Cytomegalovirus reactivation in patients diagnosed with severe COVID-19: A point prevalence study in a general hospital.

OBJECTIVE: To determine the prevalence of CMV reactivation in a population admitted for severe COVID-19 to a general hospital. METHODS: Point prevalence study in all hospitalized patients with severe COVID-19 (admitted either to general wards or ICU). Determination of the presence of CMV DNA in circulating blood. COVID-19 was confirmed in patients with compatible clinical manifestations, usually with pneumonia and a positive nasopharyngeal PCR test. RESULTS: We included 140 hospitalized patients with COVID-19 who consented to participate. A total of 16 patients (11.42%), had circulating CMV-DNA in peripheral blood at the time of the study. Patients with positive CMV viral load were mainly ICU patients (11/37 -29,7%) and only 5/103 cases (4,85%) were hospitalized into general wards. The accumulated doses of corticosteroids (prednisone equivalents) in the study day were (median and IQR) 987.50 mg (396.87-2,454.68) and 187.50 mg (75.00-818.12) respectively in CMV positive and negative patients (p < 0.001). A significant proportion of CMV positive patients were discovered because of the study and were clinically unsuspected by their physicians. The coinfected COVID-CMV positive population had a higher risk of accumulated secondary nosocomially-acquired infections and a worse prognosis. CONCLUSIONS: CMV reactivation should be systematically searched in patients in COVID-19 cases admitted to the ICU.

Effect of platform subway depth on the presence of Airborne PM2.5, metals, and toxic organic species.

PM2.5 that have been related to public health risks, were collected during two seasons with High-Vol samplers in platforms of a Mexican subway station, which interconnects through transfers three lines having different depths. The objective was to study the influence of depth on the PM2.5 concentrations and their species. PM2.5 concentrations in cold-dry and warm-dry seasons presented statistical differences, being in average 57 and 66 µgm-3 respectively, in the shallower line 9; 90 µgm-3 and 111 µgm-3 in line 1; and 104 and 122 µgm-3in the deepest line 7. During the cold-dry season and warm-dry season PM2.5concentrations in the subway environment were respectively up to 3.5 times and up to 5 times greater than in the ambient air. Like PM2.5, metals analyzed with an OES-ICP presented higher concentrations in deeper lines as well as PAHs quantified with CG-MS, which ranged from 4.5 to 11.7 ngm-3. High PM2.5, metals and organic toxic concentrations found in deeper lines of the subway environment represent a risk for commuters endorsing the need for ventilation systems to reduce them. Zn, Pb, V and Ni in subway particles presented the highest solubility in artificial lysosomal fluid suggesting high bioavailability in the lung fluids.

Grado de conocimientos y actitudes de la enfermería de la Comunidad Autónoma de Madrid (cam) ante el dolor: diplomados en enfermería y profesionales / No disponible

El dolor se ha convertido en el quinto signo vital (1-3) y es hoy día un tema crítico en la atención del paciente. El tratamiento eficaz del mismo sigue siendo uno de los problemas más importantes y urgentes del sistema de asistencia sanitaria de los países desarrollados de todo el mundo. Si bien el dolor en los pacientes es un tema muy en boga actualmente, sin embargo, lo que es poco cuestionado es la formación de los futuros profesionales de Enfermería en el cuidado de dichos pacientes. El estudio y el tratamiento del dolor deberían ser inculcados en los estudiantes de Enfermería dentro de su formación, tanto teórica como práctica. Es muy importante la labor que asumen también los docentes en el tema. El reto para la profesión de Enfermería consistiría en este terreno en que organice, estructure y apoye un programa consistente en la activación de programas docentes para estudiantes y enfermeros en ejercicio. Para iniciar nuestro trabajo de investigación realizamos un análisis por una parte, de los actuales programas curriculares de las distintas escuelas de enfermería de la CAM, con asignaturas con contenidos en dolor, analizándose la similitud o no entre ellos, los epígrafes tratados, etc., todo ello comparado con el esbozo curricular que la IASP (International Association of Study of Pain) propuso para los estudios de enfermería; y por otra, se describen los conocimientos y las actitudes de ambos grupos en enfermería ante el dolor, tanto profesionales como estudiantes de enfermería. Para observar el grado de conocimientos y actitudes ante el dolor de ambos grupos, se introdujo como herramienta el NKAS-RP (Nurses' Knowledge and attitudes Survey Regarding Pain) (4). El grupo de trabajo se propuso, por tanto, tres objetivos generales: el primero, descripción de los temarios de las asignaturas de la carrera de enfermería con contenidos en dolor, y el 2.º y 3.º objetivos, definir los conocimientos y las actitudes ante el dolor de los estudiantes de enfermería y de los profesionales enfermeros de la CAM. Se trata de un estudio descriptivo, observacional, aleatorio y multicéntrico, que analiza los conocimientos actuales, así como las actitudes del grupo de enfermería, tanto entre estudiantes (futuros diplomados en enfermería) como entre profesionales. Se llevó a cabo entre los años 2008 al 2010, utilizándose para dar a conocer los resultados del mismo el paquete estadístico SPSS versión 17.0. Como resultados, se obtuvieron, al igual que en estudios previos, a nivel mundial, unos pobres conocimientos en dolor y unas malas actitudes ante dicho síntoma. Se propone para mejorarlos, en el caso de los estudiantes, cambios en los programas curriculares de la diplomatura (futuro grado) de enfermería, y en el caso de los profesionales, formación continuada, así como actualización de conocimientos en dicho tema (AU)

