Effect of Inappropriate Treatment in Hospitalized Patients with Pyelonephritis Treated with Cefuroxime: A Cohort Study.

The aim of this study was to evaluate the effect of inappropriate therapy in adult patients with community-acquired pyelonephritis caused by Escherichia coli receiving empirical treatment with cefuroxime during hospital stay and readmission. A retrospective cohort study was performed. Inappropriate treatment was considered treatment for a nonsusceptible isolate according to the results of the urine culture. Adjustment for confounding factors was performed with propensity score-derived inverse probability of treatment weighting. Between 2013 and 2020, 747 patients were included, 102 (13.7%) of whom received inappropriate therapy. Compared to appropriate therapy, inappropriate therapy was associated with a shorter length of stay in the adjusted analysis (Hazard Ratio = 0.34; 95% CI = 0.23-0.49). After 735 patients were discharged from the hospital, 66 were readmitted in the following 30 days. In comparison with appropriate therapy, inappropriate antimicrobial therapy was not related to readmission (OR 1.47; 95% CI = 0.35-2.79). Inappropriate therapy was not related to a longer hospital stay or readmission due to pyelonephritis after adjusting for confounders and covariates.

Percutaneous tracheostomy in COVID patients. Experience in our hospital center after one year of pandemic and review of the literature

Background: The pandemic caused by SARS-COV-2 has caused an increase in the need of tracheostomies in patients affected with respiratory distress syndrome. In this article we report our experience during a year of pandemic, we develop our surgical technique to perform percutaneous tracheostomy with the patient in apnea and we compare our results with those of other centers through a bibliographic review. Material and Methods: A one-year retrospective clinical study was carried out on tracheotomies performed on patients admitted to the intensive care unit with severe SARS-CoV-2, with difficulty for ventilation or weaning. The technique performed was percutaneous, with fibroscopic control through the endotracheal tube, keeping the patient under apnea during the opening of the airway, reducing by this method the risk of exposure to the virus. Results: From 35 percutaneous tracheotomies performed, 31% of the patients died from respiratory complications due to SARS-COV-2, but none due to the surgical procedure. The most frequent complication (8.5% of patients) was bleeding around the tracheostoma, resolved with local measures. No healthcare provider involved in the performance of the technique had symptoms or was diagnosed with COVID-19. Conclusions: Our technique of performing percutaneous tracheostomy maintaining apnea during the procedure, under fibroscopic control, has proven to be safe for all those involved in the procedure, and for the patient.(AU)

Protective association exhibited by a single nucleotide polymorphism of the IFIH1 gene in patients with psoriasis: A case-control study. / Asociación protectora del polimorfismo de nucleótido único en IFIH1 en pacientes con psoriasis: estudio de casos y controles.

INTRODUCTION: Psoriasis is a chronic inflammatory dermatosis, a with variable clinical presentation and whose multifactorial etiology carries an essential genetic component. Multiple genetic variations associated with psoriasis have been described around the world. However, these variants are unknown among the Colombian population. This study aimed to evaluate the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene and its ssociation with the development of psoriasis in a Colombian population. METHODS: An observational, unmatched, case-control study was performed, including 51 patients with psoriasis and 151 population controls, all with self-reported Paisa ancestry (from the Antioquia region). All individuals were genotyped for the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene, and its association with psoriasis was pursued. Both groups were demographically characterized, and cases were also assessed for clinical variables. RESULTS: Through the allelic association analysis, cases were found to have a lower frequency of the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene than controls; 5% versus 22.67%, respectively. There were no significant differences in age or sex. We also found that psoriasis vulgaris was the most common variant (78%), that about half of the cases had nail psoriasis (56%), 19.6% had psoriatic arthritis, and that 45% had some comorbidity. CONCLUSIONS: The results obtained from this study confirm that carriers of the single nucleotide polymorphism rs10930046 (His460Arg) in the IFIH1 gene have a decreased risk of developing psoriasis.

