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1.
Cureus ; 16(7): e64941, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39035587

ABSTRACT

The advent of digital workflows has revolutionized oral rehabilitation, offering excellent prosthesis and restoration adaptation while reducing work time. This case report aims to describe a full-arch rehabilitation protocol using mucosa-supported prostheses through a digital workflow. The technique begins with scanning the upper jaw and taking an impression of the lower jaw, followed by scanning to create a digital cast. Next, border molding and the final impression of both arches are performed using a closed-mouth technique, during which the patient is guided to perform lateral and protrusive movements. Subsequently, intraoral scanning of the occlusion and both impressions is conducted, leading to the design of the final dentures with the established occlusion. Finally, the dentures are printed in Formlabs resin specifically designed for dentures. The digital workflow facilitates the manufacturing of mucosa-supported full-arch prostheses effectively. This method allows for the adjustment of the vertical dimension of occlusion, ensures excellent adaptation of the prosthesis to the soft tissues, and provides aesthetic satisfaction for the patient. Additionally, it reduces the number of sessions required to install the definitive prosthesis.

2.
Plants (Basel) ; 13(7)2024 Mar 27.
Article in English | MEDLINE | ID: mdl-38611495

ABSTRACT

Hamelia patens (Rubiaceae), known as firebush, is a source of bioactive monoterpenoid oxindole alkaloids (MOAs) derived from monoterpenoid indole alkaloids (MIAs). With the aim of understanding the regulation of the biosynthesis of these specialized metabolites, micropropagated plants were elicited with jasmonic acid (JA) and salicylic acid (SA). The MOA production and MIA biosynthetic-related gene expression were evaluated over time. The production of MOAs was increased compared to the control up to 2-fold (41.3 mg g DW-1) at 72 h in JA-elicited plants and 2.5-fold (42.4 mg g DW-1) at 120 h in plants elicited with SA. The increment concurs with the increase in the expression levels of the genes HpaLAMT, HpaTDC, HpaSTR, HpaNPF2.9, HpaTHAS1, and HpaTHAS2. Interestingly, it was found that HpaSGD was downregulated in both treatments after 24 h but in the SA treatment at 120 h only was upregulated to 8-fold compared to the control. In this work, we present the results of MOA production in H. patens and discuss how JA and SA might be regulating the central biosynthetic steps that involve HpaSGD and HpaTHAS genes.

3.
An. Fac. Med. (Perú) ; 85(1): 57-61, ene.-mar. 2024. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1556801

ABSTRACT

RESUMEN Introducción. El uso inapropiado de antimicrobianos en las unidades de cuidados intensivos (UCI) contribuye a la resistencia bacteriana. Objetivo. El propósito del presente estudio fue medir el uso y tipo de antimicrobianos en los pacientes hospitalizados en la Unidad de Cuidados Intensivos del Hospital Regional de Loreto (HRL). Métodos. Estudio de tipo descriptivo. Revisamos 120 historias clínicas en pacientes de UCI-HRL desde enero a junio 2023. Resultados. La mayoría de los pacientes usaron antimicrobianos (74,2%), indicados por shock séptico (42,7%), de 1 a 3 antimicrobianos (93,2%), con terapia de 1 a 3 días (45%). Del total de antimicrobianos usados, la mayor proporción fueron bactericidas 89 (90,4%), de la familia de cefalosporinas (33,1%) y carbapenémicos (23,5%); los fármacos más empleados fueron ceftriaxona (26,5%) y meropenem (21,1%) por vía intravenosa (90,4%). Conclusión. La mayor proporción de pacientes hospitalizados usan antimicrobianos de la familia de cefalosporinas y carbapenémicos.


ABSTRACT Introduction. Inappropriate use of antimicrobials in the Intensive Care Unit (ICU) contributes to bacterial resistance. Objective. The purpose of the present study was to measure the use and type of antimicrobials in patients hospitalized in the Intensive Care Unit of the Loreto Regional Hospital (HRL). Methods. Descriptive study. We reviewed 120 medical records in ICU-HRL patients from January to June 2023. Results. Most patients used antimicrobials (74.2%), indicated for septic shock (42.7%), 1 to 3 antimicrobials (93.2%), with therapy of 1 to 3 days (45%). Of the total number of antimicrobials used, the greatest proportion were bactericides 89 (90.4%), from the cephalosporin family (33.1%) and carbapenemics (23.5%); the most commonly used drugs were ceftriaxone (26.5%) and meropenem (21.1%) by the intravenous route (90.4%). Conclusion. The highest proportion of hospitalized patients use antimicrobials of the cephalosporin and carbapenemics family.

4.
Microbiol Resour Announc ; 13(4): e0012224, 2024 Apr 11.
Article in English | MEDLINE | ID: mdl-38526096

ABSTRACT

We report the genome of Erwinia amylovora phage Omen, isolated from a Portuguese orchard. Omen has a genome size of 85,304 bp, belongs to the genus Kolesnikvirus (myovirus morphotype), and shares over 80% nucleotide identity with various Erwinia phage genomes.

