Effect of Mexico's vaccination program on Covid-19 cases, hospitalizations, and deaths among older adults in Mexico City.

OBJECTIVE: To characterize the impact of Mexico's Co-vid-19 vaccination campaign of older adults. MATERIALS AND METHODS: We estimated the absolute change in sympto-matic cases, hospitalizations and deaths for vaccine-eligible adults (aged >60 years) and the relative change compared to vaccine-ineligible groups since the campaign started. Re-sults. By May 3, 2021, the odds of Covid-19 cases among adults over 60 compared to 50-59 year olds decreased by 60.3% (95%CI: 53.1, 66.9), and 2 003 cases (95%CI: 1 156, 3 130) were avoided. Hospitalizations and deaths showed similar trends. CONCLUSIONS: Covid-19 events decreased after vaccine rollout among those eligible for vaccination.

Chemical, Radiometric and Mechanical Characterization of Commercial Polymeric Films for Greenhouse Applications.

In the agricultural sector, companies involved in the production of plastic greenhouses are currently searching for a suitable covering adapted for every climate in the world. For this purpose, this research work has determined the chemical, radiometric and mechanical properties of 53 polymeric films samples from Europe and South America. The chemical tests carried out with these samples were elemental analysis (C, H and N) and FT-IR spectrometry. The radiometric properties here studied were the transmission, absorption and reflection coefficients along the spectrum between 300 and 1100 nm. For the mechanical properties, tensile strength, tear strength and dart impact strength, tests were carried out. Finally, all these data were collected, and a multivariate statistical analysis was carried out using the SPSS statistical to group the samples into statistical groups adapted to specific climatic regions. The elemental analysis and FT-IR spectrometry allowed group the samples into nine groups. The samples were grouped according to their chemical (elemental analysis), radiometric and mechanical properties by multivariate analysis. The dendrogram separated five very different groups in terms of number of samples. These groups have specific chemical, radiometric and mechanical characteristics that separate them from the rest. These groups make it possible to narrow down the applications and correlate with the radiometric properties to see in which geographical area of the world they are most effective in increasing yields and achieving higher quality production.

The Importance of Being Correlated: Implications of Dependence in Joint Spectral Inference across Multiple Networks.

Spectral inference on multiple networks is a rapidly-developing subfield of graph statistics. Recent work has demonstrated that joint, or simultaneous, spectral embedding of multiple independent networks can deliver more accurate estimation than individual spectral decompositions of those same networks. Such inference procedures typically rely heavily on independence assumptions across the multiple network realizations, and even in this case, little attention has been paid to the induced network correlation that can be a consequence of such joint embeddings. In this paper, we present a generalized omnibus embedding methodology and we provide a detailed analysis of this embedding across both independent and correlated networks, the latter of which significantly extends the reach of such procedures, and we describe how this omnibus embedding can itself induce correlation. This leads us to distinguish between inherent correlation-that is, the correlation that arises naturally in multisample network data-and induced correlation, which is an artifice of the joint embedding methodology. We show that the generalized omnibus embedding procedure is flexible and robust, and we prove both consistency and a central limit theorem for the embedded points. We examine how induced and inherent correlation can impact inference for network time series data, and we provide network analogues of classical questions such as the effective sample size for more generally correlated data. Further, we show how an appropriately calibrated generalized omnibus embedding can detect changes in real biological networks that previous embedding procedures could not discern, confirming that the effect of inherent and induced correlation can be subtle and transformative. By allowing for and deconstructing both forms of correlation, our methodology widens the scope of spectral techniques for network inference, with import in theory and practice.

Inference for Multiple Heterogeneous Networks with a Common Invariant Subspace.

The development of models and methodology for the analysis of data from multiple heterogeneous networks is of importance both in statistical network theory and across a wide spectrum of application domains. Although single-graph analysis is well-studied, multiple graph inference is largely unexplored, in part because of the challenges inherent in appropriately modeling graph differences and yet retaining sufficient model simplicity to render estimation feasible. This paper addresses exactly this gap, by introducing a new model, the common subspace independent-edge multiple random graph model, which describes a heterogeneous collection of networks with a shared latent structure on the vertices but potentially different connectivity patterns for each graph. The model encompasses many popular network representations, including the stochastic blockmodel. The model is both flexible enough to meaningfully account for important graph differences, and tractable enough to allow for accurate inference in multiple networks. In particular, a joint spectral embedding of adjacency matrices-the multiple adjacency spectral embedding-leads to simultaneous consistent estimation of underlying parameters for each graph. Under mild additional assumptions, the estimates satisfy asymptotic normality and yield improvements for graph eigenvalue estimation. In both simulated and real data, the model and the embedding can be deployed for a number of subsequent network inference tasks, including dimensionality reduction, classification, hypothesis testing, and community detection. Specifically, when the embedding is applied to a data set of connectomes constructed through diffusion magnetic resonance imaging, the result is an accurate classification of brain scans by human subject and a meaningful determination of heterogeneity across scans of different individuals.

