A Possible Case of Centronuclear Myopathy: A Case Report.

Congenital myopathies (CMs) are a group of diseases that primarily affect the muscle fiber, especially the contractile apparatus and the different components that condition its normal functioning. They present as muscle weakness and hypotonia at birth or during the first year of life. Centronuclear CM is characterized by a high incidence of nuclei located centrally and internally in muscle fibers. Clinical case: a 22-year-old male patient with symptoms of muscle weakness since early childhood, with difficulty in performing physical activity according to his age, with the presence of a long face, a waddling gait, and a global decrease in muscle mass. Electromyography was performed, showing a neurogenic pattern and not the expected myopathic one, neuroconduction with reduced amplitude of the motor potential of the peroneal nerve and axonal and myelin damage of the posterior tibial nerves. The microscopic study of the studied striated muscle fragments stained with hematoxylin-eosin and Masson's trichrome showed the presence of fibers with central nuclei, diagnosing CM. The patient meets most of the description for CM, with involvement of all striated muscles, although it is important to note the neurogenic pattern present in this case, due to the denervation of damaged muscle fibers, which contain terminal axonal segments. Neuroconduction shows the involvement of motor nerves, but with normal sensory studies, axonal polyneuropathy is unlikely, due to normal sensory potentials. Different pathological findings have been described depending on the mutated gene in this disease, but all coincide with the presence of fibers with central nuclei for diagnosis by this means, which is so important in institutions where it is not possible to carry out genetic studies, and allowing early specific treatment, according to the stage through which the patient passes.

Challenges and opportunities for the production of lactic acid bacteria inoculants aimed for ensiling processes.

The use of bacterial inoculants for ensiling based on lactic acid bacteria (LAB) to obtain conserved forages has become an alternative for the improvement of milk and meat productivity in cattle, specifically by optimizing the nutritional and microbial quality of animal feed. LAB inoculant production involves microbial and technological aspects such as biomass obtention, the use of cocultures, the inclusion of probiotics, the production of antimicrobial peptides, operational methods used in bioreactors, and the formulation of the end product to be commercialized to farmers. This review explores the technical aspects of the manufacture of bacterial inoculants, from the main features desired in LAB for ensiling purposes to the alternatives of the bioprocess involved.

[Validation of the immunological method of kinetic interaction of microparticles in solution (KIMS) for the determination of phenytoin in saliva at the Hospital de Niños de Santísima Trinidad.] / Validación del método inmunológico de interacción cinética de micropartículas en solución (KIMS) para la determinación de fenitoína en saliva en el hospital de Niños de la Santísima Trinidad.

Phenytoin (DFH), is an anticonvulsant widely used for the treatment of different types of seizures.(1) Therapeutic monitoring (TDM) is required for DFH due to its narrow therapeutic range and nonlinear pharmacokinetics, among other characteristics. Monitoring is frequently done on plasma or serum (total drug) through immunological methods. DFH can also be monitored in saliva, which shows a good correlation with plasma. The concentration of DFH in saliva reflects the concentration of free drug and due to the simplicity in its collection, it leads to a less stressful process for the patient. The aim of this study was to validate the immunological method of kinetic interaction of microparticles in solution (KIMS) for the determination of DFH using saliva as biological matrix. Linearity, precision, detection and quantification limit, accuracy and interference were analyzed. Infostat 8.0 student version software was used for statistical analysis. The method was linear in a range between 0.41 and 5ug/ml. The detection and quantification limits were 0.14 and 0.45ug/ml, respectively. The equation of the straight line obtained based on the method comparison between KIMS and HPLC-UV was DFHKIMS= 0,81* DFHHPLC ­ 0,03.  The KIMS method proved to have the necessary analytical characteristics to be applied as a useful and practical tool for the follow-up of those patients with difficult venous access and/or children with chronic DFH treatments.

