Soluble concentrations of the terminal complement complex C5b-9 correlate with end-organ injury in preeclampsia.

OBJECTIVE: We sought to determine if soluble levels of C5b-9, the terminal complement complex, correlate with end-organ injury in preeclampsia. STUDY DESIGN: Project COPA (Complement and Preeclampsia in the Americas), a multi-center observational study in Colombia from 2015 to 2016, enrolled hypertensive pregnant women into four groups: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia with severe features. Trained coordinators collected clinical data, blood and urine. End-organ injury was defined by serum creatinine ≥ 1.0 mg/dl, aspartate transaminase ≥ 70U/L, platelet count < 150,000/µl, or lactate dehydrogenase ≥ 500 U/L. Data were analyzed by χ2 or Fisher's exact test with significance at P < 0.05. MAIN OUTCOME MEASURE: C5b-9 concentrations in plasma and urine, using enzyme linked immunosorbent assays. RESULTS: In total, 298 hypertensive participants were enrolled. Plasma and urine C5b-9 levels were measured in all participants and stratified by quartile (Q1-4), from lowest to highest C5b-9 concentration. Participants with low plasma C5b-9 levels (Q1) were more likely to have end-organ injury compared to those with higher levels (Q2-Q4) [platelet count < 150,000/µl (20.8% vs. 8.4%, P = 0.01); elevated serum creatinine ≥ 1.0 mg/dl (14.9% vs. 4.5%, P = 0.009)]. In contrast, participants with high urinary C5b-9 levels (Q4) were more likely to have end-organ injury compared to those with lower levels (Q1-Q3) [platelet count < 150,000/µl (19.7% vs. 7.4%, P = 0.003); elevated serum creatinine ≥ 1.0 mg/dl (12.3% vs. 4.4%, P = 0.025)]. CONCLUSION: We identified a pattern of increased urine and low plasma C5b-9 levels in patients with preeclampsia and end-organ injury. Soluble C5b-9 levels may be used to identify complement-mediated end-organ injury in preeclampsia.

Differences in Endothelial Activation and Dysfunction Induced by Antiphospholipid Antibodies Among Groups of Patients With Thrombotic, Refractory, and Non-refractory Antiphospholipid Syndrome.

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by pregnancy morbidity or thrombosis and persistent antiphospholipid antibodies (aPL) that bind to the endothelium and induce endothelial activation, which is evidenced by the expression of adhesion molecules and the production of reactive oxygen species (ROS) and subsequent endothelial dysfunction marked by a decrease in the synthesis and release of nitric oxide (NO). These endothelial alterations are the key components for the development of severe pathological processes in APS. Patients with APS can be grouped according to the presence of other autoimmune diseases (secondary APS), thrombosis alone (thrombotic APS), pregnancy morbidity (obstetric APS), and refractoriness to conventional treatment regimens (refractory APS). Typically, patients with severe and refractory obstetric APS exhibit thrombosis and are classified as those having primary or secondary APS. The elucidation of the mechanisms underlying these alterations according to the different groups of patients with APS could help establish new therapies, particularly necessary for severe and refractory cases. Therefore, this study aimed to evaluate the differences in endothelial activation and dysfunction induced by aPL between patients with refractory obstetric APS and other APS clinical manifestations. Human umbilical vein endothelial cells (HUVECs) were stimulated with polyclonal immunoglobulin-G (IgG) from different groups of patients n = 21), including those with primary (VTI) and secondary thrombotic APS (VTII) and refractory primary (RI+), refractory secondary (RII+), and non-refractory primary (NR+) obstetric APS. All of them with thrombosis. The expression of adhesion molecules; the production of ROS, NO, vascular endothelial growth factor (VEGF), and endothelin-1; and the generation of microparticles were used to evaluate endothelial activation and dysfunction. VTI IgG induced the expression of adhesion molecules and the generation of microparticles and VEGF. RI+ IgG induced the expression of adhesion molecules and decreased NO production. RII+ IgG increased the production of microparticles, ROS, and endothelin-1 and reduced NO release. NR+ IgG increased the production of microparticles and endothelin-1 and decreased the production of VEGF and NO. These findings reveal differences in endothelial activation and dysfunction among groups of patients with APS, which should be considered in future studies to evaluate new therapies, especially in refractory cases.

