Low-density lipoproteins, resveratrol and quercetin as alternative additives to improve boar semen cooling.

Low-density lipoproteins (LDL), quercetin (Q) and resveratrol (R) have been used for sperm preservation to improve sperm quality in different species. To evaluate the effects of LDL, Q and R during the cooling of boar semen. Fifteen boar semen samples were diluted in a BTS extender supplemented with the treatments: LDL at 6%, Q at 10 µM (Q10), 30 µM (Q30) and 50 µM (Q50), or R at 10 µM (R10), 30 µM (R30) and 50 µM. A control without supplementation was included. The semen was stored by cooling at 16°C for 96 h. Every 24 h, sperm motility and kinetics were evaluated using a computer-assisted sperm analyzer (IVOS). At 24 and 96 h of cooling, functional membrane integrity and mitochondrial membrane potential (ΔΨM) of sperm were evaluated by the hypoosmotic swelling test (HOST) an flow cytometry with JC-1 probe, respectively, LDL improved progressive motility of sperm during cooling. Likewise, LDL increased average path velocity (VAP) and straight-line velocity (VSL) and/or curvilinear velocity (VCL) during the first 48 h of cooling. The use of Q between 10 and 30 µM caused a reduction in total motility, progressive motility and amplitude of the lateral head displacement during the entire cooling period, as well as a decrease in VAP, VSL and VCL at 96 h of cooling. LDL, Q10, Q30 and Q50 modulated mitochondrial activity by reducing high-ΔΨM sperm at 0 and 96 h of cooling. During the cooling of the boar semen prior to artificial insemination, the parameters of sperm quality that could influence fertility decrease; however, the inclusion of antioxidants and additives that protect the plasma membrane, such as LDL, could mitigate the damaging effects on spermatozoa. It is concluded that LDL can improve the motility and kinetics of boar semen during cooling while it could modulating the sperm's mitochondrial activity. On the contrary, Q could alter the motility and kinetics of boar sperm during the cooling period.

Prehospital hypoxemia, measured by pulse oximetry, predicts hospital outcomes during the New York City COVID-19 pandemic.

OBJECTIVE: To determine if oxygen saturation (out-of-hospital SpO2), measured by New York City (NYC) 9-1-1 Emergency Medical Services (EMS), was an independent predictor of coronavirus disease 2019 (COVID-19) in-hospital mortality and length of stay, after controlling for the competing risk of death. If so, out-of-hospital SpO2 could be useful for initial triage. METHODS: A population-based longitudinal study of adult patients transported by EMS to emergency departments (ED) between March 5 and April 30, 2020 (the NYC COVID-19 peak period). Inclusion required EMS prehospital SpO2 measurement while breathing room air, transport to emergency department, and a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction test. Multivariable logistic regression modeled mortality as a function of prehospital SpO2, controlling for covariates (age, sex, race/ethnicity, and comorbidities). A competing risk model also was performed to estimate the absolute risks of out-of-hospital SpO2 on the cumulative incidence of being discharged from the hospital alive. RESULTS: In 1673 patients, out-of-hospital SpO2 and age were independent predictors of in-hospital mortality and length of stay, after controlling for the competing risk of death. Among patients ≥66 years old, the probability of death was 26% with an out-of-hospital SpO2 >90% versus 54% with an out-of-hospital SpO2 ≤90%. Among patients <66 years old, the probability of death was 11.5% with an out-of-hospital SpO2 >90% versus 31% with an out-of-hospital SpO2 ≤ 90%. An out-of-hospital SpO2 level ≤90% was associated with over 50% decreased likelihood of being discharged alive, regardless of age. CONCLUSIONS: Out-of-hospital SpO2 and age predicted in-hospital mortality and length of stay: An out-of-hospital SpO2 ≤90% strongly supports a triage decision for immediate hospital admission. For out-of-hospital SpO2 >90%, the decision to admit depends on multiple factors, including age, resource availability (outpatient vs inpatient), and the potential impact of new treatments.

A modified simple triage and rapid treatment algorithm from the New York City (USA) Fire Department.