The pain has become the fifth vital sign and is now a critical issue in patient care. Effective treatment of it is still one of the most important and urgent health care system in developed countries worldwide. While pain in patients is a very in vogue these days, however, which is unchallenged is the education of future nursing professionals in the care of such patients. The study and treatment of pain should be instilled in nursing students in their training, both theoretical and practical. The work is very important that teachers also take on the subject. The challenge for the nursing profession in this field would you organize, structure and support a program involving the activation of educational programs for students and practicing nurses. To start our research we made an analysis on the one hand, the current curricula of different schools of nursing in the CAM, with subjects with pain content, analyzing the similarity or not between them, the treated sections, etc. all this curriculum outline compared to the IASP (International Association of Study of Pain) proposed for nursing studies and, secondly, we describe the knowledge and attitudes of both groups in nursing to pain, both professional and qualified nurses. To observe the degree of knowledge and attitudes towards pain in both groups, was introduced as a tool the NKAS-RP (Nurses’ Knowledge and Attitudes Survey Regarding Pain). The working group is proposed, therefore, three general objectives: The first description of the curricula of the courses in the career of nursing content in pain, and el2 and 3 goals, define the knowledge and attitudes to pain nursing students and nurses of the CAM. This is a descriptive, observational, multicenter, randomized, which analyzes the current knowledge and attitudes of the nursing staff, both among students (future graduates in nursing) and among professionals. Was carried out between 2008 and 2010, used to publicize the results of the statistical package SPSS version 17.0. As results were obtained, as in previous studies, worldwide, a poor knowledge of pain and a bad attitude before that symptom. It is proposed to improve: in the case of students, changes in the curriculum of the Diploma (future degree) nurses, and in the case of professionals, continuing education and refresher courses in that subject (AU)

Biexponential analysis of diffusion-tensor imaging of the brain in patients with cirrhosis before and after liver transplantation.

BACKGROUND AND PURPOSE: DTI has shown increased MD of water molecules in the brain of patients with cirrhosis, consistent with low-grade edema. This study further characterizes this edema by using biexponential analysis of DTI data, a technique that may differentiate cytotoxic and vasogenic edema. MATERIALS AND METHODS: A total of 41 patients with cirrhosis awaiting liver transplantation and 16 healthy controls were studied by DTI by using a single-shot echo-planar technique with 11 b-values (range, 0-7500 s/mm(2)) and 6 noncollinear directions. Measurements were fitted to biexponential function to determine MD and FA for the fast and slow diffusion components. Regions of interest were selected in the parietal white matter and corticospinal tract. The assessment was repeated 1 year after liver transplantation in 24 of these patients. RESULTS: In parietal white matter, patients with cirrhosis showed an increase in fast MD and a decrease in fast FA that normalized after liver transplantation. In the corticospinal tract, there was an increase in fast and slow MD that normalized after transplantation, and a decrease in FA that persisted posttransplantation. There was no association of DTI parameters with minimal HE (n =12). CONCLUSIONS: Biexponential analysis of DTI supports the presence of edema in the brain of patients with cirrhosis that reverts after transplantation. In parietal white matter, the increase in brain water was mainly located in the interstitial compartment, while the corticospinal tract showed a mixed pattern (intra- and extracellular). In addition, the findings on posttransplantation were consistent with microstructural damage along the corticospinal tract.

Insuficiencia hepática por enfermedad hepática crónica agudizada / No disponible

No disponible

Actualización en el tratamiento de la encefalopatía hepática / Update on the management of hepatic encephalopathy

No disponible

Effects of disodium fumarate on in vitro rumen microbial growth, methane production and fermentation of diets differing in their forage:concentrate ratio.