Laparoscopía de etapificación y citología peritoneal en cáncer gástrico: descripción de la técnica quirúrgica / Staging laparoscopy and peritoneal cytology in gastric cancer: technique description and review of the literature

Resumen Introducción: El cáncer gástrico continúa representando la más alta mortalidad por cáncer en hombres en Chile. En una revisión sistemática, evidenciaron que en el 59% de los pacientes que se catalogaron como M0 mediante diferentes estudios como TC, resonancia magnética y PET, se detectaron metástasis a la laparoscopia de etapificación. El objetivo de este estudio es describir la técnica quirúrgica de esta laparoscopía incluida la citología peritoneal y una revisión de la literatura en cuanto a sus indicaciones y posibilidad de cambio de conducta. Materiales y Método: Se realizó la búsqueda de artículos vía MED - LINE/PubMed (U.S.A. National Library of Medicine), Cochrane Library, Elsevier, SciELO; no se aplicó análisis estadístico, se incluyeron 23 referencias relacionadas al tema y materias afines internacionales y nacionales. El procedimiento que describiremos será la laparoscopia diagnóstica y la citología de líquido peritoneal para estudio anatomopatológico. Discusión y Conclusiones: La laparoscopía de etapificación, logra un cambio de conducta en un 20% aproximadamente de los casos, pero hacen faltan más estudios de validación de esta en los centros que tratan dicha enfermedad en el país.

Introduction: Gastric cancer continues to represent the highest mortality from cancer in men in Chile. In a systematic review, they showed that 59% of the patients who were classified as M0 by different studies such as CT, magnetic resonance imaging and PET, metastases were detected at staging laparoscopy. The objective of this study is to describe the surgical technique of staging laparoscopy including peritoneal cytology and a review of the literature regarding its indications and the possibility of behavior change. Materials and Method: Articles were searched via MEDLINE/PubMed (U.S.A. National Library of Medicine), Cochrane Library, Elsevier, SciELO, no statistical analysis was applied, 23 references related to the topic and related international and national subjects were included. The procedure to be described will be diagnostic laparoscopy and peritoneal fluid cytology for pathological study. Discussion and Conclusions: Staging laparoscopy achieve a change in behavior in approximately 20% of the cases, but more validation studies are needed in the centers that treat this disease in the country.

Plasma CD59 concentrations are increased in preeclampsia with severe features and correlate with laboratory measures of end-organ injury.

OBJECTIVES: Dysregulation of CD59 may lead to increased complement-mediated end-organ injury in preeclampsia. We sought to determine if soluble CD59 concentrations are altered in preeclampsia with severe features. STUDY DESIGN: Observational case-control study, which enrolled subjects prospectively from six centers in Colombia from 2015 to 2016. Cases had preeclampsia with severe features and controls were either healthy or had chronic hypertension, gestational hypertension, or preeclampsia without severe features. Trained coordinators collected clinical data, blood and urine. Analyses were by test of medians and Spearman's correlation. MAIN OUTCOME MEASURES: Soluble CD59 concentration in plasma and urine, using enzyme linked immunosorbent assays. RESULTS: In total, 352 subjects were enrolled (104 cases; 248 controls). Compared to healthy women or those with other hypertensive disorders of pregnancy, women with preeclampsia with severe features had increased concentration of CD59 in plasma (P < 0.001) and decreased CD59 in urine (P = 0.01). In sub-group analyses, plasma CD59 concentrations were increased in preeclampsia with severe features compared to healthy controls (P < 0.001) or controls with either chronic hypertension (P = 0.002) or gestational hypertension (P = 0.02). Increased plasma CD59 concentrations correlated with decreased platelet count and increased lactate dehydrogenase, creatinine, aspartate transaminase, urine protein/creatinine ratio, systolic blood pressure and diastolic blood pressure (P < 0.01, all correlations). CONCLUSION: In women with preeclampsia with severe features, soluble CD59 concentrations were increased in plasma and decreased in urine, and plasma levels correlated with increased blood pressure and end-organ injury. Soluble CD59 concentrations may help identify a subset of women with preeclampsia that have altered regulation of terminal complement proteins.

Terminal Complement Activation in Preeclampsia.