5.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 3): S437-S444, 2023 Oct 02.
Article in Spanish | MEDLINE | ID: mdl-37934901

ABSTRACT

Background: Central Cord Syndrome is the most common incomplete spinal cord injury, and it represents 9% of all spinal injuries of the adult. Objective: to determine the risk factors associated with lethality or/and mechanical ventilation (MV) in patients with Central Cord Syndrome (CCS). Material and Methods: upon a retrospective cohort with patients with posttraumatic CCS we evaluated at the time of emergency admission and until the hospital discharge. The dependent variable was dead or MV. We calculated incidence, relative risk (RR) with CI95% and a multivariate model for the association of statistically significant variables by means of a risk coefficient model upon the variables that evidenciated tendencies towards risk. Results: From 101 patients with CCS, 85.1% with a severe medullary canal stenosis and 9.9% required MV; the mortality was 13.9%. The only risk factor associated with dead was the use of MV with an RR of 3.6 (CI95% 1.4-9.5); the risk with tendencies towards MV was being older than 60 RR 5.4 (CI95% 0.6-44.2). Other factors demonstrated a tendency towards mortality, but they were not statistically significant. Conclusions: MV is a risk factor associated with mortality, other factors evidenciated tendencies towards mortality; being older than 60, hypertension, diabetes mellitus, narrow spinal canal, more than 20 days of hospital stay and being intervened farther than 10 days from the accident. The incidence of mortality in our sample is greater than thus reported previously on other international articles. To know and identify these and other factors will let us identify patients with a greater risk of complications.


Introducción: el síndrome medular central es la lesión medular incompleta más común y representa el 9% de las lesiones medulares del adulto. Objetivo: determinar la letalidad del síndrome medular central (SMC) y sus factores de riesgo asociados a fallecer y/o uso de ventilación mecánica (VM). Material y métodos: cohorte retrospectiva en pacientes con SMC que acuden a urgencias y valorados hasta su egreso. La variable dependiente fue VM o muerte. Se calculó la incidencia, riesgo relativo (RR) e IC95%; se usaron modelos multivariados de asociación con las variables significativas mediante un modelo de cocientes de riesgos, y aquellas que presentaron algún grado de tendencia de acuerdo con el RR por encima de 1. Resultados: se recolectó la información de una muestra de 101 pacientes con SMC que recibieron atención en la unidad entre 2015 y 2021, 85.1% presentaron estenosis medular, 9.9% de pacientes requirieron VM, la mortalidad fue de 13.9%. El factor de riesgo asociado a muerte fue la VM con RR 3.6 (IC95%: 1.4-9.5); el factor con tendencia a VM fue ser mayor de 60, RR 5.4 (IC95%: 0.6-44.2). Otros factores evidenciaron tendencia a mortalidad o VM sin significancia estadística. Conclusiones: el factor de riesgo asociado a mortalidad fue VM, otros evidencian tendencia hacia mortalidad, como ser mayor de 60 años, hipertensión arterial, diabetes mellitus, estenosis medular por debajo de los 10 milímetros, más de 20 días de estancia hospitalaria y ser intervenidos más de 10 días posterior al accidente. La mortalidad en nuestra población se encuentra muy elevada en comparación con estudios internacionales previos. Conocer los factores de riesgo ayudaran a identificar a los pacientes con mayor riesgo de muerte o VM.


Subject(s)
Central Cord Syndrome , Spinal Cord Injuries , Adult , Humans , Central Cord Syndrome/complications , Retrospective Studies , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology , Hospitalization , Risk Factors , Respiration, Artificial
6.
Rev Med Inst Mex Seguro Soc ; 61(6): 802-808, 2023 Nov 06.
Article in Spanish | MEDLINE | ID: mdl-37995343

ABSTRACT

Background: Cardiopulmonary bypass generates an exacerbated response that may lead to sepsis. Objective: To describe the association between procalcitonin levels and sepsis diagnosis in cardiovascular surgery subjects with cardiopulmonary bypass. Methods: A case-series study was conducted in 142 patients. Serum procalcitonin levels were measured at 24 hours and at 72 hours after surgery using a point of care testing based on quantitative immunochromatographic method. To assess association between procalcitonin levels and sepsis status, we calculated area under the curve (AUC) and sensitivity, specificity, and predictive values for the best cut-off point. Results: From 142 patients studied, 7 developed sepsis after surgery (4.9%). For 24-hours procalcitonin levels AUC was 0.921 and best cut-off point was 3.8 ng/mL (sensitivity 0.857 and specificity 0.904). In the case of 72-hours procalcitonin levels, we observed a value of 0.868 for AUC and best cut-off point was 8.4 ng/mL (sensitivity 0.86 and specificity 0.97). Conclusions: Procalcitonin levels at 24 and 72 hours after cardiovascular surgery with cardiopulmonary bypass are associated with sepsis presence at cut-off points of 3.8 and 8.4 ng/mL respectively.


