Impact of the Precursor on the Physicochemical Properties and Photoactivity of TiO2 Nanoparticles Produced in Supercritical CO2.

The synthesis of TiO2 nanoparticles (NPs) in supercritical media has been reported over the last two decades. However, very few studies have compared the physicochemical characteristics and photoactivity of the TiO2 powders produced from different precursors, and even fewer have investigated the effect of using different ratios of hydrolytic agent/precursor (HA/P) on the properties of the semiconductor. To bridge this knowledge gap, this research focuses on the synthesis and characterization of TiO2 NPs obtained in a supercritical CO2 medium from four different TiO2 precursors, namely diisopropoxytitanium bis (acetylacetonate) (TDB), titanium (IV) isopropoxide (TIP), titanium (IV) butoxide (TBO), and titanium (IV) 2-ethylhexyloxide (TEO). Further, the effect of various HA/P ratios (10, 20, 30, and 40 mol/mol) when using ethanol as a hydrolytic agent has also been analyzed. Results obtained have shown that the physicochemical properties of the catalysts are not significantly affected by these variables, although some differences do exist between the synthesized materials and their catalytic performances. Specifically, photocatalysts obtained from TIP and TEO at the higher HA/P ratios (HA/P = 30 and HA/P = 40) led to higher CO2 photoconversions (6.3-7 µmol·g-1·h-1, Apparent Quantum Efficiency < 0.1%), about three times higher than those attained with commercial TiO2 P-25. These results have been imputed to the fact that these catalysts exhibit appropriate values of crystal size, surface area, light absorption, and charge transfer properties.

Long-term cost-effectiveness analysis of sacral neuromodulation in the treatment of severe faecal incontinence.

AIM: The aim of this study was to evaluate the long-term cost-effectiveness of sacral neuromodulation in the treatment of severe faecal incontinence as compared with symptomatic management. METHODS: In the public health field, a micro-costing evaluation method was conducted from the perspectives of the health system and the society. The incremental cost-effectiveness ratio was used as a decision index, and we considered various scenarios to evaluate the impact of the cost of symptomatic management and percutaneous nerve evaluation success rate in its calculation. Clinical data were retrieved from a consecutive cohort of 93 patients with severe faecal incontinence undergoing sacral neuromodulation after a failure of conservative (pharmacological and biofeedback) and/or surgical (sphincteroplasty) first-line treatments were considered. RESULTS: The long-term incremental cost-effectiveness ratio comparing sacral neuromodulation versus symptomatic management was 14347€/QALY and 28523€/QALY from the societal and health service provider's perspectives, respectively. If the definitive pulse generator implant success rate was 100%, incremental cost-effectiveness would correspond to 6831€/QALY and 16761€/QALY, respectively. CONCLUSIONS: Sacral neuromodulation may be considered a cost-effective technique in the long-term treatment of severe faecal incontinence from the societal and health care sector perspectives. Improving patient selection and determining the predictive outcome factors for successful sacral neuromodulation in the treatment of faecal incontinence would improve cost-effectiveness.

Photocatalytic Reduction of CO2 with N-Doped TiO2-Based Photocatalysts Obtained in One-Pot Supercritical Synthesis.

The objective of this work was to analyze the effect of carbon support on the activity and selectivity of N-doped TiO2 nanoparticles. Thus, N-doped TiO2 and two types of composites, N-doped TiO2/CNT and N-doped TiO2/rGO, were prepared by a new environmentally friendly one-pot method. CNT and rGO were used as supports, triethylamine and urea as N doping agents, and titanium (IV) tetraisopropoxide and ethanol as Ti precursor and hydrolysis agent, respectively. The as-prepared photocatalysts exhibited enhanced photocatalytic performance compared to TiO2 P25 commercial catalyst during the photoreduction of CO2 with water vapor. It was imputed to the synergistic effect of N doping (reduction of semiconductor band gap energy) and carbon support (enlarging e--h+ recombination time). The activity and selectivity of catalysts varied depending on the investigated material. Thus, whereas N-doped TiO2 nanoparticles led to a gaseous mixture, where CH4 formed the majority compared to CO, N-doped TiO2/CNT and N-doped TiO2/rGO composites almost exclusively generated CO. Regarding the activity of the catalysts, the highest production rates of CO (8 µmol/gTiO2/h) and CH4 (4 µmol/gTiO2/h) were achieved with composite N1/TiO2/rGO and N1/TiO2 nanoparticles, respectively, where superscript represents the ratio mg N/g TiO2. These rates are four times and almost forty times higher than the CO and CH4 production rates observed with commercial TiO2 P25.