OBJECTIVE: To evaluate whether C5b-9 concentrations in blood and urine are increased in preeclampsia with severe features. METHODS: The Complement and Preeclampsia in the Americas study is a prospective, multicenter case-control study performed at six centers in Colombia from November 2015 to July 2016. The case group included women with preeclampsia with severe features, and the control group included women who were healthy or had chronic hypertension, gestational hypertension, or preeclampsia without severe features. We enrolled two women in the control group for every woman in the case group. Soluble C5b-9 concentrations were measured by enzyme-linked immunosorbent assays in blood and urine. The primary outcome was C5b-9 concentrations in women in the case group compared with all women in the control group, and the secondary outcome was C5b-9 levels in women in the case group compared with individual control subgroups. Differences were assessed by test of medians, and associations were further evaluated by receiver operating characteristic curve analysis and logistic regression with α=0.05. RESULTS: Three hundred fifty-two patients were enrolled. Plasma C5b-9 concentrations did not differ significantly between women in the case group and those in the control group, but urine C5b-9 concentrations were higher in women in the case group (median [interquartile range] 9.9 [1.6-43.7] vs 1.8 [0.54-4.1] ng/mL, P<.001). In subgroup analysis, plasma C5b-9 concentrations were increased in women in the case group compared with healthy women in the control group (median [interquartile range] 2,778 [1,633-4,230] vs 1,374 [1,064-2,332] ng/mL, P<.001), and urine C5b-9 concentrations were increased in women in the case group compared with all control subgroups (P<.001). Using receiver operating characteristic analysis, urine C5b-9 concentrations differentiated preeclampsia with severe features from hypertensive women in the control group (area under the receiver operating characteristic curve 0.74, 95% CI 0.68-0.80). Urine C5b-9 22 ng/mL or greater (range 0-158.4 ng/mL) was the optimal cut point for diagnosis of preeclampsia with severe features with adjusted odds ratio of 10.0 (95% CI 3.5-28.8, P<.001). CONCLUSION: Urinary excretion of terminal complement effector C5b-9 is higher in women with preeclampsia with severe features compared with women with other hypertensive disorders of pregnancy and women without hypertension.

Valor diagnóstico de variables lipídicas y antropométricas en las disfunciones metabólicas / Diagnostic value of lipid and anthropometric variables in metabolic dysfunctions / Valor diagnóstico de variáveis lipídicas e antropométricas nas disfunções metabólicas

El objetivo del estudio fue evaluar el desempeño de detección del índice de disfunción metabólica (IDM) construido a partir de los valores de circunferencia abdominal, triglicéridos e índice de masa corporal. Se estudiaron 829 sujetos (327 de sexo masculino, 60,4±19,8 años). Se establecieron los diagnósticos de resistencia a la insulina (RI), y síndrome metabólico según los criterios del HOMA-IR, NCEP-ATP III (SM) y NCEP-ATP III revisado (SM-R). Se usó el área bajo las curvas ROC (ABC), los puntos de corte óptimo (PCO), sensibilidad (SEN), especificidad (ESP), valor predictivo positivo y valor predictivo negativo (VPN) para la evaluación del desempeño del IDM. Se pudo constatar que el IDM tiene una capacidad de detección aceptable puesto que se observó un ABC>0,75 en todos los casos. Además, se encontraron valores mayores (p<0,01) de IDM en los grupos con SM, SM-R y RI en comparación con los grupos que no padecían las patologías. Adicionalmente, los PCO para la RI (IDM>21,01), SM (IDM>16,01) y el SM-R (IDM>19,51) reportaron valores de ESP, SEN, VPN mayores que 0,70. Por tanto, a partir de un índice compuesto por tres variables tomadas de un estudio médico de rutina, se pueden diagnosticar dos patologías que conllevan al desarrollo de la diabetes y enfermedades cardiovasculares.

The objective of the study was to evaluate the performance of metabolic dysfunction index (MDI) detection constructed from the values of abdominal circumference, triglycerides and body mass index. A total of 829 subjects (327 males, 60.4±19.8 years), diagnosed with insulin resistance (IR) and metabolic syndrome according to the HOMA-IR, NCEP-ATP III (SM) and NCEP -ATP III revised (SM-R) criteria were studied. The area under the ROC curves (AUC), the optimal cut-off points (OCP), sensitivity (SEN), specificity (SPE), positive predictive value and negative predictive value (NPV) were used to evaluate the performance of the MDI. It was found that the MDI has an acceptable detection capacity since an AUC>0.75 was observed in all cases, and higher values (p<0.01) of MDI were found in the groups with SM, SM-R and IR compared to groups that do not suffer from the pathologies. Additionally, the OCPs for IR (MDI>21.01), SM (MDI>16.01) and SM-R (MDI>19.51) reported values of SPE, SEN, NPV greater than 0.70. Therefore, from an index composed of three variables taken from a routine medical study, two pathologies can be diagnosed that lead to the development of diabetes and cardiovascular diseases.

O objetivo do estudo foi avaliar o desempenho de detecção do índice de disfunção metabólica (IDM) construído a partir dos valores de circunferência abdominal, triglicerídeos e índice de massa corporal. Foram estudados 829 indivíduos (327 homens, 60,4±19,8 anos), estableceram-se os diagnósticos de resistência à insulina (RI) e síndrome metabólica de acordo com os critérios de HOMA-RI, NCEP-ATP III (SM) e NCEP-ATP III revisado (SM-R). A área sob as curvas ROC (ABC), os pontos de corte ótimo (PCO), sensibilidade (SEN), especificidade (ESP), valor preditivo positivo e valor preditivo negativo (VPN) foram utilizados para avaliar o desempenho do IDM. Verificou-se que o IDM possui uma capacidade de detecção aceitável, visto que uma ABC>0,75 foi observada em todos os casos. Valores maiores (p<0,01) de IDM foram encontrados nos grupos com SM, SM- R e RI em comparação com grupos que não sofrem com as patologias. Além disso, os PCOs para a RI (IDM>21.01), SM (IDM>16.01) e SM-R (IDM>19.51), relataram valores de ESP, SEN, VPN maiores que 0,70. Portanto, a partir de um índice composto por três variáveis de um estudo médico de rotina, duas patologias podem ser diagnosticadas que levam ao desenvolvimento de diabetes e doenças cardiovasculares.

