Seroprevalence of Trypanosoma cruzi in Eight Blood Banks in Mexico.

BACKGROUND: The true prevalence of Chagas disease in Mexico is unknown. However, it has been estimated that 1.1-4 million people are infected with Trypanosoma cruzi, which represents a potential risk for transmission of the disease via contaminated blood. AIM OF THE STUDY: To determine the Chagas disease seroprevalence in donors from eight blood banks in the north of Mexico City, and the northeast of the State of Mexico. STUDY DESIGN AND METHODS: Serum samples from blood donors (n = 515,038) were tested to detect the presence of anti-Trypanosoma cruzi antibodies in eight blood banks. The serologic screening test was performed in each of the blood banks. To confirm the seropositive blood donors, only two out of the eight blood banks used a test with a different principle with the aim of identifying anti-Trypanosoma cruzi antibodies. All tests were validated by the Mexican Institute for Epidemiological Diagnosis and Reference. RESULTS: One thousand two hundred and ten blood donors were seropositive for Trypanosoma cruzi, which represents a 0.23% seroprevalence (95% CI 0.22-0.25%). Of the seropositive blood donors, 97.03 % resided in the northeast area of the State of Mexico, Mexico City, and southern part of the State of Hidalgo. CONCLUSIONS: Active transmission of Chagas disease may be occurring in non-endemic regions in the northeast of the State of Mexico.

Protocolo de ayuno peritransfusional en enterocolitis necrotizante, en recién nacidos colombianos / Implementation of a peri-transfusion fasting protocol in necrotizing enterocolitis, in Colombian newborns

Objetivo: Determinar la diferencia de incidencia de enterocolitis necrotizante asociada a transfusión en recién nacidos pretérmino con y sin implementación de un protocolo de ayuno peritransfusional. Métodos: Estudio observacional retrospectivo. Se incluyeron todos los recién nacidos pretérmino que fueron transfundidos con unidad de glóbulos rojos entre julio 2015 y octubre 2016 en la unidad de recién nacidos un centro de tercer nivel de Colombia. El protocolo de ayuno peritransfusional se inició a partir de abril 2016. La enterocolitis necrotizante asociada a transfusión se definió como enterocolitis necrotizante presentada dentro de las 48 horas posteriores a la transfusión. Se analizaron variables demográficas, alimentación, número de transfusiones y variables asociadas a enterocolitis necrotizante. Resultados: Durante el tiempo de estudio, 148 recién nacidos prematuros necesitaron al menos una transfusión de glóbulos rojos que representaron 385 eventos de transfusión. Se informaron siete casos de enterocolitis necrotizante asociada a transfusión. La incidencia acumulada global fue 4,7 por ciento (3,6 por ciento con protocolo de ayuno peritransfusional y 6,3 por ciento sin protocolo), la tasa de incidencia global de enterocolitis necrotizante asociada a transfusión fue 18/1000 personas-transfusión (IC95 por ciento 7-37/1000 personas-transfusión), mayor en el grupo sin protocolo (28/1000 personas-transfusión) que en el grupo con protocolo (12/1000 personas-transfusión), pero sin significación estadística. Conclusiones: La implementación del protocolo de ayuno peritransfusional podría disminuir la incidencia y gravedad de la enterocolitis necrotizante asociada a transfusión. Se requieren estudios prospectivos para establecer la relación entre la alimentación enteral durante la transfusión y la enterocolitis necrotizante(AU)

Objective: Determine the difference in incidence of transfusion-associated necrotizing enterocolitis in preterm newborns with and without implementation of a peri-transfusion fasting protocol. Methods: Retrospective observational study. All preterm newborns that were transfused with red blood cell units during the period from July 2015 to October 2016 in the newborns´ unit at a third level of care center in Colombia were included. The peri-transfusion fasting protocol started on April 2016. Transfusion-associated necrotizing enterocolitis was defined as necrotizing enterocolitis presented within 48 hours after the transfusion. Demographic variables, feeding, number of transfusions and variables associated with necrotizing enterocolitis were analyzed. Results: During the study time, 148 premature newborns needed at least one transfusion of red blood cells that accounted for 385 transfusion events. Seven cases of transfusion-associated necrotizing enterocolitis were reported. The overall cumulative incidence was 4.7 percent (3.6 percent with peri-transfusion fasting protocol and 6.3 percent without protocol), the overall incidence rate of transfusion-associated necrotizing enterocolitis was 18/1000 people-transfusion (IC 95 percent 7-37/1000 people-transfusion); it was higher in the group without protocol (28/1000 people-transfusion) than in the group with protocol (12/1000 people-transfusion), but without statistical significance. Conclusions: Implementation of the peri-transfusion fasting protocol may decrease the incidence and severity of necrotizing enterocolitis associated with transfusion. Prospective studies are required to establish the relationship between enteral feeding during transfusion and necrotizing enterocolitis(AU)

