Appropriateness of Acetaminophen Dosing by Caregivers of Pediatric Patients Presenting to the Emergency Department at the University Pediatric Hospital in Puerto Rico.

OBJECTIVE: Evaluate the appropriateness of acetaminophen dosing by caregivers seeking care for their children/wards at the emergency department of a pediatric hospital. METHODS: Design: Cross-sectional descriptive study. Setting: The emergency department of the University Pediatric Hospital in San Juan, Puerto Rico. Participants: Eighty-eight caregivers who had, in the past 24 hours, administered a known quantity of acetaminophen to a pediatric patient under their care and were visiting the emergency room with that patient. Intervention: The caregivers were interviewed by the investigators, using a standardized questionnaire. Main outcome measures: The appropriateness of the acetaminophen doses administered by caregivers. The product's dosage form and strength, measurement device used (if any), and demographic data (of the caregiver and child) were also collected. Doses of 10 to 15 mg/kg of acetaminophen were considered appropriate. RESULTS: Overall, 45% of the caregivers had administered an inappropriate dose. Of these, 70% were subtherapeutic and 30% were supratherapeutic. Although 74% of the caregivers knew their child's/ward's weight, only 50% had used it to determine the dose. Caregivers with previous experience (as caregivers) were most likely to have administered an inappropriate dose (P = 0.03). Physicians were the source most consulted (40%) by caregivers, followed by the product's label (35%). Only 9% of the caregivers consulted a pharmacist for dosing recommendations. CONCLUSION: Nearly half of all the caregivers administered an incorrect acetaminophen dose, suggesting that there is a need for better caregiver education. Due to their accessibility at the point of sale of OTC medications and pharmacotherapy knowledge, pharmacists could have an active role in promoting the safe and effective use of acetaminophen.

Globalized low-income countries may experience higher COVID-19 mortality rates

Understanding the factors underpinning COVID-19 infection and mortality rates is essential in order to implement actions that help mitigate the current pandemic. Here we evaluate how a suit of 15 climatic and socio-economic variables influence COVID-19 exponential growth-phase infection and mortality rates across 36 countries. We found that imports of goods and services, international tourism and the number of published scientific papers are good predictors of COVID-19 infection rates, indicating that more globalized countries may have experienced multiple and recurrent introductions of the virus. However, high-income countries showed lower mortality rates, suggesting that the consequences of the current pandemic will be worse for globalized low-income countries. International aid agencies could use this information to help mitigate the consequences of the current pandemic in the most vulnerable countries.

Range-wide neutral and adaptive genetic structure of an endemic herb from Amazonian Savannas.

Conserving genetic diversity in rare and narrowly distributed endemic species is essential to maintain their evolutionary potential and minimize extinction risk under future environmental change. In this study we assess neutral and adaptive genetic structure and genetic diversity in Brasilianthus carajensis (Melastomataceae), an endemic herb from Amazonian Savannas. Using RAD sequencing we identified a total of 9365 SNPs in 150 individuals collected across the species' entire distribution range. Relying on assumption-free genetic clustering methods and environmental association tests we then compared neutral with adaptive genetic structure. We found three neutral and six adaptive genetic clusters, which could be considered management units (MU) and adaptive units (AU), respectively. Pairwise genetic differentiation (F ST) ranged between 0.024 and 0.048, and even though effective population sizes were below 100, no significant inbreeding was found in any inferred cluster. Nearly 10 % of all analysed sequences contained loci associated with temperature and precipitation, from which only 25 sequences contained annotated proteins, with some of them being very relevant for physiological processes in plants. Our findings provide a detailed insight into genetic diversity, neutral and adaptive genetic structure in a rare endemic herb, which can help guide conservation and management actions to avoid the loss of unique genetic variation.

Correction for Ichiwaki et al., "Genome Sequence of Micromonospora sp. NBS 11-29, an Antibiotic and Hydrolytic Enzyme Producer, Isolated from River Sediment in Brazil".

[This corrects the article DOI: 10.1128/genomeA.00552-17.].