Joint Embedding of Graphs.

Feature extraction and dimension reduction for networks is critical in a wide variety of domains. Efficiently and accurately learning features for multiple graphs has important applications in statistical inference on graphs. We propose a method to jointly embed multiple undirected graphs. Given a set of graphs, the joint embedding method identifies a linear subspace spanned by rank one symmetric matrices and projects adjacency matrices of graphs into this subspace. The projection coefficients can be treated as features of the graphs, while the embedding components can represent vertex features. We also propose a random graph model for multiple graphs that generalizes other classical models for graphs. We show through theory and numerical experiments that under the model, the joint embedding method produces estimates of parameters with small errors. Via simulation experiments, we demonstrate that the joint embedding method produces features which lead to state of the art performance in classifying graphs. Applying the joint embedding method to human brain graphs, we find it extracts interpretable features with good prediction accuracy in different tasks.

Graph Matching between Bipartite and Unipartite Networks: to Collapse, or not to Collapse, that is the Question.

Graph matching consists of aligning the vertices of two unlabeled graphs in order to maximize the shared structure across networks; when the graphs are unipartite, this is commonly formulated as minimizing their edge disagreements. In this paper we address the common setting in which one of the graphs to match is a bipartite network and one is unipartite. Commonly, the bipartite networks are collapsed or projected into a unipartite graph, and graph matching proceeds as in the classical setting. This potentially leads to noisy edge estimates and loss of information. We formulate the graph matching problem between a bipartite and a unipartite graph using an undirected graphical model, and introduce methods to find the alignment with this model without collapsing. We theoretically demonstrate that our methodology is consistent, and provide non-asymptotic conditions that ensure exact recovery of the matching solution. In simulations and real data examples, we show how our methods can result in a more accurate matching than the naive approach of transforming the bipartite networks into unipartite, and we demonstrate the performance gains achieved by our method in simulated and real data networks, including a co-authorship-citation network pair, and brain structural and functional data.

Joint embedding: A scalable alignment to compare individuals in a connectivity space.

A common coordinate space enabling comparison across individuals is vital to understanding human brain organization and individual differences. By leveraging dimensionality reduction algorithms, high-dimensional fMRI data can be represented in a low-dimensional space to characterize individual features. Such a representative space encodes the functional architecture of individuals and enables the observation of functional changes across time. However, determining comparable functional features across individuals in resting-state fMRI in a way that simultaneously preserves individual-specific connectivity structure can be challenging. In this work we propose scalable joint embedding to simultaneously embed multiple individual brain connectomes within a common space that allows individual representations across datasets to be aligned. Using Human Connectome Project data, we evaluated the joint embedding approach by comparing it to the previously established orthonormal alignment model. Alignment using joint embedding substantially increased the similarity of functional representations across individuals while simultaneously capturing their distinct profiles, allowing individuals to be more discriminable from each other. Additionally, we demonstrated that the common space established using resting-state fMRI provides a better overlap of task-activation across participants. Finally, in a more challenging scenario - alignment across a lifespan cohort aged from 6 to 85 - joint embedding provided a better prediction of age (r2 = 0.65) than the prior alignment model. It facilitated the characterization of functional trajectories across lifespan. Overall, these analyses establish that joint embedding can simultaneously capture individual neural representations in a common connectivity space aligning functional data across participants and populations and preserve individual specificity.

Microbiome alterations are related to an imbalance of immune response and bacterial translocation in BDL-rats.