INTRODUCCIÓN: La psoriasis es una dermatosis inflamatoria crónica, con presentación clínica variable y cuya etiología involucra un componente genético importante. Alrededor del mundo se han descrito múltiples variaciones genéticas asociadas a la enfermedad. Sin embargo, en población colombiana se desconocen estas variantes. En este estudio se evalúa el polimorfismo de nucleótido único rs10930046 (His460Arg) en el gen IFIH1 y su asociación con el desarrollo de psoriasis en población colombiana. Además, se caracteriza a los individuos demográfica y clínicamente. MÉTODOS: Se realizó un estudio observacional de casos y controles, no pareado, que incluyó 51 individuos con psoriasis y 151 controles poblacionales, todos de ancestría paisa (proveniente de la región de Antioquia) auto reportada. A todos los individuos se les realizó genotipificación del polimorfismo de nucleótido único rs10930046 (His460Arg) en el gen IFIH1 y se les determinó la asociación con la enfermedad. Se caracterizaron demográficamente ambos grupos y los casos clínicamente. RESULTADOS: Se encontró que los casos presentaron una menor frecuencia del polimorfismo de nucleótido único rs10930046 (His460Arg) en el gen IFIH1 en relación a los controles, 5 versus 22,67% respectivamente, con un análisis de asociación alélico. No hubo diferencias significativas en edad ni en sexo. La psoriasis vulgar fue la variante de presentación más común (78%). Alrededor de la mitad de los casos presentaron psoriasis ungular (56%), en menor frecuencia artritis psoriásica (19,6%) y el 45% de los casos tuvo alguna comorbilidad. CONCLUSIONES: Los resultados obtenidos confirman que los portadores del polimorfismo de nucleótido único rs10930046 (His460Arg) en el gen IFIH1, presentan un riesgo disminuido de desarrollar psoriasis.

Enfermedad relacionada con IgG4. A propósito de un caso / IgG4 Related disease. A case report

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First case of Aspergillus caelatus airway colonization in a Chronic Obstructive Pulmonary Disease patient.

BACKGROUND: During a cross-sectional study on allergic aspergillosis in Chronic Obstructive Pulmonary Disease patients in Bogotá, Colombia, we reported the case of a 65-year-female patient with GOLD 2011 D classification, presenting dyspnea at the time of visit and aspergillus in repeated sputum cultures. METHODS: The isolate was identified at the section level based on macroscopic and microscopic characteristics and gene sequencing was used for precise molecular identification. Antifungal sensibility was determined by Sensititre YeastOne™ while virulence was assessed using a Galleria mellonella larvae model. RESULTS: The clinical isolate was first identified as Aspergillus section Flavi and sequencing of ß-tubulin and calmodulin genes, in addition to the identification of alfR (aflatoxin regulator) gene, allowed the undoubted identification of the clinical isolate as Aspergillus caelatus. It exhibited virulence in G. mellonella similar to A. flavus and a high in vitro susceptibility against all antifungals except for amphotericin B. CONCLUSION: This is the first human case of airway colonization attributed to A. caelatus. Resistance pattern justified the interest to discriminate this cryptic species.

Temporal headache and jaw claudication may be the key for the diagnosis of giant cell arteritis

