Antimicrobial activity of Lactiplantibacillus plantarum against shiga toxin-producing Escherichia coli.

AIMS: The aim of the present work was to characterize the Lactiplantibacillus sp. LP5 strain, isolated from pork production, and identify bacteriocin-like inhibitory substances produced by this strain. METHODS AND RESULTS: In this study, LP5 was identified by species-specific PCR and 16S rRNA sequencing. Additionally, bacterial growth kinetics, antimicrobial activity, the detection of genes related to plantaricin production, and the genetic expression of plantaricins were determined. Lactiplantibacillus sp. LP5 was identified as Lactiplantibacillus plantarum. The well-diffusion test using cell-free supernatants (CFS), neutralized CFS, CFS treated with catalase, and CFS treated with proteinase K showed that inhibitory effects on a Shiga toxin-producing Escherichia coli (STEC) strain were produced by bacteriocins. The PCR technique allowed the detection of genes encoding E/F plantaricins, as well as J/K and whole genome sequencing, and bacteriocin mining analysis allowed us to confirm the presence of these plantaricins. CONCLUSIONS: We can conclude that the inhibitory effect of L. plantarum LP5 isolated from pigs against the STEC EDL933 strain could be associated with the bacteriocins production and represents a potential use as a probiotic strain.

Safety and Immunogenicity of a Chimeric Subunit Vaccine against Shiga Toxin-Producing Escherichia coli in Pregnant Cows.

Shiga toxin-producing Escherichia coli (STEC) is a zoonotic pathogen that causes gastroenteritis and Hemolytic Uremic Syndrome. Cattle are the main animal reservoir, excreting the bacteria in their feces and contaminating the environment. In addition, meat can be contaminated by releasing the intestinal content during slaughtering. Here, we evaluated the safety and immunogenicity of a vaccine candidate against STEC that was formulated with two chimeric proteins (Chi1 and Chi2), which contain epitopes of the OmpT, Cah and Hes proteins. Thirty pregnant cows in their third trimester of gestation were included and distributed into six groups (n = 5 per group): four groups were administered intramuscularly with three doses of the formulation containing 40 µg or 100 µg of each protein plus the Quil-A or Montanide™ Gel adjuvants, while two control groups were administered with placebos. No local or systemic adverse effects were observed during the study, and hematological parameters and values of blood biochemical indicators were similar among all groups. Furthermore, all vaccine formulations triggered systemic anti-Chi1/Chi2 IgG antibody levels that were significantly higher than the control groups. However, specific IgA levels were generally low and without significant differences among groups. Notably, anti-Chi1/Chi2 IgG antibody levels in the serum of newborn calves fed with colostrum from their immunized dams were significantly higher compared to newborn calves fed with colostrum from control cows, suggesting a passive immunization through colostrum. These results demonstrate that this vaccine is safe and immunogenic when applied to pregnant cows during the third trimester of gestation.

Evaluation of food baits to capture Drosophila suzukii in the southern of Brazil.

Drosophila suzukii is one of the main pests of small fruits in the world. An effective monitoring is fundamental to detect the presence of the fly and to predict the infestation of fruits in new areas. We evaluated the food baits Ceratrap®, Torula®, Biofruit®, Suzukii Trap®, apple cider vinegar, and a homemade mixture comprising wine, vinegar and molasses (WVM) for D. suzukii attractiveness, and if reproductive stage affects females attraction and capture in the different baits. Bait selectivity of non-target insects was assessed. The preference of adults between ripe blackberry fruit and the food baits was also evaluated. Adults showed a higher attraction (61.97% of the captured insects) to the WVM mixture than to Ceratrap® (1.32%), Torula® (0.52%), Biofruit® (13.15%), Suzukii Trap® (17.6%), and apple vinegar (5.4%). Considering the attractiveness to D. suzukii, Suzukii Trap® and apple vinegar were the most selective to non-target insects. In general, reproductively immature females showed a preference for Biofruit®, apple vinegar, and WVM, whereas mature females did not show bait preferences. Adults preferred ripe blackberry fruit over the WVM mixture. Understanding the field behavior of D. suzukii is of foremost importance to estimate insect population density and outline pest management strategies.