Ablación de taquicardia supraventricular resistente a terapia médica y a cardioversión eléctrica en una gestante / Ablation of supraventricular tachycardia resistant to medical treatment and electrical cardioversion in a pregnant woman

Resumen Las arritmias cardiacas son complicaciones frecuentes durante el embarazo, y de hecho se ha considerado que este estado incrementa la incidencia de arritmias en pacientes con y sin enfermedad cardiaca estructural. El manejo de las arritmias en la paciente embarazada debe tener en cuenta no solo el bienestar materno sino el fetal, característica que restringe muchas de las terapias usadas en población no embarazada; sin embargo, es poco frecuente la falta de respuesta a terapia médica y cardioversión eléctrica. Se presenta el caso de una paciente gestante con taquicardia supraventricular por reentrada por vía accesoria sin respuesta a diferentes medidas farmacológicas y a varios intentos de cardioversión eléctrica, que requirió estudio electrofisiológico y ablación emergentes. Adicionalmente, se listan algunos aspectos claves sobre el tema.

Abstract Cardiac arrhythmias are common complications during pregnancy, and it appears that the incidence of arrhythmias has been increasing in patients with and without structural cardiac disease. The management of arrhythmias in the pregnant patient must not only take into account the well-being of the mother, but also that of the foetus, a fact that restricts many of the therapies used in the non-pregnant population. However, the lack of response to medical treatment and electrical cardioversion is rare. The case is presented of a pregnant patient with supraventricular re-entry tachycardia with no response to different pharmacological measures and to several attempts of electro-cardioversion that required an electrophysiological work-up and resulting ablation. Some key aspects on the subject are also mentioned.

Arritmias en la paciente embarazada / Arrhythmias in pregnant patients

Resumen Las arritmias cardiacas son complicaciones frecuentes en el embarazo e incluso durante éste aumenta su incidencia, siendo más frecuentes las supraventriculares que las ventriculares. Las arritmias en la paciente embarazada representan además un riesgo para presentar eventos fetales adversos tanto por la arritmia en sí misma, como por los riesgos potenciales de los medicamentos usados para el tratamiento. En este artículo se revisan los aspectos más relevantes respecto al mecanismo y tratamiento de las arritmias en la paciente embarazada.

Abstract Cardiac arrhythmias are frequent complications in pregnancy and their incidence even increases during this period, supraventricular being more common than ventricular ones. Arrhythmias in pregnancy also entail a risk to develop fetal adverse effects due to the arrhythmia itself, as well as due to the potential risks of drugs used for their treatment. This article reviews the most relevant aspects regarding the mechanism and treatment of arrhythmias in pregnant patients.

Antibiosis of Trichoderma spp strains native to northeastern Mexico against the pathogenic fungus Macrophomina phaseolina.

Sampling of agricultural soils from the Mexican northeastern region was performed to detect Trichoderma spp., genetically characterize it, and assess its potential use as a biologic control agent against Macrophomina phaseolina. M. phaseolina is a phytopathogen that attacks over 500 species of cultivated plants and causes heavy losses in the regional sorghum crop. Sampling was performed immediately after sorghum or corn harvest in an area that was approximately 170 km from the Mexico-USA border. Sixteen isolates were obtained in total. Using colony morphology and sequencing the internal transcribed spacers (ITS) 1 and 4 of 18S rDNA, 14 strains were identified as Trichoderma harzianum, T. koningiopsis and T. virens. Subsequently, their antagonistic activity against M. phaseolina was evaluated in vitro, and 11 isolates showed antagonism by competition and stopped M. phaseolina growth. In 4 of these isolates, the antibiosis phenomenon was observed through the formation of an intermediate band without growth between colonies. One strain, HTE808, was identified as Trichoderma koningiopsis and grew rapidly; when it came into contact with the M. phaseolina colony, it continued to grow and sporulated until it covered the entire petri dish. Microscopic examination confirmed that it has a high level of hyperparasitism and is thus considered to have high potential for use in the control of this phytopathogen.