La Fenitoína (DFH), es un anticonvulsivante ampliamente utilizado para el tratamiento de distintos tipos de convulsiones.(1) El monitoreo terapéutico (TDM) es requerido para la DFH debido a su estrecho rango terapéutico y farmacocinética no lineal, entre otras características. Los monitoreos se realizan frecuentemente en plasma o suero (droga total) a través de métodos inmunológicos. También se puede monitorear DFH en saliva, la cual presenta una buena correlación con el plasma. La concentración de DFH en saliva refleja la concentración de droga libre y debido a la simplicidad en su recolección, conlleva a un proceso menos estresante para el paciente. El objetivo del trabajo fue validar el método inmunológico de interacción cinética de micropartículas en solución (KIMS) para la determinación de DFH usando como matriz biológica saliva. Se analizó linealidad, precisión, límite de detección y cuantificación, exactitud e interferencia. Se utilizó el software Infostat 8.0 versión estudiantil para el análisis estadístico. El método fue lineal en un intervalo entre 0,41 y 5ug/ml. Los límites de detección y cuantificación fueron 0,14 y 0,45ug/ml respectivamente. La ecuación de la recta obtenida en base a la comparación de métodos entre KIMS y HPLC-UV fue DFHKIMS= 0,81* DFHHPLC - 0,03.  El método KIMS demostró tener las características analíticas necesarias paran ser aplicada como herramienta útil y práctica para el seguimiento de aquellos pacientes de difícil acceso venoso y/o niños con tratamientos crónicos con DFH.

Diversity of enterobacterales in sediments of lagoons with fish farming activity and analysis of antibiotic resistance.

The use of antibiotics in fish production can induce bacterial populations to develop resistance to multiple antibiotics and transfer antibiotic resistance genes to other bacteria, including clinically relevant bacteria. This study evaluated the diversity of Enterobacterales in sediment from lagoons with fish farming activity and analyzed antibiotic resistance in the central region of Peru. Sediment samples were collected from four fish-active ponds and transported to the laboratory for analysis. Bacterial diversity was analyzed using DNA sequencing and antibiotic resistance was tested using the disk diffusion method. The results showed variability of bacterial diversity in the ponds with fish farming activity. Simpson's index indicated that the Habascocha lagoon is the most diverse in bacterial species of the order Enterobacterales (0.8), but the least dominant. The Shannon-Wiener index revealed that it is the most diverse (2.93) and the Margalef index revealed that species richness in this lagoon is high (5.72). Similarity percentage analysis (SIMPER) allowed the identification of the main Enterobacterales with the highest percentage contribution in the frequencies of individuals. In general, the Enterobacterales species isolated showed multi-resistance to the antibiotics used and Escherichia coli was the most resistant.

Microbial diversity in intensively farmed lake sediment contaminated by heavy metals and identification of microbial taxa bioindicators of environmental quality.

The cumulative effects of anthropogenic stress on freshwater ecosystems are becoming increasingly evident and worrisome. In lake sediments contaminated by heavy metals, the composition and structure of microbial communities can change and affect nutrient transformation and biogeochemical cycling of sediments. In this study, bacterial and archaeal communities of lake sediments under fish pressure contaminated with heavy metals were investigated by the Illumina MiSeq platform. Despite the similar content of most of the heavy metals in the lagoon sediments, we found that their microbial communities were different in diversity and composition. This difference would be determined by the resilience or tolerance of the microbial communities to the heavy metal enrichment gradient. Thirty-two different phyla and 66 different microbial classes were identified in sediment from the three lagoons studied. The highest percentages of contribution in the differentiation of microbial communities were presented by the classes Alphaproteobacteria (19.08%), Cyanophyceae (14.96%), Betaproteobacteria (9.01%) y Actinobacteria (7.55%). The bacteria that predominated in sediments with high levels of Cd and As were Deltaproteobacteria, Actinobacteria, Coriobacteriia, Nitrososphaeria and Acidobacteria (Pomacocha), Alphaproteobacteria, Chitinophagia, Nitrospira and Clostridia (Tipicocha) and Betaproteobacteria (Tranca Grande). Finally, the results allow us to expand the current knowledge of microbial diversity in lake sediments contaminated with heavy metals and to identify bioindicators taxa of environmental quality that can be used in the monitoring and control of heavy metal contamination.

Metagenomic data on the composition of bacterial communities in lake environment sediments for fish farming by next generation Illumina sequencing.

This article contains data on the bacterial communities of lagoon sediments with fish potential in the Central Andes of Peru. The surface sediment samples were collected from four lagoons destined for continental water fish farming. DNA extraction was performed from 0.5 g of sample through the Presto™ Soil DNA Extraction Kit. Bacterial sequencing of the 16S rRNA amplicon was performed on the DNA extracted from the sediment. At least 36 Phyla bacteria were detected, the bacterial communities being dominated by Proteobacteria, Cyanobacteria, Actinobacteria, Firmicutes, Chloroflexi. These data can be used for predictive analysis to gain a better understanding of the dynamics of bacterial communities in environments under pressure from fish farming.