OBJECTIVES: Bacterial translocation in patients with cirrhosis is an important triggering factor for infections and mortality. In the bile duct ligation (BDL) model, crucial players of bacterial translocation are still unknown. This study aims to determine the interrelation between microbiome composition in the colon, mesenteric lymph nodes, and liver, as well as the local inflammatory microenvironment in the BDL model. MATERIALS AND METHODS: Liver damage was assayed by Masson trichrome staining, and hepatic enzymes. The diversity of microbiota in colon stools, mesenteric lymph nodes, and liver was determined by 16S rRNA pyrosequencing. Cytokine expression in mesenteric lymph nodes was analyzed by qRT-PCR. RESULTS: Our results show that Proteobacteria was the predominant phylum found to translocate to mesenteric lymph nodes and liver in cirrhotic rats. Bile duct ligation induces a drastic intestinal dysbiosis, revealed by an increased relative abundance of Sarcina, Clostridium, Helicobacter, Turicibacter, and Streptococcus genera. However, beneficial bacteria, such as Lactobacillus, Prevotella and Ruminococcus were found to be notably decreased in BDL groups. Mesenteric pro-inflammatory (TNF-α, IL-1ß, IL-6, TLR-4) and regulatory (TGF-ß, Foxp3, and IL-10) molecules at 30 days post-BDL were significantly increased. Conversely, TGF-ß and Foxp3 were significantly augmented at 8 days post-BDL. CONCLUSION: Dysbiosis in the colon and mesenteric lymph nodes is linked to an imbalance in the immune response; therefore, this may be an important trigger for bacterial translocation in the BDL model.

Rizobacterias promotoras del crecimiento vegetal: una alternativa de biofertilización para la agricultura sustentable / Plant growth promoting rhizobacteria: a biofertilization alternative for sustainable agriculture

RESUMEN La agricultura moderna enfrenta nuevos desafíos, integrando enfoques ecológicos y moleculares, para lograr mayores rendimientos de los cultivos y reducir al mínimo los impactos sobre el ambiente. Para generar mayores rendimientos se han incrementado significativamente las dosis de fertilizantes sintéticos por unidad de superficie, los cuales pueden provocar contaminación, daños a la salud y pérdida de la fertilidad de los suelos, convirtiéndose en una de las preocupaciones más importantes en la producción agrícola. Para mejorar la producción sin el uso de fertilizantes de origen sintético, las investigaciones se han orientado hacia el desarrollo de nuevas biotecnologías: provocando que exista un interés creciente en los microorganismos benéficos del suelo ya que éstos pueden promover el crecimiento de las plantas y, en algunos casos, evitar infecciones del tejido vegetal por patógenos. Las interacciones de las rizobacterias promotoras del crecimiento vegetal (RPCV) con el medio biótico - plantas y microorganismos - son muy complejas y utilizan diferentes mecanismos de acción para promover el crecimiento de las plantas. Estos mecanismos se agrupan en: 1) Biofertilización; 2) Fito-estimulación; y 3) Biocontrol. Inocular los cultivos con RPCV reduce sustancialmente el uso de fertilizantes sintéticos y los impactos negativos al suelo, aumenta el rendimiento de los cultivos, contribuyendo a la economía del productor y a la alimentación de la población. Esta revisión describe aspectos básicos inherentes a la interacción entre las RPCV y las especies vegetales, centrándose en los beneficios que aportan las RPCV a la actividad agrícola.

ABSTRACT Modern agriculture faces new challenges, integrating ecological and molecular approaches, to achieve higher crop yields and to minimize negative impacts on the environment. To generate higher yields, the doses of synthetic fertilizers per unit area have been significantly increased, which can cause contamination, damage to the health and loss of soil fertility, making this one of the most important concerns in agricultural production. To improve production without the use of fertilizers of chemical origin, research has been oriented towards the development of new biotechnologies: causing a growing interest in beneficial microorganisms in the soil, as these can promote plant growth and, in some cases, avoid infections of plant tissue by pathogens. The interactions of plant growth promoting rhyzobacteria (PGPR) with the biotic medium - plants and microorganisms - are very complex and use different mechanisms of action to promote plant growth. These mechanisms are grouped into: 1) Biofertilization; 2) Phytostimulation and 3) Biocontrol. Inoculating the crops with PGPR could substantially reduce the use of synthetic fertilizers and the negative impacts to the soil, increase crop yields, contributing to the producer's economy and the population's nutrition. This review describes basic aspects inherent to the interaction between PGPR and plant species, focusing on the benefits of PGPR to the agricultural activity.

