Characterization of the Bacteriophage vB_VorS-PVo5 Infection on Vibrio ordalii: A Model for Phage-Bacteria Adsorption in Aquatic Environments.

A mathematical first-order difference equation was designed to predict the dynamics of the phage-bacterium adsorption process in aquatic environments, under laboratory conditions. Our model requires knowledge of bacteria and bacteriophage concentrations and the measurements of bacterial size and velocity to predict both the number of bacteriophages adsorbed onto their bacterial host and the number of infected bacteria in a given specific time. It does not require data from previously performed adhesion experiments. The predictions generated by our model were validated in laboratory. Our model was initially conceived as an estimator for the effectiveness of the inoculation of phages as antibacterial therapy for aquaculture, is also suitable for a wide range of potential applications.

[Scorpionism causing severe acute flaccid paralysis. Case report]. / Alacranismo severo causante de parálisis flácida aguda. Reporte de caso.

BACKGROUND: Scorpionism is a public health problem in various regions of the world, being Mexico the country with the highest number of cases. Clinical manifestations range from local symptoms to severe disease with an impact on cardiovascular, respiratory and neurological level, and even death. There are no reports of acute flaccid paralysis as a manifestation of the clinical picture of the scorpion sting of the Centruroides gender, Family Buthidae, highly toxic, causes high rates of morbidity and mortality in our region. CLINICAL CASE: We documented a case of scorpionism, caused by a scorpion gender Buthidae, Centruroides family, which caused acute flaccid paralysis, after resolution of other severe manifestations. There is only one case report of scorpionism that produces acute flaccid paralysis in the literature, but it is related to the Parabuthus scorpion, endemic of South Africa. CONCLUSIONS: The knowledge of this complication, new for our region, will maximize efforts to diagnose and appropriately manage this symptoms, with the adequate application of the specific fabotherapy and advanced life support for proper survival in the patients with compromise of vital functions and imminent risk of death mainly by respiratory failure.

Introducción: el alacranismo es un problema de salud pública en diversas regiones del mundo, siendo México el país que tiene mayor número de casos. Las manifestaciones clínicas oscilan desde sintomatología local hasta cuadros graves con repercusiones a nivel cardiovascular, respiratorio y neurológico, e incluso la muerte. No existen reportes de parálisis flácida como una manifestación del cuadro clínico por picadura del alacrán del género Centruroides, familia Buthidae, especie altamente tóxica, endémica y causante de altos índices de morbimortalidad en nuestra región. Caso clínico: documentamos un caso de alacranismo grave, provocado por escorpión de la familia Buthidae del género Centruroides, que causó parálisis flácida aguda, posterior a resolución de otras manifestaciones severas. Solo existe un reporte de caso de alacranismo que produce parálisis flácida aguda en la literatura médica, pero relacionado con el escorpión de la familia Parabuthus, endémico de Sudáfrica, el cual no es endémico en México. Conclusiones: conocer esta complicación, nueva para nuestra región, permitirá maximizar esfuerzos para diagnosticar y manejar oportunamente esta entidad con la aplicación temprana de faboterápico específico y soporte vital avanzado.

Biomarcadores precoces de fracaso renal agudo tras angiografía coronaria o cirugía cardíaca en pacientes con síndrome coronario o fallo cardíaco agudos / Early biomarkers of acute kidney failure after heart angiography or heart surgery in patients with acute coronary syndrome or acute heart failure

Antecedentes: El fracaso renal agudo (FRA) es una complicación frecuente tras la cirugía cardíaca y la angiografía coronaria que ensombrece el pronóstico de estos pacientes. El diagnóstico se basa en el ascenso de la creatinina sérica, que es tardío. Es necesaria la identificación y validación de nuevos biomarcadores precoces que permitan intervenciones más tempranas y eficaces. Objetivos: Evaluar la sensibilidad y especificidad de interleuquina-18 (IL-18) en orina, neutrophil gelatinase-associated lipocalin en orina (uNGAL) y cistatina C en suero para la detección precoz del FRA en una población de pacientes con síndrome coronario agudo o fallo cardíaco y sometidos a cirugía cardíaca o cateterismo. Métodos: Se incluyeron en el estudio 135 pacientes ingresados en una unidad de cuidados intensivos por síndrome coronario agudo o fallo cardíaco por patología coronaria o valvular y a los que se realizaron una angiografía cardíaca o una cirugía cardíaca de revascularización o recambio valvular. Se determinaron los biomarcadores a las 12 horas de la intervención y se monitorizó la creatinina sérica durante los siguientes seis días para el diagnóstico del FRA. Resultados: Para NGAL se obtuvo un área bajo la curva ROC (AUC) de 0,983 y para cistatina C e IL-18 de 0,869 y 0,727, respectivamente. Para un punto de corte de NGAL en orina de 31,9 ng/ml la sensibilidad fue del 100% y la especificidad del 91%. Conclusiones: uNGAL es un marcador precoz de FRA en pacientes con síndrome coronario o fallo cardíaco agudo y sometidos a cirugía cardíaca y angiografía cardíaca, con una capacidad predictiva superior a cistatina o a IL-18 (AU)