BACKGROUND: Temporal artery biopsy (TAB) is a surgical procedure with a low positive yield. The purpose of this study is to determine which variables are the most important in the giant cell arteritis (GCA) diagnosis. The objective of this evaluation is to improve the percentage of positive temporal artery biopsy and if possible, avoid the biopsy in some cases. MATERIAL AND METHODS: A retrospective clinical study consisted of 90 patients who had undergone TAB at the Río Hortega Hospital (Spain) from January 2009 to December 2016. Clinical findings, erythrocyte sedimentation rates (ESR) and other laboratory parameters, American College of Rheumatology (ACR) criteria for GCA score and biopsy results were recorded. RESULTS: Nineteen (21.1%) biopsies were positive for GCA. The mean age in positive TAB was 78.6 years old (SD 7.93), and 73.7% were female. Presence of temporal headache (p = 0.003), jaw claudication (p = 0.001), abnormal artery exploration (p = 0.023), elevated erythrocyte sedimentation rate (p = 0.035), CRP (p = 0.018) and platelets (p = 0.042), were significantly associated with GCA. Multivariate logistic regression revealed that the best predictors for the diagnosis of GCA are headache and jaw claudication, adjusted by sex, age, and temporal exploration. CONCLUSIONS: TAB has benefit only for patients who score a 2 or 3 on the ACR criteria for GCA without biopsy. These findings highlight the need for a better diagnostic strategy for patients with suspected temporal arteritis

The use of monoclonal antibodies anti-lectin from freshwater prawn Macrobrachium rosenbergii (DeMan, 1879) in the recognition of protein with lectin activity in Decapod's hemolymph.

We determined the cross-reactivity of a monoclonal antibody against the Macrobrachium rosenbergii lectin with proteins in the hemolymph from Procambarus clarkii (Pc), Procambarus americanus (Pa), Litopenaeus setiferus (Ls), and Pseudothelphusa americana (Psa). Crustaceans' hemolymph agglutinated erythrocytes from rat, mouse, guinea pig, and rabbit. Decapods' hemolymph hemagglutinating activity was inhibited by N-acetylated carbohydrates as well as by antibodies. Western blot assays indicated that the antibodies recognized two main proteins of 97.5 and 80.9 kDa in all hemolymphs studied; moreover, ELISA assays indicated that, in PSa, 7.2% of total proteins showed crossreactivity with antibodies in Pa, Pc, and Lc hemolymphs represented 4.2, 3.1%, and 2.5%, respectively. Our results suggested that antibodies recognize the lectin active site in the crustacean species tested; we propose the use of antibodies as an immunological marker for lectin identification and quantification among crustaceans.

The effect of sugars and free amino acids from the freshwater prawn Macrobrachium rosenbergii hemolymph on lectin activity and on oxidative burst.

We determined the effect of low molecular weight components (LMWC) from healthy juvenile and adult Macrobrachium rosenbergii hemolymph on lectin activity and oxidative burst (OB) in hemocytes. In an attempt to identify the LMWC that affect the lectin's hemagglutinating activity or oxidative burst, we determined the hemolymph carbohydrates and free amino acids (FAA) concentration. The LMWC (<2000 Da) were obtained after dialysis of the hemolymph. Our results showed that LMWC from juveniles exerted a greater inhibition on lectin than LMWC from adult hemolymph. Production of superoxide radicals by hemocytes was lower in the presence of juvenile (p<0.05) as compared to adult LMWC. FAA composition of the hemolymph and of LMWC from adults showed higher proportion of alanine (which corresponded to 25% of total FAA) and proline (>20%); whereas, in juveniles, the main FAA identified were glycine (>40%) and alanine (26%). N-Acetyl-D-glucosamine (GlcNAc) was the main sugar residue in the hemolymph and LMWC from juveniles; its concentration was 2.4 times higher than glucose (Glc), whereas, in adults, Glc was the main free sugar residue. Our results suggest that the proportion of FAA and carbohydrates in the hemolymph of M. rosenbergii seems to be correlated with the maturation process; furthermore, the high proportion of free GlcNAc and glycine regulate, in the juvenile stage, lectin activity and cellular oxidative mechanisms, respectively.