Multi-cultural perspectives on group singing among diverse older adults.

Group choir singing has been shown to have health benefits for older adults. However, because most studies have included predominantly white participants, it is unknown whether findings generalize to older adults from more diverse backgrounds. This multi-site qualitative study assessed perceived benefits of group singing for socioeconomically and racially/ethnically diverse older adults. We interviewed 31 choir participants, 6 music professionals and 6 administrators involved in a large, cluster-randomized trial. We used content analysis to identify themes. Psychosocial engagement was most commonly reported, with six components: emotional well-being, self-esteem, self-confidence, social connection and support, decreased loneliness, and cultural identity and multi-cultural appreciation. A few reported cognitive and physical benefits. They also suggest that group singing among ethnically diverse older adults can have multiple psychosocial benefits and enhance a sense of cultural identity and appreciation of other cultures. These findings can help in selecting structured outcome measures for choir interventions.

High prevalence of human papillomavirus type 66 in low-grade cervical lesions of Mexican women.

Our aim was to analyze the prevalence of high-risk human papillomavirus (HR-HPV) and its association with risk factors related to cervical lesions. We used 362 cervical samples from a transversal study to detect nineteen types from the high-risk HPV clade by highly sensitive PCR. Unexpectedly, we found a very high prevalence of HPV type 66 (32.8%), particularly in low-grade squamous intraepithelial lesions. A significant association of HPV66 with previously sexually transmitted disease was observed (p < 0.05). Our results strongly suggest that HPV66 might be indicative of cervical lesions that will not progress to cancer. HPV genotyping by methods that grouped type 66 with other HR-HPV clade types should be interpreted with caution.

Prevalence of oncogenic human papillomavirus in patients with cervical lesion. / Prevalencia del virus del papiloma humano oncogénico en pacientes con lesión cervical.

BACKGROUND: High risk human papillomavirus (hrHPV) infection is associated with the development of cervical cancer (CC) in 99.7%. The prevalence of HPV varies according to the geographic region, lesion degree, method of detection, among other variables. OBJECTIVE: To determine the prevalence of hrHPV and identify some risk factors in a group of women with cervical lesions from Mexico City. MATERIAL AND METHODS: Of 421 women, 310 were included. Questionnaires of risk factors were administered, and cervical samples which included the entire spectrum of cervical lesions according to the Bethesda system were obtained. HPV genotyping was made with INNO-LiPA system. Population characteristics were analyzed with descriptive statistics. Risk factors' odds ratio (OR) was calculated with chi squared using SPSS software, version 24.0. RESULTS: 91.6% of the samples were positive for hrHPV. The prevalent types were 16, 66, 52 and 51. By age group there were not statistically significant differences in the risk of HPV infection. Having had three or more sexual partners increased the risk of infection by hrHPV (OR: 2.99; 95% confidence interval [95% CI]: 1.247.24). Sexually transmitted diseases increased the probability of infection by hrHPV different to types 16, and 18 (OR: 2.47; 95% CI, 1.24-7.24 and 1.50-4.06). CONCLUSIONS: The high prevalence of types 66, 52 and 51 is a finding that has not been described previously in our population. We hope that this study will help to improve health services in order to decrease the incidence of cervical ­cancer.