Pentoxifylline Added to Steroid Window Treatment Phase Modified Apoptotic Gene Expression in Pediatric Patients With Acute Lymphoblastic Leukemia.

Pentoxifylline is a xanthine that possesses antitumor properties and that can induce higher apoptosis in the leukemic cells of pediatric patients with acute lymphoblastic leukemia (ALL) during treatment with prednisone. We conducted a phase 1 pilot, controlled, randomized trial to evaluate the gene expression modified by pentoxifylline during the steroid window of induction to remission phase in patients newly diagnosed with ALL. Experimental and control treatments induced broad changes in the gene expression profile. Patients who received just prednisone upregulated 377 and downregulated 344 genes, in contrast with patients treated with the experimental treatment (combination of prednisone and pentoxifylline), who demonstrated upregulation of 1319 and downregulation of 1594 genes. The most important genes modified in this pathway are those with proapoptotic activity, the majority of these overexpressed. Thus, the addition of pentoxifylline to the treatment with prednisone during steroid window in patients with ALL modified the gene expression profile and changed different signal pathways of the leukemic cell. The combination of both drugs represents a therapeutic alternative for potentiating antileukemic therapy.

Glaucoma Medication Preferences among Glaucoma Specialists in Mexico.

AIM: To determine the glaucoma specialists' preferences for the different brands of topical glaucoma medications available in Mexico. MATERIALS AND METHODS: A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. RESULTS: Data from 111 (74%) glaucoma specialists were collected. Imot (timolol 0.5%; Sophia, Mexico) was the preferred brand for the beta-blockers (BB) class by 71% (n = 79) of the participants. Azopt (brinzolamide 1%; Alcon Lab, US) was the preferred carbonic anhydrase inhibitor (CAI) by 54% (n = 60) of the glaucoma specialists. Lumigan (bimatoprost 0.01% and 0.03%; Allergan Inc., U.S.) was the first choice for the prostaglandin analogues (PGAs) in 62% (n = 70) of the answers. The most frequently prescribed alpha-agonist (AA) was Agglad (brimonidine 0.2%; Sophia Lab, Mexico) in 44% (n = 49) of the answers. Medication accessibility (31%), cost (29%), and recommended dose (23%) were the three main factors influencing the glaucoma specialists' preferences. CONCLUSION: Medication cost and accessibility, as well as posology, remain the main factors influencing brand preferences among glaucoma doctors. In our professional opinion, the therapeutic effect must be the leading factor when prescribing topical medications in the daily practice, so that patients receive the best treatment option. CLINICAL SIGNIFICANCE: This survey provides an understanding of the decision-making process when prescribing glaucoma medications by glaucoma specialists in a Latin American developing country. Ideally, patient treatment should be individualized and aimed to achieve the best results possible for their specific condition.How to cite this article: Lazcano-Gomez G, Alvarez-Ascencio D, Haro-Zuno C, Turati-Acosta M, Garcia-Huerta M, Jimenez-Arroyo J, Castañeda-Diez R, Castillejos-Chevez A, Gonzalez-Salinas R, Dominguez-Dueñas F, Jimenez-Roman J. Glaucoma Medication Preferences among Glaucoma Specialists in Mexico. J Curr Glaucoma Pract 2017;11(3):97-100.

Interspinous spacer in persistent discogenic pain: percutaneous approach or open technique / Espaçador interespinhoso em dor discogênica persistente: acesso percutâneo ou técnica a céu aberto / Espaciador interespinoso en dolor discogénico persistente: vía percutánea o técnica abierta

ABSTRACT Objective: To compare the postoperative clinical course of placement of interspinous spacer with open technique (ISO) with percutaneous interspinous spacer (PIS). Methods: Quasi-experimental, longitudinal study of 42 patients with discogenic pain uncontrolled with analgesics, aged 35-55 years old, 21 women, and 21 men. Clinical history, location of pain, VAS scale before and after surgery, Oswestry Disability Index and Macnab modified scale at 6 months were used. Results: When performing quantitative analysis statistical significance (p = 0.0478, 0.0466, 0.0399) was demonstrated with Student's t test between the results according to VAS scale; in the qualitative analysis with the Oswestry index and Macnab modified scale it was demonstrated the hypothesis that the results is dependent of the surgical technique. Conclusions: According to the results, we can conclude that there is a statistically significant difference depending on the surgical technique used with respect to the rate of disability and functionality in daily life as well as in the improvement of pain symptoms.