Metabolomics studies of allelopathy: a review

SUMMARY Introduction: Allelopathy is a harmful effect indirectly or directly produced by one plant to another through the production of chemical substances that enter the environment. Allelopathy has a pertinent significance for systems of ecological, sustainable, and integrated management. These natural reactions have multiple effects, ranging from processes of inhibition and stimulation of growth in neighbor plants to inhibition of seed germination. Metabolomics is a discipline integral that studies all the metabolites in a particular tissue, organ, or organism in a specific developmental stage or under particular environmental conditions, and it allows for the assessment of the contribution of genetic and environmental factors to the modification of metabolism. With the growing number of "omics", new approaches can be used to understand metabolic changes that occur in plants, especially in proteomics and metabolomics, and thus those analyses could be profiled in coming years with the objective of knowing the allelopathome of a larger number of plant species and their interactions. Aim: To provide a recent update on the science of allelopathy in the context of physiology, practical application of metabolomics in allelopathic studies, allelochemicals analyzed by metabolomics in alfalfa, rice, canola, sorghum, rye, wheat and other crops and finally mentionated the biological activity of allelopathic secondary metabolites. Methods: A recent comprehensive literature search of allelopathy and metabolomics in journal databases was carried out. Results: The concept of allelopathy, allelopathic mechanisms, metabolomic studies in allelopathy, allelochemicals analysed by metabolomics in alfalfa, rice, canola, rye sorghum, wheat and other agro-industrially important crops, and the biological activity of allelopathic secondary metabolites are detailed. Conclusions: These studies suggest that a combination of secondary metabolites can be used to attack weeds. In situ and In vitro culture of secondary metabolites (allelochemical types) is recommended to be used as organics compounds in weed organic control in the future.

Introducción: la alelopatía es un efecto nocivo producido directa o indirectamente por una planta a otra a través de la producción de sustancias químicas que ingresan al medio ambiente. La alelopatía es importante para los sistemas de manejo ecológico, sostenible e integrado. Estas reacciones naturales tienen múltiples efectos, que van desde procesos de inhibición y estimulación del crecimiento en plantas vecinas hasta la inhibición de la germinación de semillas. La metabolómica es una disciplina integral que estudia todos los metabolitos en un determinado tejido, órgano u organismo en una determinada etapa de desarrollo o en determinadas condiciones ambientales, y permite evaluar la contribución de los factores genéticos y ambientales a la modificación del metabolismo. Con el creciente número de "ómicas", se pueden utilizar nuevos enfoques para comprender los cambios metabólicos que ocurren en las plantas, especialmente en proteómica y metabolómica, y así esos análisis podrían perfilarse en los próximos años con el objetivo de conocer el alelopatoma de un mayor número. de las especies de plantas y sus interacciones. Objetivo: proporcionar una actualización reciente sobre la ciencia de la alelopatía en el contexto de la fisiología, la aplicación práctica de la metabolómica en los estudios alelopáticos, los aleloquímicos analizados por metabolómica en alfalfa, arroz, canola, sorgo, centeno, trigo y otros cultivos y, finalmente, mencionar los aspectos biológicos. actividad de los metabolitos secundarios alelopáticos. Métodos: se realizó una búsqueda bibliográfica exhaustiva reciente sobre alelopatía y metabolómica en bases de datos de revistas. Resultados: se detalla el concepto de alelopatía, los mecanismos alelopáticos, los estudios metabolómicos en alelopatía, los aleloquímicos analizados por metaboló-mica en alfalfa, arroz, canola, sorgo de centeno, trigo y otros cultivos de importancia agroindustrial, y la actividad biológica de los metabolitos secundarios alelopáticos. Conclusiones: estos estudios sugieren que se puede utilizar una combinación de metabolitos secundarios para atacar a las malas hierbas. Se recomienda el cultivo in situ e in vitro de metabolitos secundarios (de tipo aleloquímico) para ser utilizados como compuestos orgánicos en el control orgánico de las malas hierbas en el futuro.

Introdução: A alelopatia é um efeito nocivo produzido de forma indireta ou direta por uma planta a outra por meio da produção de substâncias químicas que adentram o meio ambiente. A alelopatia é importante para sistemas de manejo ecológico, sustentável e integrado. Essas reações naturais têm múltiplos efeitos, que vão desde processos de inibição e estimulação do crescimento em plantas vizinhas até a inibição da germinação de sementes. A metabolômica é uma disciplina integral que estuda todos os metabólitos em um determinado tecido, órgão ou organismo em um estágio de desenvolvimento específico ou condições ambientais particulares, e permite avaliar a contribuição de fatores genéticos e ambientais para a modificação do metabolismo. Com o crescente número de "ômicas", novas abordagens podem ser utilizadas para entender as alterações metabólicas que ocorrem nas plantas, principalmente em proteômica e metabolómica, e assim essas análises poderão ser perfiladas nos próximos anos com o objetivo de conhecer o alelopatoma de um número maior das espécies vegetais e suas interações. Objetivo: fornecer uma atualização recente sobre a ciência da alelopatia no contexto da fisiologia, aplicação prática da metabolômica em estudos alelopáticos, aleloquímicos analisados por metabolômica em alfafa, arroz, canola, sorgo, centeio, trigo e outras culturas e, finalmente, mencionar atividade de metabólitos secundários alelopáticos. Métodos: uma pesquisa bibliográfica abrangente recente sobre alelopatia e metabolismo foi conduzida em bancos de dados de periódicos. Resultados: o conceito de alelopatia, mecanismos alelopáticos, estudos metabólicos em alelopatia, aleloquímicos analisados por metabolômicos em alfafa, arroz, canola, sorgo de centeio, trigo e outros cultivos agroindustriais importantes, e a atividade biológica dos metabólitos secundários alelopáticos são detalhados. Conclusões: esses estudos sugerem que uma combinação de metabólitos secundários pode ser usada para atacar ervas daninhas. Recomenda-se o cultivo in situ e in vitro de metabólitos secundários (tipo alquímico) para uso como compostos orgânicos no controle de ervas daninhas orgânicas no futuro.