INTRODUCCIÓN: La infección por el virus del papiloma humano (VPH) de alto riesgo oncogénico (VPHar) se asocia al cáncer cervicouterino en el 99.7% de los casos. La prevalencia de VPH varía según la región geográfica, el grado de lesión y el método de detección, entre otras variables. OBJETIVO: Determinar la prevalencia de VPHar e identificar factores de riesgo en mujeres con lesión cervical de la Ciudad de Mexico. MATERIAL Y MÉTODOS: De 421 mujeres, se incluyeron 310. Se aplicaron cuestionarios y se obtuvieron muestras que incluyeron todo el espectro de las lesiones cervicales según el sistema Bethesda. La tipificación del VPH se hizo mediante el sistema INNO-LiPA. Las características de la población se analizaron con estadística descriptiva. Con la prueba de chi cuadrada se calculó la razón de momios (RM) de los factores de riesgo con el programa SPSS, versión 24.0. RESULTADOS: El 91.6% de las muestras fueron positivas para VPHar. Los VPH prevalentes fueron los tipos 16, 66, 52 y 51. Por edad no hubo significación estadística para riesgo de infección por VPHar. Haber tenido tres o más parejas sexuales elevó el riesgo de infección por HPVar (RM: 2.99; intervalo de confianza del 95 [IC 95%]: 1.247.24). Las infecciones de transmisión sexual favorecieron el riesgo de infección por otros VPHar distintos de los tipos 16 y 18 (RM: 2.47; IC 95%: 1.24-7.24 y 1.50-4.06). CONCLUSIÓN: La elevada prevalencia de VPH 66, 52 y 51 es un hallazgo que no ha sido descrito previamente en nuestra población. Esperamos que este estudio contribuya a mejorar los programas de los servicios de salud dirigidos a disminuir la incidencia de cáncer cervicouterino.

The Recovery from Alcohol Consumption: Analysis of the Construct of Relapse.

OBJECTIVE: A systematic review was conducted to identify definitions that facilitated the study of relapse as both behavioral pattern and process. METHODS: The review was conducted following the PRISMA-P guidelines. Articles that met the following inclusion criteria were considered: (a) published in peer-reviewed journals, (b) provided an explicit operational definition of relapse, (c) assessed relapse during or after a specific psychological or self-care group intervention, (d) focused on alcohol consumption, and (e) were published between 2000 and September 2016. RESULTS: "Any drinking" was the most frequent outcome used to identify relapse, although other discrete outcomes were also considered. Nevertheless, none of the definitions operationalize the notion of the return to a problematic drinking pattern and/or the process of relapse. CONCLUSION: Problems related to any drinking definition are discussed and we propose the use of a composed index to study relapse.

OBJETIVO: Se realizó una revisión sistemática para identificar definiciones que permitieran el estudio de la recaída como un patrón y proceso conductual. MÉTODO: La revisión fue realizada siguiendo los lineamientos de la guía PRISMA-P. Los artículos que cumplían con los siguientes criterios fueron revisados: (1) publicados en revistas con revisión por pares, (b) definían explícitamente la recaída, (c) se evaluó la recaída después o durante un tratamiento psicológico o participación en un grupo de autoayuda, (d) la intervención se enfocaba en el consumo de alcohol, (d) publicados entre el año 2000 y septiembre de 2016. RESULTADOS: Cualquier consumo fue el resultado más frecuentemente usado para definir la recaída, aunque otros resultados discretos también se consideraron. No obstante, ninguna de las definiciones operacionales reflejó la noción del regreso a un patrón de consumo problemático y/o el proceso a la recaída. CONCLUSIONES: Problemas relacionados a la definición de cualquier consumo son discutidos y se propone un índice compuesto para estudiar la recaída.

Distracción osteogénica en el servicio de cirugía oral ymaxilofacial del Hospital Militar Central de Bogotá / Distraction osteogenesis at the oral and maxillofacial surgery department of the Hospital Militar Central Bogotá