Biological characteristics of Grapholita molesta (Lepidoptera: Tortricidae) induced to diapause in laboratory.

In southern Brazil, Grapholita molesta (Busck) (Lepidoptera: Tortricidae) uses diapause as survival strategy during the winter (May-August). In our study, we evaluated the effect of diapause on biological characteristics of the species for 4 months in laboratory. Newly hatched larvae of G. molesta were induced to diapause changing the photoperiod and temperature (T) (12 ± 1°C), relative humidity (RH) (70 ± 10%), and a photophase of 12 h and, when they started diapause in the prepupal stage, the conditions were kept for 4 months. Afterwards, the insects were induced to finalize the diapause process at T 25 ± 1°C, RH 70 ± 10%, and a photophase of 16 h. We evaluated the duration and viability of the larval stages and pupae, pupae weight at 24 h and sex ratio (sr), periods of preoviposition, oviposition, and postoviposition; adult life span (males and females); fecundity (daily and total); embryonic period duration and eggs viability, comparing the data with insects nondiapause. The results show that diapause greatly affected the viability of pupal-adult stages of the population (21.8%) when compared with insects' nondiapause (80.0%). Total fecundity (83.0 eggs) and mean life span (12.0 d) of insects diapause was significantly lower compared with insects nondiapause (173.0 and 17.0), respectively. However, these differences were not observed in the sr, which was similar to insects diapause (sr = 0.41) and insects nondiapause (sr = 0.49). The diapause induced for 4 months negatively affects reproduction and life span of adults of G. molesta.

Multimodal, PSMA-Targeted, PAMAM Dendrimer-Drug Conjugates for Treatment of Prostate Cancer: Preclinical Evaluation.

Introduction: Prostate cancer (PC) is the second most common cancer and the fifth most frequent cause of cancer death among men. Prostate-specific membrane antigen (PSMA) expression is associated with aggressive PC, with expression in over 90% of patients with metastatic disease. Those characteristics have led to its use for PC diagnosis and therapies with radiopharmaceuticals, antibody-drug conjugates, and nanoparticles. Despite these advancements, none of the current therapeutics are curative and show some degree of toxicity. Here we present the synthesis and preclinical evaluation of a multimodal, PSMA-targeted dendrimer-drug conjugate (PT-DDC), synthesized using poly(amidoamine) (PAMAM) dendrimers. PT-DDC was designed to enable imaging of drug delivery, providing valuable insights to understand and enhance therapeutic response. Methods: The PT-DDC was synthesized through consecutive conjugation of generation-4 PAMAM dendrimers with maytansinoid-1 (DM1) a highly potent antimitotic agent, Cy5 infrared dye for optical imaging, 2,2',2"-(1,4,7-triazacyclononane-1,4,7-triyl)triacetic acid (NOTA) chelator for radiolabeling with copper-64 and positron emission tomography tomography/computed tomography (PET/CT), lysine-urea-glutamate (KEU) PSMA-targeting moiety and the remaining terminal primary amines were capped with butane-1,2-diol. Non-targeted control dendrimer-drug conjugate (Ctrl-DDC) was formulated without conjugation of KEU. PT-DDC and Ctrl-DDC were characterized using high-performance liquid chromatography, matrix assisted laser desorption ionization mass spectrometry and dynamic light scattering. In vitro and in vivo evaluation of PT-DDC and Ctrl-DDC were carried out in isogenic human prostate cancer PSMA+ PC3 PIP and PSMA- PC3 flu cell lines, and in mice bearing the corresponding xenografts. Results: PT-DDC was stable in 1×PBS and human blood plasma and required glutathione for DM1 release. Optical, PET/CT and biodistribution studies confirmed the in vivo PSMA-specificity of PT-DDC. PT-DDC demonstrated dose-dependent accumulation and cytotoxicity in PSMA+ PC3 PIP cells, and also showed growth inhibition of the corresponding tumors. PT-DDC did not accumulate in PSMA- PC3 flu tumors and did not inhibit their growth. Ctrl-DDC did not show PSMA specificity. Conclusion: In this study, we synthesized a multimodal theranostic agent capable of delivering DM1 and a radionuclide to PSMA+ tumors. This approach holds promise for enhancing image-guided treatment of aggressive, metastatic subtypes of prostate cancer.