Data on the concentration of heavy metals and metalloids in lotic water of the Mantaro river watershed and human risk assessment, Peru.

This article contains data on the concentration of heavy metals and metalloids in the water of seven rivers in the Mantaro river watershed in the central Andes of Peru, collected during the autumn of 2019. The concentrations of Cu, Fe, Pb, Zn and As were determined by flame atomic absorption spectrophotometry to assess human risk. The concentration of heavy metals and arsenic varied according to the sector of the rivers evaluated. The cluster analysis identified four different groups among the observation sectors. The risk assessment for humans was conducted on the basis of exposure doses to heavy metals and arsenic in water by ingestion and dermal pathways, using standard methods established by USEPA. These data can be reused as a basis for estimating the cancer risk or as a comparison group for future risk studies. They can also be useful to public health policy makers when proposing surveillance and control programmes using remedial technologies.

Validation of a immunoassay for the determination of vancomycin in cerebospinal fluid. / [Validación de un método inmunológico para la determinación de vancomicina en líquido cefalorraquídeo.]

Introduction: Vancomycin (VAN) is an antibiotic used to treat serious infections. Its use is related to adverse effects such as acute facial hyperemia, nephrotoxicity and ototoxicity. By having a very narrow therapeutic range, its monitoring is necessary to maximize efficiency and minimize toxic effects. It is estimated that its concentration in CSF is approximately 10% of the plasma level in patients who receive intravenous treatment and who have meninges inflammation. Plasma concentrations of VAN are not a reliable indicator of those present in CSF. The aim of this study was to validate an immunological method based on the kinetic interaction of microparticles in solution (KIMS) for the determination of VAN in CSF. Materials and Methods: KIMS was validated for the evaluation of VAN in CSF. For this, the parameters of linearity, precision, accuracy, limit of detection, limit of quantification, interference, selectivity and specificity were determined. Results: The method was linear in a range between 0 and 15 µg/mL, the CV% obtained oscillated between 0.7 and 2.5% on the linear range. The LOD and LOQ were 0.4 µg/mL and 1.4 µg/mL respectively. The equation of the line obtained based on the correlation of methods between KIMS and HPLC-UV was y = 0.9151x + 1.1695, R² = 0.9453. Conclusion: The KIMS method demonstrated to have an adequate sensitivity and specificity to determine VAN in CSF and being a useful tool for monitoring patients who present complicated infections at CNS level. Materials and Methods: KIMS was validated for the evaluation of VAN in CSF. For this, the parameters of linearity, precision, accuracy, limit of detection, limit of quantification, interference, selectivity and specificity were determined. Results: The method was linear in a range between 0 and 15 µg/mL, the CV% obtained oscillated between 0.7 and 2.5% on the linear range. The LOD and LOQ were 0.4 µg/mL and 1.4 µg/mL respectively. The equation of the line obtained based on the correlation of methods between KIMS and HPLC-UV was y = 0.9151x + 1.1695, R² = 0.9453. Conclusion: The KIMS method demonstrated to have an adequate sensitivity and specificity to determine VAN in CSF and being a useful tool for monitoring patients who present complicated infections at CNS level.

Introducción: La vancomicina (VAN) es un antibiótico utilizado para el tratamiento de infecciones graves. Su uso está relacionado con efectos adversos como hiperemia facial aguda, nefrotoxicidad y ototoxicidad. Al tener un rango terapéutico muy estrecho, el monitoreo terapéutico resulta necesario para maximizar la eficiencia y minimizar los efectos tóxicos. Se estima que su concentración en LCR es, aproximadamente, un 10% de la plasmática en pacientes que reciben tratamiento endovenoso del mismo y que presentan inflamación de las meninges. Las concentraciones plasmáticas de VAN no son un indicador confiable de las presentes en LCR. El objetivo de este trabajo fue validar un método inmunológico basado en la interacción cinética de micropartículas en solución (KIMS) para la determinación de VAN en LCR. Materiales y Métodos: Se validó el método KIMS para la valoración de VAN en LCR. Para ello, se determinaron los parámetros de linealidad, precisión, exactitud, límite de detección, límite de cuantificación, interferencia, selectividad y especificidad. Resultados: el método fue lineal en un intervalo entre 0 y 15 µg/mL, los CV% obtenidos oscilaron entre 0,7 y 2,5% en el rango lineal. Los LOD y LOQ fueron 0,4 µg/mL y 1,4 µg/mL respectivamente. La ecuación de la recta obtenida en base a la correlación de métodos entre KIMS y HPLC-UV fue y= 0,9151x + 1,1695, R²=0,9453. Conclusión: El método KIMS demostró tener una sensibilidad y especificidad apropiadas para la determinación de VAN en LCR y, ser una herramienta útil para el monitoreo de pacientes que presenten infecciones complicadas a nivel del SNC.