Introducción: la circulación extracorpórea durante la cirugía cardiovascular genera una respuesta exacerbada que puede asociarse con sepsis. Objetivo: describir la asociación entre los niveles de procalcitonina y el diagnóstico de sepsis en sujetos de cirugía cardiovascular con circulación extracorpórea. Material y métodos: se realizó un estudio de serie de casos en 142 pacientes. Los niveles de procalcitonina fueron medidos a las 24 horas y a las 72 horas después de la cirugía. Para evaluar la asociación entre los niveles de procalcitonina y la identificación de sepsis, se calculó el área bajo la curva (AUC) y la sensibilidad y especificidad identificando el mejor punto de corte. Resultados: de un total de 142 pacientes estudiados, 7 desarrollaron sepsis (4.9%). En los niveles de procalcitonina en las 24 horas, el AUC fue de 0.921 y el mejor punto de corte fue 3.8 ng/mL (sensibilidad de 0.857 y especificidad de 0.904). En el caso de los niveles de procalcitonina a las 72 horas, observamos un AUC de 0.868 y el mejor punto de corte fue 8.4 ng/mL (sensibilidad de 0.86 y especificidad de 0.97). Conclusiones: los niveles de procalcitonina a las 24 y 72 horas de la cirugía cardiovascular con circulación extracorpórea se asociaron con la presencia de sepsis con los puntos de corte de 3.8 ng/mL y 8.4 ng/mL respectivamente.


Subject(s)
Procalcitonin , Sepsis , Humans , Cardiopulmonary Bypass/adverse effects , Calcitonin , ROC Curve , Sepsis/diagnosis , Sepsis/etiology , Biomarkers , C-Reactive Protein
7.
Cir Cir ; 91(5): 658-663, 2023.
Article in English | MEDLINE | ID: mdl-37844886

ABSTRACT

BACKGROUND: Open abdomen is an alternative for the management of trauma patient, and negative pressure therapy of the wound using VAC® device is a genuine sort of treatment. Although the device poses technical advantages, risks are present and a critical complication is the enteroatmospheric fistula formation (EAF). OBJECTIVE: To analize the role of negative pressure therapy length and VAC® device number of changes on the EAF formation in trauma patients udergoing open abdomen. METHOD: Cut-off points were calculated using receiver operational characteristics curve. Values were compared with Student's t or Mann-Withney U tests, considering statistically significant p < 0.05. RESULTS: EAF were present in 39 cases (5.9%). A significant difference in the presence of EAF was present in patients with negative pressure therapy of the wound length ≥ 11.2 days (46.9 vs. 1.3%; relative risk [RR]: 3.67; 95% confidence interval [95% IC]: 2.4-6.68; p = 0.017) and when ≥ 2.6 VAC® device changes were performed (34.6 vs. 0.5%; RR: 6.92; 95% IC: 1.1-4.3; p < 0.001). CONCLUSIONS: At our institution, the practice of >3 VAC® device changes and length of therapy > 11 days should be carefully considered leading to reduce the risk of EAF formation.


INTRODUCCIÓN: El abdomen abierto es una alternativa para manejar al paciente traumatizado, y una variante para instituirlo es la terapia de presión negativa de la herida con el dispositivo VAC®. Aunque tiene ventajas técnicas, no está exento de riesgos y una complicación crítica es la formación de fístulas enteroatmosféricas (FEA). OBJETIVO: Analizar el papel de la duración de la terapia de presión negativa y del número de cambios del dispositivo VAC® sobre la aparición de FEA en pacientes traumatizados manejados con abdomen abierto. MÉTODO: Se establecieron puntos de corte con curva de características operacionales del receptor. Los valores se compararon con la prueba t de Student o U de Mann-Whitney, considerando p < 0.05 como valor estadísticamente significativo. RESULTADOS: La FEA se presentó en 39 casos (5.9%). Hubo una diferencia significativa en la aparición de FEA en pacientes con duración de la terapia de presión negativa de la herida ≥ 11.2 días (46.9 vs 1.3%; riesgo relativo [RR]: 3.67; intervalo de confianza del 95% [IC95%]: 2.4-6.68; p = 0.017) y cuando se practicaron ≥ 2.6 cambios del dispositivo VAC® (34.6 vs. 0.5%; RR: 6.92; IC95%: 1.1-4.3; p < 0.001). CONCLUSIONES: En nuestra institución, la práctica de más de tres cambios del dispositivo VAC® y el mantenimiento de la terapia por más de 11 días debe ser cuidadosamente considerado para reducir el riesgo de formación de FEA.