Antibiosis of Trichoderma spp strains native to northeastern Mexico against the pathogenic fungus Macrophomina phaseolina

Abstract Sampling of agricultural soils from the Mexican northeastern region was performed to detect Trichoderma spp., genetically characterize it, and assess its potential use as a biologic control agent against Macrophomina phaseolina. M. phaseolina is a phytopathogen that attacks over 500 species of cultivated plants and causes heavy losses in the regional sorghum crop. Sampling was performed immediately after sorghum or corn harvest in an area that was approximately 170 km from the Mexico-USA border. Sixteen isolates were obtained in total. Using colony morphology and sequencing the internal transcribed spacers (ITS) 1 and 4 of 18S rDNA, 14 strains were identified as Trichoderma harzianum, T. koningiopsis and T. virens. Subsequently, their antagonistic activity against M. phaseolina was evaluated in vitro, and 11 isolates showed antagonism by competition and stopped M. phaseolina growth. In 4 of these isolates, the antibiosis phenomenon was observed through the formation of an intermediate band without growth between colonies. One strain, HTE808, was identified as Trichoderma koningiopsis and grew rapidly; when it came into contact with the M. phaseolina colony, it continued to grow and sporulated until it covered the entire petri dish. Microscopic examination confirmed that it has a high level of hyperparasitism and is thus considered to have high potential for use in the control of this phytopathogen.

Obesidad en escolares venezolanos y factores de riesgo para el desarrollo de diabetes tipo 2 / Obesity in school-age venezuelan Children and risk factors for prevention of type 2 diabetes

Las enfermedades no transmisibles representan un problema de salud pública a nivel mundial. Los objetivos de este estudio fueron: determinar la prevalencia de obesidad y la asociación con variables socioeconómicas, antropométricas, composición corporal, actividad física, consumo de alimentos y seguridad alimentaria e identificar riesgo temprano de diabetes tipo 2 (DT2) en niños escolares urbanos. El presente es un estudio transversal, de 1052 niños de escuelas públicas y privadas de ocho ciudades de Venezuela. Las variables obtenidas incluyeron: peso, talla, índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), actividad física y en una sub-muestra glicemia capilar y circunferencia de cintura. Se aplicó una encuesta para determinar estrato socio económico (ESE), actividad física, percepción de seguridad alimentaria y hábitos de estilo de vida. La prevalencia de obesidad fue 26,4 % según IMC y 26,5%, según PGC; el déficit fue de 10,3% según IMC y de 13,5% según PGC. El 40,2% de los niños pertenecían a ESE medios, bajos y muy bajos, en tanto que 48,7% pertenecía al ESE medio alto, según el Método Graffar-Méndez Castellano. En el análisis de correspondencias múltiples se observó una alta contribución al eje factorial de los excesos de grasa corporal, peso e IMC por parte del consumo de comida chatarra, dulces, bebidas azucaradas y proteínas fritas. La ciudad con mayor prevalencia de obesidad de acuerdo con el PGC fue Maracay. El análisis (OR) entre la glicemia y las diferentes variables no fue significativo. Se identificó además la presencia de la doble carga desnutrición y obesidad en la población escolar estudiada(AU)

Non communicable diseases are a major health concern. The aim of this study was to measure obesity prevalence among school age children in 8 cities of Venezuela and the association with sociodemographic, antropometric, physical activity, body composition and food security variables and to identify risk factors for developing type 2 diabetes in the future. This is a cross sectional study of 1052 children recruited in 2011 at public and private schools. Anthropometric variables, body mass index (BMI) and body fat percentage (BFP) were obtained and there was a subsample in Caracas where capillary glucose and waist circumference were performed. A semi-structured questionnaire for evaluating socioeconomic status (SES), perception of food insecurity and lifestyle habits was given to parents of children in order to obtain information. A general prevalence 26.4 % of Obesity according to BMI was reported, whereas by BFP was 26.5%, deficit of BMI was 10.3% and low BFP 13.5%. The city with the highest prevalence of obesity according to BFP was Maracay, Aragua State. The 40.2% of children belonged to medium, low and very low SES, while 48.5% classified as medium high SES according to Graffar-Mendez Castellano’s method. A high contribution of excess of fried foods, sweets, sugary beverages and junk foods was found to the axis of high BMI, weight and BFP when Multiple Correspondence Analysis was performed. OR analysis didn’t show significance between different variables. There was a consistent finding of the existence of the double burden: obesity-undernutrition as has been shown in other studies(AU)

Chemical composition of the essential oil from the leaves of Carapa guianensis collected from Venezuelan Guayana and the antimicrobial activity of the oil and crude extracts.