Investigating how perceived risk and availability of marijuana relate to marijuana use among adolescents in Argentina, Chile, and Uruguay over time.

AIMS: Amid changing marijuana policies in the Southern Cone, we examined relationships between marijuana-related risk factors and marijuana use among adolescents in Argentina, Chile, and Uruguay from 2001 to 2016. METHODS: Using cross-sectional surveys from 8th, 10th, and 12th graders and weighted time-varying effect models, we estimated associations between perceived risk (no/low risk versus moderate/great risk) and perceived availability (easy/very easy versus difficult/very difficult/not able to obtain) of marijuana, and any past-month marijuana use. RESULTS: In all countries, marijuana use increased over time and adolescents who perceived no/low risk and easy availability had higher odds of use. In Argentina, the bivariate risk/use association weakened from 2001 (OR = 15.24, 95%CI = 9.63, 24.12) to 2004 [OR = 3.86 (2.72, 5.48)] and strengthened until 2011 [OR = 8.22 (7.56, 10.30)]; the availability/use association strengthened from 2005 [OR = 5.32 (4.05, 6.98)] to 2009 [OR = 20.77 (15.57, 27.70)] and weakened until 2014 [OR = 11.00 (9.11, 13.27)]. In Chile, the risk/use association weakened from 2001 [OR = 7.22 (6.57, 7.95)] to 2015 [OR = 5.58 (4.82, 6.48)]; the availability/use association weakened from 2001 [OR = 5.92 (4.96, 7.06)] to 2015 [OR = 4.10 (3.15, 5.34)]. In Uruguay, the risk/use association weakened from 2003 [OR = 34.22 (22.76, 51.46)] to 2016 [OR = 6.23 (4.96, 7.83)]; the availability/use association weakened from 2005 [OR = 29.13 (13.39, 63.39) to 2007 [OR = 9.42 (3.85, 23.07)], and strengthened until 2016 [OR = 22.68 (12.03, 42.76)]. CONCLUSIONS: Overall, the association between risk and use weakened in all countries, suggesting risk perceptions became a weaker determinant of marijuana use. Perceived availability remained strongly associated with use and may become an increasingly important driver of use (particularly in Uruguay and Argentina).

Missed opportunities in the diagnosis of human immunodeficiency virus infection in the Region of Aragon. Late diagnosis importance. / Oportunidades perdidas en el diagnóstico de la infección por el virus de inmunodeficiencia humana en la Comunidad de Aragón. Importancia del diagnóstico tardío.

INTRODUCTION: Late Diagnosis (LD) of Human Immunodeficiency Virus (HIV) infection (CD4 lymphocytes <350/µl at diagnosis of the disease), deteriorates the condition of those affected and increases the probability of transmission. The objective of the present study was to analyse the prevalence of LD, to identify missed diagnostic opportunities (MDO) and to find out which level of the health care delivery system they took place. METHODS: Retrospective, observational and descriptive study of the population diagnosed with infection of HIV/AIDS in the period 2011-2015 in Aragon. MDO were identified during the 3 years prior to diagnosis of the disease in all levels of the health care delivery system as well as frequentation of consultations. The indicator conditions (IC) that generated more MDO were analysed according to the latest recommendations for early diagnosis of HIV in the health care setting. RESULTS: 435 newly diagnosed HIV/AIDS cases were analysed. 45.1% were diagnosed in Primary Healthcare (PH). 49.4% presented criteria of LD and 61.1% were infected through heterosexual contact. The majority of MDO (68.5%) were given in PH. The IC that generated the most MDO were seborrheic dermatitis/exanthema (19.4%) and fever of unknown origin (10.3%). However, the IC that were associated with higher LD were pneumonia acquired in the community and unjustified weight loss. CONCLUSION: In Aragon, prevalence of LD is high, the main route of infection is heterosexual and most of MDO go unnoticed in PH. The dissemination of current guidelines for requesting IC guided HIV testing and HIV screening across the preoperative period will result in an effective measure to decrease the LD.

Enhanced Bacteriocin Production by Pediococcus pentosaceus 147 in Co-culture With Lactobacillus plantarum LE27 on Cheese Whey Broth.