Recidiva e incidencia de fístula tras el drenaje urgente de un absceso anal. Resultados a largo plazo / Recurrence and incidence of fistula after urgent drainage of an anal abscess. Long-term results

Introducción: El absceso anal es el problema proctológico urgente más frecuente. La tasa de recidiva y la incidencia de fístula publicada tras el drenaje y desbridamiento de un absceso anal es ampliamente variable. El presente estudio tiene como objetivo analizar la tasa de recurrencia y la incidencia de fístula a largo plazo tras el drenaje y desbridamiento urgente de un absceso anal. Métodos: Estudio observacional retrospectivo de una cohorte prospectiva con absceso anal de origen criptoglandular. Todos los pacientes (n = 303) fueron evaluados a los dos meses y al año de la intervención. Al quinto año se revisaron todas las historias clínicas y se llamó telefónicamente o se citó en consulta para valoración. Se registraron los antecedentes específicos de patología anal, características del absceso, momento y tipo de la recidiva, presencia de sintomatología en la primera revisión y presencia de fístula clínica y/o ecográfica. Resultados: Seguimiento medio de 119,7 meses. Tasa de recidiva 48,2% (82,2% en 1er año). Doscientas veintidós ecografías realizadas. Incidencia de fístula ecográfica: 70% sintomáticos vs. 2,4% asintomáticos (p < 0,001). Incidencia global de fístula 40,3%. Los antecedentes de patología anal y la presencia de clínica en la revisión postoperatoria aumentan significativamente la posibilidad de recidiva (p < 0,001). La fístula es estadísticamente más frecuente si el absceso presenta recurrencia (p < 0,001). Conclusiones: Tras el drenaje y desbridamiento de un absceso anal la mitad de los pacientes recidivan y un 40% desarrollan fístula. Seguimientos mayores de un año no son necesarios. La ecografía endoanal para la evaluación de la presencia de fístula es muy cuestionable en ausencia de signos o síntomas(AU)

Introduction: Anal abscess is the most frequent urgent proctological problem. The recurrence rate and reported incidence of fistula after drainage and debridement of an anal abscess is widely variable. The objective of this study is to analyse the long-term recurrence rate and the incidence of fistula after drainage and urgent debridement of an anal abscess. Methods: Retrospective observational study of a prospective cohort with anal abscess of cryptoglandular origin. All patients (n = 303) were evaluated two months and one year after the intervention. At the 5th year, all the medical records were reviewed and a telephone call or appointment was made for an assessment if necessary. Specific antecedents of anal pathology, abscess characteristics, time and type of recurrence, presence of symptoms in the first revision and presence of clinical and/or ultrasound fistula were recorded. Results: Mean follow-up 119.7 months. Recurrence rate 48.2% (82.2% in the first year). Two hundred twenty-two ultrasounds performed. Incidence of ultrasound fistula: 70% symptomatic vs. 2.4% asymptomatic (p < 0.001). Global incidence of fistula 40.3%. The history of anal pathology and the presence of symptoms in the postoperative review significantly increase the possibility of recurrence (p < 0.001). The fistula is statistically more frequent if the abscess recurs (p < 0.001). Conclusion: After drainage and debridement of an anal abscess, half of the patients relapse and 40% develop fistula especially in the first year, so longer follow-ups are not necessary. Endoanal ultrasound for the evaluation of the presence of fistula is highly questionable in the absence of signs or symptoms(AU)

Recurrence and incidence of fistula after urgent drainage of an anal abscess. Long-term results.

INTRODUCTION: Anal abscess is the most frequent urgent proctological problem. The recurrence rate and reported incidence of fistula after drainage and debridement of an anal abscess is widely variable. The objective of this study is to analyse the long-term recurrence rate and the incidence of fistula after drainage and urgent debridement of an anal abscess. METHODS: Retrospective observational study of a prospective cohort with anal abscess of cryptoglandular origin. All patients (n = 303) were evaluated two months and one year after the intervention. At the 5th year, all the medical records were reviewed and a telephone call or appointment was made for an assessment if necessary. Specific antecedents of anal pathology, abscess characteristics, time and type of recurrence, presence of symptoms in the first revision and presence of clinical and/or ultrasound fistula were recorded. RESULTS: Mean follow-up 119.7 months. Recurrence rate 48.2% (82.2% in the first year). Two hundred twenty-two ultrasounds performed. Incidence of ultrasound fistula: 70% symptomatic vs. 2.4% asymptomatic (p < 0.001). Global incidence of fistula 40.3%. The history of anal pathology and the presence of symptoms in the postoperative review significantly increase the possibility of recurrence (p < 0.001). The fistula is statistically more frequent if the abscess recurs (p < 0.001). CONCLUSION: After drainage and debridement of an anal abscess, half of the patients relapse and 40% develop fistula especially in the first year, so longer follow-ups are not necessary. Endoanal ultrasound for the evaluation of the presence of fistula is highly questionable in the absence of signs or symptoms.

Fistulectomy and endorectal advancement flap repair for cryptoglandular anal fistula: recurrence and functional outcome over 10 years of follow-up.

