Review of carbapenemics de-escalation in extended-spectrum b-lactamases producing enterobacteriaceae urinary tract infections in clinical practice / Revisión de la desescalada de carbapenémicos en las infecciones del tracto urinario por enterobacterias productoras de betalactamasas

The indiscriminate use of carbapenem antibiotics in urinary tract infections poses a risk of increasing antimicrobial resistance to them. The use of carbapenem antibiotics should be reserved for those urinary tract infections caused by extended-spectrum β-lactamases -producing Enterobacteriaceae. However, there is sufficient evidence of the possibility of using different therapeutic options to carbapenems in certain infections with extended-expectrum β-lactamases isolation and sensitivity data. Of the patients analysed in the study, those with urinary tract infection by extended-spectrum β-lactamases -producing Enterobacteriaceae treated with antibiotics other than carbapenemics based on susceptibility data, achieved resolution of infection in those cases where they were clinically well, so the use of these alternatives would be an appropriate optimisation and rational use of carbapenemic. (AU)

El uso indiscriminado de antibióticos carbapenémicos en infecciones del tracto urinario supone un riesgo de aumento de la resistencia antimicrobiana a los mismos. El uso de antibióticos carbapenémicos debe reservarse para aquellas infecciones del tracto urinario causadas por Enterobacterias productoras de betalactamasas de espectro extendido. Sin embargo, existe evidencia suficiente de la posibilidad de utilizar opciones terapéuticas diferentes a los carbapenémicos en determinadas infecciones con datos de sensibilidad. De los pacientes analizados en el estudio, aquellos con infección del tracto urinario por Enterobacterias productoras de betalactamasas de espectro extendido y tratados con antibióticos distintos a los carbapenémicos según datos de sensibilidad, consiguieron resolver la infección en aquellos casos en los que presentaban buen estado clínico por lo que el uso de estas alternativas supondría una adecuada optimización y uso racional de carbapenémicos. (AU)

La función diagnóstica en salud mental infantil ¿Estamos patologizando el sufrimiento propio de la experiencia humana? / No disponible

El objetivo de este artículo editorial es difundir los comentarios y reflexiones más destacadas del "Encuentro de socios de la Asociación de Científicos en Salud Mental del Niño y del Adolescente- Fundación Alicia Koplowitz del 2019" como opinión de expertos para invitar a reflexión de profesionales sobre los diagnósticos en salud mental infantil

No disponible

Evaluación de la administración de carboximaltosa férrica intravenosa en la consulta de enfermedad renal crónica avanzada, para el control de la anemia / Evaluation of the intravenous administration of iron carboxymaltose for controlling anemia in advanced chronic kidney disease

La carboximaltosa férrica es una formulación de hierro endovenosa segura y de fácil dosificación, se puede administrar hasta 1 gramo iv en una sola sesión y permite ahorro de tiempo de los pacientes y de enfermería. Presentamos los resultados de su administración en una consulta de enfermedad renal crónica, analizando sus resultados y la repercusión en la carga de trabajo del personal de enfermería. Material y Métodos: Se analizaron todos los pacientes en seguimiento de la consulta de enfermedad renal crónica en nuestro centro desde Ene-11 hasta Dic-14 que recibieron carboximaltosa férrica iv. Se registraron sus datos basales y los resultados clínicos y analíticos a los seis meses. Resultados: Fueron identificados 85 pacientes en ese periodo. Edad media de 72±12 años, con un filtrado glomerular estimado basal de 28±11ml/min y a los seis meses de 30±11 (p:n.s). La hemoglobina basal y a los seis meses fueron de 10±4 y 11±3 g/dl respectivamente (p:<0,001). El hematocrito basal y final fueron: 34±4 vs 39±6 % (p:<0,001). Los niveles de ferritina e índice de saturación de transferrina basales vs seis meses fueron respectivamente: 88±97 vs 308±327 ng/ml (p:<0,001) y 11,2±6 vs 22,3±11 (p:<0,001). Dado que el tiempo medio de administración de cualquier formulación de hierro endovenoso es de 30 minutos, la estimación en base al número de administraciones es de un ahorro de 85 y 170 horas en estos 4 años si se compara con formulaciones que requieren de tres a cinco sesiones respectivamente. A su vez el número de punciones se ha reducido, sin observarse complicaciones asociadas. Conclusiones: La carboximaltosa férrica es segura y eficaz mostrando una recuperación de los niveles de hemoglobina y de los depósitos de hierro. Su facilidad de administración ha permitido ahorros sustanciales de tiempo. Esto junto a sus escasos efectos secundarios la hacen idónea para la administración ambulatoria (AU)

Ferric carboxymaltose is a safe and easy dosage of intravenous iron formulation; it can be administered intravenously up to 1 gram in a single session and allows time savings of patients and nursing. We present the results of his administration in a unit of chronic kidney disease, analyzing the results and the impact on the workload of the nursing staff. Materials and methods: All patients followed in the chronic kidney disease unit at our center from January 2011 to December 2014 and who received intravenous iron carboxymaltose were analyzed. Their baseline data and clinical and laboratory results at six months were recorded. Results: 85 patients were identified during this period. Mean age of 72 ± 12 years, with a baseline estimated glomerular filtration rate of 28 ± 11 ml / min and at six months of 30 ± 11 (p >0.05). Baseline and at six months hemoglobin levels were 10 ± 4 and 11 ± 3 g / dl, respectively (p <0.001). The basal and final hematocrit were: 34 ± 4 vs 39 ± 6% (p <0.001). Baseline ferritin levels and transferrin saturation index versus levels at six months were respectively: 88 ± 97 vs 308 ± 327 ng / ml (p <0.001) and 11.2 ± 6 vs 11 ± 22.3 (p <0.001 ). Since the average administration time by any formulation of intravenous iron is 30 minutes, the estimate based on the number of administrations is a saving of 85 and 170 hours on these four years when compared with formulations that require three to five respectively sessions. In turn, the number of punctures has been reduced without associated complications observed. Conclusion: Carboxymaltose iron is safe and effective showing a recovery of hemoglobin levels and iron deposits. Its ease of administration has allowed substantial time savings. This, together with its few side effects makes it ideal for outpatient administration (AU)