The production of bacteriocins by lactic acid bacteria (LAB) has been of wide interest in the food industry due to their potential application in biopreservation. The production of bacteriocins is usually low in single strain fermentation, but can improve when the bacteriocinogenic strain is cultured in association with another bacteria. The present work aims to evaluate the growth and production of bacteriocins by Pediococcus pentosaceus 147 (bacteriocinogenic strain) in co-culture with Lactobacillus plantarum LE27 (inducer strain) using a culture medium based on cheese whey (CW). Strains were inoculated in co-culture in a CW broth at 7.24 Log CFU/mL of initial concentration of P. pentosaceus 147 and incubated at 37°C. Bacteriocin production was measured after 24 h by the critical dilution method, biomass was measured by plating on MRS agar (1% aniline blue), and a mono-culture was used as a control. The titers of bacteriocins produced by P. pentosaceus 147 in mono-culture were 19,200 AU/mL lower than those obtained in co-culture with Lb. plantarum LE27 at 51,200 AU/mL. The effect of adding the inducer strain at different times of incubation (3, 6, 9, and 12 h) was evaluated, with the addition of the induction factor at the beginning of the incubation of P. pentosaceus 147 generating the highest bacteriocin activity. This study shows the potential of inducing bacteriocinogenesis using co-cultures of strains of the genera Pediococcus and Lactobacillus and using alternative substrates such as cheese whey.

INDIVIDUAL DOSIMETRY IN DISPOSAL REPOSITORY OF HEAT-GENERATING NUCLEAR WASTE.

Certain working scenarios in a disposal facility of heat-generating nuclear waste might lead to an enhanced level of radiation exposure for workers in such facilities. Hence, a realistic estimation of the personal dose during individual working scenarios is desired. In this study, the general-purpose Monte Carlo N-Particle code MCNP6 (Pelowitz, D. B. (ed). MCNP6 user manual LA-CP-13-00634, Rev. 0 (2013)) was applied to simulate a representative radiation field in a disposal facility. A tool to estimate the personal dose was then proposed by taking into account the influence of individual motion sequences during working scenarios. As basis for this approach, a movable whole-body phantom was developed to describe individual body gestures of the workers during motion sequences. In this study, the proposed method was applied to the German concept of geological disposal in rock salt. The feasibility of the proposed approach was demonstrated with an example of working scenario in an emplacement drift of a rock salt mine.

Ampliación de la distribución norte de Neoraimondia arequipensis subsp. gigantea (Werd. & Backeberg) Ostolaza / Expansion of the northern distribution of Neoraimondia arequipensis subsp. gigantea (Werd. & Backeberg) Ostolaza

Resumen Se registra Neoraimondia arequipensis subesp. gigantea en los bosques secos de Tumbes, ampliándose su distribución geográfica en el norte del Perú. Se realizó la identificación fenotípica de 70 individuos y genotípica basada en la secuenciación del gen matK (Maturase K gene). El hábitat de esta especie se caracteriza por la presencia de suelo de tipo pedregoso y rocoso, ubicados aledaños a zonas de quebradas y altitudes entre 20 a 60 m. Además, se registran observaciones de interacciones biológicas de este cactus con fauna y flora endémica del departamento de Tumbes.

Abstract Neoraimondia arequipensis subsp. gigantea is registered in the dry forests of Tumbes, expanding its geographical distribution in northern Peru, based on the phenotypic identification of 70 individuals and genotypic by sequencing the matK gene (Maturase K gene). The habitat of this species is characterized by the presence of stony and rocky soil, located adjacent to areas of ravines and altitudes between 20 to 60 meters above sea level. In addition, we include the record of biological interactions of this cactus with endemic fauna and flora of the department of Tumbes.