Subject(s)
Abdominal Injuries , Intestinal Fistula , Negative-Pressure Wound Therapy , Humans , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Treatment Outcome , Negative-Pressure Wound Therapy/adverse effects , Abdominal Injuries/complications , Abdominal Injuries/surgery , Abdomen/surgery
8.
An. Fac. Med. (Perú) ; 84(3)sept. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1519996

ABSTRACT

La dermatitis herpetiforme es una enfermedad autoinmune que se caracteriza por la presencia de lesiones vesiculares y prurito en la superficie extensora de las extremidades, nalgas y parte baja de la espalda. Se presenta el caso clínico de una mujer de 21 años, natural y procedente de Iquitos, que presentó múltiples vesículas dolorosas, pruriginosas, de base eritematosa y purulentas en ambos codos durante un mes. Posteriormente, estas lesiones se diseminaron a ambas rodillas y se agregó prurito intenso. La paciente experimentó períodos alternantes de remisión y exacerbación. La correlación del cuadro clínico, resultados serológicos y de biopsia, junto con respuesta terapéutica a la dapsona confirmaron el diagnóstico de dermatitis herpetiforme, con una evolución favorable y remisión de la enfermedad.


Dermatitis herpetiforme is an autoimmune disease characterized by the presence of vesicular lesions and itching on the extensor surface of the limbs, buttocks, and lower back. The clinical case of a 21-year-old woman, a native of and from Iquitos, is presented. She presented multiple painful, itchy vesicles with an erythematous and purulent base on both elbows for a month. Subsequently, these lesions spread to both knees, and intense itching was added. The patient experienced alternating periods of remission and exacerbation. The correlation of the clinical picture, serological and biopsy results, along with the therapeutic response to dapsona, confirmed the diagnosis of dermatitis herpetiforme, with a favorable evolution and remission of the disease.

9.
Sci Total Environ ; 903: 166317, 2023 Dec 10.
Article in English | MEDLINE | ID: mdl-37591386

ABSTRACT

The Mexican Atlantic coast is vulnerable to sea level rise due to its low, sandy shorelines with extensive adjacent wetlands. The increasing trends at the regional level are similar to global trends (~3 ± 0.04 mm/year): between 1.8 mm/year in Alvarado, Veracruz, to 3.6 mm/year in Isla Mujeres, Quintana Roo. A synthetic model was applied to Mexican Atlantic coast under two sea level rise scenarios for the year 2100. Our objectives were: 1) to identify potentially floodable zones in the face of a sea level rise of one and two meters on the Mexican Atlantic coast with a synthetic model using SRTM and LiDAR topographic data; 2) to determine vegetation and land use affected in the potentially floodable zones; and 3) quantify the vulnerable human population. With topographic data we identified low areas (one and two meters) to assess potentially floodable zones; these were intersected with data layers of vegetation, land use, and human population. Deltaic zones, coastal lagoons and low-lying areas of the Yucatan Peninsula were regions with the largest potentially floodable surface. In the one-meter sea rise scenario, 581,674 ha were identified as potentially floodable, and 896,151 in the two-meter scenario. The most vulnerable vegetation and land use types were wetlands, such as cattail marshes (tulares; ~29 %) and mangroves (~27 %), as well as cultivated grasslands (~6 %). The indirectly affected coastal population could be approximately 5.5 million in these scenarios (~33 %), and the directly affected population could range between 124,000 and 440,000 (~0.72 and 2.55 %, respectively). These results indicate that there will be strong effects in economic, social, and environmental impacts on the Atlantic coast of Mexico in the event of a one- and two-meters sea level rise. This type of work will enable proposal conservation and adaptation strategies for human populations and coastal cities.

10.
Acta bioquím. clín. latinoam ; 57(2): 175-183, jun. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1519863

ABSTRACT

Resumen Durante la menopausia se producen cambios metabólicos que favorecen la ganancia de peso y la obesidad abdominal, lo cual facilita el desarrollo de dislipidemias y aumenta el riesgo cardiovascular. El propósito del estudio fue comparar el perfil lipídico y los índices de riesgo cardiometabólico (IRCM) entre mujeres posmenopáusicas del Municipio Naguanagua, Estado Carabobo, Venezuela, clasificadas de acuerdo con su grado de adiposidad. El estudio fue de corte transversal, descriptivo, en el cual participaron 205 mujeres con una mediana de edad de 56 años. Se evaluaron indicadores de adiposidad: índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), circunferencia de cintura (CC), e índice cintura/talla (ICT); así como el perfil lipídico y los IRCM. Se encontraron altos porcentajes de exceso de peso (80%), exceso de grasa corporal (92%), obesidad abdominal (61%) y riesgo metabólico de acuerdo con el ICT (69%). Las mujeres con obesidad mostraron los valores más bajos de cHDL, y aquellas con grasa muy alta, obesidad abdominal y riesgo metabólico de acuerdo con el ICT, los valores más elevados del índice TG/HDL. Se recomiendan otros estudios en este grupo poblacional para comprender mejor la asociación encontrada entre el grado de adiposidad y las alteraciones en el metabolismo de los lípidos con el fin de tomar acciones preventivas en estos trastornos relacionados con el síndrome metabólico.


