Diagnostic Performance of Airway Ultrasound for the Assessment of Difficult Laryngoscopy: A Systematic Review and Meta-Analysis.

OBJECTIVE: This study aimed to review and appraise the evidence regarding airway ultrasound assessment in predicting difficult laryngoscopy in adult patients. DESIGN: A systematic review of the literature was conducted according to the Cochrane collaboration guidelines and the recommendations for the systematic review and meta-analysis of diagnostic studies. Observational studies that evaluated the diagnostic performance of airway ultrasound for the prediction of difficult laryngoscopy were included for consideration. SETTING: Literature searches were performed in 4 databases (PubMed [Medline], Embase, Clinical Trials, and Google Scholar) to identify all observational studies using any ultrasound technique to assess difficult laryngoscopy. The search terms included "sonography," "ultrasound," "airway," "difficult airway," "difficult laryngoscopy," "Cormack," "risk factors," "ultrasound at the point of care," "difficult ventilation," "difficult intubation" and others, combined with sensitive filters. The search was done for studies performed in the last 20 years in English or Spanish. PARTICIPANTS: Adult patients older than 18 years old under general anesthesia for an elective procedure. Evident anatomic airway abnormalities, obstetric populations, those using an alternative imaging method besides ultrasound, and animal studies were excluded. INTERVENTIONS: Preoperative bedside ultrasound measuring distances and ratios from the skin to different reference points, such as the ratio of the hyomental distance in a neutral position (HMDN) and hyomental distance in extension (HMDR), HMDN, and the skin-to-epiglottis distance (SED), the preepiglottic area, and tongue thickness, among others. MEASUREMENTS AND MAIN RESULTS: A total of 24 studies evaluated the prediction of a difficult laryngoscopy using airway ultrasound. The diagnostic performance and the number of ultrasound parameters reported in the studies were variable. Meta-analysis was performed for 3 measurements consistently included in most studies. The SED and the HMDR ratio presented a sensitivity of 75% and 61%, respectively, and a specificity of 86% and 88%, respectively. The ratio of the preepiglottic distance to the epiglottic distance at the midpoint of the vocal cords (pre-E/E-VC) presented the best performance for predicting a difficult laryngoscopy (sensitivity: 82%, specificity: 83%, diagnostic odds ratio: 22.2). CONCLUSION: With the currently available evidence, the 3 commonly used point-of-care ultrasound measures used to identify difficult laryngoscopy, (SED, HMDR, and pre-E/E-VC), showed better sensitivity and similar specificity to clinical measures. Future studies and more data may change the authors' confidence in these conclusions, given the wide variability of measurements noted in studies.

Exchange of cellular components between platelets and tumor cells: impact on tumor cells behavior.

Background: Platelets are active players in tumorigenesis, although the exact interactive mechanisms and their direct impact on tumor cells remain largely unknown. Methods: Bidirectional transference of lipids, proteins and RNA between platelets and tumor cells and its impact on tumor cell behavior and tumor process are analyzed in this work. Phenotypic, genetic and functional modifications induced by platelets were analyzed both in tumor cell lines and in circulating tumor cells (CTCs). Results: Data from these assays showed that platelets transferred structural components to tumor cells with higher efficiency than tumor cells to platelets (p = 0.001). This biological interplay occurred by direct contact, internalization or via extracellular vesicles. As a result, tumor cells acquired platelet markers (CD61 and CD42), showed decreased EpCAM, expressed epithelial-to-mesenchymal transition markers, and increased proliferation rates. Moreover, we were able to detect CD61 in CTCs from early and advanced prostate cancer. Conclusions: Our results demonstrated, for the first time, that platelets educate tumor cells by highly efficient transference of lipids, proteins and RNA through different mechanisms. These results suggest that tumor cells and CTCs might acquire highly dynamic and aggressive phenotypes due to platelets interaction including EMT, stem-like phenotype and high proliferative rates.

Hipertensión y obesidad en niños de un centro de educación preescolar de la ciudad de Popayán­Colombia: Un estudio descriptivo / Hypertension and obesity in children of a pre-school education center in the city of Popayán-Colombia: A descriptive study

Objetivo: el objetivo de la presente investigación es describir la prevalencia de hipertensión y obesidad, como factores de riesgo cardiovascular en niños pertenecientes a un centro de educación preescolar la ciudad de Popayán- Colombia. Materiales y métodos: Estudio descriptivo, de corte transversal. Se estimaron medidas antropométricas y de presión arterial en 45 preescolares. Resultados: la obesidad, de acuerdo a IMC, se presentó en un 11.1% de los preescolares, mientras que 6.6% de los individuos evaluados tuvieron mediciones de tensión arterial sistólica o diastólica, en rango de hipertensión arterial. Conclusiones: los hallazgos de la presente investigación sugieren que la aparición de factores de riesgo para la enfermedad cardiovascular, tiene lugar en edades muy tempranas. La generación de hábitos saludables podría prevenir la aparición y persistencia de dichos factores..(AU)

Objective: the aim of current investigation is to describe the prevalence of hypertension and obesity, as the cardiovascular risk factors in children belonging to a pre-school education center in the City of Popayán- Colombia. Materials and methods: Descriptive, cross-sectional study. Anthropometric measurements and blood pressure were estimated in 45 preschoolers. Results: obesity, according to IMC, was presented in 11.11% of the preschool children, while 6.66% of the individuals evaluated had blood pressure, systolic or diastolic blood pressure in the range of arterial hypertension. Conclusions: the findings of the present investigation suggest that the appearance of risk factors for cardiovascular disease occurs at very young ages. The generation of healthy habits could prevent the appearance and persistence of these factors..(AU)