PURPOSE: To examine long-term recurrence and anal continence of patients with anal fistula treated by fistulectomy and endorectal advancement flap repair. METHOD: Retrospective analysis of a prospective cohort of 115 patients (77.4% males, mean age 48.9 years) requiring 130 procedures, with a minimum follow-up of 10 years. Recurrence included reappearance of fistula after wound healing or presence of an abscess or chronic suppuration in the operated area at follow-up. Fecal incontinence was evaluated by the Cleveland Clinic Florida (CCF-FI) fecal incontinence scoring system. RESULTS: The mean and SD duration of the follow-up period was 155.5 (21.7) months. Recurrence developed in 31 (23.8%) cases, 28 (90.3%) of which within the first year, with a mean time to recurrence of 4.9 (2.9) months. The success rate was 76.2%. Anal continence was normal in 80% of patients before surgery, 63.8% at 1-year follow-up, and 71.5% at the end of follow-up (p < 0.001). Overall, continence worsened in 16.9% of cases. The mean (95% CI) CCF-FI score was 0.78 (0.35-1.21) preoperatively, 1.04 (0.64-1.43) at 1 year after surgery, 0.90 (0.52-1.29) at 5 years, and 1.16 (0.66-1.67) at the end of the study (p < 0.05). Neither recurrence nor continence was significantly associated with previous anal or fistula surgical procedures or complexity of the fistula. CONCLUSION: In this study, fistulectomy and endorectal advancement flap repair was associated with a long-term high rate of success. Most recurrences occurred within the first year and continence showed a mild deterioration over time. CLINICAL TRIAL REGISTRATION: Not applicable.

Juego, plasticidad cerebral y habilidades cognitivas / Game, brain plasticity and cognitive skills

La actividad de jugar es importante dentro del desarrollo humano, mientras se juega, se ponen en práctica distintas habilidades cognitivas en interacción con el funcionamiento de sistemas sensoriales y el sistema motor del cuerpo, lo cual se asocia a la construcción de aprendizajes. Jugar es una actividad que facilita comprender cómo es el mundo y cómo nos integramos en él. El presente artículo tiene como objetivo desarrollar una reflexión sobre la relación del juego con la plasticidad cerebral y el desarrollo de habilidades cognitivas. La hipótesis se centra en destacar el juego como una actividad que estimula la plasticidad cerebral y facilita el fortalecimiento de las habilidades cognitivas en todas las etapas del ciclo vital (no exclusivamente en la infancia). La guía de la cavilación consistió en una revisión del concepto de juego relacionado con conceptos de aprovechamiento de la plasticidad cerebral y estimulación de habilidades mentales. El propósito que ha orientado el artículo es convocar a la reflexión sobre la concepción y práctica del juego, con la intención de sumar a posicionar la actividad de jugar como una estrategia valiosa en los procesos de aprendizaje. El interés de los resultados se centra en dar sustento teórico a la acción de promover cada vez más la inclusión del juego en las intervenciones profesionales, en los procesos educativos y en las actividades de la vida cotidiana. La conclusión a la que se llega es que jugar resulta una excelente estrategia para facilitar la expresión de la plasticidad cerebral y las habilidades cognitivas.

The activity of playing is important within human development, while playing, different cognitive skills are put into practice in interaction with the functioning of sensory systems and the body's motor system, which is associated with the construction of learning. Playing is an activity thatmakes it easier to understand what the world is like and how we integrate ourselves into it. The present article aims to develop a reflection on the relationship between play and brain plasticity and the development of cognitive abilities. The hypothesis focuses on highlighting play as an activity that stimulates brain plasticity and facilitates the strengthening of cognitive abilities at all stages of the life cycle (not exclusively in childhood). The musing guide consisted of a review of the concept of play related to concepts of making use of brain plasticity and stimulating mental abilities. The purpose of the article is to call for reflection on the conception and practice of the game, with the intention of adding to position the activity of playing as a valuable strategy in the learning processes. The interest of the results is centered on giving theoretical support to the action of increasingly promoting the inclusion of the game in professional interventions, in educational processes and in activities of daily life. The conclusion reached is that playing is an excellent strategy to facilitate the expression of brain plasticity and cognitive abilities.

Removal of emerging pollutant dibutylhydroxytoluene from water with CNT/TiO2 catalysts in a visible LED photoreactor.

For the photocatalytic degradation of antioxidant 2,6-di-tert-butyl-hydroxytoluene (BHT), several TiO2-based composites have been prepared in MWCNT from titanium isopropoxide and ethanol via supercritical CO2 synthesis followed by calcination at 400 °C. TEM and XRD showed uniform coverage of CNT by 10 nm TiO2 particles in the anatase form, and spectral analyses revealed the formation of CNT/TiO2 structure. Further, synthesized material displayed significant visible light absorption and absorption edge shifted to longer wavelengths. Once the material was characterized, the effect of adsorption and photochemical degradation of BHT was investigated in the wavelength range from 400 to 700 nm, in batch mode, by monitoring the concentrations of BHT as a function of time. CNT/TiO2 composites were more efficient than commercial TiO2 P25 in the photodegradation of the antioxidant. In particular, CNT50/TiO250, a composite with 50% by weight of CNT, was the best catalyst, stable, and completely degrading BHT within 30 min of exposure to visible light. The role played by different reactive oxidative species (h+, OH ·, 1O2, and [Formula: see text]) in the photocatalytic reaction was also studied by using appropriate radical scavengers that inhibited the corresponding active species. Superoxide radical was found the main oxidizing agent.

