínicos de Sporothrix schenckii. Métodos: Se usó la técnica de microdilución en caldo para evaluar la sensibilidad a los antifúngicos y el método de tablero de damas para las interacciones entre estos fármacos. Resultados: La concentración mínima inhibitoria (CMI) de SRT estuvo en el rango de 4-8μg/ml, mientras que para AMB, VRC e ITC fue de 0,5-4 μg/ml, 0,5-8 μg/ml y 0,125-2 μg/ml, respectivamente. La SRT mostró sinergia con ITC frente a una cepa, efecto aditivo principalmente con VRC, e indiferencia con AMB. Conclusiones: Los valores de la CMI de SRT para los aislamientos ensayados son indicativos del potencial de este fármaco como adyuvante en el tratamiento de la esporotricosis, especialmente en casos complicados o de enfermedad diseminada


Asunto(s)
Humanos , Sertralina/farmacocinética , Esporotricosis/tratamiento farmacológico , Sporothrix/efectos de los fármacos , Itraconazol/farmacocinética , Voriconazol/farmacocinética , Anfotericina B/farmacocinética , Técnicas In Vitro/métodos , Sporothrix/aislamiento & purificación , Micosis/tratamiento farmacológico , Quimioterapia Combinada/métodos , Pruebas de Sensibilidad Microbiana/métodos
7.
Rev Iberoam Micol ; 36(3): 139-141, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31171430

RESUMEN

BACKGROUND: Sertraline (SRT) is an antidepressant that has proven its activity in vitro against Cryptococcus, Coccidioides, Trichosporon and other fungi. Disseminated sporotrichosis, although rare, has a high mortality and its treatment is difficult and prolonged, often relying in combining two or more antifungals. AIMS: In our study we evaluate the antifungal activity of SRT, alone and in combination with itraconazole (ITC), voriconazole (VRC) and amphotericin B (AMB), against 15 clinical isolates of Sporothrix schenckii. METHODS: We used the broth microdilution method as described by the CLSI to test the susceptibility to antifungals, and the checkerboard microdilution method to evaluate drug interactions. RESULTS: The minimum inhibitory concentration (MIC) with SRT was in the range of 4-8µg/ml, while for AMB, VRC and ITC were 0.5-4µg/ml, 0.5-8µg/ml and 0.125-2µg/ml, respectively. In addition, SRT showed synergy with ITC in one strain, mainly additivity with VRC, and indifference with AMB in others. CONCLUSIONS: The MIC values with SRT for the isolates studied show the potential role of this drug as an adjuvant in the treatment of sporotrichosis, especially in disseminated or complicated cases.


Asunto(s)
Sertralina/farmacología , Sporothrix/efectos de los fármacos , Anfotericina B/administración & dosificación , Anfotericina B/farmacología , Antifúngicos/administración & dosificación , Antifúngicos/farmacología , Combinación de Medicamentos , Humanos , Itraconazol/administración & dosificación , Itraconazol/farmacología , Pruebas de Sensibilidad Microbiana , Sporothrix/aislamiento & purificación , Voriconazol/administración & dosificación , Voriconazol/farmacología
8.
Rev. iberoam. micol ; 35(1): 11-16, ene.-mar. 2018. tab, graf
Artículo en Inglés | IBECS | ID: ibc-170916

RESUMEN

Background. Candidemia is one of the most common nosocomial infections globally and it is associated with considerable excess mortality and costs. Abreast, biofilm-forming strains are associated with even higher mortality rates and poor prognosis for the patient. Aims. To evaluate a possible association between the biofilm-forming capability of Candida bloodstream isolates and the clinical evolution in patients with candidemia. Methods. An observational, retrospective study was conducted at a tertiary care university hospital during 9 years (2006-2015). The biofilm quantitation of the Candida bloodstream isolates was determined by crystal violet staining and XTT reduction assay. Results. A total of 218 cases of candidemia had been diagnosed and 89 isolates were obtained. The mortality rate was 36% and the main risk factors were antibiotic exposure and the use of catheters. Candida tropicalis (52.8%) was the most frequent species, followed by Candida albicans (30.4%), Candida parapsilosis sensu stricto (10.1%), Candida orthopsilosis (3.4%), Candida krusei (2.2%) and Candida glabrata sensu stricto (1.1%). All the strains were biofilm producers, which is an important contribution to the patient's mortality. C. tropicalis showed the highest production of biomass biofilm, whereas C. glabrata exhibited the highest metabolic activity. Conclusions. This study contributes to expand the knowledge about the local epidemiology of candidemia and highlights the impact of Candida biofilm on patient's outcome (AU)