PCR en tiempo real: una metodología útil para la detección y cuantificación de granulovirus / Real Time PCR: a useful methodology for detection and quantitation of granulovirus

El uso de baculovirus como agentes de control biológico de insectos plaga, se ha convertido en una estrategia efectiva que se ha implementado gradualmente en diferentes sistemas productivos a nivel mundial. Para el desarrollo de un bioplaguicida a base de baculovirus, es necesario contar con una metodología para determinar el título viral en el producto en proceso y terminado. Para tal fin, en este trabajo se diseñó y optimizó una técnica de cuantificación viral (Betabaculovirus) mediante PCR cuantitativo (q-PCR). Se utilizó una sonda TaqMan diseñada sobre el gen de granulina, altamente conservado. Para la técnica de q-PCR se determinó la especificidad, sensibilidad y reproducibilidad, encontrando que puede detectar y cuantificar aislamientos del género Betabaculovirus provenientes de cinco especies diferentes de insectos (granulovirus de Tecia solanivora, Phthorimaea operculella,Erinnyis ello, Tuta absoluta y Spodoptera frugiperda) incluso de diferente origen geográfico, pero no detecta aislamientos del género Alphabaculovirus (nucleopoliedrovirus de Spodoptera ornithogalli, Diatraea saccharalis o S. frugiperda). El límite mínimo de detección de la técnica fue de 6,4 x 10-4 ng de ADN, lo que equivale a 1,25 x 10(5) copias del gen. Así mismo, la variación intra e inter ensayos fue mínima, demostrando la reproducibilidad de la misma. La aplicabilidad de la técnica fue evaluada para la detección de granulovirus en muestras de larva, suelo, y para determinar la concentración viral en un bioplaguicida formulado como concentrado emulsionable. En conclusión, la técnica de q-PCR desarrollada fue reproducible, sensible y específica, con aplicabilidad en estudios de persistencia viral en campo, control de infecciones en crías de insectos y control de calidad de bioplaguicidas a base de betabaculovirus.

The use of baculovirus as a biocontrol agent is an effective strategy, which has been gradually implemented in different production systems worldwide. For the development of a biopesticide based on baculovirus, it is necessary to have a methodology to determine the viral concentration in the process and in the finished product. In this study, a technique for viral quantification by quantitative PCR (q-PCR) was designed and optimized; therefore we used a TaqMan probe designed on granulin gene which is highly conserved. The specificity, sensitivity and reproducibility of the technique were determined. The q-PCR was able to detect and quantify isolates from the genus Betabaculovirus from five different insects species (granulovirus from Tecia solanivora, Phthorimaea operculella, Erinnys ello, Tuta absoluta and Spodoptera frugiperda) even from different geographic origins, while other isolates of baculovirus as from the genus Alphabaculovirus (nucleopolyhedrovirus from Spodoptera ornithogalli, Diatraea saccharallis or S. frugiperda) were not detected. The minimum detection limit of the technique was 6.4 x 10-4 ng /µl of DNA, equivalent to 1.25 x 10³ gene copies. Additionally, intra- and inter-assays variation was minimal, demonstrating the reproducibility of technique. The applicability of the technique was evaluated for detecting granulovirus from samples of larva and soil, and to determine the virus concentration in the biopesticide formulated as emulsifiable concentrate. In conclusion, quantitative PCR was a technique reproducible, sensitive and specific to allow viral persistence studies in field, viral infection control in rearing and quality control of a biopesticide based on betabaculovirus.

Diversidad de pseudomonas fluorescentes en cultivos de papa de la región Cundiboyacense y su actividad antagonista in vitro sobre Rhizoctonia solani / Diversity of Fluorescent Pseudomonas in Potato Crops of the Cundiboyacense Region and its in vitro Antagonic Activity against Rhizoctonia solani

Las pseudomonas fluorescentes son unas de las bacterias benéficas más importantes a nivel de la rizosfera gracias a que pueden controlar algunos fitopatógenos habituales del suelo como resultado de su capacidad antagonista. Hay muy pocos trabajos realizados para conocer la composi-ción y diversidad de pseudomonas fluorescentes en paí-ses tropicales. En este trabajo se determinó la composi-ción de pseudomonas fluorescentes provenientes de dife-rentes cultivos de papa ubicados en la región Cundiboyacense, entre 2.100 y 3.200 msnm, la cual es considerada la zona de mayor producción de papa de Colombia. Así mismo se evaluó el efecto de algunas prác-ticas de cultivo sobre dicha composición. Finalmente se determinó la capacidad de antagonismo de algunos aisla-mientos de pseudomonas fluorescentes contra Rhizoctonia solani. Fueron evaluadas 45 muestras de rizosfera y rizoplano de cultivos de papa provenientes de 15 campos de papa diferentes. Las muestras se procesaron usando una modificación del medio King B, la cual resultó ser más eficiente para aislar pseudomonas fluorescentes, que otras reportadas en la literatura. El 80,7por cien y 82,7por cien de las pseudomonas fluorescentes aisladas en rizosfera y rizoplano, respectivamente, fueron Pseudomonas fluorescens, mostrando poca diversidad en las muestras evaluadas. Por otra parte se observó un efecto de la estra-tegia de rotación de cultivo maíz-papa, sobre el número de pseudomonas fluorescentes aisladas de la rizosfera. Estos resultados tienen implicaciones para el diseño de estrategias de manejo integrado de plagas en los cultivos de los países tropicales.