Abstract During menopause, metabolic changes occur that promote weight gain and abdominal obesity, facilitating the development of dyslipidemias and increasing cardiovascular risk. The purpose of the study was to compare the lipid profile and the cardiometabolic risk indexes (IRCM) among postmenopausal women from the Naguanagua Municipality, Carabobo State, Venezuela, classified according to their degree of adiposity. It was a cross-sectional, descriptive study in which 205 women with a median age of 56 years participated. Adiposity indicators were evaluated: body mass index (BMI), percentage of body fat (PBF), waist circumference (WC), and waist-to-height ratio (WHtR); as well as the lipid profile and the IRCM. High percentages of excess weight (80%), excess body fat (92%), abdominal obesity (61%) and metabolic risk according to the WHtR (69%) were found. Women with obesity showed the lowest values of HDL-C, and those with very high fat, abdominal obesity, and metabolic risk according to the WHtR, the highest values of the TG/HDL index. Other studies are recommended on this population group to better understand the association found between the degree of adiposity and alterations in lipid metabolism to take preventive actions in these disorders related to the metabolic syndrome.


Resumo Durante a menopausa ocorrem alterações metabólicas que favorecem o ganho de peso e a obesidade abdominal, facilitando o desenvolvimento de dislipidemias e aumentando o risco cardiovascular. O objetivo do estudo foi comparar o perfil lipídico e os índices de risco cardiometabólico (IRCM) entre mulheres na pós-menopausa do município de Naguanagua, estado de Carabobo, Venezuela, classificadas de acordo com seu grau de adiposidade. O estudo foi transversal, descritivo, do qual participaram 205 mulheres com mediana de idade de 56 anos. Foram avaliados os indicadores de adiposidade: índice de massa corporal (IMC), percentual de gordura corporal (PGC), circunferência da cintura (CC) e índice cintura/estatura (ICE); bem como o perfil lipídico e o IRCM. Foram encontrados altos percentuais de excesso de peso (80%), excesso de gordura corporal (92%), obesidade abdominal (61%) e risco metabólico segundo o ICE (69%). Mulheres com obesidade apresentaram os menores valores de cHDL, e aquelas com muito alto teor de gordura, obesidade abdominal e risco metabólico segundo o ICE, os maiores valores da relação TG/HDL. Outros estudos neste grupo populacional são recomendados para melhor entender a associação encontrada entre o grau de adiposidade e as alterações no metabolismo lipídico, a fim de tomar ações preventivas nesses distúrbios relacionados com a síndrome metabólica.

11.
Rev. sanid. mil ; 77(1): e02, ene.-mar. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1450383

ABSTRACT

Resumen Objetivo: Evidenciar la mejora en la autoestima específica docente y del conocimiento integral de los dominios cognitivos de Bloom en los participantes en el curso 2CeQ®, estimados a través del incremento y análisis comparativo en la puntuación obtenida en la Escala de Autoestima de Rosenberg (EAR) y ejercicios de evaluación pre y poscurso. Diseño, metodología o aproximación: Estudio analítico comparativo transversal, de datos correspondientes a los valores de las variables (puntuación obtenida) de dos cuestionarios (Escala de Autoestima de Rosenberg [EAR] y ejercicios de evaluación pre y poscurso) contestados por los participantes en el curso. Análisis estadístico: frecuencia relativa de ocurrencia, medidas de dispersión y prueba t (p<0.05 fue estadísticamente significativo). Resultados: Se incluyeron 21 individuos. Se observó una mejora significativa en la puntuación de la autoestima específica como docente quirúrgico según la EAR (16.3±5 [7-25] vs 20.9±5.2 [13-30]; p=0.003). En el ejercicio de evaluación, hubo una diferencia estadísticamente significativa en la puntuación pre y poscurso (38.5±14.3 [10.3-70.6] vs 72.4±17 [29.4-88.2]; p=0.006). Limitaciones del estudio o implicaciones: Serie unicéntrica, con limitado número del tamaño de la muestra, lo que impide validar los resultados. Originalidad o valor: Estudio en epistemología educativa quirúrgica nacional, único en su clase. Hallazgos o conclusión: La participación en el Curso "2CeQ Docencia Quirúrgica®" aumenta la autoestima específica para el ejercicio docente y la capacidad técnica para desarrollar el proceso de enseñanza aprendizaje, por lo cual puede coadyuvar a elevar la calidad de los programas educativos.