The effects of disodium fumarate on microbial growth, CH4 production and fermentation of three diets differing in their forage content (800, 500 and 200 g/kg DM) by rumen micro-organisms in vitro were studied using batch cultures. Rumen contents were collected from four Merino sheep. Disodium fumarate was added to the incubation bottles to achieve final concentrations of 0, 4 and 8 mm-fumarate, and (15)N was used as a microbial marker. Gas production was measured at regular intervals from 0 to 120 h of incubation. Fumarate did not affect (P>0.05) any of the measured gas production parameters. In 17 h incubations, the final pH and the production of acetate and propionate were increased linearly (P<0.001) by the addition of fumarate. Fumarate tended to increase (P=0.076) the organic matter disappearance of the diets and to decrease (P=0.079) the amount of NH3-N in the cultures. Adding fumarate to batch cultures tended (P=0.099) to decrease CH4 production, the mean values of the decrease being 5.4 %, 2.9 % and 3.8 % for the high-, medium- and low-forage diet, respectively. Fumarate tended to increase (P=0.082) rumen microbial growth for the high-forage diet, but no differences (P>0.05) were observed for the other two diets. These results indicate that the effects of fumarate on rumen fermentation depend on the nature of the incubated substrate, the high-forage diet showing the greatest response.

[Acute appendicitis. A clinicopathological analysis of 200 cases]. / Apendicitis aguda. Análisis clinicopatológico de 200 casos.

OBJECTIVES: a) to carry out a prospective study of 200 cases of acute appendicitis in adult patients; b) to correlate clinical, laboratory, radiological, and pathological findings. MATERIAL AND METHODS: clinical data were collected from all patients; every patient had hematic biometry, urine exam (UE), abdominal radiography, an histopathological study appendix. RESULTS: the patients were 98 males and 102 females; 66.5% were between 15 and 25 years old. All patients had abdominal pain, 56.5% nausea and vomit, 49% fever, 10.5% diarrhea, and 6% urinary symptoms. Post-operatory complications were seen in 24.5%. Leucocytosis greater than 10,000 was found in 82.5%, some alteration of UE in 45%, and abnormal radiography in 56.5%. Histopathological study showed simple appendicitis in 16.5%, hemorrhagic in 8%, purulent in 22%, hemo-purulent in 30.5%, an perforated in 21%. CONCLUSIONS: the diagnosis of appendicitis is basically a clinical one, since 17.5% showed normal white-cell count, and 43.5% normal radiography.

[Neonatal septicemia: incidence and risk factors]. / Sepsis neonatal: incidencia y factores de riesgo.

The cases of 131 newborns with positive blood cultures have been reviewed. These children were born in our hospital between 1985 and 1990. We found that the incidence of sepsis was 4.3/1000 newborns. Early neonatal sepsis was the most frequent, representing 58% of the cases. Late sepsis in hospitalized infants represented 1.34% of the cases. Streptococcus B was the microorganism most frequently isolated (26.7%), followed by S. epidermidis (19.8%), E. coli (13.7%) and S. aureus (10.68%). In over 50% of the cases of early sepsis, maternal-fetal risk factors were present. Mortality was 7.6%, with half of these cases due to Streptococcus B.

Meloidogyne cruciani n. sp. a Root-knot Nematode from St. Croix (U.S. Virgin Islands) with Observations on Morphology of This and Two Other Species of the Genus.

Meloidogyne cruciani n. sp. infecting tomato (Lycopersicon esculentum Mill.) in the U.S. Virgin Islands is described and illustrated. M. cruciani is distinguished from other species of the genus by having punctations around the anus of the female and by the second-stage juveniles possessing tri-lobed esophageal glands which are longer than most other species, with their posterier end at about 46.4% of the body length. The esophageal glands of the immature and adult females are contained in five separate lobes.

Post-infection Development and Morphology of Meloidogyne cruciani.

The development and life stages of Meloidogyne cruciani on tomato was studied at 28 C. Roots of 2-wk-old 'Rutgers' tomato seedlings were exposed to inoculum for 24 h, rinsed, and the seedlings repotted. No major changes in juvenile development were observed prior to 8 days after inoculation. At 11 days the second-stage juvenile had enlarged considerably. The genital primordium had not yet asumed the V-shape characteristic of developing females, but the presence of rectal glands identified the juveniles as females. At this time (11 days), two additional, previously undescribed esophageal lobes were first observed; they were adjacent to the dorsal and subventral glands. After molting from second to third stage, the stylet cone, shaft, and the lumen of the stylet knobs are shed and remain attached to the second-stage cuticle. The excretory duct of the third-stage juveniles was directed anteriorly from the excretory pore of the second-stage cuticle and appear attached to the body wall of the third-stage juveniles opposite the procorpus. At 19 days after inoculation, the last molt took place. The adult female possessed a new stylet, a large five-gland esophagus, a prominent excretory system ending in a unicellular gland and a fully developed reproductive system.

Radip induction of ether anaesthesia and controlled maintenacne by a combination of intravenous and inhalation administration without the risk of explosion.

The induction and maintenance of anaesthesia with ether using a combined intravenous infusion and a constant low inspired concentration are discribed. Predictions from a mathematical model were checked against animal experiments. Anaesthesia occurred within 5 min. The mehtod obviates the need for explosive mixtures.