Antecedentes. La candidemia es una de las infecciones nosocomiales más frecuentes globalmente y se encuentra asociada con una elevada mortalidad y coste económico. Las cepas productoras de biopelícula se asocian con elevadas tasas de mortalidad y mal pronóstico para el paciente. Objetivos. Evaluar una posible asociación entre la capacidad de formación de biopelícula de aislamientos sanguíneos de Candida y la evolución clínica de pacientes con candidemia. Métodos. Durante 9 años (2006-2015) se ha llevado a cabo un estudio observacional y retrospectivo en un hospital universitario de tercer nivel de atención. La cuantificación de biopelícula de los aislamientos sanguíneos de Candida se determinó por tinción con cristal violeta y ensayo de reducción de XTT. Resultados. Se diagnosticó un total de 218 casos de candidemia y se obtuvieron 89 aislamientos. La tasa de mortalidad fue del 36% y los principales factores de riesgo fueron la exposición a antibióticos y el uso de catéteres. Candida tropicalis (52,8%) fue la especie más frecuente, seguida por Candida albicans (30,4%), Candida parapsilosis sensu stricto (10,1%), Candida orthopsilosis (3,4%), Candida krusei (2,2%) y Candida glabrata sensu stricto (1,1%). Todas las cepas produjeron biopelícula, una contribución importante a la mortalidad de los pacientes. C. tropicalis mostró la producción más alta de biomasa de biopelícula, mientras que C. glabrata exhibió la actividad metabólica más alta. onclusiones. Este estudio contribuye a expandir el conocimiento de la epidemiología local de la candidemia y resalta el impacto de las biopelículas de Candida en el pronóstico del paciente (AU)


Asunto(s)
Humanos , Biopelículas/crecimiento & desarrollo , Candida/patogenicidad , Candidiasis/microbiología , Candidemia/epidemiología , Factores de Riesgo , México/epidemiología , Estudios Retrospectivos , Hospitalización/estadística & datos numéricos
9.
Infection ; 46(1): 25-30, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28815430

RESUMEN

PURPOSE: Cryptococcal meningitis is a potentially fatal fungal infection associated with a significant attributable morbidity and mortality, especially among HIV/AIDS patients. The first-line therapy for the treatment of this clinical entity is the combinatory therapy of amphotericin B plus flucytosine. However, the high cost, toxic effects, and limited repertoire of effective antifungal drugs have led to the investigation of novel molecules. This is a prospective, double-blinded, and randomized study performed in a Mexican tertiary care center to evaluate the antifungal activity of sertraline in the treatment of cryptococcal meningitis in HIV patients. METHODS: During June 2015-December 2016, patients were recruited and included in one of two study groups: group A was given standard antifungal treatment plus sertraline 200 mg/day, while group B was given standard antifungal plus placebo. Lumbar punctures were performed on days 0, 7, and 14 of the study, and cryptococcal antigenemia and quantitative fungal culture in cerebrospinal fluid at each time point were evaluated to measure the rate of fungal clearance. RESULTS: The fungal loads and cryptococcal antigenemia titers showed a marked tendency to decrease by day 14 in both groups. Otherwise, group B exhibited a slightly higher nonstatistical rate of fungal clearance (-0.2868 ± 0.08275 log CFU/ml/day) than group A (-0.2496 ± 0.08340 log CFU/ml/day). CONCLUSIONS: A statistical difference between study groups was not found. This is the first study in Latin America that reports the experience of using sertraline as an adjuvant in the antifungal management of cryptococcal meningitis in HIV patients.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Adyuvantes Farmacéuticos/uso terapéutico , Antifúngicos/uso terapéutico , Meningitis Criptocócica/tratamiento farmacológico , Sertralina/uso terapéutico , Adulto , Anciano , Método Doble Ciego , Femenino , Infecciones por VIH/complicaciones , Humanos , Masculino , Meningitis Criptocócica/líquido cefalorraquídeo , México , Persona de Mediana Edad , Estudios Prospectivos , Centros de Atención Terciaria , Adulto Joven
10.
Rev Iberoam Micol ; 35(1): 11-16, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29287632