Recurrence and incidence of fistula after urgent drainage of an anal abscess. Long-term results. / Recidiva e incidencia de fístula tras el drenaje urgente de un absceso anal. Resultados a largo plazo.

INTRODUCTION: Anal abscess is the most frequent urgent proctological problem. The recurrence rate and reported incidence of fistula after drainage and debridement of an anal abscess is widely variable. The objective of this study is to analyse the long-term recurrence rate and the incidence of fistula after drainage and urgent debridement of an anal abscess. METHODS: Retrospective observational study of a prospective cohort with anal abscess of cryptoglandular origin. All patients (n = 303) were evaluated two months and one year after the intervention. At the 5th year, all the medical records were reviewed and a telephone call or appointment was made for an assessment if necessary. Specific antecedents of anal pathology, abscess characteristics, time and type of recurrence, presence of symptoms in the first revision and presence of clinical and/or ultrasound fistula were recorded. RESULTS: Mean follow-up 119.7 months. Recurrence rate 48.2% (82.2% in the first year). Two hundred twenty-two ultrasounds performed. Incidence of ultrasound fistula: 70% symptomatic vs. 2.4% asymptomatic (p < 0.001). Global incidence of fistula 40.3%. The history of anal pathology and the presence of symptoms in the postoperative review significantly increase the possibility of recurrence (p < 0.001). The fistula is statistically more frequent if the abscess recurs (p < 0.001) CONCLUSION: After drainage and debridement of an anal abscess, half of the patients relapse and 40% develop fistula especially in the first year, so longer follow-ups are not necessary. Endoanal ultrasound for the evaluation of the presence of fistula is highly questionable in the absence of signs or symptoms.

Metabolomic data of phenolic compounds from Acer negundo extracts.

Phytochemical and metabolomic data were obtained for the most important phenolic compounds in ethanolic extracts from the endangered Acer negundo tree in Morelia, Michoacan. Samples of leaves and stems were subjected to ethanolic extraction with electric rotavapor. We developed a metabolomic analysis that encompassed the correlation between the leaf and stem extracts through principal component analysis. The data were obtained with an infinity Agilent ultrahigh resolution liquid chromatograph coupled to a Agilent triple quadrupole mass spectrometer. The protocol used was a dynamic MRM (Multiple Reaction Monitoring). Clustering result shown as heatmap (distance measure using euclidean, and clustering algorithm using ward.D).

Overview of the current situation regarding the coronavirus. / Panorama de la situación actual con respecto al coronavirus.

Coronaviruses (CoV) are pathogens that are transmitted to animals and humans; they spread around the world. Six types of coronavirus have been identified as causing human disease: four cause mild respiratory symptoms, while two types, the Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS), have caused epidemics with high mortality rates. Human coronaviruses cause common cold, lead to lower respiratory tract infections and are involved in pediatric gastroenteritis. Currently, the coronavirus SARS-CoV-2 has been transmitted between species, included humans, and is a very virulent respiratory virus, causing the disease known as COVID-19, which to date, has not an authorized medical treatment. The World Health Organization announced that the outbreak of COVID-19 has been upgraded from a health emergency to a pandemic. Therefore, the objectives of this paper are to mention the basic concepts of coronavirus (structure, genome, mutation and recombination), its epidemiological description, animal-human transmission mechanism, pathogenesis and therapeutics.

Los coronavirus (CoV) son patógenos que se transmiten a los animales y a los humanos; tienen una distribución mundial. Se han identificado seis tipos de CoV como causantes de enfermedades humanas: cuatro causan síntomas respiratorios leves, mientras que dos tipos, el síndrome respiratorio del Medio Oriente (MERS) y el síndrome respiratorio agudo severo (SARS), han causado epidemias con altas tasas de mortalidad. Los coronavirus humanos causan el resfriado común, provocan infecciones de las vías respiratorias inferiores y están implicados en la gastroenteritis infantil. En la actualidad, el coronavirus SARS-CoV-2 se ha transmitido entre especies, incluido el hombre, y tiene la característica de ser un virus respiratorio muy virulento que causa la enfermedad conocida como COVID-19, la cual hasta la fecha no tiene un tratamiento médico autorizado. La Organización Mundial de la Salud anunció que el brote de COVID-19 ha pasado de ser una emergencia sanitaria a una pandemia. Por lo tanto, los objetivos de este documento son mencionar las generalidades de los coronavirus (estructura, genoma, mutación y recombinación), la descripción epidemiológica, el mecanismo de transmisión entre animales y humanos, la patogénesis y la terapéutica.

Improved Outcomes in Hemodialysis/Hemodiafiltration Treatments Applying Exercise and Physiological Monitoring Techniques: Preliminary Results.

End-stage renal disease affects millions of people worldwide, and the only definitive solutions are renal transplants that are not widely available. Temporary solutions are renal replacement therapies such as peritoneal dialysis, hemodialysis and hemodiafiltration. These therapies as they are applied today are just partial measures and have many drawbacks and complications such as high mortality rates and high costs due to the use of supplemental drugs and emergency room visits. Many enhancements to the therapies have been published, but they are not applied consistently in real world practice. Our work presents the results from the systematic application of several techniques to provide individualized therapies that can minimize the drawbacks and improve patient outcomes. This approach is based on the use of exercise, analysis of cardiovascular parameters, such as heart-rate variability, body composition and dry weight measurements through the use of bioimpedance and real-time monitoring of energy expenditure and nutrition intradialytically in order to provide individualized and dynamically variable therapies. Results show that patients can lead long, productive lives while maintaining a quality of life equivalent to that of a renal transplant.