The essential oil obtained by hydrodistillation of Carapa guianensis Aubl. (Meliaceae) leaves was analyzed by GC-FID and GC-MS. Twenty-three components were identified, which made up 93.7% of the oil. The most abundant constituents were bicyclogermacrene (28.5%), alpha-humulene (17.2%), germacrene B (11.9%), and trans-beta-caryophyllene (9.9%). Antimicrobial activity of the essential oil, as well as the crude extracts of the leaves obtained by refluxing the dried leaves with n-hexane, dichloromethane, and methanol, was determined using the disc diffusion assay. Activity against Staphylococcus aureus ATCC 29923 and Enterococcus faecalis ATCC 29212 was only found for the essential oil and the methanolic extract, at minimal inhibitory concentrations (MIC) of 400 microg/mL and 50 microg/mL.

Tigeciclína: una glicilciclína ¿se puede usar en niños? / Tigecycline: a glycylcycline can it be used in children?

El arsenal antimicrobiano ha aumentado en los últimos años, debido principalmente a que nos encontramos en la era de la resistencia bacteriana. Han aparecido nuevos agentes antimicrobianos, especialmente para infecciones hospitalarias, aunque también para infecciones adquiridas en la comunidad. La Tigeciclina es un antimicrobiano de amplio espectro con actividad antibacteriana, especialmente contra patógenos multirresistentes. Tiene estructura similar a las tetraciclinas. Es un derivado de la minociclina y por ello no ha sido aprobado su uso en niños menores de 8 años. Sin embargo, aunque no se justifica su uso rutinario o como antibiótico de primera línea; se puede indicar en casos seleccionados, preferiblemente en combinación con otros antibióticos

The antimicrobial arsenal has increased in recent years, mainly because we are in the era of bacterial resistance. There are new agents antimicrobials, especially for hospital infections, but also for community-acquired infections. Tigecycline is a broad-spectrum with antibacterial activity, especially against multidrug-resistant pathogens. Has structure similar to tetracyclines. It is a derivative of minocycline and therefore has not been approved for use in children younger than 8 years. However, although there is no justification for routine use or as first-line antibiotic, may be indicated in selected cases, preferably in combination with other antibiotics

Caracterización molecular y agronómica de aislados de Trichoderma spp nativos del noreste de México / Molecular and agronomic characterization of Trichoderma spp natives of northeastern Mexico

Trichoderma sp es un hongo frecuentemente usado en actividades agrícolas, pues actúa como antagonista de diversas especies de hongos fitopatógenos. En este estudio se realizó el aislamiento de cuatro cepas de Trichoderma sp nativas del noreste de México, las cuales fueron identificadas a nivel molecular mediante la secuenciación del ITS 1. Además se evaluó su capacidad antagonista en contra los hongos fitopatógenos Macrophomina phaseolina y Fusarium oxysporum, que afectan severamente cultivos de sorgo, maíz y fríjol en el noreste de México. La identificación se realizó de acuerdo al grado de concordancia con secuencias reportadas y corresponden a las especies T. hammatum (HK701); T. koningiopsis (HK702); T. asperellum (HK703) y Trichoderma sp (HK704). Por otra parte, las pruebas de antagonismo muestran que los aislados HK701, HK703 y HK704 inhiben por competencia el crecimiento de M. phaseolina y F. oxysporum, mientras que HK702 tiene la capacidad para hiperparasitar dichos fitopatógenos. Finalmente, se evaluó la promoción de crecimiento de T. asperellum HK703, en maíz (Pionner 30P49®), usando para ello concentraciones de tratamiento de 1x10e2 hasta 1x10e6 esp/mL. En estos ensayos se midió la producción de biomasa. Los resultados muestran que en concentraciones intermedias se tiene el mayor incremento en altura de plantas y mayor producción de peso seco en follaje y raíz. Entre los parámetros antes mencionados existen diferencias significativas.

Trichoderma sp is a fungus often used in agricultural activities, because it acts as an antagonist of several species of plant pathogenic fungi. In this study four strains of Trichoderma sp was isolated from the northeastern Mexico, which were identified by sequencing the ITS 1. We also evaluated its ability antagonistic against phytopathogenic fungi Macrophomina phaseolina and Fusarium oxysporum this fungi are reported affecting severely maize, sorghum and beans crops in northeastern Mexico. The identification was made according to the degree of consistency with reported sequences and the data show that the isolates belong to the species T. hammatum (HK701), T. koningiopsis (HK702), T. asperellum (HK703) and Trichoderma sp (HK704). Antagonism tests showed that the isolated, HK701, HK703 and HK704 inhibited the growth by competition to M phaseolina and F. oxysporum, while the HK702 has the ability to hyperparasites these pathogens. Finally was evaluated in maize (Pioneer 30P49®) We measured the dry weight and biomass production. The results show that at intermediate concentrations have the greatest increase in plant height and dry height of root and foliage.

H1N1 influenza pandemic and maternal mortality in Antioquia, Colombia.