Influence of water quality on diversity and composition of fungal communities in a tropical river.

Freshwater fungi are key decomposers of organic material and play important roles in nutrient cycling, bio-remediation and ecosystem functioning. Although aquatic fungal communities respond to pollution, few studies have quantitatively assessed the effect of freshwater contamination on fungal diversity and composition; and knowledge is scarcer for tropical systems. Here we help fill this knowledge gap by studying a heavily-contaminated South American river spanning a biodiversity hotspot. We collected 30 water samples scattered across a quality gradient over two seasons and analyzed them using Terminal Restriction Fragment Length Polymorphisms (T-RFLP) coupled with 454 Pyrosequencing. Using T-RFLP we identified 451 and 442 Operational Taxonomy Units (OTUs) in the dry and rainy seasons respectively, whereas Pyrosequencing revealed 48,553 OTUs from which 11% were shared between seasons. Although 68% of all identified OTUs and 51% of all identified phyla remained unidentified, dominant fungal phyla included the Ascomycota, Basidiomycota, Chytridiomycota, Glomeromycota, Zygomycota and Neocallimastigomycota, while Calcarisporiella, Didymosphaeria, Mycosphaerella (Ascomycota) and Rhodotorula (Basidiomycota) were the most abundant genera. Fungal diversity was affected by pH and dissolved iron, while community composition was influenced by dissolved oxygen, pH, nitrate, biological oxygen demand, total aluminum, total organic carbon, total iron and seasonality. The presence of potentially pathogenic species was associated with high pH. Furthermore, geographic distance was positively associated with community dissimilarity, suggesting that local conditions allowed divergence among fungal communities. Overall, our findings raise potential concerns for human health and the functioning of tropical river ecosystems and they call for improved water sanitation systems.

Genome Sequence of Micromonospora sp. NBS 11-29, an Antibiotic and Hydrolytic Enzyme Producer, Isolated from River Sediment in Brazil.

The genus Micromonospora comprises actinomycetes with high biotechnological potential, due to their ability to produce secondary metabolites and enzymes. In this study, we report the draft genome sequence of Micromonospora sp. NBS 11-29, which showed antibacterial, cellulolytic, and xylanolytic activities under in vitro conditions.

Sjögren's syndrome-associated interstitial lung disease: a multicenter study / Enfermedad pulmonar instersticial asociada a síndrome de Sjögren: estudio multicéntrico

Primary Sjögren syndrome (PSS) is a chronic inflammatory autoimmune disease. Interstitial lung disease (ILD) can be an extraglandular complication. Objective. To evaluate the clinical characteristics of patients diagnosed with PSS with ILD. Methods. Multicentre cohort study with 25 patients diagnosed with PSS and ILD. Data of PSS, prognostic factors, pulmonary involvement variables, complementary tests that suggest a worse diagnosis and treatment given were collected. EULAR index was measured for Sjögren's syndrome. Results. We identified 25 patients. In 15/25 the diagnosis of ILD was done before the diagnosis of PSS. The histopathological patterns found were: 12 NSIP, 5 UIP, 4 OP, 2 LIP. PFRs showed restrictive pattern. The majority of the patients received glucocorticoid therapy, antimalarial or immunosuppressive treatment. Conclusions. Patients affected with PSS must be screened to catch a precocious diagnosis of ILD. The majority of the patients were diagnosed of ILD before being diagnosed of PSS. Multicenter cohorts are increasingly demanded and a multidisciplinary management is needed (AU)