Control of Grapholita molesta (Busck, 1916) (Lepidoptera: Tortricidae) with entomopathogenic nematodes (Rhabditida: Heterorhabditidae, Steinernematidae) in peach orchards.

Oriental fruit moth Grapholita molesta (Busck, 1916) (Lepidoptera: Tortricidae) is considered a major pest in temperate fruit trees, such as peach and apple. Entomopathogenic nematodes (EPNs) are regarded as viable for pest management control due to their efficiency against tortricid in these trees. The objective of this study was to evaluate the effectiveness of native EPNs from Rio Grande do Sul state against pre-pupae of G. molesta under laboratory and field conditions. In the laboratory, pre-pupae of G. molesta were placed in corrugated cardboard sheets inside glass tubes and exposed to 17 different EPNs strains at concentrations of 6, 12, 24, 48 and 60 IJs/cm(2) and maintained at 25 °C, 70 ± 10% RH and photophase of 16 h. Insect mortality was recorded 72 h after inoculation of EPNs. Steinernema rarum RS69 and Heterorhabditis bacteriophora RS33 were the most virulent strains and selected for field application (LC95 of 70.5 and 53.8 IJs/cm(2), respectively). Both strains were highly efficient under field conditions when applied in aqueous suspension directed to larvae on peach tree trunk, causing mortality of 94 and 97.0%, respectively.

Activity of eight strains of entomopathogenic nematodes (Rhabditida: Steinernematidae, Heterorhabditidae) against five stored product pests.

Stored product pests are responsible for losses that can amount 10% during cereal storage in the world. Aiming to find an alternative method to the chemicals used for the stored-product pests, eight strains of entomopathogenic nematodes (EPNs) were tested against five species of stored product pests. The bioassays were conducted in microtubes containing paper, inoculated with EPNs and insect diet. All the insect species were susceptible to the EPNs strains. Anagasta kuehniella and Tenebrio molitor larvae and Acanthoscelides obtectus adults were highly sensitive to the higher doses with most species and/or strains of EPNs. Adults of Sitophilus oryzae and Sitophilus zeamais were relatively less sensitive to all EPNs. Therefore, EPNs show as potential control agents for stored products pests in prophylactic applications in warehouses.

Evaluation of efficacy of 18 strains of entomopathogenic nematodes (Rhabditida) against Planococcus citri (Risso, 1813) (Hemiptera: Pseudococcidae) under laboratory conditions.

Planococcus citri (Risso, 1813) (Hemiptera: Pseudococcidae) is an important plant virus vector in grapevine crops in Brazil and other countries. The mealybug grows in roots and leaves of the grapes. Entomopathogenic nematodes (EPNs) are efficient control agents against insects associated to the soil and could be applied with the same equipment used for chemical insecticides. The aim of this study was to select effective EPNs for controlling P. citri females in laboratory conditions (25±1°C, UR 60±10%). We tested 17 native [Steinernema rarum (6 strains), Steinernema glaseri, Steinernema feltiae, Steinernema riobrave, Steinernema sp., Heterorhabditis bacteriophora (7 strains)] and only one exotic strain (Steinernema carpocapsae ALL). The bioassays were done on Petri dishes infested with females of P. citri, which were sprayed with EPNs juveniles. The strain with larger pathogenicity and virulence in laboratory was H. bacteriophora RS33 (from 69.0% to 92.2% of mortality), native of Rio Grande do Sul.

Molecular and Genetic Characterization of Colicinogenic Escherichia coli Strains Active against Shiga Toxin-Producing Escherichia coli O157:H7.

The objective of this work was to molecularly and genotypically characterize and test the inhibitory activity of six colicinogenic Escherichia coli strains (ColEc) and their partially purified colicins against STEC O157:H7 isolated from clinical human cases. Inhibition tests demonstrated the activity of these strains and their colicins against STEC O157:H7. By PCR it was possible to detect colicins Ia, E7, and B and microcins M, H47, C7, and J25. By genome sequencing of two selected ColEc strains, it was possible to identify additional colicins such as E1 and Ib. No genes coding for stx1 and stx2 were detected after analyzing the genome sequence. The inhibitory activity of ColEc against STEC O157:H7 used as an indicator showed that colicins are potent growth inhibitors of E. coli O157:H7, being a potential alternative to reduce the presence of pathogens of public health relevance.

