Neuromonitoreo con electroencefalograma procesado, más que profundidad anestésica / Neuromonitoring with processed electroencephalogram, more than anesthetic depth

Resumen: El neuromonitoreo intraoperatorio con electroencefalograma (EEG) y electroencefalograma procesado (pEEG) permite la evaluación de cambios en la actividad eléctrica cerebral generados por los anestésicos, además de prevenir eventos adversos como recuerdo intraoperatorio, sobredosis farmacológica, compromiso hemodinámico y/o neurológico, delirio y disfunción cognitiva postoperatoria. Sin embargo, la actividad eléctrica cortical puede estar modulada y ser afectada por alteraciones fisiopatológicas, independientemente del efecto de los fármacos anestésicos, por lo que, tanto el EEG como el pEEG pueden ser auxiliares en el diagnóstico oportuno de trastornos metabólicos, hipóxicos, supresión de la actividad eléctrica cerebral, estados epilépticos no convulsivos, hipertensión intracraneal, hipoperfusión o isquemia cerebral. El neuromonitoreo de rutina con el monitor disponible es recomendable con el fin de mejorar nuestra experiencia en su uso para una anestesia personalizada y de precisión, estableciendo estado de profundidad anestésica y dosis farmacológica óptima para el mantenimiento de los mecanismos implicados en la autorregulación de la perfusión cerebral, mejor comprensión de la fisiología, función cerebral y su interacción con los anestésicos e impacto hemodinámico del paciente neuroquirúrgico y no neuroquirúrgico, identificando signos precoces de posibles complicaciones derivadas del procedimiento o por efecto farmacológico y su rápida resolución.

Abstract: Intraoperative neuromonitoring with electroencephalogram (EEG) and processed electroencephalogram (pEEG) allows the evaluation of changes in brain electrical activity and unconsciousness generated by anesthetics, as well as preventing adverse events such as intraoperative recall, drug overdose, hemodynamic and/or neurological compromise, delirium and postoperative cognitive dysfunction. However, cortical electrical activity can be modulated and affected by pathophysiological alterations, independently of the effect of anesthetic drugs, both EEG and pEEG can be helpful in the timely diagnosis of metabolic, hypoxic, and suppression of electrical activity disorders brain, non-convulsive status epilepticus, intracranial hypertension, hypoperfusion or cerebral ischemia. Routine neuromonitoring with the available monitor is recommended in order to improve our experience in order to achieve a patient personalized and precise anesthesia level, arriving to an optimal dose for the maintenance of the mechanisms involved in the autoregulation of cerebral perfusion, understanding brain physiology, function as well as its interaction with drugs and hemodynamic impact to neurosurgical and non-neurosurgical patients, identifying early signs of possible complications derived from the procedure or due to pharmacological effect and their rapid resolution.

Reporte de Pecari tajacu y Procyon lotor con anomalías cromáticas en el Estado de Guerrero, México

Este trabajo documenta el primer registro de anomalías cromáticas en el pecarí de collar (Pecari tajacu) y el tercero en el mapache (Procyon lotor) para México. Los hallazgos se realizaron durante el monitoreo realizado entre el 2009 y el 2021, utilizando cámaras-trampa, principalmente en la ecorregión de la Sierra Madre del Sur del estado de Guerrero, México. Procyon lotor fue registrado entre el 5 de noviembre y el 1 de diciembre de 2019, en vegetación riparia de bosque tropical caducifolio (17°47'35"N, 98°39'59"W, 1134 m de altitud). Mientras que Pecari tajacu se registró el 7 de junio y el 22 de julio del 2021 en una brecha saca cosecha abandonada (17°38'12"N, 100°40'50"W; 1532 m de altitud).

This paper documents the first record of chromatic anomalies in Collared Peccary (Pecari tajacu) and the third in the Raccoon (Procyon lotor) for Mexico. The findings were made during monitoring conducted between 2009 and 2021, using camera traps, primarily in the Sierra Madre del Sur ecoregion of the state of Guerrero, Mexico. Procyon lotor was recorded between November 5th and December 1st, 2019, in riparian vegetation of a deciduous tropical forest (17°47'35"N, 98°39'59"W, 1134 m altitude). Meanwhile, Pecari tajacu was recorded on June 7th and July 22nd, 2021, in an abandoned crop clearing (17°38'12"N, 100°40'50"W; 1532 m altitude).