Assessment of urinary TWEAK levels in Mexican patients with untreated lupus nephritis: An exploratory study / Evaluación de los niveles urinarios de TWEAK en pacientes mexicanos con nefritis lúpica sin tratamiento farmacológico: Estudio exploratorio

Objectives: Urinary levels of TWEAK (uTWEAK) may be correlated with the degree of lupus nephritis (LN) activity. Our objective was to determine the sensitivity and specificity of uTWEAK in Mexican patients with untreated active lupus nephritis. Methods: An exploratory study was performed; four groups of patients were analyzed as follows: 1) patients with systemic lupus erythematosus (SLE) without renal activity (SLE-LN), 2) patients with SLE with renal activity (SLE+LN), 3) patients with other types of glomerulopathy (glomerulonephritis, GMN), 4) and healthy patients (controls). Results: In all, 44 patients, with an average age of 35.9±11.5 years, were evaluated. uTWEAK levels were higher in patients with SLE+LN compared with patients in the other groups: SLE+LN 12.88±8.33, SLE-LN 3.12±2.31, GMN 4.36±2.31 and controls 2.41±1.94pg/mg Cr (p=0.007). A total of 72.7% of the cases had renal activity index scores above 12, and 90.9% of the cases had scores of chronicity below 6 points. Receiver Operating Characteristic (ROC) curve analysis revealed that uTWEAK levels above 4.91pg/mg Cr had a sensitivity of 81% and a specificity of 75% for the diagnosis of renal activity due to lupus, with an area under the curve of 0.876 (95% CI: 0.75-0.99). However, no significant correlation was observed between the levels of uTWEAK and the histological findings specific to the activity and chronicity associated with SLE. Conclusions: Our study revealed that uTWEAK can adequately distinguish renal activity due to lupus, but cannot predict the degree of histological activity in Mexican patients with active lupus nephropathy (AU)

Objetivos: Los niveles urinarios de TWEAK (uTWEAK) pueden correlacionarse con el grado de actividad de nefritis lúpica (NL). Nuestro objetivo fue determinar la sensibilidad y especificidad de los uTWEAK en pacientes mexicanos con NL activa sin tratamiento farmacológico previo. Metodología: Se realizó un estudio exploratorio en el que se incluyeron 4 grupos de pacientes: 1) pacientes con lupus eritematoso sistémico sin actividad renal (LES-NL); 2) pacientes con lupus eritematoso sistémico con actividad renal (LES+NL); 3) pacientes con otras glomerulopatías y 4) controles sanos. Resultados: La edad promedio de los 44 pacientes fue de 35,9±11,5 años. Los uTWEAK fueron más elevados en pacientes con LES+NL comparados con los otros grupos: LES+NL (12,88±8,33), LES-NL (3,12±2,31), otras glomerulopatías (4,36±2,31) y grupo control (2,41±1,94pg/mgCr) (p=0,007). En el 72,7% de los casos se observó un índice de actividad renal mayor a 12 puntos y en el 90,9% de los casos los índices de cronicidad estaban por debajo de 6 puntos. La curva ROC reveló que los niveles urinarios por encima de 4,91pg/mg Cr tienen sensibilidad del 81% y especificidad del 75% para el diagnóstico de actividad renal secundaria a lupus, con área debajo de la curva de 0,876 (IC 95%: 0,75-0,99). Sin embargo, no se observó correlación significativa entre los uTWEAK y los hallazgos histológicos específicos de actividad y cronicidad asociados a LES. Conclusiones: Nuestro estudio revela que los uTWEAK pueden distinguir adecuadamente actividad renal secundaria a lupus, pero no predicen el grado de actividad histológica en pacientes mexicanos con NL activa (AU)

Assessment of urinary TWEAK levels in Mexican patients with untreated lupus nephritis: An exploratory study.

OBJECTIVES: Urinary levels of TWEAK (uTWEAK) may be correlated with the degree of lupus nephritis (LN) activity. Our objective was to determine the sensitivity and specificity of uTWEAK in Mexican patients with untreated active lupus nephritis. METHODS: An exploratory study was performed; four groups of patients were analyzed as follows: 1) patients with systemic lupus erythematosus (SLE) without renal activity (SLE-LN), 2) patients with SLE with renal activity (SLE+LN), 3) patients with other types of glomerulopathy (glomerulonephritis, GMN), 4) and healthy patients (controls). RESULTS: In all, 44 patients, with an average age of 35.9±11.5 years, were evaluated. uTWEAK levels were higher in patients with SLE+LN compared with patients in the other groups: SLE+LN 12.88±8.33, SLE-LN 3.12±2.31, GMN 4.36±2.31 and controls 2.41±1.94pg/mg Cr (p=0.007). A total of 72.7% of the cases had renal activity index scores above 12, and 90.9% of the cases had scores of chronicity below 6 points. Receiver Operating Characteristic (ROC) curve analysis revealed that uTWEAK levels above 4.91pg/mg Cr had a sensitivity of 81% and a specificity of 75% for the diagnosis of renal activity due to lupus, with an area under the curve of 0.876 (95% CI: 0.75-0.99). However, no significant correlation was observed between the levels of uTWEAK and the histological findings specific to the activity and chronicity associated with SLE. CONCLUSIONS: Our study revealed that uTWEAK can adequately distinguish renal activity due to lupus, but cannot predict the degree of histological activity in Mexican patients with active lupus nephropathy.