RESUMO Objetivo: Comparar a evolução clínica pós-operatória da colocação de espaçador interespinhoso com técnica a céu aberto (EIA) com a colocação percutânea do espaçador interespinhoso percutâneo (EIP). Métodos. Estudo quase experimental, longitudinal de 42 pacientes com dor discogênica não controlada com analgésicos, na faixa etária de 35 a 55 anos de idade, 21 mulheres e 21 homens. Empregou-se história clínica, localização da dor, escala EVA antes e após a cirurgia, índice de incapacidade de Oswestry e escala modificada de Macnab aos 6 meses. Resultados. Ao se realizar a análise quantitativa, verificou-se significância estatística (p = 0,0478, 0,0466, 0,0399) com o teste t de Student entre os resultados, de acordo com a escala EVA; na análise qualitativa, com a escala de Oswestry e de Macnab modificada foi demonstrada a hipótese de que o resultado é dependente da técnica cirúrgica. Conclusões: De acordo com os resultados obtidos, podemos concluir que há uma diferença estatisticamente significante, dependendo da técnica utilizada com relação à taxa de incapacidade e funcionalidade na vida diária, assim como na melhora dos sintomas dolorosos.

RESUMEN Objetivo: Comparar la evolución clínica posquirúrgica de la colocación de espaciador interespinoso abierto (EIA) contra la colocación de espaciador interespinoso percutáneo (EIP). Método: Estudio cuasi-experimental, longitudinal de 42 pacientes con dolor discogénico no controlado con analgésicos, con un rango de edad de 35 a 55 años, 21 mujeres y 21 hombres. Se utilizó historia clínica, localización del dolor, escala EVA pre y posquirúrgica, test de discapacidad de Oswestry y la escala modificada de Macnab a los 6 meses. Resultados: Al realizar el análisis cuantitativo se demostró una significación estadística (p = 0,0478, 0,0466, 0,0399) con la prueba t de Student entre los resultados de acuerdo a la escala de EVA; en el análisis cuantitativo con la escala modificada de Macnab y Oswestry se demostró la hipótesis en la que el resultado es dependiente de la técnica quirúrgica empleada. Conclusiones: De acuerdo a los resultados obtenidos podemos concluir que hay diferencia estadística dependiendo de la técnica quirúrgica utilizada con respecto al índice de discapacidad y funcionalidad en la vida diaria, así como en la mejoría de la sintomatología álgica.

El valor percibido y la satisfacción del cliente en actividades dirigidas virtuales y con técnico en centros de fitness / Perceived value and customer satisfaction in virtual fitness and trainer-guided group activities in fitness centres / O valor percebido e a satisfação do cliente em acitivade virtuais dirigidas e com técnico em centros de fitness

En la actualidad la industria del fitness se encuentra en la senda del crecimiento. Uno de los servicios que mayor presencia está teniendo en los centros de fitness son las actividades dirigidas con técnico, las cuales han evolucionado hacia actividades dirigidas virtuales debido a la inclusión de la tecnología. Esta investigación analiza el valor percibido y la satisfacción de los clientes en ambas actividades, explorando las diferencias existentes entre dichos servicios y la relación entre ambas variables. La muestra se compuso de 572 usuarios de un centro de fitness (319 mujeres y 253 hombres) con edades comprendidas entre los 15 y 63 años. Los resultados muestran diferencias significativas entre el valor percibido y la satisfacción entre los dos servicios deportivos, obteniendo valores más positivos en las que requieren un técnico deportivo. Asimismo, la satisfacción del cliente mostró ser dependiente del valor percibido, obteniendo un mayor vínculo en el caso de las actividades dirigidas virtuales. Estos resultados suscitan a la reflexión por parte de los gestores de las instalaciones deportivas sobre la incorporación o no de este tipo de servicios deportivos

At present, the fitness industry is on a growth path. One of the most prominent services in fitness centres is trainer-guided group fitness activities, which have evolved into virtual fitness activities with the inclusion of technology. This research analyses perceived value and customer satisfaction in both activities, exploring the differences between them and the relationship between the two variables. The sample consisted of 572 subjects belonging to a private fitness centre (319 women and 253 men), between 15 and 63 years old. The results show significant differences between perceived value and satisfaction in the two sports services, with sports requiring a trainer getting more positive values. Furthermore, customer satisfaction shows a dependence on perceived value, with a stronger link being obtained in the case of virtual fitness activities. These results and an in-depth analysis on the inclusion, or not, of these sport services are thought-provoking for managers of these facilities