Abstract Objetive: To show improvement in teaching-specific self-esteem and comprehensive knowledge on Bloom's cognitive domains, among participants in 2CeQ® Course, estimated through increase and comparative analysis of pre- and post-course scores obtained from Rosenberg's Self-esteem Scale (RSS) and evaluation-tests. Design, methodology and approximation: Transversal, analytic and comparative study of pre- and post-course values from data corresponding to RSS and evaluation tests scores, answered by participants. Statistics: Occurrence relative frequency, dispersion calculations, and t test (p<0.05 statistically significant). Results: 21 individuals were included. A significant improvement in surgical-teaching self-esteem from RSS (16.3±5 [7-25] vs 20.9±5.2 [13-30]; p=0.003) and a statistically significant difference between pre- and postcourse test's scores (38.5±14.3 [10.3-70.6] vs 72.4±17 [29.4-88.2]; p=0.006 were observed). Limitations and implications of study: Unicentric series and a limited sample, avoiding the validation of results. Originality or value: Study on national surgical education epistemology, one of a kind. Findings and conclusion: Participation in "2CeQ" Course increases specific self-esteem for teaching and technical ability to develop teaching and learning process, helping to optimize the quality of educational programs.

12.
ACS Sustain Chem Eng ; 11(5): 1752-1762, 2023 Feb 06.
Article in English | MEDLINE | ID: mdl-36778521

ABSTRACT

Macroalgae are a promising feedstock for several industries due to their large content of proteins and carbohydrates and the high biomass productivities. A novel extraction and fractionation concept based on ionic liquids (ILs) using Ulva lactuca as model organism is presented. Biomolecules are first extracted by means of IL-assisted mechanical shear, followed by two-phase partitioning or ultrafiltration in order to fractionate proteins and carbohydrates and to recover the IL. Ethyl methyl imidazolium dibutyl phosphate ([Emim][DBP]) is strongly selective to proteins, leading to extraction yields up to 80.4% for proteins and 30.7% for carbohydrates. The complete process, including extraction and ultrafiltration, allowed protein recovery of up to 64.6 and 15.4% of the carbohydrates in the retentate phase, while a maximum of 85.7% of the IL was recovered in the permeate phase. The native structure of the extracted proteins was preserved during extraction and fractionation as shown by gel electrophoresis. Selective extraction of proteins from macroalgae under non-denaturing conditions using ILs followed by the recovery of IL using ultrafiltration is for the first time reported. The proposed extraction-fractionation approach is simple and can be potentially applied for the biorefinery of macroalgae at the commercial scale.

13.
Clin Case Rep ; 11(1): e6763, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36619492

ABSTRACT

Streptococcus intermedius is a commensal bacterium reported in a few cases as the causative agent of brain and lung abscesses, pneumonia, and endocarditis. Lung abscesses due to Streptococcus intermedius are rare, especially in pregnancy. We describe the first case of lung abscess due to Streptococcus intermedius in a pregnant woman.

14.
Rev Med Inst Mex Seguro Soc ; 61(1): 123-129, 2023 Jan 02.
Article in Spanish | MEDLINE | ID: mdl-36542807

ABSTRACT

Background: The presence of duodenal atresia related to type IIIb intestinal atresia is a rare association, with few cases reported in the literature, representing a surgical challenge considering that even isolated cases of type IIIb intestinal atresia are a challenge. The objective was to report the successful surgical management of a case of a complex intestinal malformation, characterized by duodenal occlusion secondary to annular pancreas and type IIIb intestinal atresia, with intestinal malrotation by definition and the presence of Meckel's diverticulum. Clinical case: We present the case report of a newborn sent to the second level of care with a diagnosis of duodenal obstruction not diagnosed prenatally, which resulted in duodenal atresia due to annular pancreas and type IIIb intestinal atresia according to the Grosfeld classification. The presence of duodenal atresia with type IIIb intestinal atresia is an extremely rare condition, even more so associated with annular pancreas. These cases are a challenge considering the short length of the small intestine and its consequent need for total parenteral nutrition for a prolonged period. Conclusions: The surgical management of this complex intestinal malformation resulted in a case with an adequate post-surgical evolution, based on the immediate start of enteral feeding with a short period of need for total parenteral nutrition that finally resulted in a short hospital stay.