INTRODUCTION: The objective of this study was to determine if modification of the Simple Triage and Rapid Treatment (START) system by the addition of an Orange category, intermediate between the most critically injured (Red) and the non-critical, non-ambulatory injured (Yellow), would reduce over- and under-triage rates in a simulated mass-casualty incident (MCI) exercise. METHODS: A computer-simulation exercise of identical presentations of an MCI scenario involving a 2-train collision, with 28 case scenarios, was provided for triaging to two groups: the Fire Department of the City of New York (FDNY; n=1,347) using modified START, and the Emergency Medical Services (EMS) providers from the Eagles 2012 EMS conference (Lafayette, Louisiana USA; n=110) using unmodified START. Percent correct by triage category was calculated for each group. Performance was then compared between the two EMS groups on the five cases where Orange was the correct answer under the modified START system. RESULTS: Overall, FDNY-EMS providers correctly triaged 91.2% of cases using FDNY-START whereas non-FDNY-Eagles providers correctly triaged 87.1% of cases using unmodified START. In analysis of the five Orange cases (chest pain or dyspnea without obvious trauma), FDNY-EMS performed significantly better using FDNY-START, correctly triaging 86.3% of cases (over-triage 1.5%; under-triage 12.2%), whereas the non-FDNY-Eagles group using unmodified START correctly triaged 81.5% of cases (over-triage 17.3%; under-triage 1.3%), a difference of 4.9% (95% CI, 1.5-8.2). CONCLUSIONS: The FDNY-START system may allow providers to prioritize casualties using an intermediate category (Orange) more properly aligned to meet patient needs, and as such, may reduce the rates of over-triage compared with START. The FDNY-START system decreases the variability in patient sorting while maintaining high field utility without needing computer assistance or extensive retraining. Comparison of triage algorithms at actual MCIs is needed; however, initial feedback is promising, suggesting that FDNY-START can improve triage with minimal additional training and cost.

Web-based training on weapons of mass destruction response for emergency medical services personnel.

OBJECTIVE: To develop, implement, and assess a web-based simulation training program for emergency medical services (EMS) personnel on recognition and treatment of ocular injuries resulting from weapons of mass destruction (WMD) attacks. DESIGN: The training program consisted of six modules: WMD knowledge and event detection, ocular anatomy, ocular first aid (ie, flushing, cupping, and patching), and three WMD simulations (ie, sarin gas release, anthrax release, and radioactive dispersal device). Pretest, post-test, and 1-month follow-up test and a program evaluation were used to measure knowledge gain and retention and to assess the effectiveness of the program. SETTING: New York State EMS. PARTICIPANTS: Four hundred and sixty-four individuals participated in the training program and all waves of the testing (86 percent retention rate). MAIN OUTCOME VARIABLES: The effectiveness of the training intervention was measured using pretest and post-test questionnaires and analyzed using dependent t-tests. RESULTS: Assessment scores for overall knowledge increased from the pretest (mean = 15.7, standard deviation [SD] = 2.1) to the post-test (mean = 17.8, SD = 1.3), p < 0.001, and from pretest (mean = 15.7, SD = 2.1) to 1-month follow-up test (mean = 16.6, SD = 2.0), p < 0.001. Ninety-two percent of respondents indicated that the program reinforced understanding of WMDs. CONCLUSIONS: This training method provides an effective and low-cost approach to educate and evaluate EMS personnel on emergency treatment of eye trauma associated with the use of WMD. Online training should also be supplemented with hands-on practice and refresher trainings.

Pediatric nerve agent poisoning: medical and operational considerations for emergency medical services in a large American city.

Most published recommendations for treatment of pediatric nerve agent poisoning are based on standard resuscitation doses for these agents. However, certain medical and operational concerns suggest that an alternative approach may be warranted for treatment of children by emergency medical personnel after mass chemical events. (1) There is evidence both that suprapharmacological doses may be warranted and that side effects from antidote overdosage can be tolerated. (2) There is concern that many emergency medical personnel will have difficulty determining both the age of the child and the severity of the symptoms. Therefore, the Regional Emergency Medical Advisory Committee of New York City and the Fire Department, City of New York, Bureau of Emergency Medical Services, in collaboration with the Center for Pediatric Emergency Medicine of the New York University School of Medicine and the Bellevue Hospital Center, have developed a pediatric nerve agent antidote dosing schedule that addresses these considerations. These doses are comparable to those being administered to adults with severe symptoms and within limits deemed tolerable after inadvertent nerve agent overdose in children. We conclude that the above approach is likely a safe and effective alternative to weight-based dosing of children, which will be nearly impossible to attain under field conditions.

Análisis y evaluación del proceso de georrectificación de imágenes ikonos de áreas de exploración y producción petrolera / Analysis and evaluation of the georectification process of ikonos images of petroleum exploration and production areas

Las imágenes digitales en su formato original tienen distorsiones geométricas que se originan en el momento de su adquisición. Para corregir tales distorsiones es necesario aplicar un proceso denominado georrectificación, que requiere de puntos de control terrestre (PCT) claramente identificables en la imagen y en el terreno, permitiendo obtener un producto con la integridad geométrica de un mapa. La investigación comprende el análisis y evaluación de diferentes modelos matemáticos para la georrectificación, para lo que se contó con tres imágenes digitales IKONOS pancromáticas pertenecientes a Petróleos de Venezuela S.A. (PDVSA). Estas imágenes cubren una superficie de aproximadamente 330km² del área operativa de la empresa OleoLUZ (filial de PDVSA), ubicada al norte de la ciudad de Maracaibo. Los PCT utilizados en el proceso de georrectificación se generaron a partir de mediciones GPS. La georrectificación de las imágenes se realizó con el software PCI Geomatics V.8.2.1. Los experimentos realizados determinaron que el modelo matemático más adecuado fue el polinomio de 3er orden, obteniéndose como producto final tres imágenes georrectificadas con residuales menores a ± 1m

Crush syndrome.