Prevalencia de parásitos intestinales en niños de 2-5 años en hogares comunitarios de Cartagena de Indias, Colombia / Presence of intestinal parasites in children 2-5 years of age in community homes in Cartagena de Indias, Colombia

RESUMEN Las enteroparasitosis constituyen un importante problema de salud pública a nivel global, afectando principalmente a la población infantil de los países tropicales. Nuestro objetivo fue determinar la prevalencia de parásitos intestinales en niños de 2 a 5 años en 17 hogares comunitarios del Instituto Colombiano de Bienestar Familiar (ICBF) en la Zona Industrial y Bahía de Cartagena de Indias. Para ello, se realizó un estudio descriptivo de corte transversal; se analizaron muestras mediante coprología de 207 niños de ambos sexos. No hubo diferencias significativas asociadas al sexo y edad (p>0,05). La frecuencia de enteroparasitos en la población infantil de 2 a 5 años fue de un 70,5%, donde el 59,5%, presentó una sola especie de parásito, el 34,2% dos y 6,1% tres y cuatro especies. Los principales protistas (86,3%) encontrados fueron Blastocystis hominis (60,2%) y Giardia lamblia (24,6%). En el grupo de Helmintos (13,7%) se destacaron Ascaris lumbricoides (9,6%) e Hymenolepis nana (6,2%). Las enteroparasitosis continúan como un importante problema de salud pública en condiciones del trópico Colombiano, especialmente en población infantil de zonas vulnerables de Cartagena - Colombia. Evidenciando la necesidad de revisar las políticas dirigidas a reducir la frecuencia del parasitismo intestinal.

ABSTRACT Intestinal parasites constitute an important public health problem at a global level, mainly affecting the pediatric population of tropical countries. The objective of this study was to determine the prevalence of intestinal parasites in children 2 to 5 years of age in 17 community homes of the Colombian Institute of Family Welfare (ICBF) in the Industrial Zone and Cartagena de Indias Bay, Colombia. A descriptive cross-sectional study was carried out among 207 children of both sexes. Samples were analyzed by coprology. There were no significant differences associated with sex and age (p>0.05). The frequency of enteroparasites in children aged 2 to 5 was 70.5 %, where 59.5% presented a single species of parasite, 34.2% two and 6.1% three and four species. The main protists (86.3%) found were Blastocystis hominis (60.2%) and Giardia lamblia (24.6%). In the group of Helminths (13.7%), Ascaris lumbricoides (9.6%) and Hymenolepis nana (6.2%) were observed. Intestinal parasites continue to be an important public health problem in the Colombian tropics, especially among children in vulnerable areas of Cartagena, Colombia. There is a need to review policies aimed at reducing the frequency of intestinal parasitism.

Oportunidades perdidas en el diagnóstico de la infección por el virus de inmunodeficiencia humana en la Comunidad de Aragón. Importancia del diagnóstico tardío / Missed opportunities in the diagnosis of human immunodeficiency virus infection in the Region of Aragon. Late diagnosis importance

Introducción: El diagnóstico tardío (DT) de la infección por el virus de la inmunodeficiencia humana (VIH) (linfocitos CD4<350/μl al diagnóstico de la enfermedad) empeora el pronóstico de los afectados y aumenta las probabilidades de transmisión. El objetivo del presente trabajo fue analizar la prevalencia de DT, identificar las oportunidades diagnósticas perdidas (ODP) y averiguar el nivel asistencial donde se produjeron. Métodos: Estudio retrospectivo, observacional, descriptivo de la población diagnosticada de infección por VIH/sida en el periodo 2011-2015 en Aragón. Se identificaron las ODP durante los 3 años previos al diagnóstico de la enfermedad en todos los niveles asistenciales, así como la frecuentación asistencial. Se analizaron las condiciones indicadoras (CI) que generaron más ODP, según las últimas recomendaciones para el diagnóstico precoz del VIH en el medio sanitario. Resultados: Se analizaron 435 nuevos casos de VIH/sida. El 45,1% fueron diagnosticados en Atención Primaria (AP). El 49,4% presentaron criterios de DT y el 61,1% se contagiaron vía heterosexual. La mayor parte de ODP (68,5%) se dieron en AP. Las CI que generaron más ODP fueron la dermatitis seborreica/exantema (19,4%) y la fiebre sin causa aparente (10,3%). Sin embargo, las CI que se asociaron a mayor DT fueron la neumonía adquirida en la comunidad y la pérdida de peso injustificada. Conclusión: En Aragón, la prevalencia de DT es elevada, la principal vía de transmisión es la heterosexual y la mayor parte de las CI pasan desapercibidas en AP. La difusión de las guías actuales para solicitar una prueba de VIH orientada por CI y el screening VIH en todo preoperatorio es una medida eficaz para disminuir el DT