Description of the National Mortality Register of Panama.

Introduction: The National Mortality Register (NMR) of Panama is a key element in demographic analysis and in acquiring an updated picture of population health in Panama. The main objectives of this study are to characterize the NMR and to enumerate its strengths and weaknesses. Methods: We describe the history, processes, and structure of the Vital Statistics Section of the National Institute of Statistics and Census (the curator of the NMR database). In addition, we discuss publication punctuality, underregistration of the data, the proportion of registered deaths certified by medical doctors, and the top 5 causes of death according to the 80 groups of the International Classification of Diseases, Tenth Revision. We also examine works derived from the register's data, from the first publication on its website (2002) until 2019. Results: The NMR procedures were described. The web reports of the NMR were performed with a delay of between 1 to 2 years. The underregistration of deaths in 2002-2019 was 14.7%, and the national yearly proportion of deaths certified by medical doctors was always above 90%. Hard-to-reach areas had higher underregistration proportions and fewer deaths certified by medical doctors. Information extracted from the NMR supports several national and international reports, geographic information systems, and studies. The most common causes of death between 2002 and 2019 were noncommunicable diseases. Conclusions: The NMR is a robust official information system. However, hard-to-reach areas require improvement in terms of the NMR. The NMR is used for publishing official reports, writing studies, and updating reports on the current health status of Panama in a timely fashion following international guidelines.

Komatiites as Complex Adsorption Surfaces for Amino Acids in Prebiotic Environments, a Prebiotic Chemistry Essay.

Komatiites represent the oldest known terrestrial rocks, and their composition has been cataloged as the closest to that of the first terrestrial crust after the cooling of the magma ocean. These rocks could have been present in multiple environments on the early Earth and served as concentrators of organic molecules. In this study, the adsorption of five amino acids (glycine, lysine, histidine, arginine, and aspartic acid) on a natural komatiite, a simulated komatiite, and the minerals olivine, pyroxene, and plagioclase were analyzed under three different pH values: acid pH (5.5), natural pH of the aqueous solution of each amino acid and alkaline pH (11). Adsorption experiments were performed in solid-liquid suspensions and organic molecules were analyzed by spectrophotometry. The main objective of this essay was to determine if the complex surfaces could have participated as concentrators of amino acids in scenarios of the primitive Earth and if the adsorption responds to the change of charge of the molecules. The results showed that komatiite is capable of adsorbing amino acids in different amounts depending on the experimental conditions. In total, 75 systems were analyzed that show different adsorptions, which implies that different interactions are involved, particularly in relation to the type of amino acid, the type of solid material and the conditions of the medium.

Public Policies and Programs for the Prevention and Control of Breast Cancer in Latin American Women: Scoping Review.

BACKGROUND: Breast cancer has positioned itself worldwide as one of the main public health problems, especially in Latin America. In some countries, several programs for the prevention and control of breast cancer in women have been developed and implemented on a permanent basis, but there are no public reports on the policies that originated such programs. OBJECTIVE: A scoping review of scientific publications that identify the type, extent, and scope of policies and programs for the prevention and control of breast cancer in Latin American women was performed, and the main results were presented in this paper. METHODS: This scoping review was carried out according to the method by Arksey and O'Malley based on 3 fundamental questions about breast cancer prevention and control policies in Latin America: their type, extent and scope, and reference framework. The search period was from 2000 to 2019, and the search was carried out in the following databases: MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Academic Search Complete (EbscoHost), ISI Web of Science (Science Citation Index), and Scopus in English, Spanish, and Portuguese, and Scielo, Cochrane, and MEDES-MEDicina in Spanish and Portuguese. Of the 743 studies found, 20 (2.7%) were selected, which were analyzed using descriptive statistics and qualitative content analysis. RESULTS: The selected studies identified several Latin American countries that have generated policies and programs to prevent and control breast cancer in women, focusing mainly on risk communication, prevention and timely detection, effective access to health services, improvement of the screening process, and evaluation of screening programs. Evaluation criteria and greater participation of civil society in policy design and program execution are still lacking. This could undoubtedly help eliminate existing barriers to effective action. CONCLUSIONS: Although several Latin American countries have generated public policies and action programs for the prevention and control of breast cancer, a pending issue is the evaluation of the results to analyze the effectiveness and impact of their implementation given the magnitude of the public health problem it represents and because women and civil society play an important role in its prevention and control. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/12624.

