Forty years of research into crassulacean acid metabolism in the genus Clusia: anatomy, ecophysiology and evolution.

Clusia is the only genus containing dicotyledonous trees with a capacity to perform crassulacean acid metabolism (CAM). Since the discovery of CAM in Clusia 40 years ago, several studies have highlighted the extraordinary plasticity and diversity of life forms, morphology and photosynthetic physiology of this genus. In this review, we revisit aspects of CAM photosynthesis in Clusia and hypothesize about the timing, the environmental conditions and potential anatomical characteristics that led to the evolution of CAM in the group. We discuss the role of physiological plasticity in influencing species distribution and ecological amplitude in the group. We also explore patterns of allometry of leaf anatomical traits and their correlations with CAM activity. Finally, we identify opportunities for further research on CAM in Clusia, such as the role of elevated nocturnal accumulation of citric acid, and gene expression in C3-CAM intermediate phenotypes.

Recommended Approaches to Minimize Aerosol Dispersion of SARS-CoV-2 During Noninvasive Ventilatory Support Can Cause Ventilator Performance Deterioration: A Benchmark Comparative Study.

BACKGROUND: SARS-CoV-2 aerosolization during noninvasive positive-pressure ventilation may endanger health care professionals. Various circuit setups have been described to reduce virus aerosolization. However, these setups may alter ventilator performance. RESEARCH QUESTION: What are the consequences of the various suggested circuit setups on ventilator efficacy during CPAP and noninvasive ventilation (NIV)? STUDY DESIGN AND METHODS: Eight circuit setups were evaluated on a bench test model that consisted of a three-dimensional printed head and an artificial lung. Setups included a dual-limb circuit with an oronasal mask, a dual-limb circuit with a helmet interface, a single-limb circuit with a passive exhalation valve, three single-limb circuits with custom-made additional leaks, and two single-limb circuits with active exhalation valves. All setups were evaluated during NIV and CPAP. The following variables were recorded: the inspiratory flow preceding triggering of the ventilator, the inspiratory effort required to trigger the ventilator, the triggering delay, the maximal inspiratory pressure delivered by the ventilator, the tidal volume generated to the artificial lung, the total work of breathing, and the pressure-time product needed to trigger the ventilator. RESULTS: With NIV, the type of circuit setup had a significant impact on inspiratory flow preceding triggering of the ventilator (P < .0001), the inspiratory effort required to trigger the ventilator (P < .0001), the triggering delay (P < .0001), the maximal inspiratory pressure (P < .0001), the tidal volume (P = .0008), the work of breathing (P < .0001), and the pressure-time product needed to trigger the ventilator (P < .0001). Similar differences and consequences were seen with CPAP as well as with the addition of bacterial filters. Best performance was achieved with a dual-limb circuit with an oronasal mask. Worst performance was achieved with a dual-limb circuit with a helmet interface. INTERPRETATION: Ventilator performance is significantly impacted by the circuit setup. A dual-limb circuit with oronasal mask should be used preferentially.

Tovomita nebulosa (Clusiaceae), a new species from Cerro de la Neblina, Venezuela

Although the number of recently described Tovomita species is relatively high, much more remains to be done, given that each new survey of representative Amazonian collections reveals many potentially undescribed taxa. In the treatment for Tovomita published in Flora of the Venezuelan Guayana, at least six distinct morphotypes did not match any previously described species. Here we recognize morphotype "D" as a new endemic species from Cerro de la Neblina. Additionally, we provide an identification key to the Tovomita species in Venezuela. (AU)

Noninvasive ventilation: education and training. A narrative analysis and an international consensus document.

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients' lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated. Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries.

Educando al público sobre SIDA en Lima, Perú / Educating public about AIDS in Lima, Peru

Presenta los objetivos, metodología, resultados y conclusiones

Impacto del SIDA : Perú 1988 / Impact of AIDS : Peru 1988

Expone la situación epidemiológica del SIDA en América Latina y específicamente Perú. Detalla el número de casos por países y por regiones. Señala los patrones de transmisión más frecuentes en la región. Para Perú, especifica el número de casos por sexo, edad y factores de riesgo. Describe el Programa OMS de lucha contra el SIDA, especificando sus lineamientos y el rol de las comisiones nacionales

Prevención de la transmisión sexual del VIH / Prevention of sexual transmission of AIDS