Introduction: Late Diagnosis (LD) of Human Immunodeficiency Virus (HIV) infection (CD4 lymphocytes <350/μl at diagnosis of the disease), deteriorates the condition of those affected and increases the probability of transmission. The objective of the present study was to analyse the prevalence of LD, to identify missed diagnostic opportunities (MDO) and to find out which level of the health care delivery system they took place. Methods: Retrospective, observational and descriptive study of the population diagnosed with infection of HIV/AIDS in the period 2011-2015 in Aragon. MDO were identified during the 3 years prior to diagnosis of the disease in all levels of the health care delivery system as well as frequentation of consultations. The indicator conditions (IC) that generated more MDO were analysed according to the latest recommendations for early diagnosis of HIV in the health care setting. Results: 435 newly diagnosed HIV/AIDS cases were analysed. 45.1% were diagnosed in Primary Healthcare (PH). 49.4% presented criteria of LD and 61.1% were infected through heterosexual contact. The majority of MDO (68.5%) were given in PH. The IC that generated the most MDO were seborrheic dermatitis/exanthema (19.4%) and fever of unknown origin (10.3%). However, the IC that were associated with higher LD were pneumonia acquired in the community and unjustified weight loss. Conclusion: In Aragon, prevalence of LD is high, the main route of infection is heterosexual and most of MDO go unnoticed in PH. The dissemination of current guidelines for requesting IC guided HIV testing and HIV screening across the preoperative period will result in an effective measure to decrease the LD

Determinación de Levetiracetam en suero humano por cromatografía líquida con detección de arreglo de diodos / Levetiracetam determination in human serum by liquid chromatography with diode array detection / Determinação de Levetiracetam em soro humano por cromatografia líquida com detecção de arranjo de diodos

Se desarrolló y validó un nuevo método analítico para determinar Levetiracetam (LEV) en suero humano utilizando cromatografía líquida de alta resolución (HPLC) con detección de arreglo de diodos. El procedimiento es sencillo, puede ser incluido en la rutina del laboratorio y prestar servicio tanto en el monitoreo terapéutico como en la urgencia. El método incluye las siguientes etapas: extracción líquido-líquido con diclorometano y evaporación de la fase orgánica, la droga se reconstituye con fase móvil, se inyecta en el cromatógrafo y se detecta a 205 nm. El tiempo de retención de LEV es de 5 minutos y no presenta interferentes con respecto a otras drogas comúnmente prescriptas con Levetiracetam. La curva de trabajo presentó un rango de linealidad entre 5,2 y 82,9 μg/mL, un límite de detección y cuantificación de 0,8 μg/mL y 2,7 μg/mL, respectivamente. La recuperación fue del 99,8%.

A new analytical method for Levetiracetam (LEV) determination in human serum was developed and validated by high performance liquid chromatography (HPLC) with diode detection. It is a simple methodology that can be included in the laboratory routine and can be useful in both therapeutic drug monitoring and emergencies. The drug extraction is performed through a liquid-liquid extraction with methyl chloride. Subsequently, the organic phase is evaporated, reconstituted with the mobile phase, and injected in the chromatograph to be detected at 205 nm. LEV retention time is 5 min and it does not show interference with respect to other drugs commonly prescribed with Levetiracetam. The work curve showed linearity between 5.2 and 82.9 μg/mL and a detection and quantification limit of 0.8 μg/mL and 2.7 μg/mL, respectively, while the recovery was of 99.8%.

Foi desenvolvido e validado um novo método analítico para determinar Levetiracetam (LEV) em soro humano, utilizando cromatografia líquida de alta eficiência (HPLC) com detecção de arranjo de diodos. O procedimento é simples, pode ser incluído na rotina do laboratório e prestar serviço tanto na monitorização terapêutica quanto na urgência. O método inclui as seguintes etapas: extração líquido-líquido com diclorometano, e evaporação da fase orgânica, o fármaco é reconstituído com fase móvel, é injetado no cromatógrafo e detectado a 205 nm. O tempo de retenção de LEV é de 5 minutos e não apresenta interferentes com relação a outras drogas, comumente prescritas com Levetiracetam. A curva de trabalho apresentou um intervalo de linearidade entre 5.2 a 82.9 μg/mL, um limite de detecção e quantificação de 0.8 μg/mL e 2.7 μg/mL respectivamente. A recuperação foi de 99.8%.

Survival after left ventricular free wall rupture in an elderly woman with acute myocardial infarction treated only medically.