Introducción: la presencia de atresia duodenal relacionada con atresia intestinal tipo IIIb es una asociación rara, con pocos casos reportados en la literatura, y representa un reto quirúrgico si se toma en cuenta que incluso los casos aislados de atresia intestinal tipo IIIb lo representan. El objetivo fue reportar el manejo quirúrgico exitoso del caso de una malformación intestinal compleja, caracterizada por una oclusión duodenal secundaria a páncreas anular y atresia intestinal tipo IIIb, con una malrotación intestinal por definición y la presencia de divertículo de Meckel. Caso clínico: reportamos el caso de un recién nacido enviado de segundo nivel de atención con un diagnóstico de obstrucción duodenal no diagnosticado prenatalmente, que resultó en atresia duodenal por páncreas anular y atresia intestinal tipo IIIb, según la clasificación de Grosfeld. La presencia de atresia duodenal con atresia intestinal tipo IIIb es una condición extremadamente rara y todavía lo es más asociada con páncreas anular. Estos casos son un desafío si se toma en cuenta la corta longitud de intestino delgado y su consiguiente necesidad de nutrición parenteral total por un periodo prolongado. Conclusiones: el manejo quirúrgico de esta malformación intestinal compleja resultó en un caso con una adecuada evolución postquirúrgica, basada en el inicio mediato de alimentación enteral con un periodo corto de necesidad de nutrición parenteral total que finalmente resultó en una corta estancia hospitalaria.


Subject(s)
Duodenal Obstruction , Intestinal Atresia , Infant, Newborn , Humans , Duodenal Obstruction/diagnosis , Duodenal Obstruction/etiology , Duodenal Obstruction/surgery , Intestinal Atresia/diagnosis , Intestinal Atresia/surgery , Pancreas/surgery , Pancreas/abnormalities
15.
Rev Peru Med Exp Salud Publica ; 39(2): 241-244, 2022.
Article in Spanish, English | MEDLINE | ID: mdl-36477327

ABSTRACT

Plasmodium vivax causes 81% of all malaria cases and is the most common species in the Peruvian Amazon. We present the case of a male patient with cerebral malaria caused by Plasmodium vivax, who had general malaise and fever, and then presented seizures more than twice a day with loss of consciousness and motor functional limitation. Plasmodium vivax trophozoites were detected by thick blood smear, besides, we also observed low counts of all three blood cell types. Treatment began with artesunate and clindamycin for five days, then one unit of packed red blood cells was transfused; treatment continued with primaquine for seven days. The patient showed clinical improvement with neurological sequelae in one lower limb.


Plasmodium vivax es la especie más común en la Amazonía peruana y ocasiona el 81% del total de casos de malaria. Presentamos el caso de un paciente adulto varón con malaria cerebral por Plasmodium vivax, que inicia con malestar general y fiebre, luego presenta convulsiones más de dos veces al día con pérdida de consciencia y limitación funcional motora. Se le realiza gota gruesa donde se observa trofozoítos de Plasmodium vivax y depresión de las tres series sanguíneas. Se inicia tratamiento con artesunato y clindamicina por cinco días, se le transfunde un paquete globular, y continua con primaquina por siete días. El paciente muestra mejoría clínica con secuela neurológica en extremidad inferior izquierda.


Subject(s)
Malaria, Cerebral , Plasmodium vivax , Male , Humans , Malaria, Cerebral/complications , Peru
16.
Rev Peru Med Exp Salud Publica ; 39(3): 368-371, 2022.
Article in Spanish, English | MEDLINE | ID: mdl-36478172

ABSTRACT

Cutaneous tuberculosis is a rare presentation of Mycobacterium tuberculosis infection. We present the case of a woman without important medical history, with a disease period of one year and a half, characterized by sporotrichoid-like lesions, with lymphocutaneous dissemination in the right upper limb, and with slowly progressive evolution. The histopathological tests revealed Langhans type giant cells and scarce necrosis. The patient received therapy with a sensitive antituberculous scheme, and evolved favorably.


La tuberculosis cutánea es una presentación rara de la infección por Mycobacterium tuberculosis. Se presenta el caso de una mujer sin antecedentes médicos de importancia, con un tiempo de enfermedad de año y medio, caracterizado por lesiones tipo esporotricoide, con diseminación linfocutánea en miembro superior derecho, de evolución lentamente progresiva. Se realizó un estudio histopatológico encontrándose células gigantes tipo Langhans y escasa necrosis. El paciente recibió terapia de esquema sensible antituberculoso, con evolución favorable.


Subject(s)
Tuberculosis , Humans , Peru
17.
Mol Med ; 28(1): 131, 2022 11 08.
Article in English | MEDLINE | ID: mdl-36348276