The latent reservoir of inducible, infectious HIV-1 does not decrease despite decades of antiretroviral therapy.

HIV-1 persists in a latent reservoir in resting CD4+ T cells despite antiretroviral therapy (ART). The reservoir decays slowly over the first 7 years of ART (t1/2 = 44 months). However, whether decay continues with long-term ART is unclear. Recent integration site studies indicate gradual selection against inducible, intact proviruses, raising speculation that decades of ART might allow treatment interruption without viral rebound. Therefore, we measured the reservoir in 42 people on long-term ART (mean 22 years) using a quantitative viral outgrowth assay. After 7 years of ART, there was no long-term decrease in the frequency of inducible, replication-competent proviruses but rather an increase with an estimated doubling time of 23 years. Another reservoir assay, the intact proviral DNA assay, confirmed that reservoir decay with t1/2 of 44 months did not continue with long-term ART. The lack of decay reflected proliferation of infected cells. Most inducible, replication-competent viruses (79.8%) had env sequences identical to those of other isolates from the same sample. Thus, although integration site analysis indicates changes in reservoir composition, the proliferation of CD4+ T cells counteracts decay, maintaining the frequency of inducible, replication-competent proviruses at roughly constant levels over the long term. These results reinforce the need for lifelong ART.

Biology and fertility life table of the green aphid Chaetosiphon fragaefolli on strawberry cultivars.

Our objective was to study the biology and develop a fertility life table for the aphid Chaetosiphon fragaefolli (Cockerell) (Hemiptera: Aphididae) on leaves of strawberry, Fragaria × ananassa, Duchesne ex Rozier (Rosales: Rosaceae), of the cultivars Albion, Aromas, Camarosa, Camino Real, Diamante, Earlibrite, and Saborosa. This study was conducted under controlled conditions: 25 ± 1 (°)C, 70 ± 10% RH, and 12:12 L:D . Arenas were set up consisting of leaves inside Petri dishes containing 3% agar. Female aphids obtained after the last nymphal ecdysis were individually placed in arenas for 24 hours. The following biological parameters were evaluated: duration and survival of the nymph stage and of the life cycle (nymph-nymph), daily and total fecundity, and adult longevity. The aphids completed their biological cycle on all of the cultivars. The shortest durations (in days) of the nymphal stage were on the cultivars Camino Real and Camarosa (8.67 and 8.74 days, respectively), and the longest was on Aromas (11.12 days). The lowest survival was on cultivar Aromas (51%) and the highest on Saborosa (96%). When the time to development to the adult stage was compared, the aphids developed fastest (14.63 days) and survival was highest (96%) on cultivar Saborosa. Aphids reared on cultivar Aromas leaves had the longest pre-reproductive period (8.74 days), the greatest longevity (26.88 days), and the longest duration of the life cycle (19.76 days). Based on the fertility life table, cultivars Camarosa and Saborosa were the most favorable for development of C. fragaefolli, while Albion and Aromas were the most inadequate for aphid development.

Experience with ultrasound use in central venous catheterization (jugular-femoral) in pediatric patients in an intensive care unit. / Experiencia en el uso de ultrasonido en cateterismo venoso central (yugular-femoral) en pacientes pediátricos en una unidad de cuidados intensivos.

OBJECTIVE: Describe ultrasound-guided central venous catheterization use comparing the number of attempts (1 versus 2 or more attempts) in relation to catheters placed in the internal jugular vein (IJV) versus the femoral vein (FV). MATERIAL AND METHODS: Descriptive, prospective study of central venous catheters (CVCs) inserted via ultrasound-guided puncture in patients aged 1 month to 18 years. A multivariate regression model was done considering the primary endpoint, first puncture success in relation to the insertion site (IJV versus FV), and predictors of success. RESULTS: A total of 257 CVCs were inserted: IJV 118 (45.9%), FV 139 (54.1%); 161 (62.7%) were inserted in the first attempt and 96 (37.3%) required more than 1 attempt. IJV insertions were successful with the first puncture in 86 patients (53.5%) and FV insertions, in 75 (46.5%) (p 0.0018; OR: 0.43 [95% CI: 0.24-0.76]). There were 21 (8.1%) immediate complications: 3 (1.86%) were related to the first puncture, 18 (18.75%), to more than 1 puncture (p 0.0001 [95% CI: 3.36-45.68]). There were 4 cases of severe complications, including pneumothorax. CONCLUSIONS: Ultrasound-guided venous catheterization demonstrated to be significantly successful in the first attempt when using the IJV versus FV, especially in infants younger than 6 months. Immediate complications occurred more frequently in patients requiring more than 1 puncture.