Background: Acute kidney injury (AKI) is a common complication in cardiac surgery and coronary angiography, which worsens patients' prognosis. The diagnosis is based on the increase in serum creatinine, which is delayed. It is necessary to identify and validate new biomarkers that allow for early and effective interventions. Aims: To assess the sensitivity and specificity of neutrophil gelatinase-associated lipocalin in urine (uNGAL), interleukin-18 (IL-18) in urine and cystatin C in serum for the early detection of AKI in patients with acute coronary syndrome or heart failure, and who underwent cardiac surgery or catheterization. Methods: The study included 135 patients admitted to the intensive care unit for acute coronary syndrome or heart failure due to coronary or valvular pathology and who underwent coronary angiography or cardiac bypass surgery or valvular replacement. The biomarkers were determined 12 hours after surgery and serum creatinine was monitored during the next six days for the diagnosis of AKI. Results: The area under the ROC curve (AUC) for NGAL was 0.983, and for cystatin C and IL-18 the AUCs were 0.869 and 0.727, respectively. At a cut-off of 31.9ng/ml for uNGAL the sensitivity was 100% and the specificity was 91%. Conclusions: uNGAL is an early marker of AKI in patients with acute coronary syndrome or heart failure and undergoing cardiac surgery and coronary angiography, with a higher predictive value than cystatin C or IL-18 (AU)

Evolución de la función renal y factores de progresión en pacientes nefrectomizados / Evolution of kidney function and progression factors in nephrectomised patients

A las consultas externas de nefrología acude un importante número de pacientes nefrectomizados, quienes son remitidos tras la cirugía o bien cuando presentan un deterioro de la función renal o alguna otra patología asociada. Existen diferentes estudios sobre pacientes nefrectomizados en los que se valoran la función renal y su evolución (tanto en sanos como en pacientes con factores de comorbilidad), con unos resultados muy variables. Presentamos un estudio observacional y retrospectivo sobre 92 pacientes, monorrenos quirúrgicos, atendidos en las consultas de nefrología de nuestro centro, con una edad promedio de 67 años (rango, 22-89 años) y con un promedio de seguimiento posterior a la cirugía de 21 años. La población fue dividida en dos grupos según el filtrado glomerular (FG): los pacientes del grupo 1 presentaban un FG inferior a 60 ml/minantes de la cirugía y los del grupo 2 presentaban un FG superiora 60 ml/min. En el grupo 1, en el momento de la nefrectomía,24 pacientes tenían un FG promedio de 48 ml/min, el 63%hipertensión arterial (HTA) y el 8% presentaban proteinuria. El21% de los pacientes del grupo 1 tardó 20 años de promedio(10-30 años) en entrar en estadios 4 y 5, y 5 casos evolucionaron hasta necesitar terapia renal sustitutiva. El grupo 2 estaba formado por 68 pacientes con un FG promedio de 76,5 ml/min, un 34% con HTA y un 10% con proteinuria. El 80% del grupo2 alcanzó el estadio 3 en un promedio de 17,47 años después de la intervención quirúrgica (1-48 años). El 19,1%presentaron, a lo largo de su evolución, un FG superior a60 ml/min, tras una media de 22 años de evolución. Nuestros resultados indican que los pacientes monorrenos quirúrgicos presentan una progresión de la enfermedad renal muy lenta, y se observa una tendencia a la progresión de la insuficiencia renal al presentar proteinuria (AU)

Data recorded from external visit in hospitals, reflects high number of nephrectomized patients. Most of these patients were remitted after any surgery or deteriorizated renal function or any other associated pathology. Several studies of nephrectomized patients are reported in literature concerning both healthy patients and comorbility factors, and renal function and its evolution are evaluated. However, obtained results present a wide variability, which needs to be assessed. In this study we present a retrospective observational study of 92 one-kidney surgical patients, visited in Nephrology surgery of University Clinic Hospital. Patients presented an average age of 67 years old (range 22-89 years old), and a postsurgery monitoring of 21 years. Population was divided in two groups according with their glomerular filtration (FG). Before surgery, group 1 presented FG <60 ml/min and group 2 >60 ml/min, respectively. Group 1 patients (a total of 24 patients) presented an FG average of 48 ml/min, 8% had proteinuria and 63% presented high blood pressure. 21% of them needed an average of 20 years (10-30 years) to reach E4 and E5 steps and in general, most of them progressed to insufficient renal chronic disease. Five cases achieved renal therapy replacement. Group 2 patients, composed of a total of 68 patients, had an FG average of 76.5 ml/min, and 10% of patients presented proteinuria and 34% HTA; however, 80% of group 2 patients achieve E3 step with average age of 17 years, and a post-surgery of 47 years (1-48 years). A total of 19.1 % presented an FG higher 60 ml/min with an average development of 22 years along their evolution. According to the results obtained it is suggested that monorrenal surgical patients present a low progression of renal disease and it is also observed a progressive tendency to the chronic renal failure due to emerging ofproteinuria (AU)