RESUMEN

BACKGROUND: Candidemia is one of the most common nosocomial infections globally and it is associated with considerable excess mortality and costs. Abreast, biofilm-forming strains are associated with even higher mortality rates and poor prognosis for the patient. AIMS: To evaluate a possible association between the biofilm-forming capability of Candida bloodstream isolates and the clinical evolution in patients with candidemia. METHODS: An observational, retrospective study was conducted at a tertiary care university hospital during 9 years (2006-2015). The biofilm quantitation of the Candida bloodstream isolates was determined by crystal violet staining and XTT reduction assay. RESULTS: A total of 218 cases of candidemia had been diagnosed and 89 isolates were obtained. The mortality rate was 36% and the main risk factors were antibiotic exposure and the use of catheters. Candida tropicalis (52.8%) was the most frequent species, followed by Candida albicans (30.4%), Candida parapsilosis sensu stricto (10.1%), Candida orthopsilosis (3.4%), Candida krusei (2.2%) and Candida glabrata sensu stricto (1.1%). All the strains were biofilm producers, which is an important contribution to the patient's mortality. C. tropicalis showed the highest production of biomass biofilm, whereas C. glabrata exhibited the highest metabolic activity. CONCLUSIONS: This study contributes to expand the knowledge about the local epidemiology of candidemia and highlights the impact of Candida biofilm on patient's outcome.


Asunto(s)
Candida/fisiología , Candidemia/microbiología , Infección Hospitalaria/microbiología , Adulto , Biopelículas , Candida/aislamiento & purificación , Candidemia/sangre , Niño , Preescolar , Infección Hospitalaria/sangre , Estudios Transversales , Progresión de la Enfermedad , Susceptibilidad a Enfermedades , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Lactante , Masculino , México , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Centros de Atención Terciaria/estadística & datos numéricos
11.
IEEE Trans Biomed Eng ; 62(3): 922-9, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25420255

RESUMEN

Constrained independent component analysis (C-ICA) algorithms provide an effective way to introduce prior information into the complex- and real-valued ICA framework. The work in this area has focus on adding constraints to the objective function of algorithms that assume a unitary demixing matrix. The unitary condition is required in order to decouple-isolate-the constraints applied for each individual source. This assumption limits the optimization space and, therefore, the separation performance of C-ICA algorithms. We generalize the existing C-ICA framework by using a novel decoupling method that preserves the larger optimization space for the demixing matrix. This framework allows for the constraining of either the sources or the mixing coefficients. A constrained version of the nonunitary entropy bound minimization algorithm is introduced and applied to actual complex-valued fMRI data. We show that constraining the mixing parameters using a temporal constraint improves the estimation of the spatial map and timecourses of task-related components.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Procesamiento de Señales Asistido por Computador , Algoritmos , Encéfalo/fisiología , Humanos
12.
J Dermatol ; 40(9): 746-8, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23855624

RESUMEN

Chromoblastomycosis is a slowly growing chronic cutaneous mycosis associated with a variety of cutaneous lesions. Extra-dermal involvement is rare. A 58-year-old man was admitted to the hospital with nausea, vomiting, weakness and a history of weight loss. On inspection, he had a large verrucous mass in the sacral region, and two large subcutaneous nodules in the anterior thoracic wall. He claimed the lesions were several years old. Biopsy and histological studies were positive for chromoblastomycosis. Routine chest radiography showed hilar enlargement, and a chest computed tomography was ordered. Pulmonary nodules were evident, and endoscopically acquired samples were also positive for chromoblastomycosis. Extra-dermal and systemic involvement in chromoblastomycosis is exceedingly rare and often associated with immunosuppression. There is only one other case of pulmonary chromoblastomycosis reported in the published work.