Frecuencia de colonización y sensibilidad de Staphylococcus aureus en un grupo de niños sanos en Asunción

Introducción: La portación nasal de Staphylococcus aureus (SA) en individuos sanos constituye una fuente potencial de infección. La prevalencia de infecciones por SA adquiridas en la comunidad ha aumentado entre los niños sanos. Aunque la epidemiología de la colonización e infección por SA en otros países se ha estudiado ampliamente, los datos son limitados en el Paraguay. Objetivos: Determinar la prevalencia de la portación nasal por SA y su susceptibilidad antimicrobiana en una población de escolares sanos en Asunción, y evaluar factores de riesgo asociados a la colonización. Material y métodos: Estudio multicéntrico, prospectivo, descriptivo y analítico, sobre la colonización nasal por SA en niños de 5 a 16 años, durante el periodo comprendido entre junio y julio del 2016. Previa autorización de los padres y la escuela, se recogieron datos demográficos y factores de riesgo para la colonización. La determinación de SA se realizó mediante muestras de hisopado de las narinas de los niños. Se realizaron pruebas de susceptibilidad antimicrobiana en Agar Mueller y la sensibilidad a la vancomicina se realizó mediante tiras de E-Test®. Los datos fueron registrados en planillas Excel y analizados con el software R v.3.4.2 Resultados: 299 niños fueron incluidos en el estudio. De estos, 58%(173) eran mujeres con una media de edad de 10,6 (±2,5) años. El 79,9% procedía de Asunción y vivía con una media de 5,1 (±1,8) habitantes en el domicilio. Se determinó la presencia de SA en el 30,8% (92/299) de los niños. El 63% de los niños refirió algún factor de riesgo para la colonización por SA. Se objetivo que el antecedente de una enfermedad previa OR=1,92 (95%IC 0,88-4,28), el uso de antibióticos previos OR=1,51 (95%IC 0,89-2,55), la convivencia con mascotas OR=1,42(95%IC 0,81-2,50) y los tratamientos crónicos OR=1,20 (95%IC 0,55-2,61) fueron las variables asociadas a un mayor riesgo de presentar colonización por SA. Conclusión: En el presente estudio se objetivó que el 30,8% de los niños incluidos en el estudio presentaba colonización por SA y que los factores asociados a un mayor riesgo de colonización han sido el antecedente de una enfermedad previa, el uso de antibióticos, la convivencia con mascotas y los tratamientos crónicos.

Introduction: Staphylococcus aureus (SA) nasal carriage in healthy individuals is a potential source of infection. The prevalence of SA infections acquired in the community has increased among healthy children. Although the epidemiology of colonization and infection by SA in other countries has been studied extensively, data are limited in Paraguay. Objectives: To determine the prevalence of nasal carriage by SA and its antimicrobial susceptibility in a population of healthy schoolchildren in Asunción, and to evaluate risk factors associated with colonization. Material and methods: This was a multicenter, prospective, descriptive and analytical study on nasal colonization by SA in children aged 5 to 16 years between June and July 2016. After obtaining authorization from parents and the school, we collected data on demographics and on risk factors for colonization. The SA colonization determination was made by swabbing samples from the children's nostrils. Antimicrobial susceptibility tests were performed on Mueller Agar and the sensitivity to vancomycin was made using E-Test® strips. The data were recorded in Excel spreadsheets and analyzed with the R v.3.4.2 software. Results: 299 children were enrolled in the study. Of these, 58% (173) were female with an average age of 10.6 (± 2.5) years. 79.9% came from Asunción and lived with an average of 5.1 (± 1.8) inhabitants at home. The presence of SA was detected in 30.8% (92/299) of the children. 63% of children reported some risk factor for colonization by SA. We found that a history of a previous disease OR = 1.92 (95% CI 0.88-4.28), the use of previous antibiotics OR = 1.51 (95% CI 0.89-2.55), cohabitation with pets OR = 1.42 (95% CI 0.81-2.50) and chronic treatments OR = 1.20 (95% CI 0.55-2.61) were the variables associated with an increased risk for colonization by SA. Conclusion: In the present study it was found that 30.8% of the children enrolled in the study were colonized by SA and that factors associated with an increased risk of colonization were a history of a previous disease, the use of antibiotics, coexistence with pets and chronic treatments.

Cytochrome P450 complement (CYPome) of Candida oregonensis, a gut-associated yeast of bark beetle, Dendroctonus rhizophagus.