Na actualidade a indústria do fitness encontra-se na senda do crescimento. Um dos serviços que maior presença está a ter nos centros defitness são as actividades dirigidas com um técnico, as quais têm evoluído para actividades virtuais dirigidas devido à inclusão da tecnologia. Estainvestigação analisa o valor percebido e a satisfação dos clientes em ambas as actividades, explorando as diferenças existentes entre estes serviços e arelação entre ambas as variáveis. A amostra foi composta por 572 utentes de um centro de fitness (319 mulheres e 253 homens) com idades compreendidasentre os 15 e os 63 anos. Os resultados revelam diferenças significativas entre o valor percebido e a satisfação entre os dois serviços desportivos, obtendovalores mais positivos as que requerem um técnico desportivo. Assim mesmo, a satisfação do cliente mostrou ser dependente do valor percebido, obtendoum maior vínculo no caso das actividades virtuais dirigidas. Estes resultados suscitam a reflexão por parte dos gestores das instalações desportivas sobrea incorporação ou não deste tipo de serviços desportivos

Relationship between motor variability, accuracy, and ball speed in the tennis serve.

The main objective of this study was to analyze the motor variability in the performance of the tennis serve and its relationship to performance outcome. Seventeen male tennis players took part in the research, and they performed 20 serves. Linear and non-linear variability during the hand movement was measured by 3D Motion Tracking. Ball speed was recorded with a sports radar gun and the ball bounces were video recorded to calculate accuracy. The results showed a relationship between the amount of variability and its non-linear structure found in performance of movement and the outcome of the serve. The study also found that movement predictability correlates with performance. An increase in the amount of movement variability could affect the tennis serve performance in a negative way by reducing speed and accuracy of the ball.

Iron-deficiency anemia as presentation of pouchitis.

GOALS: This study sought to describe the percentage and cause of anemia in patients who underwent ileal pouch with anal anastomosis (IPAA) for ulcerative colitis (UC), and to compare the distribution of complications in patients with and without anemia, especially pouchitis, after IPAA. BACKGROUND: IPAA is the surgical procedure of choice for UC. Complications include pouchitis (40%), strictures (30%), small bowel obstruction (10%), pelvic sepsis (<5%), and urinary and sexual dysfunctions (<5%). Few studies have described the prevalence of anemia after IPAA, but no conclusive findings have been reported. STUDY: Patients who had undergone IPAA for UC were recruited from the UPR Inflammatory Bowel Disease Clinic and the Gastroenterology Research Unit. Demographic and medical data were obtained. Anemia was diagnosed using standard hematologic criteria. Serum iron, ferritin, transferrin, folate, vitamin B12, erythropoietin, total iron-binding capacity, reticulocyte count, peripheral smear, and bone marrow aspirate were evaluated in patients with anemia. Data analysis was performed with EPI Info version 6.4d. RESULTS: Iron-deficiency anemia was identified in 55.5% (10/18) of patients and pouchitis was found in 77% (14/18). All 10 patients with anemia had pouchitis, whereas only 4 of the 8 without anemia had pouchitis. In half of the anemic patients, pouchitis was asymptomatic. CONCLUSIONS: Iron-deficiency anemia may be a clinical presenting sign of pouchitis. Hemoglobin levels may be considered as surveillance tools for pouchitis in patients with IPAA.

[Treatment of hyaline membrane disease in the preterm newborn with exogenous lung surfactant: a controlled study]. / Estudio controlado del tratamiento de la enfermedad de membrana hialina del recién nacido pretérmino con surfactante pulmonar exógeno (porcino vs. bovino).