El síndrome de Sjögren primario (SSP) es una enfermedad inflamatoria autoinmune. La enfermedad pulmonar intersticial (EPI) puede ser una complicación extraglandular. Objetivo. Evaluar las características clínicas de los pacientes diagnosticados de SSP con EPI. Métodos. Estudio de cohortes multicéntrico con 25 pacientes diagnosticados de SSP y EPI. Se recopilaron datos propios del SSP, factores pronóstico, variables de medida de la afectación pulmonar, pruebas complementarias que sugieren un peor pronóstico, así como el tratamiento recibido. Se calculó el índice EULAR para el síndrome de Sjögren. Resultados. Se identificaron 25 pacientes. Quince de ellos fueron diagnosticados de EPI antes que de SSP. Los patrones histopatológicos encontrados fueron 12 con neumonía intersticial inespecífica, 5 con neumonía intersticial común, 4 con neumonía organizada, 2 con neumonía intersticial linfocítica. Las pruebas de función respiratoria mostraron un patrón restrictivo. La mayoría de los pacientes recibió un tratamiento con glucocorticoides, antipalúdicos o inmunodepresores. Conclusiones. Los pacientes afectados por SSP deben ser sometidos a pruebas para detectar un diagnóstico precoz de EPI. La mayoría de los pacientes fueron diagnosticados de EPI antes que de SSP. Los estudios de cohortes multicéntricos son cada vez más demandados y se precisa una gestión multidisciplinar (AU)

Sjögren's syndrome-associated interstitial lung disease: A multicenter study.

UNLABELLED: Primary Sjögren syndrome (PSS) is a chronic inflammatory autoimmune disease. Interstitial lung disease (ILD) can be an extraglandular complication. OBJECTIVE: To evaluate the clinical characteristics of patients diagnosed with PSS with ILD. METHODS: Multicentre cohort study with 25 patients diagnosed with PSS and ILD. Data of PSS, prognostic factors, pulmonary involvement variables, complementary tests that suggest a worse diagnosis and treatment given were collected. EULAR index was measured for Sjögren's syndrome. RESULTS: We identified 25 patients. In 15/25 the diagnosis of ILD was done before the diagnosis of PSS. The histopathological patterns found were: 12 NSIP, 5 UIP, 4 OP, 2 LIP. PFRs showed restrictive pattern. The majority of the patients received glucocorticoid therapy, antimalarial or immunosuppressive treatment. CONCLUSIONS: Patients affected with PSS must be screened to catch a precocious diagnosis of ILD. The majority of the patients were diagnosed of ILD before being diagnosed of PSS. Multicenter cohorts are increasingly demanded and a multidisciplinary management is needed.

Evaluation of three methods for preservation of Azotobacter chroococcum and Azotobacter vinelandii

La preservación de bacterias es asunto de granimportancia debido a que muchas de ellas son usadas enprocesos biotecnológicos que requieren mantener su viabilidad ypropiedades genéticas. En este estudio, se evaluaron tres métodospara la preservación de A. chroococcum C26 y A. vinelandii C27;criopreservación, liofilización, e inmovilización en polímerossecos, durante 60, 30 y 60 días, respectivamente. A su vez, seestudió el efecto de tres agentes protectivos para la liofilizacióny para la criopreservación y cuatro polímeros. La eficiencia delos métodos fue evaluada contando células viables y midiendoactividad como fijación de nitrógeno. Los resultados mostraronque la mejor técnica, la cual mantuvo la viabilidad y la actividad,fue la liofilización, seguida por inmovilización y criopreservación.La liofilización mantuvo estable la habilidad bacteriana para fijarnitrógeno, la tasa de sobrevivencia bacteriana (TSB) fue superioral 80%; y el mejor resultado se evidenció cuando se usó S/BSAcomo agente protectivo. La inmovilización mantuvo la BSRsuperior al 80%, y la fijación de nitrógeno fue disminuida en 20%.La criopreservación tuvo pérdida sustancial de viabilidad para C26(TSB aprox. 70%); mientras que C27 se preservó bien. La fijaciónde nitrógeno fue significativamente disminuida para ambas cepasindependientemente del agente crioprotectivo usado (P < 0.05).Los resultados sugieren que el éxito de los métodos de preservaciónpara Azotobacter depende de la técnica, el agente protectivo y la cepausada; siendo la liofilización con S/BSA la técnica con mejoresresultados para preservar las bacterias de este género...