Response to Cold: A Comparative Transcriptomic Analysis in Eight Cold-Adapted Yeasts.

Microorganisms have evolved to colonize all biospheres, including extremely cold environments, facing several stressor conditions, mainly low/freezing temperatures. In general, terms, the strategies developed by cold-adapted microorganisms include the synthesis of cryoprotectant and stress-protectant molecules, cold-active proteins, especially enzymes, and membrane fluidity regulation. The strategy could differ among microorganisms and concerns the characteristics of the cold environment of the microorganism, such as seasonal temperature changes. Microorganisms can develop strategies to grow efficiently at low temperatures or tolerate them and grow under favorable conditions. These differences can be found among the same kind of microorganisms and from the same cold habitat. In this work, eight cold-adapted yeasts isolated from King George Island, subAntarctic region, which differ in their growth properties, were studied about their response to low temperatures at the transcriptomic level. Sixteen ORFeomes were assembled and used for gene prediction and functional annotation, determination of gene expression changes, protein flexibilities of translated genes, and codon usage bias. Putative genes related to the response to all main kinds of stress were found. The total number of differentially expressed genes was related to the temperature variation that each yeast faced. The findings from multiple comparative analyses among yeasts based on gene expression changes and protein flexibility by cellular functions and codon usage bias raise significant differences in response to cold among the studied Antarctic yeasts. The way a yeast responds to temperature change appears to be more related to its optimal temperature for growth (OTG) than growth velocity. Yeasts with higher OTG prepare to downregulate their metabolism to enter the dormancy stage. In comparison, yeasts with lower OTG perform minor adjustments to make their metabolism adequate and maintain their growth at lower temperatures.

Biphasic synovial sarcoma of the hypopharynx: Case report and literature review.

INTRODUCTION: Synovial Sarcoma is a rare malignancy that accounts between 8 and 10% of soft tissue neoplasms, with the highest presentation rate in extremities, an extremely uncommon condition in head and neck. CLINICAL FINDINGS: We present a case of an 18-year-old male with synovial sarcoma situated at hypopharynx who underwent surgical resection and postoperative radiotherapy. CONCLUSION: Synovial Sarcoma represents a rare head and neck malignancy with challenging diagnostic approach due to its frequency and nonspecific clinical manifestations. Surgical treatment must assure good free margins. Adjuvant radiotherapy has a positive impact in local recurrence and survival.

Pre- and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification.

Abdominal wall hernias are common and can present as technical challenges to surgeons. When large, hernias diminish quality of life. Various classifications of incisional hernias have been proposed; however, there are many terms, sometimes causing confusion (1). Radiologists must know the normal anatomy of the abdominal wall, the CT protocol, and what if any maneuvers can be performed to better identify an abdominal wall defect. The description of the radiological approach for primary and incisional wall hernias is based on the 2007 European Hernia Society classification, with particular emphasis on presurgical and postsurgical imaging findings. This classification provides a simple and reproducible method to describe hernias to offer proper surgical management. We highlight this classification so that radiologists and surgeons can have a unified language.

Hematoma subcapsular hepático pos-CPRE: reporte de caso y revisión de la literatura / Subcapsular hepatic hematoma after ERCP. Case report and literature review

Resumen Presentamos el caso de un paciente de 68 años, sin antecedentes de importancia, que por su cuadro clínico y resultados paraclínicos fue clasificado con riesgo intermedio para coledocolitiasis. En efecto, por medio de colangiorresonancia se realizó el diagnóstico confirmatorio. Fue llevado a colangiopancreatografía retrograda endoscópica en dos ocasiones -la primera fallida por papila intradiverticular-; en el segundo intento (exitoso con extracción del lito), el paciente presentó evolución posprocedimiento tórpida, con marcado dolor abdominal y anemización. Fue llevado a tomografía de abdomen con contraste, la cual confirmó el diagnóstico de hematoma subcapsular. Se decidió implementar el manejo conservador y se logró un control adecuado del sangrado.