OBJETIVOS: Describir el uso de la guía ecográfica en el cateterismo venoso central, comparando el número de intentos (1 versus 2 o más intentos), en relación con los catéteres insertados en vena yugular interna (VYI) versus vena femoral (VF). Material y métodos. Estudio descriptivo, prospectivo de catéteres venosos centrales (CVC) colocados mediante punción ecoguiada en pacientes de 1 mes a 18 años. Se realizó un modelo de regresión multivariado considerando el punto final primario, éxito a la primera punción en relación con el sitio de inserción (VYI versus VF) y variables predictoras de éxito. RESULTADOS: Se colocaron 257 CVC, VYI 118 (45,9 %), VF 139 (54,1 %); 161 (62,7 %) insertados en la primera punción y 96 (37,3 %) requirieron más de una punción. Las inserciones en VYI fueron exitosas en la primera punción en 86 pacientes (53,5 %) y en VF fueron 75 (46,5 %) (p 0,0018; OR: 0,43 [IC95%: 0,24-0,76]). Hubo 21 (8,1 %) complicaciones inmediatas, 3 (1,86 %) se relacionaron con la primera punción, 18 (18,75 %) lo hicieron con más de una punción (p 0,0001 [IC95%: 3,36-45,68]). Las complicaciones graves, como neumotórax, fueron 4. CONCLUSIONES: El cateterismo venoso guiado por ultrasonido demostró ser significativamente exitoso en el primer intento cuando el vaso de elección fue la VYI comparado con VF, especialmente en menores de 6 meses. Las complicaciones inmediatas fueron más frecuentes en los pacientes que requirieron más de una punción.

Carbapenem-resistant Enterobacteriaceae bloodstream infections: A case-control study from a pediatric referral hospital in Argentina.

Background: Antibiotic-resistant gram-negative bloodstream infections (BSI) remain a leading cause morbidity and mortality in pediatric patients with a high impact on the public health system. Data in resource-limited countries, including those in Latin America and the Caribbean region, are scarce. The aim of the study was to identify risk factors for acquiring carbapenem-resistant Enterobacteriaceae (CRE) bacteremia in children and to assess the use of resources. Methods: A retrospective case-control study was conducted to analyze demographic, epidemiological, clinical, microbiological, and outcome data as well as the use of resources between 2014 and 2019. Univariate and logistic regression analysis was performed in order to identify risk factors associated with CRE-BSI. The R software version 4.1.2 was used. Results: A total of 46 cases with CRE-BSI and 92 controls with gram-negative non-CRE-BSI were included. No statistical difference was observed regarding: median age (36 months; IQR, 11.2-117 vs. 48 months, IQR 13-119), male sex (50 vs. 60%), and underlying disease (98 vs. 91%) in cases vs. controls, respectively. The most frequent mechanism of CRE bacteremia were: KPC in 74%, OXA in 15%, and NDM in 6.5%. A total of 54.3% of cases vs. 32.6 % (p = 0.016) of controls were admitted to the pediatric intensive care unit (PICU), and 48 vs. 21% (p = 0.001) required mechanical ventilation. Bacteremia secondary to intra-abdominal infection was observed in 56.5% of cases vs. 35% of controls (p = 0.032). Previous colonization with CRE was detected in 76% of cases vs. 8% of controls. Combination antimicrobial treatment was most frequent in cases vs. control (100 vs. 56.5%). No difference was observed in median length of hospital stay (22 days; IQR, 19-31 in cases vs. 17.5 days; IQR, 10-31 in controls; p = 0.8). Overall case fatality ratio was 13 vs. 5.5%, respectively. The most statistically significant risk factors included previous PICU stay (OR, 4; 95%CI, 2-8), invasive procedures/surgery (OR, 3; 95%CI, 1-7), central venous catheter placement (OR, 6.5; 95%CI, 2-19), urinary catheter placement (OR, 9; 95%CI 4-20), mechanical ventilation (OR, 4; 95%CI, 2-10), liver transplantation (OR, 8; 95%CI, 2-26), meropenem treatment (OR, 8.4; 3.5-22.6) in univariate analysis. The logistic regression model used for multivariate analysis yielded significant differences for previous meropenem treatment (OR, 13; 95%CI, 3-77; p = 0.001), liver transplantation (OR, 13; 95%CI, 2.5-100; p = 0.006), and urinary catheter placement (OR, 9; 95%CI, 1.4-94; p = 0.03). Conclusion: CRE-BSI affects hospitalized children with underlying disease, mainly after liver transplantation, with previous urinary catheter use and receiving broad-spectrum antibiotics, leading to high PICU requirement and mortality. These risk factors will have to be taken into account in our region in order to establish adequate health policies and programs to improve antimicrobial stewardship.

