Inference for the Analysis of Ordinal Data with Spatio-Temporal Models.

In this work, we propose a spatio-temporal Markovian-like model for ordinal observations to predict in time the spread of disease in a discrete rectangular grid of plants. This model is constructed from a logistic distribution and some simple assumptions that reflect the conditions present in a series of studies carried out to understand the dissemination of a particular infection in plants. After constructing the model, we establish conditions for the existence and uniqueness of the maximum likelihood estimator (MLE) of the model parameters. In addition, we show that, under further restrictions based on Partially Ordered Markov Models (POMMs), the MLE of the model is consistent and normally asymptotic. We then employ the MLE's asymptotic normality to propose methods for testing spatio-temporal and spatial dependencies. The model is estimated from the real data on plants that inspired the model, and we used its results to construct prediction maps to better understand the transmission of plant illness in time and space.

Complicaciones perinatales asociadas con la ganancia excesiva de peso durante el embarazo / Perinatal outcomes associated to overweight gain during pregnancy in women at a regional hospital in northwest of Mexico

Resumen OBJETIVO: evaluar la asociación entre la ganancia de peso durante el embarazo y las complicaciones perinatales: enfermedad hipertensiva del embarazo, diabetes gestacional, cesárea de urgencia y macrosomía fetal. MATERIALES Y MÉTODOS: estudio de casos y controles anidados en una cohorte de pacientes que recibieron control prenatal y atención del parto en el Hospital General Regional del Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora. Los momios se calcularon según las complicaciones perinatales, el índice de masa corporal pregestacional y la ganancia total de peso durante todo el embarazo. RESULTADOS: se seleccionó una cohorte de seguimiento de 714 pacientes de las que solo se estudió a 426 que, a su vez, se dividieron en dos grupos de 213 cada uno: de casos y controles. En el grupo de casos la frecuencia de obesidad fue de 17.6% (n = 55) y 40.3% (n=126) de sobrepeso. En el grupo control 6.7% (n=21) de obesidad y 50.8% (n=159) en los controles. En comparación con las pacientes con peso pregestacional normal, no se observó riesgo significativo de complicaciones perinatales en las pacientes con sobrepeso previo a la gestación (RM=0.79, IC 95%: 0.57-1.11, p=0.189). En las pacientes con obesidad pregestacional se observó un riesgo significativo (RM=2.63, IC 95%: 1.51- 4.60, p=.001). CONCLUSIONES: la ganancia de peso a lo largo del embarazo, superior a la recomendada, es un factor riesgo significativo de complicaciones perinatales, independiente del peso previo a la gestación.

Abstract OBJECTIVE: To evaluate the association between weight gain during pregnancy and perinatal complications: hypertensive pregnancy disease, gestational diabetes, emergency cesarean section and fetal macrosomia. MATERIALS AND METHODS: Nested case-control study in a cohort of patients who received prenatal care and delivery care at the Regional General Hospital of the Mexican Social Security Institute of Ciudad Obregon, Sonora. The odds were calculated according to perinatal complications, pregestational body mass index and total weight gain throughout pregnancy. RESULTS: A follow-up cohort of 714 patients was selected, of whom only 426 were studied, which in turn were divided into two groups of 213 each: cases and controls. In the group of cases the frequency of obesity was 17.6% (n=55) and 40.3% (n=126) of overweight. In the control group 6.7% (n=21) of obesity and 50.8% (n=159) in controls. Compared with patients with normal pregestational weight, no significant risk of perinatal complications was observed in pre-gestational overweight (OR=0.79, CI 95%: 0.57-1.11, p=0.189). A significant risk was observed in patients with pregestational obesity (OR=2.63, CI 95%: 1.51- 4.60, p=.001). CONCLUSIONS: Weight gain during pregnancy, higher than recommended, is a significant risk factor for perinatal complications, independent of pre-gestational weight.

[Operative morbidity of the hidrodisección with epinefrina during the surgery for prolapse of pelvic organs]. / Morbilidad operatoria de la hidrodisección con epinefrina en la cirugía del prolapso de órganos pélvicos.

Objetive: To assess the effect of the hydrodissection on operative morbidity and operative time in patients undergoing vaginal surgery for pelvic organ prolapse. Material and methods: Experimental, prospective, longitudinal, comparative, randomized study: randomized controlled clinical. Randomly, 44 patients were assigned to receive management hydrodissection with epinephrine (Group 1= 22) or not hydrodissection (Group 2= 22) prior to the start of the surgical procedure. The variables analyzed were operative morbidity (defined as infection, hematoma and surgical postoperative bleeding requiring transfusion) and surgical time required to complete the procedure. Results: The average age was 58.1 years (± 9.3) in the group of hydrodissection and 63.0 years (± 10.6) in the group without hydrodissection (p = .111). The frequency of postoperative complications was similar enters both groups (p> .05) presenting only one case of postoperative hematoma in Group 1 and none in Group 2. The operative bleeding was significantly lower in the hydrodissection group (240.9 ± 111.9 mL) compared with the group of non hydrodissection (324.1 ± 104.9 mL). No significant difference in operative time was found (p = 0.67) compared with 135.5 (± 22.6) minutes in Group 1 and 139.3 (± 32.5) minutes. Conclusion: Hydrodissection with epinephrine compared with non Hydrodissection significantly reduces operative bleeding but no differences in operative morbidity and operative time in patients undergoing vaginal surgery in the management of pelvic organ prolapse.