Abstract This is the case of a 68-year-old female patient, with no relevant history, who was classified as intermediate risk for choledocholithiasis due to her symptoms and lab test results. The diagnosis was confirmed by means of cholangioresonance. She was taken to ERCP on two occasions; the first failed due to intradiverticular papilla, and during the second attempt (successful with the removal of the stone), the patient had a torpid post-procedure evolution, with marked abdominal pain and anemization. An abdominal tomography with contrast was performed, which confirmed the diagnosis of subcapsular hematoma. A conservative management was implemented, achieving adequate bleeding control.

Anchialine cave-dwelling sponge fauna (Porifera) from La Quebrada, Mexico, with the description of the first Mexican stygobiont sponges.

Porifera has been relatively well studied from underwater caves worldwide. However, sponges in Mexico are only known from two anchialine caves: La Quebrada and El Aerolito, both in Cozumel Island. An ecological study found that sponges have the second highest species richness and density in La Quebrada. The aim of the present work is to describe the sponge biodiversity inhabiting the dark zone of La Quebrada anchialine cave. A total of ten species were found and are described herein, six are new species to science vis. Calyx maya n. sp. a thinly branched sponge; Haliclona (Reniera) stygobia n. sp. globe-shaped with the thinnest diameter of oxeas in its group; Haliclona (Halichoclona) chankanaabiis n. sp. tubular habit with the smallest oxeas in its group; Neosiphonia microtriaeneae n. sp. characterized by very small dichotriaenes; Svenzea germanyanezi n. sp. a lone conical shape; and Diplastrella cozumella n. sp. for its tri to multilobed tylostyles. The other four species are previously known from open reefs or deep-sea: Discodermia adhaerens, Siphonidium ramosum, Cinachyrella kuekenthali, and Plakinastrella onkodes. This is the only inventory of Porifera in Mexican caves up to now, thus the species here described are the first stygobiont sponges from Mexico with an endemism rate of Porifera in this anchialine cave of 60%. Conservation programs are needed to preserve this unique and special ecosystem.

Exomes of Ductal Luminal Breast Cancer Patients from Southwest Colombia: Gene Mutational Profile and Related Expression Alterations.

Cancer is one of the leading causes of mortality worldwide. Breast cancer is the most frequent cancer in women, and in recent years it has become a serious public health problem in Colombia. The development of large-scale omic techniques allows simultaneous analysis of all active genes in tumor cells versus normal cells, providing new ways to discover the drivers of malignant transformations. Whole exome sequencing (WES) was obtained to provide a deep view of the mutational genomic profile in a set of cancer samples from Southwest Colombian women. WES was performed on 52 tumor samples from patients diagnosed with invasive breast cancer, which in most cases (33/52) were ductal luminal breast carcinomas (IDC-LM-BRCA). Global variant call was calculated, and six different algorithms were applied to filter out false positives and identify pathogenic variants. To compare and expand the somatic tumor variants found in the Colombian cohort, exome mutations and genome-wide expression alterations were detected in a larger set of tumor samples of the same breast cancer subtype from TCGA (that included DNA-seq and RNA-seq data). Genes with significant changes in both the mutational and expression profiles were identified, providing a set of genes and mutations associated with the etiology of ductal luminal breast cancer. This set included 19 single mutations identified as tumor driver mutations in 17 genes. Some of the genes (ATM, ERBB3, ESR1, TP53) are well-known cancer genes, while others (CBLB, PRPF8) presented driver mutations that had not been reported before. In the case of the CBLB gene, several mutations were identified in TCGA IDC-LM-BRCA samples associated with overexpression of this gene and repression of tumor suppressive activity of TGF-ß pathway.

A Heterologous Viral Protein Scaffold for Chimeric Antigen Design: An Example PCV2 Virus Vaccine Candidate.