Introducción: La distracción osteogénica es una técnica quirúrgica basada en el principio de "tensión-estrés", que estimula la histogénesis y neoformación ósea. Objetivo: Describir el uso de la distracción osteogénica, así como analizar las fases de distracción de los pacientes tratados en el Servicio de Cirugía Oral y Maxilofacial del Hospital Militar Central. Diseño: Estudio observacional descriptivo. Materiales y métodos: Se realizó un muestreo no probabilístico por conveniencia donde fueron incluidos en el estudio todos los pacientes sometidos a distracción osteogénica para corrección de secuelas de trauma facial, defectos ocasionados por resecciones tumorales, corrección de anomalías dentofaciales y malformaciones congénitas entre Marzo de 2009 a Diciembre 2014. Resultados: El 73.6% de los pacientes correspondían al genero masculino, con una media de 21.79 años. El factor etiológico más frecuente fueron las anomalías dentofaciales (50.9%) seguido por las herida por arma de fuego (22.6%). Se evidenció un tiempo de latencia de 7.02 días, un período de activación de 18.25 días y un período de consolidación/remodelación de 27.30 semanas. Conclusiones: La distracción osteogénica permite la formación del hueso de soporte así como del tejido blando involucrado, es considerada una solución ideal para la restitución de tejidos independientemente del tipo de patología.

Introduction: Distraction osteogenesis is a surgical technique based on the principle of "tension-stress", which stimulates bone formation and histogenesis. Objective: To describe the use of distraction osteogenesis and to analyze its phases in patients treated at the Oral and Maxillofacial Department of the Hospital Militar Central. Design: A descriptive observational study was performed. Materials and methods: A non-probabilistic convenience sample which included all patients who underwent distraction osteogenesis from March 2009 to December 2014 for correcting sequelae of facial trauma, defects caused by tumor resection or by dentofacial anomalies and congenital malformations was analyzed. Results: 73.6% of patients were male, with an average of 21.79 years. The most common etiologic factor was the Dentofacial deformities (50.9%) followed by Gunshot wounds (22.6%). It showed a latency of 7.02 days, an activation period of 18.25 days and a period of consolidation / remodeling of 27.30 weeks. Conclusions: Distraction osteogenesis allows the formation of supporting bone and soft tissue, it is considered as an ideal solution for tissue restitution regardless the type of pathology.

Anti-cancer Parasporin Toxins are Associated with Different Environments: Discovery of Two Novel Parasporin 5-like Genes.

Cry toxins are primarily a family of insecticidal toxins produced by the bacterium Bacillus thuringiensis (Bt). However, some Cry toxins, called parasporins (PSs), are non-insecticidal and have been shown to differentially kill human cancer cells. Based on amino acid homology, there are currently six different classes of parasporins (PS1-6). It is not known what role parasporins play in nature, nor if certain PSs are associated with Bt found in particular environments. Herein, we present ten parasporin-containing isolates of Bt from the Caribbean island of Trinidad. Genes coding for PS1 and PS6 were found in isolates associated mainly with artificial aquatic environments (e.g., barrels with rain water), while Bt possessing two novel PS5-like genes (ps5-1 and ps5-2), were isolated from manure collected directly from the rectum of cattle. The amino acid sequences inferred from the two PS5-like genes were 51 % homologous to each other, while being only 41 or 45 % similar to PS5Aa1/Cry64Aa, the only reported member of the parasporin five class. The low level of amino acid homology between the two PS5-like genes and PS5Aa1 indicate that the two PS5-like genes may represent a new class of parasporins, or greatly expand the level of diversity within the current parasporin 5 class.

Frecuencia de genioplastia en cirugía ortognática en el servicio de cirugía oral y maxilofacial del Hospital Militar Central de Bogotá / Genioplasty frequency in orthognathic surgery at the Bogota Central Military Hospital oral and maxillofacial surgery service

Introducción: La genioplastia es un procedimiento versátil que maneja alteraciones en la región mentoniana, aisladas o en combinación con Anomalías Dentofaciales (ADF). Objetivo: Describir la frecuencia de genioplastia así como los diferentes métodos de fijación utilizados en pacientes sometidos a cirugía ortognática. Materiales y métodos: Estudio observacional descriptivo de los pacientes sometidos genioplastia en conjunto con cirugía ortognática en el Servicio de Cirugía Oral y Maxilofacial del Hospital Militar Central de Bogotá entre 2009 y 2015. Resultados: El 80% de las cirugías ortognáticas (197 pacientes) requirieron genioplastia como procedimiento complementario. El movimiento más frecuente fue de avance en 158 pacientes (77.8%) con predominio de pacientes ADF Clase III (91 pacientes, 44.82%), el método de fijación mas frecuente fue alambres intraóseos en el 37.05% (73 casos). Conclusiones: La genioplastia es un procedimiento predecible, con bajo riesgo de complicaciones, que maneja los defectos anatómicos y estructurales del mentón, ofreciendo resultados estéticos favorables..