Influenza A (pH1N1) infection in children admitted to a pediatric intensive care unit: differences with other respiratory viruses.

OBJECTIVES: To describe the clinical features of patients admitted to the pediatric intensive care unit (PICU) with acute lower respiratory tract infection (LRTI) attributable to influenza A pH1N1 virus and compare them with those admitted with LRTI due to other viral pathogens. DESIGN: Retrospective, observational, comparative study. SETTING: PICU in a university-affiliated, tertiary-care, pediatric hospital. PATIENTS: Patients aged >1 month with acute viral LRTI admitted to the PICU who met the following criteria: 1) influenza A pH1N1 virus infection detected between June 1, 2009 and July 16, 2009; and 2) patients with LRTI due to other viral pathogens infection detected in the same period of the year 2008 plus patients with 2009 influenza A non-pH1N1 infection. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated age, weight, gender, length of hospital stay before PICU admission, length of PICU stay, underlying disease, clinical diagnosis, severity, complications, treatment, risk of death, mortality, and cause of death. We identified 30 patients with acute LRTI due to influenza A pH1N1 virus (group 1) and 62 patients with LRTI due to other viral pathogens (group 2). Relevant characteristics in group 1: 59% of patients were aged >2 yrs. Median length of PICU stay was 15 days. An underlying condition was present in 83% of the patients. None of them had bronchiolitis on PICU admission; 12 (40%) had bilateral pneumonia; 15 (50%) had acute respiratory distress syndrome; and nine (30%) had shock. Twenty-nine patients required mechanical ventilation (96.6%); only one required extracorporeal membrane oxygenation; and 19 (63%) had respiratory complications. Six (20%) children died. When both groups were compared, patients with influenza A pH1N1 infection were older; pneumonia, acute respiratory distress syndrome, and shock were more frequently seen at the time of PICU admission, although length of stay and mortality were similar. CONCLUSIONS: Patients with influenza A pH1N1 respiratory virus infection presented with more severe illness. Outcomes were similar in both groups.

Improvement in communication during patient handoff between areas from a children's hospital. / Mejora en la comunicación durante la transferencia de pacientes entre sectores en un hospital pediátrico.

INTRODUCTION: Patient handoff is an interactive process including data communication and responsible transfer in order to safely maintain the continuity of care. Failure in this process may result in inadequate care and favor the occurrence of errors. OBJECTIVE: To implement a standardized instrument for patient handoff from the intensive care unit (ICU) to the intermediate-medium care unit (IMCU), and compare communication between health care providers before and after the intervention. POPULATION AND METHODS: Before-and-after study conducted at Hospital de Pediatría "Prof. Dr. Juan P. Garrahan." The intervention consisted in a written handoff form. The pre-intervention sample included patients transferred from ICUs to IMCUs between October 1st and October 31st, 2015. The post-intervention sample included patients transferred between March 1st and March 31st, 2016. A total of 4 IMCUs and 3 ICUs participated in the study. The main study variable was the written part of the handoff; in particular, whether it was timely and complete. RESULTS: A total of 50 handoffs were analyzed for each stage. With the written handoff, there was an increase in the communication of clinical data in 88 % of variables (oral communication between physicians, treating physician, therapeutic adequacy, diagnosis, course, etc.); the difference was statistically significant. CONCLUSION: After implementing the tool, there was an improvement in the transfer of patient clinical data relevant to the safe continuity of care.