The assessment, management, and treatment of the entrapped victim are critical skills needed to ensure a successful outcome. Individuals have been trapped in the "rubble" for even short periods of time only to succumb to predictable consequences of muscle compression injury. The clinician should be prepared to address issues of crush syndrome (including compartment syndrome) proactively and aggressively. The history of this disease is clear and well documented both in the military literature and in the earthquake rescue reviews. The key to management is managing and predicting clinical conditions before they present themselves. The potential exists in the urban environment (with the potential of building collapses) to have patients with crush syndrome that far exceed local medical capabilities should be part of modern disaster planning. This article reviews the various body systems and presents management and assessment strategies for the clinician.

Porphyromonas gingivalis-specific immunoglobulin G prevents P. gingivalis-elicited oral bone loss in a murine model.

Active immunization with Porphyromonas gingivalis whole-cell preparations has been shown to prevent P. gingivalis infection and oral bone loss. Employing passive antibody transfer and opsonization, we demonstrate with this study that immunization-elicited P. gingivalis-specific immunoglobulin G facilitates clearance of P. gingivalis in a subcutaneous chamber model and prevents P. gingivalis-elicited oral bone loss.

Immunization with Porphyromonas gingivalis capsular polysaccharide prevents P. gingivalis-elicited oral bone loss in a murine model.

The capsular polysaccharide (CPS) of the periodontal pathogen Porphyromonas gingivalis is an important virulence factor for this organism. We purified P. gingivalis CPS, immunized mice with this antigen, and assessed the vaccine potential of P. gingivalis CPS by using the murine oral challenge model. Animals immunized with P. gingivalis CPS developed elevated levels of immunoglobulin M (IgM) and IgG in serum that reacted with whole P. gingivalis organisms. The mice immunized with P. gingivalis CPS were protected from P. gingivalis-elicited oral bone loss. These data demonstrate that P. gingivalis CPS is a vaccine candidate for prevention of P. gingivalis-elicited oral bone loss.

Propuesta de clasificción para el tratamiento de la actinomicosis genital asociada a dispositivo intrauterino / Proposal of classification for treating genital actinomycosis associated to intrauterine device

Se realizó un estudio descriptivo entre enero de 1995 a diciembre de 2002, que incluyó a 152 pacientes a las que se les indicó retirar un dispositivo intrauterino y legrado diagnóstico para realizar estudio hístico; a 82 de estas pacientes se les diagnosticó una endometritis por actinomices; 30 de ellas padecían formas abscedadas de la enfermedad y ocho requirieron una intervención quirúrgica: tres electivas y cinco por urgencias, debido a rotura del absceso; el resto de esta forma clínica respondió al tratamiento médico indicado. Las edades donde mayor incidencia tuvo la endometritis por actinomices fueron entre los 40-49 años, y el tiempo de permanencia del dispositivo fue de más de 12 años. Se propone una clasificación para el tratamiento de la actinomicosis genital(AU)

Estudio biosistemático y ecológico de anopheles aquasalis (Diptera: Culicidae) y sus implicaciones para el control de la malaria en el estado Sucre: III-control biológico y manejo integrado / Study biosystematic and ecologic of anopheles aquasalis (diptera: culicidae) and it's implications for the control of the malaria in the Sucre state: III biologic control and integrated management

El principal objetivo del presente trabajo fue evaluar el impacto de la introducción de Bacillus thuringiensis israelensis (Bti) sobre las poblaciones larvarias de anopheles aquasalis Curry, principal vector de la malaria en el oriente de Venezuela. Para ello, se evaluaron tres formulaciones comerciales de Bti en diferentes tipos de criaderos de este vector. En condiciones de campo y aplicadas a la CL95, establecida previamente en el laboratorio,, Vectobac-G y Teknar tuvieron la misma efectividad contra Anopheles spp., en los criaderos totalmente exppuestos a la luz solar, con un bajo contenido de oxigeno disuelto y abundante vegetación emergente (Typhaceae y Cyperaceae). En criaderos con alta salinidad como el manglar, Teknar y Vectobac-AS fueron los más efectivos, produciendo una mortalidad mayor del 80 por ciento a los 8 días del tratamiento. La concentración de Teknar recomendada por el fabricante fue bastante efectiva para reducir la densidad larvaria durante 8 días; mientras que las concentraciones recomendadas para Vectobac-AS, solamente fueron efectivas durantre las primeras 48 horas post-tratamiento. El impacto de un proyecto piloto de control vectorial también fue evaluado en el estado Sucre (municipio Libertador). Usando la información de un estudio ecológico sobre An.aquasalis, se implementó un proyecto de control integrado basado en las aplicaciones espaciales de insecticidas alrededor de las casas y en el uso de larvicidas (Bti). Los resultados preliminares sugieren un significativo descenso en la densidad, la paridad y la expectativa de vida del vector, justamente a partir del inicio de esta nueva estrategia de control