Recombinant vaccines have low-cost manufacturing, regulatory requirements, and reduced side effects compared to attenuated or inactivated vaccines. In the porcine industry, post-weaning multisystemic disease syndrome generates economic losses, characterized by progressive weight loss and weakness in piglets, and it is caused by porcine circovirus type 2 (PCV2). We designed a chimeric antigen (Qm1) to assemble the main exposed epitopes of the Cap-PCV2 protein on the capsid protein of the tobacco necrosis virus (TNV). This design was based on the Cap-N-terminal of an isolated PCV2 virus obtained in Chile. The virus was characterized, and the sequence was clustered within the PCV2 genotype b clade. This chimeric protein was expressed as inclusion bodies in both monomeric and multimeric forms, suggesting a high-molecular-weight aggregate formation. Pigs immunized with Qm1 elicited a strong and specific antibody response, which reduced the viral loads after the PCV2 challenge. In conclusion, the implemented design allowed for the generation of an effective vaccine candidate. Our proposal could be used to express the domains or fragments of antigenic proteins, whose structural complexity does not allow for low-cost production in Escherichia coli. Hence, other antigen domains could be integrated into the TNV backbone for suitable antigenicity and immunogenicity. This work represents new biotechnological strategies, with a reduction in the costs associated with vaccine development.

Neumonía por COVID19: Valoración por imagen, lo básico / COVID­19 pneumonia: Imaging evaluation, the basics

La pandemia de COVID­19 ha resultado en una emergencia de salud global. Los estu­dios de imagen utilizados en esta enfermedad son la radiografía de tórax (RX) y la to­mografía computarizada (TC). Ambas modalidades tienen sus hallazgos descritos, pero no son específicos dado que muchas enfermedades pueden producir patrones simila­res, particularmente las neumonías virales. Los RX de tórax muestra hallazgos consis­tentes en opacidades alveolares las cuales son múltiples, periféricas, bilaterales y basales, mientras que la tomografía de tórax sus hallazgos más frecuentes son presen­cia de patrón en vidrio deslustrado, consolidaciones, engrosamiento septal, patrón en empedrado, dilatación bronquial y engrosamiento peri bronquial, broncograma, patrón de halo invertido y patrón de neumonía organizada. Los hallazgos por imagen depen­den del tiempo de evolución de la enfermedad ya que en etapas tempranas puede ser normal tanto en la RX como la TC. El riesgo de trombo embolismo pulmonar es alto y más frecuente que en pacientes con COVID­19 negativo

The COVID­19 pandemic has resulted in a global health emergency. The imaging stu­dies used in this disease are chest radiography (CXR) and computed tomography (CT). Both imaging modalities findings have had their findings. These findings described are not specific since many diseases can produce similar patterns. CXR shows somewhat consistent findings consisting of alveolar opacities which are multiple, peripheral, bilate­ral and basal, while CT the most frequent findings are the presence of grounded glass pattern, consolidations, septal thickening, crazy paving pattern, bronchial dilation and peribronchial thickening, air bronchograms, inverted halo sign and organized pneumo­nia. Imaging findings depends on the evolution time of the disease since in the early sta­ges both chest radiography and tomography may be normal. The risk for pulmonary embolism is high and more frequent than in patients with negative COVID­19

Multiwall and bamboo-like carbon nanotubes from the Allende chondrite: A probable source of asymmetry.

This study presents multiwall and bamboo-like carbon nanotubes found in samples from the Allende carbonaceous chondrite using high-resolution transmission electron microscopy (HRTEM). A highly disordered lattice observed in this material suggests the presence of chiral domains in it. Our results also show amorphous and poorly-graphitized carbon, nanodiamonds, and onion-like fullerenes. The presence of multiwall and bamboo-like carbon nanotubes have important implications for hypotheses that explain how a probable source of asymmetry in carbonaceous chondrites might have contributed to the enantiomeric excess in soluble organics under extraterrestrial scenarios. This is the first study proving the existence of carbon nanotubes in carbonaceous chondrites.