Introducción. La transferencia de pacientes es un proceso interactivo de comunicación de datos y traspaso de responsabilidades para mantener la continuidad de la atención en forma segura. Las fallas en este proceso pueden derivar en cuidados inadecuados y favorecer la comisión de errores. Objetivo. Implementar una herramienta estandarizada para la transferencia de pacientes desde la unidad de cuidados intensivos (UCI) hacia la de cuidados intermedios y moderados (CIM) y comparar la comunicación entre los profesionales antes y después de la intervención. Población y métodos. Estudio del tipo antes y después, realizado en el Hospital de Pediatría "Prof. Dr. Juan P. Garrahan". Como intervención, se utilizó un formulario de transferencia escrito. La muestra estudiada antes de la intervención estaba formada por los pacientes transferidos de las UCI a las CIM entre el 1 y el 31-10-2015. La muestra estudiada luego de la intervención fueron los pacientes transferidos entre el 1 y el 31-3-2016. Participaron cuatro CIM y tres UCI. La variable principal de estudio fue la parte escrita de la transferencia; en particular, si fue oportuna y completa. Resultados. Se analizaron 50 traspasos en cada etapa. En la transferencia escrita hubo un aumento en la comunicación de datos clínicos en el 88 % de las variables (comunicación oral médico a médico, médico responsable, adecuación terapéutica, diagnóstico, evolución, entre otras); la diferencia fue estadísticamente significativa. Conclusión. Con la implementación de la herramienta mejoró la transferencia de datos clínicos del paciente relevantes para la continuidad de la atención en forma segura.

Efficacy of indigenous entomopathogenic nematodes (Rhabditida: Heterorhabditidae, Steinernematidae), from Rio Grande do Sul Brazil, against Anastrephafraterculus (Wied.) (Diptera: Tephritidae) in peach orchards.

Laboratory, greenhouse, and field experiments were performed with the objective of selecting efficient indigenous strains of entomopathogenic nematodes (EPNs) from Rio Grande do Sul (RS) state, Brazil, for controlling the South American fruit fly, Anastrepha fraterculus (Wied.). Laboratory experiments were conducted in 24 well-plates filled with sterile sand and one insect per well. In greenhouse experiments, plastic trays filled with soil collected from the field were used, while in field experiments, holes were made in soil under the edge of peach tree canopies. Among 19 EPN strains tested, Heterorhabditis bacteriophora Poinar RS88 and Steinernema riobrave Cabanillas, Poinar, & Raulston RS59 resulted in higher A. fraterculus larval (pre-pupal) and pupal mortality, with LD(90) of 1630, 457 and 2851, 423 infective juveniles (IJs)/cm(2), respectively. Greenhouse experiments showed no differences in pupal mortality at 250 and 500IJs/cm(2) of either nematode. In the field, H. bacteriophora RS88 and S. riobravae RS59 sprayed individually over natural and artificially infested fruit (250IJs/cm(2)) resulted in A. fraterculus larval mortality of 51.3%, 28.1% and 20%, 24.3%, respectively. There was no significant difference in A. fraterculus pupal mortality sprayed with an aqueous suspension of either nematode; however, when using infected insect cadavers, H. bacteriophora RS88 was more efficient than S. riobrave RS59. Our results showed that H. bacteriophora RS88 was more virulent to insect larvae, with an efficient host search inside the infested fruit and control of pupae in the soil after being applied by aqueous suspension or infected cadavers.

Dipole-wind interactions under gap wind jet conditions in the Gulf of Tehuantepec, Mexico: A surface drifter and satellite database analysis.