Pseudoaneurysm of the left ventricle is rare and may occur as a result of transmural myocardial infarction. The course of rupture after acute myocardial infarction varies from a catastrophic event, with an acute tear leading to immediate death (acute rupture), or slow and incomplete tear leading to a late rupture (subacute rupture). Incomplete rupture may occur when the thrombus and haematoma together with the pericardium seal the rupture of the left ventricle and may develop into a pseudoaneurysm. Early diagnosis and treatment is essential in this condition. Two-dimensional color Doppler echocardiography is the first-choice method for most patients with suspected left ventricular pseudoaneurysm (LVP) and suggests left ventricular rupture in 85% to 90% of patients. We report the case of an 87-year-old woman presenting with symptoms and findings of myocardial infarction and left ventricular free wall rupture with a pseudoaneurysm formation diagnosed by echocardiography and confirmed on CT, MRI, and NM. She received only intense medical treatment, because she refused surgery with a favorable outcome. After 24-month followup, she is in NYHA functional class II. The survival of this patient is due to the contained pseudoaneurysm by dense pericardial adhesions, related to her previous coronary bypass surgery.

Microstructural and physicochemical analysis of collagen in intramuscular pin bones of Bocachico fish (Prochilodus sp.) / Análise microestrutural e físico químico do colágeno presente em espinhos intramusculares do peixe Bocachico (Prochilodus sp.) / Análisis microestructural y fisicoquímico del colágeno presente en espinas intramusculares del pescado Bocachico (Prochilodus sp.)

Background: the presence of intramuscular pin bones hinders the production and commercialization of fish fillet products; however, application of physical processes, such as thermal treatments, offers alternatives for the degradation of said bones. Objective: the present study aimed to conduct a microstructural and physicochemical analysis of Bocachico intramuscular pin bones subjected to a thermal treatment. Methods: collagen extracted from intramuscular pin bones of Bocachico fillets was analyzed using SDS-polyacrylamide gel electrophoresis and viscosity. Pin bones were subjected to 1.5, 2, and 3 minutes heating time and analyzed using electron microscopy and cutting force. Results: intramuscular pin bones contain type I collagen. Threeminute thermal treatment degraded collagen components present in the internal pin bone structure, coinciding with the lowest values of the cutting force test. Conclusions: according to our results, collagen degradation initiates in the internal structure of intramuscular pin bones and moves towards the external layer which does not show the effects of thermal treatment.

Antecedentes: la presencia de espinas intramusculares en filetes de peces impide la obtención y posterior comercialización de estos productos, motivo por el cual la aplicación de procesos físicos antes del tratamiento térmico podría ser una alternativa en la degradación de estas espinas. Objetivo: el alcance del presente estudio fue realizar análisis fisicoquímico y microestructural de espinas intramusculares de Bocachico sometidas a proceso térmico. Métodos: las espinas intramusculares de filetes de Bocachico fueron analizadas a través de electroforesis en gel de SDS-poliacrilamida (SDS-PAGE), temperatura de desnaturalización del colágeno, microscopia electrónica de trasmisión y fuerza de corte. Fueron utilizados tres tiempos de duración del tratamiento térmico (1,5, 2 y 3 min). Resultados: el colágeno presente en espinas intramusculares es tipo l. El tratamiento térmico durante tres minutos degrada los componentes del colágeno en las estructuras internas de la espina, coincidiendo con los valores menores para la prueba de fuerza de corte. Conclusiones: los resultados permiten concluir que la degradación del colágeno es iniciada desde el interior de la estructura de la espina intramuscular hacia la capa externa, sin que esta capa muestre efecto del tratamiento térmico.

Antecedentes: a presença de espinhos intramusculares impede a obtenção de filetes de peixe e posterior comercialização destes produtos, razão pela qual a aplicação de processos físicos antes do tratamento térmico pode ser uma alternativa na degradação desses espinhos. Objetivo: realizar analise físico-químico e microestrutural em espinhos intramusculares do peixe Bocachico submetidos a processo térmico. Métodos: os espinhos intramusculares de filetes do Bocachico foram analisados por eletroforese em gel de SDSpoliacrilamida (SDS-PAGE), temperatura de desnaturação do colágeno, microscopia electrónica de transmissão e força de corte. Foram utilizados três tempos de duração do tratamento térmico (1,5, 2 e 3 min). Resultados: o colágeno presente em espinhos intramusculares é do tipo l. O tratamento térmico por três minutos degrada os componentes do colágeno nas estruturas internas do espinho, coincidindo com os menores valores para o teste de resistência ao corte. Conclusões: os resultados mostram que a degradação do colágeno é iniciado desde o interior do espinho intramuscular até a capa externa, sem que essa capa externa seja afetada pelo tratamento térmico.