Oxalate secretion by ectomycorrhizal Paxillus involutus is mineral-specific and controls calcium weathering from minerals.

Trees and their associated rhizosphere organisms play a major role in mineral weathering driving calcium fluxes from the continents to the oceans that ultimately control long-term atmospheric CO2 and climate through the geochemical carbon cycle. Photosynthate allocation to tree roots and their mycorrhizal fungi is hypothesized to fuel the active secretion of protons and organic chelators that enhance calcium dissolution at fungal-mineral interfaces. This was tested using (14)CO2 supplied to shoots of Pinus sylvestris ectomycorrhizal with the widespread fungus Paxillus involutus in monoxenic microcosms, revealing preferential allocation by the fungus of plant photoassimilate to weather grains of limestone and silicates each with a combined calcium and magnesium content of over 10 wt.%. Hyphae had acidic surfaces and linear accumulation of weathered calcium with secreted oxalate, increasing significantly in sequence: quartz, granite < basalt, olivine, limestone < gabbro. These findings confirmed the role of mineral-specific oxalate exudation in ectomycorrhizal weathering to dissolve calcium bearing minerals, thus contributing to the geochemical carbon cycle.

Meningitis bacteriana por Streptococcus pyogenes: revisión de la literatura / Bacterial meningitis due to Streptococcus pyogenes: literature review

Introducción: el Streptococcus pyogenes (S. pyogenes) es una etiología poco habitual de meningitis bacteriana a pesar de ser un germen que frecuentemente produce infecciones en otras localizaciones en la edad pediátrica. Material y métodos: se revisaron los casos de bacteriemia por S. pyogenes y los factores de riesgo asociados en la base de datos del Servicio de Microbiología del Hospital Universitario La Paz desde junio de 2002 a junio de 2012. Resultados: únicamente se encontró un caso de bacteremia por S. pyogenes asociado a meningitis, que se describe en este artículo. Conclusiones: a pesar de su baja incidencia, se debe tener en cuenta el S. pyogenes en el diagnóstico diferencial de meningitis bacterianas, especialmente en pacientes con factores de riesgo asociados (AU)

Introduction: Streptococcus pyogenes (S. pyogenes) is a rare cause of meningitis despite being a common source of pediatric infections in other sites. Material and methods: A search was performed of the pediatric patients with S. pyogenes bacteremia in the microbiology database of the Hospital Infantil La Paz from June 2002 until June 2012. Results: A single case of S. pyogenes meningitis was found and is reported in this article. Conclusions: Despite its low incidence, S. pyogenes should be considered in the differential diagnosis of meningitis, particularly in patients with associated risk factors (AU)

Study of the mechanisms of cadmium biosorption by dealginated seaweed waste.

The ability of dealginated seaweed waste, a waste material derived from the commercial processing of seaweed for alginate production, to remove cadmium from solution was determined. Cadmium sorption was found to be rapid (91% removal within 5 min), achieving a residual concentration of 0.8 mg L-1 after 1-h contact time from an initial solution concentration of 10 mg L-1. The binding of cadmium by dealginate was found to be pH dependent, optimal sorption occurring at around pH 6-8. The mechanism of cadmium ion binding by dealginate was investigated by a number of techniques. Potentiometric titration of the dealginate revealed two distinct pKa values, the first having a value similar to carboxyl groups and the second comparable with that of saturated thiols and amines. Esterification of the dealginate resulted in the subsequent reduction in cadmium sorption (95% to 17%), indicating that carboxyl groups are largely responsible for sorption. Evidence from FT-IR spectra confirmed the presence of carboxyl groups in untreated dealginate, while the number of carboxyl groups was markedly reduced in the esterified sample. Furthermore, the FT-IR spectrum for dealginate was found to be similar to that previously reported for mannuronic acid-rich calcium alginate. Determination of a molar ratio in the displacement of calcium by cadmium on dealginate further supported the presence of an ion-exchange relationship. The ion-exchange constant was calculated to be 0.329 x 10(-6). The speciation of cadmium in solution both before and after sorption was determined by an ion-selective electrode (ISE) technique. The findings of this study suggest that the sorption of cadmium by dealginate is mainly due to an ion-exchange mechanism.

[Frequency of D virus markers at a specialty hospital]. / Frecuencia de marcadores del virus D en un hospital de especialidades.

Considering that hepatitis B infection prevalence is high in our hospital, we felt it necessary to determine the frequency of the delta hepatitis. We studied 85 consecutive patients who were HBsAg positive analyzing the delta antibody through the immunoenzymatic method. We found 2 cases (2.3%); one being coinfection and other one an superinfection. Because delta virus not only influences the prognosis but also the therapeutic response total treatment of hepatitis B we recommended the routine detection of delta virus.