Asunto(s)
Ascomicetos/aislamiento & purificación , Cromoblastomicosis/diagnóstico , Enfermedades Pulmonares Fúngicas/diagnóstico , Cromoblastomicosis/microbiología , Humanos , Enfermedades Pulmonares Fúngicas/microbiología , Masculino , Persona de Mediana Edad
13.
Pattern Recognit ; 45(6): 2050-2063, 2012 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-22347729

RESUMEN

Analysis of functional magnetic resonance imaging (fMRI) data in its native, complex form has been shown to increase the sensitivity both for data-driven techniques, such as independent component analysis (ICA), and for model-driven techniques. The promise of an increase in sensitivity and specificity in clinical studies, provides a powerful motivation for utilizing both the phase and magnitude data; however, the unknown and noisy nature of the phase poses a challenge. In addition, many complex-valued analysis algorithms, such as ICA, suffer from an inherent phase ambiguity, which introduces additional difficulty for group analysis. We present solutions for these issues, which have been among the main reasons phase information has been traditionally discarded, and show their effectiveness when used as part of a complex-valued group ICA algorithm application. The methods we present thus allow the development of new fully complex data-driven and semi-blind methods to process, analyze, and visualize fMRI data.We first introduce a phase ambiguity correction scheme that can be either applied subsequent to ICA of fMRI data or can be incorporated into the ICA algorithm in the form of prior information to eliminate the need for further processing for phase correction. We also present a Mahalanobis distance-based thresholding method, which incorporates both magnitude and phase information into a single threshold, that can be used to increase the sensitivity in the identification of voxels of interest. This method shows particular promise for identifying voxels with significant susceptibility changes but that are located in low magnitude (i.e. activation) areas. We demonstrate the performance gain of the introduced methods on actual fMRI data.

14.
IEEE Trans Biomed Eng ; 58(10): 2794-803, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21690000

RESUMEN

Independent component analysis (ICA) has proven quite useful for the analysis of real world datasets such as functional resonance magnetic imaging (fMRI) data, where the underlying nature of the data is hard to model. It is particularly useful for the analysis of fMRI data in its native complex form since very little is known about the nature of phase. Phase information has been discarded in most analyses as it is particularly noisy. In this paper, we show that a complex ICA approach using a flexible nonlinearity that adapts to the source density is the more desirable one for performing ICA of complex fMRI data compared to those that use fixed nonlinearity, especially when noise level is high. By adaptively matching the underlying fMRI density model, the analysis performance can be improved in terms of both the estimation of spatial maps and the task-related time courses, especially for the estimation of phase of the time course. We also define a procedure for analysis and visualization of complex-valued fMRI results, which includes the construction of bivariate t-maps for multiple subjects and a complex-valued ICASSO scheme for evaluating the consistency of ICA algorithms.


Asunto(s)
Algoritmos , Imagen por Resonancia Magnética/métodos , Análisis de Componente Principal , Procesamiento de Señales Asistido por Computador , Mapeo Encefálico , Humanos , Curva ROC
15.
Rev. colomb. ciencias quim. farm ; 39(2): 149-167, dic. 2010. tab, graf
Artículo en Español | LILACS | ID: lil-597435

RESUMEN

En este trabajo se evaluaron las tres características fundamentales de desempeño que debe cumplir un envase: protección, funcionalidad y motivación. Para ello, se estudiaron y evaluaron una serie de pruebas reportadas nacional e internacionalmente. Las diferentes pruebas se clasificaron en dos grandes grupos: pruebas físicas y pruebas fisicoquímicas; por otro lado, las pruebas biológicas que son fundamentales para la evaluación de la calidad de estos materiales no están incluidas en el protocolo propuesto, puesto que no se consideran pruebas de control de calidad de rutina. Como resultado de su evaluación experimental, se desarrolló un protocolo unificado y una guía de análisis para el control de calidad fisicoquímico de rutina de los envases y materiales de plástico.