Introduction: Genioplasty is a versatile procedure which handles defects of the chin, isolated or in combination with Dentofacial Deformities (DFD). Objective: To describe the frequency of genioplasty and the different methods of fixation used in patients undergoing orthognathic surgery. Materials and methods: Descriptive observational study of patients undergoing genioplasty in conjunction with orthognathic surgery at the Bogotá Central Military Hospital, Oral and Maxillofacial Department from January 2009 to January 2015. Results: 80% of orthognathic surgery (197 patients) required genioplasty as adjunctive procedure. The most frequent movement was advance genioplasty in 158 patients (77.8%), prevalence of DFD Class III (91 patients, 44.82%), the most frequent method was intraosseous wire fixation in 37.05% (73 cases). Conclusions: Genioplasty is a predictable procedure with low risk of complications, which handles anatomical and structural defects of the chin, offering favorable aesthetic results.

Biochemical and proteomic analysis of spliceosome factors interacting with intron-1 of human papillomavirus type-16.

The human papillomavirus type 16 (HPV-16) E6/E7 spliced transcripts are heterogeneously expressed in cervical carcinoma. The heterogeneity of the E6/E7 splicing profile might be in part due to the intrinsic variation of splicing factors in tumor cells. However, the splicing factors that bind the E6/E7 intron 1 (In-1) have not been defined. Therefore, we aimed to identify these factors; we used HeLa nuclear extracts (NE) for in vitro spliceosome assembly. The proteins were allowed to bind to an RNA/DNA hybrid formed by the In-1 transcript and a 5'-biotinylated DNA oligonucleotide complementary to the upstream exon sequence, which prevented interference in protein binding to the intron. The hybrid probes bound with the nuclear proteins were coupled to streptavidin magnetic beads for chromatography affinity purification. Proteins were eluted and identified by mass spectrometry (MS). Approximately 170 proteins were identified by MS, 80% of which were RNA binding proteins, including canonical spliceosome core components, helicases and regulatory splicing factors. The canonical factors were identified as components of the spliceosomal B-complex. Although 35-40 of the identified factors were cognate splicing factors or helicases, they have not been previously detected in spliceosome complexes that were assembled using in vivo or in vitro models.

A few nucleotide polymorphisms are sufficient to recruit nuclear factors differentially to the intron 1 of HPV-16 intratypic variants.

The HPV-16 E6/E7 genes, which contain intron 1, are processed by alternative splicing and its transcripts are detected with a heterogeneous profile in tumours cells. Frequently, the HPV-16 positive carcinoma cells bear viral variants that contain single nucleotide polymorphisms into its DNA sequence. We were interested in analysing the contribution of this polymorphism to the heterogeneity in the pattern of the E6/E7 spliced transcripts. Using the E6/E7 sequences from three closely related HPV-16 variants, we have shown that a few nucleotide changes are sufficient to produce heterogeneity in the splicing profile. Furthermore, using mutants that contained a single SNP, we also showed that one nucleotide change was sufficient to reproduce the heterogeneous splicing profile. Additionally, a difference of two or three SNPs among these viral sequences was sufficient to recruit differentially several splicing factors to the polymorphic E6/E7 transcripts. Moreover, only one SNP was sufficient to alter the binding site of at least one splicing factor, changing the ability of splicing factors to bind the transcript. Finally, the factors that were differentially bound to the short form of intron 1 of one of these E6/E7 variants were identified as TIA1 and/or TIAR and U1-70k, while U2AF65, U5-52k and PTB were preferentially bound to the transcript of the other variants.

Analysis of CpG methylation sites and CGI among human papillomavirus DNA genomes.