Seguimiento traumatológico en la consulta externa de ortopedia / Suivie traumatologique dans la consultation externe d'orthopédie / Traumatological follow-up at the orthopedic outpatient department

Los autores exponen su experiencia institucional en el seguimiento de los pacientes con inmovilizaciones por lesiones traumáticas en la consulta externa de ortopedia del Hospital General Docente Martín Chang Puga, de Nuevitas, Camagüey. El estudio estadístico efectuado demostró que el 60,3 por ciento no concluye el tratamiento indicado para su afección, el 53,1 por ciento no acude a la reconsulta y el 10,5 por ciento de los que lo hacen se ha retirado la inmovilización previamente por su cuenta. Esta conducta, además de las consecuencias futuras que puede tener para estos pacientes no concluir adecuadamente su tratamiento y la afectación económica al presupuesto estatal por los recursos invertidos no aprovechados, desestabiliza el correcto funcionamiento de este servicio. Se hacen recomendaciones con vistas a mejorar este comportamiento incorrecto por parte de los pacientes y lograr un aprovechamiento óptimo de los recursos por el personal de asistencia(AU)

The authors expose their institutional experience in the follow-up of patients with immobilizations due to traumatic injuries at the orthopedic outpatient department of the Martín Chang Puga General Teaching Hospital in Nuevitas, Camagüey. The statistical study conducted showed that 60,3 percent do not conclude the treatment indicated for their affection, 53,1 percent do not visit the physician's office again, and 10,5 percent of those who do it have previously removed the immobilization on their own. This behaviour apart from producing future consequences for those who do not conclude their treatment adequatly and affectating the state budget as a result of the misuss of resources, destabilizes the efficient work of this service. Recommendations are made to improve this incorrect conduct of the patients, and to make an optimal use of the resources on the part of the assistance personnel(AU)

Les auteurs exposent leur expérience dans la suivie des patients avec immobilisations par lésions traumatiques dans la consultation externe d'orthopédie de l'Hôpital Général Universitaire Martín Chang Puga, à Nuevitas, Camagüey. L'étude statistique réalisé a démontré que 60,3 pourcent ne finit pas le traitement indiqué, 53,1 pourcent n'assiste pas à reconsultation et 10,5 pourcent de ceux qu'y assistent ont enlevé le plâtre pour son propre compte. Cette conduite, en plus de conséquences futures pour ces patients de ne pas conclure leur traitement et l'affectation économique au budget de l'état par les resources investis non profités, destabilise le bon fonctionnement de ce service. On recommende aux patients d'améliorer cette conduite incorrecte et d'atteindre un profit optimal des ressources par le personnel de soin(AU)

Causas de hospitalización y complicaciones intrahospitalarias en lupus eritematoso sistémico / Sistemic Lupus erythematosus: hospitalization causes and hospitalary complications

Antecedentes: Actualmente, se considera que el LES es un padecimiento con baja mortalidad y alta morbilidad. Una forma de medir la morbilidad del LES es a través del estudio de las causa de hospitalización. Objetivos: Determinar las causas de hopitalización y complicaciones intrahospitalarias en pacientes con LES. Métodos: Se realizó la revisión de expedientes de los pacientes con LES hospitalizados durante 1990-93. Resultados: Ciento veintitrés pacientes tuvieron 321 hospitalizaciones y un total de 3,756 días-hospital; el promedio de estancia hospitalaria fue de 13.9 ñ 11.4 días. Las principales causas de hospitalización fueron actividad del LES (51 por ciento), complicaciones médicas relacionadas al LES o a su tratamiento (24 por ciento) e infección (15 por ciento). La frecuencia de infecciones intrahospitalarias fue del 23 por ciento. El tres por ciento de las hospitalizaciones necesitaron admisión a cuidados intensivos. Conclusiones: El 75 por ciento de las hospitalizaciones en pacientes con LES son por actividad de la enfermedad y complicaciones asociadas al LES mismo o a su tratamiento