OBJECTIVE: To evaluate the impact of the H1N1 influenza pandemic on maternal mortality in the province of Antioquia, Colombia, in 2009. METHODS: The present study was a descriptive, retrospective, cross-sectional study of maternal deaths in Antioquia in 2009 caused by H1N1-related pneumonia. The study formed part of the epidemiologic surveillance process undertaken by the Health and Social Protection Directorate of Antioquia and the particular healthcare institutions involved in the cases. RESULTS: In 2009, there were 42 maternal deaths in Antioquia, corresponding to a maternal mortality ratio of 46 per 100 000 live births. Ten deaths were due to pneumonia, 9 of which occurred after the H1N1 outbreak was first reported in early 2009. In 3 cases, the women were confirmed to have H1N1 virus infection, and the remainder fulfilled probable case criteria. The main factors contributing to the deaths were underestimation of H1N1 symptoms, and delays in administration of antiviral medication and in hospitalization. CONCLUSION: For the population subgroup of pregnant women in Antioquia, it is crucial to remain alert regarding H1N1 virus infection, guaranteeing patients adequate monitoring and/or timely administration of immunization, medication, and hospitalization.

Efecto de diferentes concentraciones de ácido antranílico en el crecimiento del maíz / The effect of different anthranilic acid concentrations on maize growth

La rizobacteria Azospirillum brasilense basa su capacidad promotora del crecimiento vegetal en la producciónde auxinas y otras hormonas, entre ellas el ácido antranílico (AA). En este trabajo se determinó el efectodel AA (0, 500, 1000, 3000 y 5000 ppm) en el crecimiento y la acumulación de biomasa del híbrido de maíz83G66 en condiciones de invernadero. El AA de 500 a 3000 ppm promovió un mayor crecimiento (área foliary altura de planta), y el AA de 1000 y 3000 ppm incrementó significativamente la biomasa seca en maíz encomparación con el testigo. El 90% de la asimilación del AA en las plantas ocurrió durante los primeros 10días después del tratamiento.

The plant growth-promoting ability of rhizo-bacterium Azospirillum brasilense is based on production of auxins and other hormones, among them outstanding antranilic acid (AA). In this work we determined the antranilic acid (0, 500, 1000, 3000, and 5000 ppm) effects on maize growth and dry biomass accumulation under greenhouse conditions using the hybrid 83G66. From 500 to 3000 ppm of AA significantly increased plant growth (leaf area and plant height) while 1000 and 3000 ppm of AA significantly increased dry biomass accumulation in maize compared with control (0 ppm). The 90 % of AA in maize plants was assimilated during the early 10 days after treatment.

Patrón de variación axial y radial del peso específico en la madera de erisma uncinatum warm / Axial and radial variation pattern in the specific gravity of the wood of erisma uncinatum warm / Padrão de variação axial e radial do peso específico na madeira de erisma uncinatum warm

La variabilidad natural de la madera es producto de su heterogeneidad celular, evidenciada tanto en su anatomía como en su composición química, las cuales a su vez, se reflejan en sus propiedades físicas y mecánicas. Se realizó la caracterización del patrón de variación axial y radial del peso específico seco en la madera de Erisma uncinatum (mureillo), procedente de la región Guayana, Venezuela. La evaluación se realizó empleando una muestra de seis árboles. Las muestras de madera se tomaron a tres niveles de altura (1,30m, 30% y 60% de la altura comercial). La evaluación radial se realizó sobre cinco puntos equidistantes en la dirección radial médula-corteza (0, 25, 50, 75, 90%). El análisis estadístico señaló que la variación entre árboles no fue estadísticamente significativa en comparación con el efecto distancia radial dentro de cada individuo. El peso específico de la madera, presentó un valor promedio de 0,52 ±0,7. La variación radial mostró un incremento lineal positivo médula-corteza (R²=0,68), con una variación de 22%, evidenciándose una demarcación preliminar entre madera juvenil y adulta, a partir del 50% de la dirección de los radios celulares. La variación axial disminuye con la altura del árbol y es menos consistente que la radial, apenas un 13%. La edad fisiológica de las células del cambium vascular es un factor importante que determina la variación del peso específico en la madera de E. uncinatum.

The natural variability of wood is a product of its cellular heterogeneity, evidenced in its anatomy as well as in its chemical composition, which in turn are reflected upon its physical and mechanical properties. A characterization of the axial and radial variation pattern in the dry specific gravity was carried out on wood of the species Erisma uncinatum ("mureillo"), from a forest in the Guayana region, Venezuela. The evaluation was carried out using a sample of six trees. Samples were taken at three different height levels (1.30m, 30% and 60% of commercial height). The radial evaluation was performed on five equidistant points in a pith-bark radial direction (0, 25, 50, 75, 90%). The statistical analysis indicated that the variation between trees was not statistically significant compared to the effect of radial distance in each individual. The specific gravity of the wood presented a mean value of 0.52 ±0.7. The radial variation showed a positive linear increase from pith to bark (R²=0.68), with a 22% variation, evidencing a preliminary boundary between juvenile and adult wood, beginning at 50% of the direction of cellular radii. The axial variation decreases with tree height and is less consistent than the radial variation, barely 13%. The physiological age of the vascular cambium is an important factor that determines the variation in the specific gravity of Erisma uncinatum wood.