BACKGROUND: Hyaline membrane disease (HMD) due to lung surfactant deficiency in the preterm newborn is an important cause of neonatal morbidity and mortality. Exogenous lung surfactant has transformed HMD therapy in developed countries, but an equivalent benefit has not been accomplished in developing countries due to a variety of factors. Porcine surfactant developed in Cuba is an inexpensive alternative to other surfactants, and its use has not been studied in our settings. METHODS: A randomized, open, prospective and controlled trial was undertaken in 44 preterm newborns with HMD diagnosis. One group received bovine surfactant (BS) (Survanta) and the other Cuban porcine surfactant (PS) (Surfacen). The following clinical response variables were evaluated: oxygenation and ventilation indexes, days with supplementary oxygen, days with mechanical ventilation, incidence of complications, time of hospitalization, and mortality. RESULTS: 23 Patients received bovine surfactant and 21 the porcine type. The two groups were clinically similar, with patterns of oxygenation and ventilation response that were the same between groups, with a tendency to higher initial oxygenation increase in the PS group. The incidence of complications was similar between groups. 10 Patients (47.6%) died in the PS group, versus 12 (52.2%) in the BS group (p > 0.05). CONCLUSIONS: Porcine surfactant had similar clinical effects than bovine surfactant in the oxygenation and ventilation variables, with no significant differences in complications ormortality. Porcine surfactant is an effective and lower cost altenative to bovine surfactant in the treatment of HMD.

Estudio controlado del tratamiento de la enfermedad de membrana hialina del recién nacido pretérmino con surfactante pulmonar exógeno (porcino vs. bovino) / Treatment of hyaline membrane disease in the preterm newborn with exogenous lung surfanctant. A controlled study

Introducción: La enfermedad de membrana hialina (EMH) por deficiencia de surfactante pulmonar en el neonato prematuro es una causa importante de morbimortalidad. El surfactante pulmonar exógeno ha revolucionado el tratamiento de esta entidad en países desarrollados, aunque este beneficio ha sido menor en países en vías de desarrollo. El surfactante porcino de manufactura cubana es económico, y su uso comparado con otros surfactantes es desconocido. Material y métodos: Se llevó a cabo un estudio prospectivo, controlado, aleatorizado, abierto, en 44 recién nacidos prematuros con EMH. Un grupo recibió surfactante bovino (SB) (Survanta), y el otro surfactante porcino (SP) de fabricación cubana (Surfacen). Se evaluó la respuesta en variables de oxigenación y ventilación, días de oxígeno suplementario, ventilación mecánica, incidencia de complicaciones, tiempo de hospitalización y mortalidad. Resultados: 23 pacientes recibieron el surfactante bovino, y 21 el porcino. Los dos grupos fueron similares clínicamente y en sus patrones de respuesta de oxigenación y ventilación, con una tendencia a mayor incremento inicial en la oxigenación en el grupo tratado con SP. La incidencia de complicaciones fue similar en los dos grupos. Fallecieron 10 pacientes (47.6%) en el grupo SP, y 12 (52.2%) en el grupo SB (p>0.05). Conclusiones: El surfactante porcino tuvo efectos clínicos similares al bovino en las variables de oxigenación y ventilación estudiadas; no hubo diferencia significativa en complicaciones y mortalidad. El surfactante porcino es una alternativa efectiva y de menor costo que el surfactante bovino para el tratamiento de la EMH.

Background: Hyaline membrane disease (HMD) due to lung surfactant deficiency in the preterm newborn is an important cause of neonatal morbidity and mortality. Exogenous lung surfactant has transformed HMD therapy in developed countries, but an equivalent benefit has not been accomplished in developing countries due to a variety of factors. Porcine surfactant developed in Cuba is an inexpensive alternative to other surfactants, and its use has not been studied in our settings. Methods: A randomized, open, prospective and controlled trial was undertaken in 44 preterm newborns with HMD diagnosis. One group received bovine surfactant (BS) (Survanta) and the other Cuban porcine surfactant (PS) (Surfacen). The following clinical response variables were evaluated: oxygenation and ventilation indexes, days with supple mentary oxygen, days with mechanical ventilation, incidence of compli cations, time of hospitalization, and mortality. Results: 23 Patients received bovine surfactant and 21 the porcine type. The two groups were clinically similar, with patterns of oxygenation and ventilation response that were the same between groups, with a tendency to higher initial oxygenation increase in the PS group. The incidence of complications was similar between groups. Ten Patients (47.6%) died in the PS group, versus 12 (52.2%) in the BS group (p>0.05) Conclusions: Porcine surfactant had similar clinical effects than bovine surfactant in the oxygenation and ventilation variables, with no significant differences in complications or mortality. Porcine surfactant is an effective and lower cost alternative to bovine surfactant in the treatment of HMD.