[Comparison of pregnancy outcomes Caesarean techniques: modified Misgav-Ladach, Pfannenstiel-Kerr and Kerr-half infraumbilical]. / Comparación de resultados obstétricos de las técnicas de cesárea: Misgav-Ladach modificada, Pfannenstiel-Kerr y media infraumbilical-Kerr.

Background: In Mexico, the prevalence of caesarean section is 40.9% in the health sector, the techniques used are the traditional Pfannenstiel-Kerr and Kerr-half infraumbilical and little experience with this new technique Misgav-Ladach modified. Objetive: To compare pregnancy outcomes (surgical and fetal extraction time, bleeding, postoperative pain, surgical wound infection, maternal and fetal death) caesarean section techniques modified Misgav-Ladach, Pfannenstiel-Kerr and infraumbilical. Material and method: Clinical trial in primiparous women with term pregnancy treated at the Medical Unit of High Specialty 23 of the Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico. Misgav-Ladach caesarean Caesarean modified and Kerr, the latter subdivided into two groups: infraumbilical Pfannenstiel incision and incision half-Kerr two groups patients were randomized. Results: 137 gilts were studied, with term pregnancy and BMI between 19 and 24.9 kg / m2. Caesarean modified Misgav-Ladach 68 patients and 69 classical Kerr (35 Pfannenstiel-Kerr and 34 infraumbilical) was performed. The surgical time in minutes was lower with modified Misgav-Ladach: 27.8 ± 8.0, Pfannenstiel-Kerr recorded 51.7 ± 12.1 and 12.0 ± infraumbilical media48.3 (p = 0.000). The time in seconds fetal extraction was lower in modified Misgav-Ladach: 96.2 ± 68.3, 474.9 ± Pfannenstiel-Kerr 294.1 and 423.2 ± 398.6 infraumbilical (p = 0.000). The trasoperatory milliliters bleeding was lower with modified Misgav-Ladach: 298.5 ± 57.3, 354.3 ± Pfannenstiel-Kerr 98.0 and 355.9 ± 110.6 infraumbilical (p = 0.001). Postoperative pain assessed with the visual analog scale in the first 24 hours was lower with modified Misgav-Ladach: 4.4 ± 1.9, 5.7 ± Pfannenstiel-Kerr and IK 2.1 6.1 ± 2.0 (p = 0.000). The start of the oral route and ambulation Nwas soon comparing modified Misgav-Ladach against Pfannenstiel-Kerr and Kerr-infraumbilical (p = 0.000). The prevalence of fever was 5.9% with modified Misgav-Ladach, 5.9% Pfannenstiel-Kerr and 32.4% withinfraumbilical-Kerr (p = 001). The discharge in hours was modified Misgav-Ladach ± 45.8 to 12.1 h, Pfannenstiel-Kerr 49.3 ± 12.3 h and 58.5 infraumbilical-Kerr ± 21.5 h (p = .000). In this study no maternal or fetal deaths were observed. Conclusion: Surgical time, bleeding, postoperative pain, better postoperative recovery and shorter hospital stays and less infection were significantly lower than with conventional techniques of caesarean Nsection or infraumbilical-Kerr technique.

Transmission efficiency of tomato apex necrosis virus by Bemisia tabaci (Hemiptera: Aleyrodidae) biotype B in tomato.

Tomato apex necrosis virus (ToANV) is a new virus that causes important damage in tomato crops from the Culiacan Valley, Sinaloa, Mexico. To understand the relationship between ToANV and its vector Bermisia tabaci (Hemiptera: Aleyrodidae) (Gennadius) biotype B, laboratory and greenhouse trials were completed to: 1) determine the acquisition and inoculation access periods of ToANV by B. tabaci from tomato to tomato, 2) understand the transmission efficiency at different B. tabaci population densities, 3) estimate the time from inoculation of the virus at different B. tabaci densities to manifestation of symptoms in the plants, and 4) determine the retention time of the virus by the insect vector. The presence of the virus in plants was determined by reverse transcription-polymerase chain reaction amplification ofa 795-bp fragment (GenBank JN704068), which is phylogenetically related to ToANV (GenBank EF063242). The results showed that B. tabaci is an effective vector for ToANV with relatively long acquisition (12 h) and inoculation (9 h) access periods; a single adult is capable of transmitting and retaining the virus for up to 7d, suggesting a persistent mode of transmission. These results will help in the development of management strategies for controlling the vector and the disease.