Gap wind jets (Tehuano winds) trigger supersquirts of colder water and mesoscale asymmetric dipoles in the Gulf of Tehuantepec (GT). However, the effects of successive gap wind jets on dipoles and their effects inside eddies have not yet been studied. Based on the wind fields, geostrophic currents, and surface drifter dispersion, this research documented three dipoles triggered and modified by Tehuano winds. Once a dipole develops, successive gap wind jets strengthen the vortices, and the anticyclonic eddy migrates southwestward while the cyclonic eddy is maintained on the east side of the GT. During the wind relaxation stage, the cyclonic eddy may propagate westward, but due to the subsequent re-intensification of the Tehuano winds, the vortex could break down, as was suggested by surface drifter dispersion pattern and geostrophic field data. The effect of the Tehuano winds was evaluating via eddy-Ekman pumping. Under Tehuano wind conditions, Ekman downwelling (upwelling) inside the anticyclonic (cyclonic) eddies may reach ~ -2.0 (0.5) m d-1 and decrease as the wind weakens. In the absence of Tehuano winds, Ekman downwelling inside the anticyclonic eddy was ~ 0.1 (-0.1) m d-1. The asymmetry of downwelling and upwelling inside eddies during Tehuano wind events may be associated with Tehuano wind forcing.

A propósito de un caso: uso de la silimarina/silibinina como análogo molecular del remdesivir para el tratamiento de pacientes diagnosticados de COVID-19 con síndrome de dificultad respiratoria aguda leve o moderado. Reporte de caso / Purpose of a case: use of silymarin / silibinin as a molecular analogue of remdesivir for the treatment of patients diagnosed of COVID-19 with acute mild or moderate respiratory difficulty syndrome. Case report.

The respiratory disease caused by SARS-CoV2 is an infectious-contagious viral disease that affects our population, especially older adults and young adults throughout the world. One of the main causes of this pathology is the limited immunization capacity at a global level, especially in developing countries, to combat outbreaks of this disease. It develops in phases of very characteristic respiratory symptoms which can guide an early diagnosis, otherwise it may require hospitalization for treatment; At a global and local level, different therapies have been tried without complete success. Presumptive diagnosis is clinical and confirmatory through nasopharyngeal swabs, which isolate beta virus, SARS-CoV-2 coronavirus, a name issued by the World Health Organization, who declared the pandemic for this disease in particular. A case of a patient with the disease caused by the virus in question is presented who comes to our health home, for not accessing a more complex hospital unit, due to hospital saturation, with a mild to moderate respiratory syndrome, in view of the impossibility of accessing other treatments, we started the administration of silymarin/silibinin in daily doses twice a day. In order for the treatment tested with different molecules to have a common denominator, which is based on attacking the cascade of inflammatory cytokines derived from the activation of the STAT3 receptor and the modulation of type 1 IFG; with corticotherapy mainly dexamethasone, or methylprednisolone, and molecules such as Remdesivir, Sofosbuvir and Ribavirin, which continue to be the focus of discussion, so optional treatments are being evaluated to combat the effects of this disease. The incidence of this disease is global, being higher in underdeveloped countries which do not have an appropriate immunization program.

[Prognostic factors predicting failure of the trial without catheter after tamsulosin in patients with acute urinary retention.] / Factores pronósticos predictores de fracaso en la prueba miccional con Tamsulosina en pacientes con retención aguda de orina.

OBJECTIVE: To analyze prognostic variables that impact on the trial without catheter after tamsulosin in patients with acute urine retention. METHODS: Retrospective analysis of a prospective database of a cohort of successive patients with acute urinary retention due to benign prostatic hyperplasia attended at the urology emergency room during one year time period. We analyzed the clinical and radiological characteristics and the international prostatic symptom score questionnaire of a total 65 male patients. RESULTS: The trial without catheter after tamsulosin showed positive results in 25 patients (38%) and failed in the remaining 40 (62%). In multivariate analysis, none of the analyzed variables resulted in an independent predictive factor for spontaneous micturition after the trial without catheter. However, the severe IPSS (p=0.085) presented an important statistical tendency for predicting failure of spontaneous micturition, as well as we found that the 84% of diabetic patients presented failure to the trial with catheter. CONCLUSIONS: The only variable that impact negatively on the trial without catheter was the severe IPSS with an approximation to statistical significance. The presence of diabetes as a related factor is a hypothesis that should be investigated with a higher number of cases.