Estudio de la función diastólica en pacientes en diálisis peritoneal. Comparación entre doppler pulsado y tisular / Study of diastolic function in peritoneal dialysis patients. Comparation between pulsed and tissue doppler

Introducción: La hipertrofia ventricular izquierda (HVI) es la expresión principal de la miocardiopatía urémica. La disfunción diastólica se asocia frecuentemente con dicha hipertrofia prediciendo futuros eventos cardiovasculares. Estudios recientes sugieren que el doppler tisular (DTI) del anillo mitral obtiene parámetros de función diastólica que no se influyen por otros factores, como ocurre con el doppler pulsado (DP) y que la relación entre la velocidad de la onda protodiastólica entre ambas técnicas (E/E´) podría ser un dato de gran importancia para el diagnóstico de disfunción diastólica. El objetivo de este estudio es verificar la prevalencia de HVI en una población de pacientes con enfermedad renal crónica (ERC) estadio 5 en tratamiento con diálisis peritoneal y estudiar la función diastólica comparando los resultados de ambas técnicas (DP/DTI), así como las posibles causas que determinan la aparición de disfunción diastólica en estos pacientes. Pacientes y métodos: Se realiza un estudio transversal en 42 pacientes en diálisis peritoneal. Todos los pacientes tenían una fracción de eyección superior al 50% y no presentaban signos clínicos de insuficiencia cardíaca, enfermedad valvular o arritmia. En todos los casos se realizó un estudio bioquímico básico, medición de la función renal residual (aclaramiento promedio de urea y creatinina), PCR ultrasensible (PCR) y un estudio con doppler en modo M, doppler pulsado y doppler tisular del anillo mitral. Resultados: El 26,2% de los pacientes presentaban una hipertrofia concéntrica, el 14,3% hipertrofia excéntrica y el 23,8% remodelado concéntrico. El DP mostró un cociente E/A menor de 0,75 en 20 casos (alteración de la relajación ventricular), en 22 casos un E/A entre 0,75 y 1,5 (patrón normal o pseudonormal) y en ningún caso el E/A era mayor de 1,5. Por otra parte, el DTI mostró en 24 pacientes un cociente E/A menor de 0,75, en 16 entre 0,75 y 1,5 y en 2 un cociente mayor de 1,5. El cociente E/E´ fue normal en 13 casos, intermedio en 12 y mayor de 10 en 17, expresando una clara disfunción diastólica. Se descubrió una relación significativa entre la función renal residual (FRR), la fracción de eyección y la presión arterial diastólica, mientras que en el estudio multivariante la HVI fue la única variable independiente significativa en relación a la disfunción diastólica (odds ratio 7,6). Conclusiones: En nuestra población de pacientes en diálisis peritoneal se observó una alta incidencia de disfunción diastólica. La HVI, presente en un alto porcentaje de pacientes, es uno de los factores que favorecen su aparición. La técnica no invasiva DTI y el cociente E/E´ se han mostrado más sensibles que el DP en el diagnóstico de la disfunción diastólica