ABSTRACT

BACKGROUND: Respiratory failure in severe coronavirus disease 2019 (COVID-19) is associated with a severe inflammatory response. Acetylcholine (ACh) reduces systemic inflammation in experimental bacterial and viral infections. Pyridostigmine increases the half-life of endogenous ACh, potentially reducing systemic inflammation. We aimed to determine if pyridostigmine decreases a composite outcome of invasive mechanical ventilation (IMV) and death in adult patients with severe COVID-19. METHODS: We performed a double-blinded, placebo-controlled, phase 2/3 randomized controlled trial of oral pyridostigmine (60 mg/day) or placebo as add-on therapy in adult patients admitted due to confirmed severe COVID-19 not requiring IMV at enrollment. The primary outcome was a composite of IMV or death by day 28. Secondary outcomes included reduction of inflammatory markers and circulating cytokines, and 90-day mortality. Adverse events (AEs) related to study treatment were documented and described. RESULTS: We recruited 188 participants (94 per group); 112 (59.6%) were men; the median (IQR) age was 52 (44-64) years. The study was terminated early due to a significant reduction in the primary outcome in the treatment arm and increased difficulty with recruitment. The primary outcome occurred in 22 (23.4%) participants in the placebo group vs. 11 (11.7%) in the pyridostigmine group (hazard ratio, 0.47, 95% confidence interval 0.24-0.9; P = 0.03). This effect was driven by a reduction in mortality (19 vs. 8 deaths, respectively). CONCLUSION: Our data indicate that adding pyridostigmine to standard care reduces mortality among patients hospitalized for severe COVID-19.


Subject(s)
COVID-19 Drug Treatment , Adult , Male , Humans , Middle Aged , Female , Pyridostigmine Bromide/therapeutic use , SARS-CoV-2 , Respiration, Artificial , Inflammation , Treatment Outcome
18.
Glob Chang Biol ; 28(23): 6992-7008, 2022 12.
Article in English | MEDLINE | ID: mdl-36053734

ABSTRACT

There is a need to revise the framework used to project species risks under climate change (CC) and land-use/cover change (LUCC) scenarios. We built a CC risk index using the latest Intergovernmental Panel on Climate Change framework, where risk is a function of vulnerability (sensitivity and adaptive capacity), exposure, and hazard. We incorporated future LUCC scenarios as part of the exposure component. We combined a trait-based approach based on biological characteristics of species with a correlative approach based on ecological niche modeling, assigning risk scores to species, taxonomic (orders), and functional (trophic, body size, and locomotion) groups of terrestrial mammals occurring in Mexico. We identified 15 species projected to lose their climatic suitability. Of the 11 taxonomic orders, Eulipotyphla, Didelphimorphia, Artiodactyla, and Lagomorpha had the highest risk scores. Of the 19 trophic groups, piscivores, insectivores under canopy, frugivores-granivores, herbivores browser, and myrmecophagous had the highest risk scores. Of the five body-sized groups, large-sized species (>15 kg) had highest risk scores. Of the seven locomotion groups, arboreal and semi-aquatics had highest risk scores. CC and LUCC scenarios reduced suitable areas of species potential distributions by 37.5% (with CC), and 51% (with CC and LUCC) under a limited full-dispersal assumption. Reductions in suitable areas of species potential distributions increased to 50.2% (with CC), and 52.4% (with CC and LUCC) under a non-dispersal assumption. Species-rich areas (>75% species) projected 36% (with CC) and 57% (with CC and LUCC) reductions in suitability for 2070. Shifts in climatic suitability projections of species-rich areas increased in number of species in northeast and southeast Mexico and decreased in northwest and southern Mexico, suggesting important species turnover. High-risk projections under future CC and LUCC scenarios for species, taxonomic, and functional group diversities, and species-rich areas of terrestrial mammals highlight trends in different impacts on biodiversity and ecosystem function.


Subject(s)
Climate Change , Ecosystem , Animals , Mexico , Biodiversity , Mammals
20.
Rev. peru. med. exp. salud publica ; 39(3): 368-371, jul.-sep. 2022. graf
Article in Spanish | LILACS, LIPECS | ID: biblio-1410007

ABSTRACT

RESUMEN La tuberculosis cutánea es una presentación rara de la infección por Mycobacterium tuberculosis. Se presenta el caso de una mujer sin antecedentes médicos de importancia, con un tiempo de enfermedad de año y medio, caracterizado por lesiones tipo esporotricoide, con diseminación linfocutánea en miembro superior derecho, de evolución lentamente progresiva. Se realizó un estudio histopatológico encontrándose células gigantes tipo Langhans y escasa necrosis. El paciente recibió terapia de esquema sensible antituberculoso, con evolución favorable.


ABSTRACT Cutaneous tuberculosis is a rare presentation of Mycobacterium tuberculosis infection. We present the case of a woman without important medical history, with a disease period of one year and a half, characterized by sporotrichoid-like lesions, with lymphocutaneous dissemination in the right upper limb, and with slowly progressive evolution. The histopathological tests revealed Langhans type giant cells and scarce necrosis. The patient received therapy with a sensitive antituberculous scheme, and evolved favorably.


Subject(s)
Humans , Female , Adolescent , Sporotrichosis/pathology , Tuberculosis, Cutaneous/pathology , Giant Cells, Langhans/pathology , Mycobacterium tuberculosis , Sporotrichosis/diagnosis , Tuberculosis, Cutaneous/diagnosis , Biopsy , Diagnosis, Differential
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