A variabilidade natural da madeira é produto de sua heterogeneidade celular, evidenciada tanto em sua anatomia como em sua composição química, as quais por sua vez, são refletidas em suas propriedades físicas e mecânicas. Realizou-se a caracterização do padrão de variação axial e radial do peso específico na madeira de Erisma uncinatum (cedrinho), procedente da região Guayana, Venezuela. A avaliação foi realizada empregando uma amostra de seis árvores. As amostras de madeira foram colhidas em três níveis de altura (1,30m, 30% e 60% da altura comercial). A avaliação radial foi realizada sobre cinco pontos equidistantes na direção radial medula-crosta (0, 25, 50, 75, 90%). A análise estatística apontou que a variação entre árvores não foi estatisticamente significativa em comparação com o efeito distância radial dentro de cada indivíduo. O peso específico na madeira, apresentou um valor médio de 0,52 ±0,7. A variação radial mostrou um incremento linear positivo medula-crosta (R²=0,68), com uma variação de 22%, evidenciando-se uma demarcação preliminar entre madeira juvenil e adulta, a partir do 50% da direção dos raios celulares. A variação axial diminui com a altura da árvore e é menos consistente que a radial, apenas em 13%. A idade fisiológica das células do câmbio vascular é um fator importante que determina a variação do peso específico na madeira de E. uncinatum.

Uso del etofenamato en el manejo del dolor postoperatorio en comparación con ketoprofeno: Hospital Universitario "Dr. Angel Larralde" Valencia estado Carabobo / Using etofenamato in postoperative pain management compared with ketoprofen: Hospital Universitario Dr. Angel Larralde Valencia state Carabobo

El etofenamato es un compuesto derivado del  cido flufenámico, sus características fisicoquímicas y farmacológicas proporcionan analgesia prolongada. Nos planteamos realizar un estudio comparativo donde se evalúen las características analgésicas y tiempo de inicio de la dosis de analgésico en el dolor postoperatorio, utilizando etofenamato intramuscular o ketoprofeno endovenoso previo acto quirúrgico. Previa aprobación por el comité de ética, se realizó un estudio prospectivo, comparativo, al azar con cien pacientes de 18 y 60 años, ASA I-II, intervenidos quirúrgicamente (cirugía abdominal, urológica, ortopédica). Se dividieron en dos grupos: grupo K (n=50) ketoprofeno 100 mg endovenoso 60 minutos antes de la intervención, grupo E (n=50) etofenamato intramuscular 60 minutos previo a la intervención. El dolor postoperatorio fue evaluado con: Escala visual análogo del dolor; Escala verbal análogo del dolor: Escala de bienestar, a la hora, 2,4, 6,8,10,12,18 y 24 horas. A las 2 horas el grupo K reportó EVA 9 (74 porciento), el grupo E reportó un EVA 3 (84 porciento) (P<0,001), el tiempo de dosis adicional fue: grupo K 74 por ciento a los 125,5 + 6,9 min, el grupo E 68 por ciento 841,6 + 10,1 min (P<0,001). La escala de bienestar reportó a las 24 horas: el grupo E 60 por ciento sentirse bien, el grupo K 36 por ciento reportó sentirse mal (P<0,001). El etofenamato proporciona analgesia postoperatoria eficaz y segura por mayor tiempo, en comparación con el ketoprofeno.

Hipertensión posparto / Postpartum hypertension

Muy pocos estudios han investigado acerca de la fisiopatología y los cambios puerperales que favorecen la presentación de la hipertensión posparto. No existen datos que soporten la formulación de protocolos para el manejo de la hipertensión en este período, y la poca literatura disponible al respecto, se basa en experiencia no sistematizada. Los trastornos hipertensivos del embarazo son un factor de riesgo importante para el desarrollo posterior de enfermedade cardiovasculares y de mortalidad asociada. Estos trastornos se deben considerar como el inicio o tal vez la continuación de un sinnúmero de eventos subclínicos aún ignorados. Para la preeclampsia, el parto únicamente soluciona la crisis temporal que produce el embarazo, mas no alivia definitivamente el trastorno. Por lo tanto es necesario establecer estrategias adecuadas de vigilancia de la salud de la mujer.