Introduction: Left ventricular hypertrophy (LVH) is the main expression of uremic cardiomyopathy. Alteration of the diastolic function is frequently associated with LVH, indicating future cardiovascular events. Recent studies suggest that the Tissue Doppler (TID) of the mitral annulus obtains parameters of diastolic function that are not influenced by other factors, unlike what occurs with the pulsed Doppler (PD), and that the relationship between the velocity of the proto-diastolic waves of both techniques (E/E’) would be the most important datum to diagnose a diastolic malfunction. The objective of this study is to verify LVH prevalence in a population of End Stage Renal Disease patients (ESRD) in peritoneal dialysis (CAPD), and to study diastolic function, comparing the results of both techniques (PD/TID), as well as the possible causes that determine the appearance of diastolic malfunction in these patients. Patients and methods: We carried out a cross-section study with 42 patients in peritoneal dialysis. All patients had an ejection fraction of over 50% and had no clinical signs of heart failure, valvular heart disease or arrhytmia. A basic biochemistry, residual renal function, C-reactive protein and an ultrasonic study with Mmode doppler, pulsed doppler and tissue doppler of the mitral annulus, were performed in all patients. Results: 26.2% of the patients had a concentric LVH, 14.3% an asymmetric LVH and 23.8% a concentric growth. The PD showed an E/A ratio under 0.75 in 20 cases (which would indicate an alteration of ventricular relaxation), an E/A between 0.75 and 1.5 in 22 (normal or pseudonormal pattern) and none with an E/A over 1.5. On the other hand, the TID showed: 24 patients with an E/A 1.5. The E/E’ proportion was normal in 13 cases (< 8), intermediate in 12 (8-10), and greater than 10 in 17, expressing a clear diastolic malfunction. Twelve of the 17 with diastolic malfunction had a pseudo-normal pattern with the PD. A relationship was observed between the E/A and age and hs-CRP. A relationship was also found between RRF, ejection fraction and diastolic pressure (p = 0.03, r = 0.32 and p = 0.006, r = 0.29), while, in the multivariant study, the presence of LVH was the only variable with enough significance to influence the diastolic malfunction (odds ratio of 7.6). Conclusions: Patients in CAPD have a high incidence of diastolic malfunction. LVH, present in a high percentage of patients, is one of the factors that favours its appearance. The non-invasive TID technique and the E/E’ ratio have shown to be more sensitive than the PD in diagnosing a diastolic malfunction

Selenium reduces the proapoptotic signaling associated to NF-kappaB pathway and stimulates glutathione peroxidase activity during excitotoxic damage produced by quinolinate in rat corpus striatum.

Quinolinate (QUIN) neurotoxicity has been attributed to degenerative events in nerve tissue produced by sustained activation of N-methyl-D-aspartate receptor (NMDAr) and oxidative stress. We have recently described the protective effects that selenium (Se), an antioxidant, produces on different markers of QUIN-induced neurotoxicity (Santamaría et al., 2003, J Neurochem 86:479-488.). However, the mechanisms by which Se exerts its protective actions remain unclear. Since some of these events are thought to be related with inhibition of deadly molecular cascades through the activation of antioxidant selenoproteins, in this study we investigated the effects of Se on QUIN-induced cell damage elicited by the nuclear factor kappaB (NF-kappaB) pathway, as well as the time-course response of striatal glutathione peroxidase (GPx) activity. Se (sodium selenite, 0.625 mg/kg/day, i.p.) was administered to rats for 5 days, and 120 min after the last administration, animals received a single striatal injection of QUIN (240 nmol/mul). Twenty-four hours later, their striata were tested for the expression of IkappaB-alpha (the NF-kappaB cytosolic binding protein), the immunohistochemical expression of NF-kappaB (evidenced as nuclear expression of P65), caspase-3-like activation, and DNA fragmentation. Additional groups were killed at 2, 6, and 24 h for measurement of GPx activity. Se reduced the QUIN-induced decrease in IkappaB-alpha expression, evidencing a reduction in its cytosolic degradation. Se also prevented the QUIN-induced increase in P65-immunoreactive cells, suggesting a reduction of NF-kappaB nuclear translocation. Caspase-3-like activation and DNA fragmentation produced by QUIN were also inhibited by Se. Striatal GPx activity was stimulated by Se at 2 and 6 h, but not at 24 h postlesion. Altogether, these data suggest that the protective effects exerted by Se on QUIN-induced neurotoxicity are partially mediated by the inhibition of proapoptotic events underlying IkappaB-alpha degradation, NF-kappaB nuclear translocation, and caspase-3-like activation in the rat striatum, probably involving the early activation of GPx.

[Nurses who treat Parkinson patients: what do they know and what do they want to know?]. / Enfermos de Parkinson. Qué conocen y qué quieren conocer?

UNLABELLED: To deal with Parkinson Disease, the education and the participation of the patient and his/her patient in the care of this disease are fundamental aspects. To know a patient's perceptions about his/her need for information, the patient's anxieties and the necessity to communicate with the medical team help to individualize the education provided for a patient. METHOD: a general qualitative descriptive study developed by means of semi-structured interviews. SAMPLE: 19 outpatients previously diagnosed with Parkinson's. The random method used was based on setting up interviews by the medical team by means of a computer. RESULTS: The majority of the patients felt their knowledge level was sufficient, although some search for more information and others showed a fear to learn more. The main source of information comes from their neurologists. The patients think that the information related to the symptoms and the drugs (for Parkinson's) is adequate, but this information is lacking regarding emotional necessities and other personal aspects. The patients think that communication is fundamental when dealing with a chronic disease, and that there is a need for individualized, very human, relationships where besides technical competence, patients hope for comprehension, security confidence and the opportunity for patients to express themselves.