Bark beetles (Curculionidae: Scolytinae) and associated microorganisms must overcome a complex tree's defence system, which includes toxic monoterpenes, to successfully complete their life cycle. A number of studies have suggested these microorganisms could have ecological roles related with the nutrition, detoxification, and semiochemical production. In particular, in filamentous fungi symbionts, cytochrome P450 (CYP) have been involved with terpenoid detoxification and biotransformation processes. Candida oregonensis has been isolated from the gut, ovaries, and frass of different bark beetle species, and it is a dominant species in the Dendroctonus rhizophagus gut. In this study, we identify, characterise, and infer the phylogenetic relationships of C. oregonensis CYP genes. The results indicate that the cytochrome P450 complement (CYPome) is composed of nine genes (CYP51F1, CYP61A1, CYP56D1, CYP52A59, CYP52A60, CYP52A61, CYP52A62, CYP5217A8, and CYP5217B1), which might participate in primary metabolic reactions such as sterol biosynthesis, biodegradation of xenobiotic, and resistance to environmental stress. The prediction of the cellular location suggests that these CYPs to be anchored to the plasma membrane, membranes of the endoplasmic reticulum, mitochondria, and peroxisomes. These findings lay the foundation for future studies about the functional role of P450s, not only for yeasts, but also for the insects with which they interact.

Cultivation-independent approach for the direct detection of bacteria in human clinical specimens as a tool for analysing culture-negative samples: a prospective study.

Administration of empirical antibiotic therapy prior to microbiological diagnosis is thought to be associated the failure of subsequent bacterial growth in culture. The aim of this study was to detect bacterial pathogens via direct amplification and sequencing of the 16S rDNA gene in samples showing negative culture results as alternative diagnostic tools to troubleshoot difficult samples. Twenty-three (7.66 %) positive samples were detected, most of which were monomicrobial infections; 15 of the cases were identified as HAIs, 6 had catheter colonisation, and 2 had sample colonisation. The pathogens identified included Escherichia, Salmonella, Pseudomonas spp., Enterococcus spp. and coagulase-negative staphylococci (CoNS). The most frequent infections were bacteraemia and urinary tract infection, but meningitis, warm infection and soft tissue infection were also documented. These findings emphasise the efficacy and usefulness of molecular diagnosis, thus 16S rDNA gene analysis is strongly indicated by HAIs diagnostics.

Validez de las bases de datos administrativas para realizar ajustes de riesgo en el análisis de los efectos adversos producidos en pacientes quirúrgicos / Usefulness of administrative databases for risk adjustment of adverse events in surgical patients

OBJETIVO: Conocer la validez de las bases de datos clínico-administrativas para realizar ajustes de riesgo en el estudio de los efectos adversos que pueden sufrir los pacientes intervenidos quirúrgicamente. MÉTODOS: Se estudiaron 1.602 episodios de hospitalización de pacientes intervenidos quirúrgicamente durante los años 2008 y 2010 en un hospital terciario situado en el norte de España. Se analizaron 40 variables de comorbilidades que recoge el Colegio Americano de Cirujanos en el National Surgical Quality Improvement Program (NSQIP) a través de 2 fuentes de información: el conjunto mínimo básico de datos (CMBD) y los datos extraídos de la historia clínica completa (HC), considerada como patrón oro. Se catalogaron las variables en función de que los valores de sensibilidad (S), valor predictivo positivo (VPP) y kappa (K) fueran superiores a 0,6. RESULTADOS: La media de comorbilidades por paciente fue de 1,6 mediante la HC y de 0,95 a través del CMBD (p < 0,0001). El CMBD no detectó ningún caso en 13 comorbilidades (estas supusieron el 8% de las comorbilidades detectadas con la HC). De las 27 comorbilidades restantes, 5 cumplieron los 3 criterios establecidos (S, VPP y k > 0,6), 2 enfermedades cumplieron 2 criterios, 12 cumplieron al menos uno y 8 no cumplieron ninguno. CONCLUSIÓN: Las bases de datos clínico-administrativas detectaron comorbilidades como diabetes o hipertensión arterial pero no aportaron suficiente información para recoger las variables necesarias para hacer el ajuste de riesgo propuesto por el NSQIP para la medición de los efectos adversos en pacientes quirúrgicos

PURPOSE: The aim of this study was to assess the usefulness of clinical-administrative databases for the development of risk adjustment in the assessment of adverse events in surgical patients. METHODS: The study was conducted at the Hospital of Navarra, a tertiary teaching hospital in northern Spain. We studied 1602 hospitalizations of surgical patients from 2008 to 2010. We analysed 40 comorbidity variables included in the National Surgical Quality Improvement (NSQIP) Program of the American College of Surgeons using 2 sources of information: The clinical and administrative database (CADB) and the data extracted from the complete clinical records (CR), which was considered the gold standard. Variables were catalogued according to compliance with the established criteria: sensitivity, positive predictive value and kappa coefficient > 0.6. RESULTS: The average number of comorbidities per study participant was 1.6 using the CR and 0.95 based on CADB (p < .0001). Thirteen types of comorbidities (accounting for 8% of the comorbidities detected in the CR) were not identified when the CADB was the source of information. Five of the 27 remaining comorbidities complied with the 3 established criteria; 2 pathologies fulfilled 2 criteria, whereas 11 fulfilled 1, and 9 did not fulfil any criterion. CONCLUSION: CADB detected prevalent comorbidities such as comorbid hypertension and diabetes. However, the CABD did not provide enough information to assess the variables needed to perform the risk adjustment proposed by the NSQIP for the assessment of adverse events in surgical patients