Afirma que la transmisión sexual es la vía más frecuente de infección por VIH y la que presenta más barreras culturales para hablar de su prevención. Supone investigar las conductas sexuales de la población y diseñar programas educativos que brinden información veraz y adecuada sobre la enfermedad

SIDA y salud pública en el Perú / AIDS and public health in Peru

Señala las ventajas y desventajas del despistaje y notificación de casos seropositivos, especialmente en la población homosexual de Perú. Menciona los riesgos de la notificación sobretodo si no se mantiene y asegura la confidencialidad. Afirma que ofrecer servicios de descarte serológico va más allá de un simple procedimiento técnico. Indica los beneficios y problemas para quienes voluntariamente se sometan al descarte de VIH

Impacto psicológico y social del SIDA en el Perú / Psychological and social impact of AIDS in Peru

Expone el impacto social,económico y psicológico que está teniendo el SIDA en el mundo y en especial Perú. Afirma que la sociedad peruana contiene factores que permiten una rápida diseminación del VIH como el uso de sangre no tamizada para transfusiones y la re-utilización de agujas y jeringas no esterilizadas. Señala los problemas y situaciones que plantea el SIDA en el lugar de trabajo,el sistema legal peruano y las cárceles. Indica los costos directos e indirectos que causa la enfermedad. Enfatiza el desarrollo de estrategias educativas para la prevención del SIDA con participación de los medios de comunicación

Otro brote de triquinosis en la ciudad de Zacatecas y observaciones sobre la eosinofilia de esta enfermedad / Another outbreak of trichinosis in the city of Zacatecas and observations on the eosinophilia of this disease

Se comunica un brote que afectó a siete personas en la ciudad de Zacatecas en enero de 1981. Seis de ellas pertenecían a una familia en la cual la eosinofilia evolucionó en forma muy concordante y mostró una buena correlación con el título de anticuerpos en la reacción de la floculación de la bentonita. El tratamiento con tiabendazol parece haber provocado una disminución rápida tanto de la eosinofilia como de la leucocitosis

Nuevos brotes de triquinosis en el estado de Zacatecas / New outbreaks of trichinosis in the State of Zacatecas

En los poblados de Machines, la Soledad y Miguel Hidalgo, del municipio de Zacatecas se produjeron en 1982 por lo menos dos brotes de triquinosis (los de Machines y la Soledad pueden ser de fuente comun) que afectaron en conjunto a 19 personas. El síntoma que más llamó la atención sobre el padecimiento fue el edema palpebral. No hubo ninguna defunción y, en general, los casos fueron benignos. Aunque no es seguro parece probable que el chorizo de Mal Paso haya constituído la fuente de infección de todos ellos

Cinetoplasto de Crithidia luciliae substrato para demostrar anticuerpos anti-DNA nativo en lupus eritematoso sistemico. / Substrate of Crithidia luciliae Kinetoplast to show native antibodies anti-DNA in systemic erythematosus lupus

Se demostraron anticuerpos anti-DNA nativo utilizando el cinetoplasto del parasito Crithidia luciliae como substrato. Se estudiaron 81 sueros, de los que 27 eran de pacientes con lupus eritematoso sistemico (LES), 20 de artritis reumatoide, 17 con padecimientos miscelaneos y 17 controles sanos. El 44% de los sueros de LES fueron positivos a la prueba y 11 de 14 sueros de pacientes con LES activo tuvieron titulos significativos de anticuerpos anti-DNA (p < 0.0005). Los grupos restantes fueron negativos. Esta prueba se considera util y sencilla para demostrar anticuerpos anti-DNA de doble cadena

Autoanticuerpos en dermatomiositis. / Autoantibodies in dermatomyositis

Se estudiaron sesenta sueros (dermatomiositis lupus eritematoso sistemico, artritis reumatoide y controles sanos) con el fin de detectar anticuerpos antimusculo esqueletico por inmunofluorescencia indirecta. Los sueros de dermatomiositis fueron reactivos contra estructuras subsarcolemales, el resto de los sueros reaccionaron contra sarcolema. Los pacientes con dermatomiositis activa mostraron titulos altos de anticuerpos que fueron fijadores de complemento. Los anticuerpos antimusculo son poco especificos y su papel patogenico en dermatomiositis se desconoce