Expresión MMP-13 en enfermedad periodontal / MMP-13 expression in periodontal disease

Objetivo: determinar si existe diferencia en la expresión y localización de MMP-13 en periodonto sano, agrandamiento gingival inducido por placa bacteriana, periodontitis crónica moderada/avanzada y periodontitis agresiva, mediante inmunohistoquímica para evidenciar un posible papel de esta colagenasa en la progresión del daño tisular en patologías infecciosas del periodonto. Métodos: el tipo de diseño seguido en este estudio fue observacional comparativo. Se tomaron biopsias de 22 pacientes que fueron diagnosticados como 5 sanos (S), 6 periodontitis crónica (PC), 6 periodontitis agresia (PA) y 5 agrandamiento gingival inducido por placa bacteriana (AGIPB), analizándose 4 estratos tisulares en cada biopsia: epitelio oral (EO), epitelio de unión (EU), conectivo adyacente al epitelio de unión (CAEU) y conectivo profundo (CP). El tipo de muestreo fue intencional, ya que los investigadores conocían las características de los sujetos que se escogieron para el estudio. Las muestras se colocaron en formalina al 10 por ciento y se incluyeron en bloques de parafina, para posteriormente realizar la técnica de inmunohistoquímica. Se hizo valoración semicuantitativa determinada por conteo celular al microscopio de luz (40X). Resultados: la mayor expresión de MMP-13 se da en la periodontitis crónica (PC) seguida por el agrandamiento gingival inducido por placada bacteriana (AGIPB), periodontitis agresiva (PA) y finalmente los pacientes sanos que no mostraron expresión alguna de esta colagenasa. El estrato tisular que más expresión mostró fue el epitelio oral a nivel del estrato granuloso. Conclusión: la MMP-13 no se expresa en biopsias de tejido sano. La expresión se presenta en tejidos que se encuentran en procesos de destrucción o de remodelación (AU)

Expresión MMP-13 en enfermedad periodontal / MMP-13 expression in periodontal disease

Objetivo: determinar si existe diferencia en la expresión y localización de MMP-13 en periodonto sano, agrandamiento gingival inducido por placa bacteriana, periodontitis crónica moderada/avanzada y periodontitis agresiva, mediatne inmunohistoquímica para evidenciar un posible papel de esta colagenaa en la progresión del daño tisular en patologías infecciosas del periodonto. Métodos: el tipo de diseño seguido en este estudio fue observacional comparativo. Se tomaron biopsias de 22 pacientes que fueron diagnosticados como 5 sanos (S), 6 periodontitis crónica (PC), 6 periodontitis agresia (PA) y 5 agrandamiento gingival inducido por placa bacteriana (AGIPB), analizándose 4 estratos tisulares en cada biopsia: epitelio oral (EO), epitelio de unión (EU), conectivo adyacente al epitelio de unión (CAEU) y conectivo profundo (CP). El tipo de muestreo fue intencional, ya que los investigadores conocían las características de los sujetos que se escogieron para el estudio. Las muestras se colocaron en formalina al 10 por ciento y se incluyeron en bloques de parafina, para posteriormente realizar la técnica de inmunohistoquímica. Se hizo valoración semicuantitativa determinada por conteo celular al microscopio de luz (40X). Resultados: la mayor expresión de MMP-13 se da en la periodontitis crónica (PC) seguida por el agrandamiento gingival inducido por placada bacteriana (AGIPB), periodontitis agresiva (PA) y finalmente los pacientes sanos que no mostraron expresión alguna de esta colagenasa. El estrato tisular que más expresión mostró fue el epitelio oral a nivel del estrato granuloso. Conclusión: la MMP-13 no se expresa en biopsias de tejido sano. La expresión se presenta en tejidos que se encuentran en procesos de destrucción o de remodelación (AU)

Expresión MMP-13 en enfermedad periodontal / MMP-13 expression in periodontal disease