Because the use of bacteria for biotechnological processes requires maintaining their viability and geneticstability, preserving them becomes essential. Here, we evaluated three preservation methods for A.chroococcum C26 and A. vinelandii C27; preservation methods: cryopreservation and immobilization in drypolymers for 60 days, and freeze-drying for 30. We evaluated their efficiency by counting viable cells andmeasuring nitrogen fixation activity. Additionally, we assessed the effect of three protective agents forfreeze-drying, three for cryopreservation, and four polymers. Freeze-drying proved the best technique tomaintain viability and activity, followed by immobilization and cryopreservation. Bacterial nitrogen fixingability remained unchanged using the freeze-drying method, and bacterial survival exceeded 80%; S/BSAwas the best protective agent. Immobilization maintained bacterial survival over 80%, but nitrogen fixationwas decreased by 20%. Lastly, cryopreservation resulted in a dramatic loss of viability for C26 (BSRapprox. 70%), whereas C27 was well preserved. Nitrogen fixation for both strains decreased regardless ofthe cryoprotective agent used (P < 0.05). In conclusion, the success of Azotobacter preservation methodsdepend on the technique, the protective agent, and the strain used. Our results also indicated that freezedryingusing S/BSA is the best technique to preserve bacteria of this genus...

Porque o uso de bactérias para processos biotecnológicos,requer a manutenção da sua viabilidade e estabilidade genética,preserva-las é essencial Avaliaram-se três métodos de preservação deA. chroococcum C26 e A. vinelandii C27; criopreservação, liofilização, eimobilização de polímeros secos. Examinamos também o efeito deagentes protetores para liofilizar, para a criopreservação, e polímeros.A eficiência foi avaliada contando as células viáveis e medindoa atividade como a fixação do azoto. Os resultados mostraramque a melhor técnica foi a liofilização seguida de imobilização ecriopreservação. A liofilização manteve inalterada a capacidadeda bactéria para fixar o azoto, e o melhor resultado foi observadoquando se usou S/BSA como agente protetor. A criopreservaçãoresultou em uma perda dramática de viabilidade para C26 (TSBaprox. 70%.), enquanto que C27 foi bem preservada. A fixaçãode azoto foi significativamente diminuída para ambas as estirpes,independentemente do agente crioprotector utilizado (P < 0.05).Em conclusão, os resultados sugerem que o êxito dos métodosde conservação de Azotobacter dependem da técnica, do agente deproteção, e da estirpe utilizada, sendo a liofilizacao com S/BSA amelhor técnica para preservar as bactérias deste género...

Implicación de la progesterona en las reacciones vasomotoras de la menopausia y su relación con el riesgo cardiovascular / Implication of progesterone in vasomotor reactions of menopause and its relation with cardiovascular risk

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Diagnosis of tuberculosis infection by tuberculin skin test and a whole-blood interferon-γ release assay in patients considered for anti-tumor necrosis factor-α therapy.

To assess the performance of QuantiFERON®-TB Gold in-Tube (QFT-GIT; Cellestis, Carnegie, Australia) and tuberculin skin test (TST) in patients with immune-mediated inflammatory diseases (IMID), before anti-tumor necrosis factor-α (TNF-α) therapy, and to compare the results with those from the healthy population. Three hundred fourteen subjects (214 with IMID and 100 controls) underwent simultaneous QFT-GIT and TST. QFT-GIT was positive in 21% of IMID patients and in 16% of controls (P = 0.29). Among IMID patients, 21% tested positive by QFT-GIT and 24%, by TST (P = 0.30). Positive QFT-GIT results were not affected by immunosuppressive therapy (odds ratio, 0.78; 95% confidence interval [CI], 0.36-1.68; P = 0.52). Agreement between both tests in those patients who tested positive by one of the tests was 50% (95% CI, 37.2-62.8). QFT-GIT is useful for identifying IMID patients requiring treatment of latent tuberculosis before anti-TNF therapy. However, given the poor agreement between TST and QFT-GIT, we advocate a strategy of simultaneous testing to optimize diagnostic sensitivity.