This work evaluated the three fundamental characteristics of performance that must fulfill a package: Protection, functionality and motivation. For it, a series of tests reported at national and international level were evaluated. The tests were classified in two great groups: Physical tests and physical-chemicals tests; in the other hand, the biological tests used to evaluate quality of this kind of materials are not included in the proposed protocol because this quality control test are not considered currently. As resulting from its experimental evaluation, it was developed a unified protocol and a guide for routine quality control test of the packages and plastic material.


Asunto(s)
Control de Calidad , Métodos de Análisis de Laboratorio y de Campo , Embalaje de Medicamentos
16.
J Signal Process Syst ; 2009: 1-6, 2009 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-21949563

RESUMEN

Although functional magnetic resonance imaging (fMRI) data are acquired as complex-valued images, traditionally most fMRI studies only use the magnitude of the data. FMRI analysis in the complex domain promises to provide more statistically significant information; however, the noisy nature of the phase poses a challenge for successful study of fMRI by complex-valued signal processing algorithms. In this paper, we introduce a physiologically motivated de-noising method that uses phase quality maps to successfully identify and eliminate noisy areas in the fMRI data so they can be used in individual and group studies. Additionally, we show how the developed de-noising method improves the results of complex-valued independent component analysis of fMRI data, a very successful tool for blind source separation of biomedical data.

17.
Rev cienc méd pinar río ; 11(2/4)abr. 2007. tab, graf
Artículo en Español | CUMED | ID: cum-35960

RESUMEN

Las exigencias en el Sistema Nacional de Salud en el contexto actual imponen cambios en la enseñanza de la Universidad Médica en los diferentes niveles de formación, los cuales requieren de un claustro profesoral con un alto nivel científico pedagógico capaz de responder a los retos de la universalización, por lo cual nos proponemos describir las tendencias del Claustro Profesoral del (2001-2006) y para ello se realizó un estudio retrospectivo, longitudinal y cuantitativo. Fueron evaluados las siguientes variables en las categorías docentes de Profesor Titular, Auxiliar, Asistente, Instructor y Auxiliar Técnico de la Docencia. Se obtuvo una tendencia al incremento en las diferentes categorías docentes donde se refleja que de un claustro de 538 profesores en el 2001, se elevó a 1937 en el 2006, lo que representa un impacto social que repercute en el fortalecimiento de las Sedes Universitarias Municipales y el beneficio de la Salud de la población (AU)


The demands of the National Health System in the present-day context impose changes in the Medical University teaching in the different levels of formation, which require a teaching staff with a high scientific pedagogical level, capable of responding to the challenges of the universalization, therefore we aim at describing the teaching staffs trends in 2001-2006, and to that end a retrospective, longitudinal, and quantitative study was carried out. The following variables were evaluated in the teaching categories: Full Professor, Assistant Professor, Lecturer, Instructor and Teaching Assistant Technician. It was found a trend to increase in the different teaching categories, where it reflects that out of a teaching staff of 538 professors in 2001, there was an increase by 1937 in 2006, which represents a social impact having repercussions in the strengthening of the Municipal University Venues and in the benefit of the populations health (AU)


Asunto(s)
Sistemas de Salud
18.
Vaccimonitor ; 16(3)Sept.- Dic. 2007. ilus, graf
Artículo en Español | CUMED | ID: cum-35811