Impact of prescribed cleaning and disinfectant use on microbial contamination in the home.

AIMS: To identify and quantify the presence of Escherichia coli, Staphylococcus aureus, Salmonella, hepatitis A and norovirus in households and to assess the effect of chlorine and quaternary ammonium-based disinfectants following a prescribed use. METHODS AND RESULTS: Eleven sites distributed in kitchen, bathroom, pet and children's areas of two groups of 30 homes each: (i) a nonprescribed disinfectant user group and (ii) a disinfectant protocol user group. During the 6-week study, samples were collected once a week except for week one when sample collection occurred immediately before and after disinfectant application to evaluate the disinfectant protocol. The concentration and occurrence of bacteria were less in the households with prescribed use of disinfectants. The greatest reductions were for E. coli (99%) and Staph. aureus (99·9999%), respectively. Only two samples were positive for HAV, while norovirus was absent. Disinfection protocols resulted in a significant (P < 0·05) microbial reduction in all areas of the homes tested compared to homes not using a prescribed protocol. CONCLUSIONS: The study suggests that disinfectant product application under specific protocol is necessary to achieve greater microbial reductions. SIGNIFICANCE AND IMPACT OF THE STUDY: Prescribed protocols constitute an important tool to reduce the occurrence of potential disease-causing micro-organisms in households.

Detection and characterization of hepatitis A virus and Norovirus in estuarine water samples using ultrafiltration--RT-PCR integrated methods.

AIMS: Waterborne outbreaks of hepatitis A and Norovirus disease have been reported and associated with contaminated water supply in various countries. However, in Mexico, there are no studies that report HAV and NV presence in water. This study reports the application of ultrafiltration and RT-nested PCR methods to concentrate and identify these viruses. METHODS AND RESULTS: Forty estuarine water samples were collected from the Huizache Caimanero Lagunary Complex. Samples were concentrated by ultrafiltration system (UFS) and RT-nested PCR was performed for HAV and NV identification. These viruses were found in 80% and 70% of the samples collected respectively and both were present in 57.5%. The DNA sequences analysis showed that 21 estuarine water samples were associated with HAV and 13 with NV. Faecal coliforms were isolated in 48.57% of the samples, while Escherichia coli were found in 34.28%. CONCLUSIONS: DNA sequencing showed that the genotype IB for HAV and GII for NV were predominant in México. No significant relationships were detected between indicators and viruses (P < 0.05). SIGNIFICANCE AND IMPACT OF THE STUDY: This study shows that the UFS is adequate for viral concentration. This is the first study analysing the genetic sequence of HAV and NV isolated from Mexican estuarine water.

Infección cervicovaginal como factor de riesgo para parto pretérmino / Cervicovaginal infection as a risk factor for premature labor

OBJECTIVE: To identify the possible association between cervicovaginal infections (CVI) and preterm delivery. DESIGN: Cohorts. REFERENCE FRAME: Instituto Nacional de PerinatologÝa, Hospital Central Militar and Hospital General Regional No. 1, IMSS, Culiacßn, Sinaloa, MÚxico. PATIENTS: Four hundred and sixty eight patients attending prenatal control and delivery care. INTERVENTIONS: Fresh smears, Gram stain, and cervicovaginal sample culture from samples obtained during the following gestational stages: First sample at 16-24 weeks, second sample at 25-32 weeks, and third sample at 33-42 weeks. The following microorganisms were studied: Candida albicans, Gardnerella vaginalis, Ureaplasma urealyticum, Streptococcus agalactiae, Mycoplasma hominis, Neisseria gonorrhoeae, Listeria monocytogenes, and Chlamydia trachomatis. In case of a positive culture, the specific treatment was indicated. MEASUREMENTS: Positive or negative culture for each of the studied pathogens, and the presence or absence of a preterm delivery for each of the patients included in the study. RESULTS: Three hundred and ninety eight were still present at the end of the study, of which 156 had a CVI and 242 had no CVI. No differences between both groups were observed concerning preterm delivery. Significant relative risks were: In the first stage, Ureaplasma urealyticum and Mycoplasma hominis with RR = 9.0 (6.81, 11.8); in the second stage, Ureaplasma urealyticum with RR = 6.2 (3.30, 11.7) and Escherichia coli with RR = 3.4 (1.33, 8.6); in the third stage, Ureaplasma urealyticum with RR = 9.19 (6.93, 12.1). The logistic regression analysis identified Ureaplasma urealyticum during the second stage with OR = 16.6 (2.9, 93.7), statistically significant with p = 0.001. The survival analysis showed differences between the two groups concerning pregnancy duration (p < 0.001). CONCLUSIONS: There is a difference in the duration in pregnancy in patients with CVI and without CVI. Ureaplasma urealyticum is consistently associated with preterm delivery.