BACKGROUND: The Human Papillomavirus (HPV) genome is divided into early and late coding sequences, including 8 open reading frames (ORFs) and a regulatory region (LCR). Viral gene expression may be regulated through epigenetic mechanisms, including cytosine methylation at CpG dinucleotides. We have analyzed the distribution of CpG sites and CpG islands/clusters (CGI) among 92 different HPV genomes grouped in function of their preferential tropism: cutaneous or mucosal. We calculated the proportion of CpG sites (PCS) for each ORF and calculated the expected CpG values for each viral type. RESULTS: CpGs are underrepresented in viral genomes. We found a positive correlation between CpG observed and expected values, with mucosal high-risk (HR) virus types showing the smallest O/E ratios. The ranges of the PCS were similar for most genomic regions except E4, where the majority of CpGs are found within islands/clusters. At least one CGI belongs to each E2/E4 region. We found positive correlations between PCS for each viral ORF when compared with the others, except for the LCR against four ORFs and E6 against three other ORFs. The distribution of CpG islands/clusters among HPV groups is heterogeneous and mucosal HR-HPV types exhibit both lower number and shorter island sizes compared to cutaneous and mucosal Low-risk (LR) HPVs (all of them significantly different). CONCLUSIONS: There is a difference between viral and cellular CpG underrepresentation. There are significant correlations between complete genome PCS and a lack of correlations between several genomic region pairs, especially those involving LCR and E6. L2 and L1 ORF behavior is opposite to that of oncogenes E6 and E7. The first pair possesses relatively low numbers of CpG sites clustered in CGIs while the oncogenes possess a relatively high number of CpG sites not associated to CGIs. In all HPVs, E2/E4 is the only region with at least one CGI and shows a higher content of CpG sites in every HPV type with an identified E4. The mucosal HR-HPVs show either the shortest CGI size, followed by the mucosal LR-HPVs and lastly by the cutaneous viral subgroup, and a trend to the lowest CGI number, followed by the cutaneous viral subgroup and lastly by the mucosal LR-HPVs.

The HPV-16 E7 oncoprotein is expressed mainly from the unspliced E6/E7 transcript in cervical carcinoma C33-A cells.

The HPV-16 E6/E7 early transcripts are first produced as bicistronic or polycistronic mRNAs, and about 90% of the original pre-mRNA is spliced to produce three new alternative mRNAs. HPV-16 spliced transcripts are expressed heterogeneously in tumors and cell lines. Our results suggest that suboptimal splicing acceptor sites in E6/E7 intron 1 and the differential expression of splicing factors are involved in the production of the heterogeneous splicing profile in cell lines. The unspliced pre-mRNA and the alternative spliced transcripts contribute differentially to the production of E7 in stably transfected C33-A cells. The highest level of E7 was produced from the least prevalent transcript, the unspliced E6/E7(pre-mRNA). The order of relative expression of E7 was unspliced E6/E7(pre-mRNA) > E6*I/E7 > E6*II/E7. Our findings suggest that E6/E7 alternative splicing may be a mechanism for differential expression of the E6 and E7 oncoproteins, which also affects the expression of their targets, the proteins p53 and pRb.

Dolor en el neonato: humanización del cuidado neonatal / Pain in newborn: humanization of neonatal care

En la práctica cotidiana en la unidad neonatal (UN) los recién nacidos son sometidos a una serie de procedimientos e intervenciones terapéuticas que ocasionan dolor, algunos niños nacen con prematurez extrema, requieren en algunas ocasiones hasta dos meses de manejo ventilatorio y procedimientos como colocación de catéteres percutáneos, acceso vascular, succión de secreciones, además del constante retiro de cintas adhesivas que lastiman la piel, los neonatos están expuestos hasta a 3 procedimientos dolorosos diariamente. El manejo de estos niños esta básicamente encaminado al tratamiento de las patologías de origen; sin embargo, el cuidado debe ser holístico, satisfaciendo sus necesidades en todos sus aspectos. Hoy en día se sabe por indicadores comportamentales y fisiológicos, que el dolor está presente en ellos, debe prevenirse y tratarse para evitar sufrimiento y efectos nocivos resultantes de cambios fisiológicos, hormonales y biológicos, que pueden reprogramar el desarrollo del sistema nervioso central debido a la percepción nociceptiva de los neonatos. La valoración y tratamiento del dolor neonatal debe ser multidisciplinario, a cargo de médicos, enfermeras y familiares, por lo que además del tratamiento farmacológico, es de gran utilidad el uso de técnicas no farmacológicas como por ejemplo el contacto madre-hijo, hablarle o arrullarlo.

The intron 1 of HPV 16 has a suboptimal branch point at a guanosine.