RESUMEN

El recubrimiento de los pisos, utilizando las resinas sintéticas autonivelantes en la construcción de las áreas controladas, empleadas en las instalaciones de producción de biológicos, en las dedicadas a los procesos de manipulación de microorganismos (contención), así como en las instalaciones para los animales de laboratorio y procesos asépticos de formulación farmacéutica, contribuyen a la seguridad biológica y farmacéutica, según sea el caso, por su continuidad integral y garantía de la calidad microbiológica del aire, así como al ahorro energético, pues disminuyen la ganancia de calor latente atribuido a la humedad incorporada al aire por otros recubrimientos permeables. Las condiciones climáticas de Cuba y la dureza del agua empleada en las mezclas cementosas son un alto potencial para la formación de “burbujas”, tema abordado en este trabajo. El conocimiento de los aspectos que provocan la formación de estas ampollas y las vías para evitarlo, son útiles y de un valor apreciable. En este artículo se presentan las experiencias obtenidas con la aplicación de los recubrimientos epoxídicos en las áreas controladas del Instituto Finlay, instalaciones que no han presentado deformaciones apreciables después de 15 años de explotación(AU)


Self-levelling epoxy resin flooring system applied in design and erection of clean rooms dedicated to both biopharmaceutical and contention laboratories and also in animal care facilities are of paramount importance in order to guarantee biological safety and pharmaceutical strength of production and research activities, microbiological air quality of facility environment andenergy saving. Hot and humid climates of Cuba as well as hardness of row water employed mixing concrete are prone to appear blisters on epoxy flooring layers. Knowledge and management of sources and facts that generate such flooring surface defectsare helpful and necessary to keep away from its observable fact. Epoxy flooring systems application at Finlay Instituteaccording to clean rooms regulations are showing(AU)


Asunto(s)
Pisos y Cubiertas de Piso
19.
AMIA Annu Symp Proc ; : 1078, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17238697

RESUMEN

A system using Unmanned Air Vehicles (UAVs), equipped for real time telemetry of video imagery, sensor support data, and GPS/INS navigation, is being developed to provide situational awareness (SA) to the central command of mass casualty incident response. UAVs provide an inexpensive and safe means of acquiring video surveillance in chaotic disaster scenes, while being durable and non-intrusive. The system provides autonomous surveillance of defined perimeters, video tracking and active following of targets of interest, and real time cueing to other imaging UAVs.


Asunto(s)
Aeronaves , Desastres , Trabajo de Rescate , Telemetría , Sistemas de Comunicación entre Servicios de Urgencia , Servicios Médicos de Urgencia , Sistemas de Información Geográfica , Grabación en Video
20.
Educ. med. super ; 14(1): 17-25, ene.-abr. 2000. tab
Artículo en Español | LILACS | ID: biblio-1511751

RESUMEN

Con el objetivo de verificar la capacidad predictiva de las pruebas de aptitud, el índice académico y los exámenes de ingreso, en relación con el rendimiento académico en la carrera de Medicina, se diseñó una investigación de seguimiento longitudinal de los estudiantes que ingresaron en el curso 91-92, utilizando los datos obtenidos durante el proceso selectivo y sus calificaciones durante los primeros 4 años de la carrera para la totalidad de las asignaturas del plan de estudio. Dada la naturaleza continua de la variable dependiente, el análisis estadístico descansó en lo esencial en el modelo de regresión múltiple. Se confirmó la relevancia del índice académico como predictor del rendimiento y se han aportado, tal vez, las primeras evidencias de la capacidad predictiva de los exámenes de ingreso. La capacidad pronóstica de las variables que se registran en el momento del ingreso se disipa a medida que el alumno transita de un curso a otro y su lugar lo ocupan los propios indicadores de rendimiento parcial


To verife predictive capacity of a aptitude tests, academic index and entrance examination., in relation to academic yield in medicine career, a longitudinal follow-up research was designed on students admited in 1991-1992 course, using data obtained during selective process and their qualifications in first 4 years of career to all subjects of course of study. Given the continuos nature of dependent variable, statistical analysis was based on the main multiple regression form. We confirmed relevance of academic index as a yield predictor, and perhaps first evidences of predictive ability of entrance examination have been provided. Prognostic abilities of variables registering in entrance, be dissipated as student pass from a course to another one, and his place is occupied by own indicators of partical yield


Asunto(s)
Criterios de Admisión Escolar , Estudiantes de Medicina , Valor Predictivo de las Pruebas
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