Objetivo: determinar si existe diferencia en la expresión y localización de MMP-13 en periodonto sano, agrandamiento gingival inducido por placa bacteriana, periodontitis crónica moderada/avanzada y periodontitis agresiva, mediatne inmunohistoquímica para evidenciar un posible papel de esta colagenaa en la progresión del daño tisular en patologías infecciosas del periodonto. Métodos: el tipo de diseño seguido en este estudio fue observacional comparativo. Se tomaron biopsias de 22 pacientes que fueron diagnosticados como 5 sanos (S), 6 periodontitis crónica (PC), 6 periodontitis agresia (PA) y 5 agrandamiento gingival inducido por placa bacteriana (AGIPB), analizándose 4 estratos tisulares en cada biopsia: epitelio oral (EO), epitelio de unión (EU), conectivo adyacente al epitelio de unión (CAEU) y conectivo profundo (CP). El tipo de muestreo fue intencional, ya que los investigadores conocían las características de los sujetos que se escogieron para el estudio. Las muestras se colocaron en formalina al 10 por ciento y se incluyeron en bloques de parafina, para posteriormente realizar la técnica de inmunohistoquímica. Se hizo valoración semicuantitativa determinada por conteo celular al microscopio de luz (40X). Resultados: la mayor expresión de MMP-13 se da en la periodontitis crónica (PC) seguida por el agrandamiento gingival inducido por placada bacteriana (AGIPB), periodontitis agresiva (PA) y finalmente los pacientes sanos que no mostraron expresión alguna de esta colagenasa. El estrato tisular que más expresión mostró fue el epitelio oral a nivel del estrato granuloso. Conclusión: la MMP-13 no se expresa en biopsias de tejido sano. La expresión se presenta en tejidos que se encuentran en procesos de destrucción o de remodelación

Participation of serum and membrane lectins on the oxidative burst regulation in Macrobrachium rosenbergii hemocytes.

Using a spectrophotometric NBT reduction assay and phagocytosis, we identified that production of superoxide anions and phagocytic activity of hemocytes from Macrobrachium rosenbergii were significantly higher in the presence of rat, rabbit, and chicken erythrocytes than with human, pig, or horse erythrocytes. Hemocytes stimulated with MrL, MrLMab, or PMA increased 4.7, 5.1, and 6.1 fold, respectively, the oxidative response as compared to non-stimulated hemocytes. MrLMab together with MrL increased 5.7 fold the oxidative capacity of hemocytes as compared to non-stimulated cells. These effects were inhibited with 100 mM GalNAc, GlcNAc, or Neu5Ac and 0.2 microM of sialylated submaxillary gland mucin and fetuin. Piroxicam inhibited (P < 0.05) the production of O(2)(-) induced by MrL, whereas iodoacetamide inhibited the effect of MrLMAb (P < 0.05) in a dose-dependent manner. Our results suggest that MrLMab might activate the oxidative burst through the metabolism of glucose as opposed to MrL which utilizes NADPH-independent mechanisms, very probably through pro-inflammatory metabolites.

Contaminación por Salmonella Arizona y otras enterobacterias en cápsulas de víbora de cascabel preparadas y distribuidas en tiendas naturistas de la ciudad capital: estudio descriptivo realizado en 52 muestras populares de cápsulas de víbora de cascabel, provenientes de 25 tiendas naturistas de la ciudad de Guatemala, en los meses de febrero-abril de 1994, Guatemala / Contamination by Salmonella Arizona and other enterobacteria in rattlesnake capsules prepared and distributed in naturist stores of the capital city: a descriptive study conducted in 52 popular samples of rattlesnake capsules, from 25 health food stores in Guatemala City, in the months of February-April 1994, Guatemala

El trabajo pretendió dar a conocer el alto grado de contaminación por bacterias principalmente Salmonella Arizona y Enterobacteriaceae, en el contenido de cápsula de víbora de Cascabel, preparadas y distribuidas en Tiendas Naturistas de la Ciudad. Se cultivó el contenido de cincuenta y dos cápsulas a través de análisis bacteriológico en donde se utilizaron diferentes medios de cultivo para la identificación de bacterias entéricas Gramnegativas.