The branch point sequence (BPS) of intron 1 of the HPV-16 was determined via RT-PCR in a cell free system, using lariat intermediates obtained by in vitro splicing reactions. We used synthetic E6/E7 transcripts and HeLa nuclear protein extracts to obtain the splicing intermediates. Then, a divergent oligonucleotide primer set, pairing on the lariat RNA that encompassed the 2'-5' phosphodiester bond formed between the 5' end of the intron and the BPS, was used for cDNA synthesis and PCR amplification. Subsequent RT-PCR assays revealed four splicing intermediates, made up of a major intermediary corresponding to the BPS and four cryptic branched sequences. Only intermediates bound at the 5' end of the intron are probably the authentic branch point sequence, and all of them branch at guanosine 328 instead of the typical adenosine. Unusually, the BPS of intron 1 of HPV-16 is a suboptimal sequence (AGUGAGU) that differs from the eukaryotic consensus BPS, which correlates with the splicing profile observed for early transcripts of HPV-16 in tumors and tumor derived cell lines. The implications of this unusual branch point sequence for splicing of the HPV-16 pre-mRNA are discussed.

Prevalencia de diagnósticos enfermeros del adulto hospitalizado en Unidades de Cuidado Intensivo Prevalencia de diagnósticos enfermeros del adulto hospitalizado en Unidades de Cuidado Intensivo / Prevalence of nursing diagnosis in the adult hospitalised patient being treated at the Intensive Care Unit

Introducción: identificar diagnósticos y, de acuerdoa ellos, planear, ejecutar y evaluar el cuidado es unreto para el profesional de Enfermería actual. Ante laescasa evidencia sobre prevalencia de diagnósticosenfermeros del adulto hospitalizado en Unidadesde Cuidado Intensivo, se realizó un estudio coneste objetivo.Materiales y métodos: estudio transversal. Seincluyeron 134 personas hospitalizadas en cuatroUnidades de Cuidado Intensivo, a quienes se lesrealizó una valoración enfermera usando un formatopreviamente validado con los diagnósticos NANDA2001-2002. Se consideró que un paciente teníaun diagnóstico real si presentaba al menos doscaracterísticas definitorias y uno de riesgo cuandoal menos un factor de riesgo estaba presente.Resultados: los diagnósticos de Enfermería másprevalentes fueron: riesgo de infección 82%(IC95% 75-88); déficit de autocuidado: uso delWC 80% (IC95% 72-86); déficit de autocuidado:baño/higiene 72% (IC95% 64-79); déficit deautocuidado: vestido/acicalamiento 69% (IC95%61-77); déficit de autocuidado: alimentación 66%(IC95% 58-74).Discusión: los hallazgos son semejantes a los deotros estudios. Conocer los diagnósticosenfermeros en UCI es tarea previa al desarrollo deestrategias para priorizar los cuidados. Serecomienda continuar investigando y trabajar conlos diagnósticos más prevalentes para contar conmejor evidencia y brindar mejor cuidado

Introduction: to identify diagnosis, and inaccordance with these diagnose, to plan,implement and evaluate nursing care, is achallenge for today’s nursing professional. The aimof this paper was to study the scarce prevalence ofnursing diagnoses in the adult hospitalised patienttreated at the Intensive Care Unit.Materials and methods: transversal study. 134hospitalised individuals receiving Intensive Care wereassessed by a nurse using a previously validatedformat using the 2001-2002 NANDA diagnoses. Itwas considered that a patient had a real diagnosis ifhe or she presented at least two definitorycharacteristics and at least one risk factor.Results: the most prevalent nursing diagnoses were:infection risk 82% (CI95% 75-88); self-care deficit:use of the WC 80% (CI95% 72-86); self-care deficit:bathing/hygiene activities 72% (CI95% 64-79);self-care deficit clothing/grooming 69% (CI95% 61-77); self-care deficit: diet 66% (CI95% 58-74).Discussion: our findings are similar to those of otherstudies. To establish a nursing diagnosis at the ICU isa step prior to the implementation of strategies aimedat prioritising the care given. It is recommended thatresearch and work be continued and using the mostprevalent nursing diagnoses to be backed up by moreevidence and in turn to offer better care