Biological survey of a cloud forest in southwestern Mexico: plants, amphibians, reptiles, birds, and mammals / Estudio biológico del bosque mesófilo de montaña en el suroeste de México: plantas, anfibios, reptiles, aves y mamíferos

Abstract: Cloud forest ecosystems contain unique flora and fauna characterized by high levels of richness and endemism. However, this ecosystem is one of the most threatened because of land-use changes stemming from anthropogenic activities. Therefore, biological inventories are necessary to adequately assess the effects of land-use changes on species now and in the future. In this study, we conducted an inventory of plants and terrestrial vertebrates (amphibians, reptiles, birds, and mammals) in three fragments of cloud forest in southwestern Mexico. Field work was carried out for 15 days per biological group during distinct time periods (2005-2008). Conventional methods of species capture and observation were employed to record species. Recorded species were then categorized based on their endemism and risk category. A total of 67 species of plants, 17 species of amphibians, 25 species of reptiles, 93 species of birds, and 46 species of mammals were recorded. The species accumulation curves for most taxa, except for birds and mammals, showed an asymptotic trend. A total of 56 species endemic to Mexico and four quasi-endemic species were recorded. Plants, amphibians, and reptiles presented the greatest number of species exclusive to Mexico (13 species). Six species of herpetofauna endemic to Guerrero were recorded. According to Mexican laws, 24 of the encountered species are under special protection, while 16 are categorized as threatened and seven as endangered. Reptiles and birds presented the greatest number of at-risk species (14 species). Bird and mammal richness in this study is high in comparison to that recorded in the cloud forests of the entire Mexican state of Guerrero (157 and 75 species, respectively). This data highlights the importance of cloud forests in the study area for local and regional biodiversity. Effective conservation strategies should be prioritized in cloud forests, as this ecosystem is poorly represented in natural protected areas.

Resumen: Los bosques mesófilos de montaña son ecosistemas que contienen flora y fauna única, y son caracterizados por sus altos niveles de riqueza y endemismo. Este ecosistema es uno de los más amenazados debido a los cambios en el uso del suelo por actividades antropogénicas. Por tanto, los inventarios bióticos en este ecosistema son necesarios para evaluar adecuadamente los cambios en el uso del suelo sobre las especies en la actualidad y en el futuro. En este estudio se desarrollaron inventarios de plantas y vertebrados terrestres (anfibios, reptiles, aves y mamíferos) en tres fragmentos de bosque mesófilo de montaña en el suroeste de México. El trabajo de campo se realizó durante 15 días por cada grupo biológico durante distintos períodos de tiempo (2005 al 2008). Los registros de las especies se obtuvieron mediante métodos convencionales de captura y observación. Se categorizaron a las especies por su endemismo y categoría de riesgo. Se registró un total de 67 especies de plantas, 17 especies de anfibios, 25 especies de reptiles, 93 especies de aves y 46 especies de mamíferos. Las curvas de acumulación mostraron un comportamiento asintótico para la mayoría de los taxa, excepto aves y mamíferos. Se obtuvo un total de 56 especies endémicas a México y cuatro cuasiendémicas. Los grupos de plantas, anfibios y reptiles presentaron el mayor número de especies exclusivas al país (13 especies), y se obtuvo un total de seis especies de herpetofauna endémicas a Guerrero. De acuerdo con las leyes mexicanas, se registró un total 24 especies en protección especial, 16 amenazadas y siete en peligro de extinción, de los cuales los grupos de los reptiles y aves presentaron el mayor número de especies en categoría de riesgo (14 especies). La riqueza de especies de aves y mamíferos en este estudio representa un número importante comparado con el total de especies registradas en los bosques mesófilos del estado de Guerrero (157 y 75 especies, respectivamente). Estos datos resaltan la importancia de los bosques mesófilos de montaña del área de estudio para la biodiversidad local y regional, por lo que deben priorizarse estrategias de conservación efectivas para este ecosistema poco representado en áreas naturales protegidas.

Pulmonary complications after non-cardiac surgeries: temporal patterns and risk factors.

BACKGROUND: Postoperative complications are the primary determinants of survival following major surgery. We aimed to characterize the early perioperative risk factors for postoperative pulmonary complications (POPCs) in patients undergoing major non-cardiac surgeries. METHODS: This study utilized a multicenter prospective observational cohort design. Adult patients undergoing non-cardiac surgeries and admitted to 21 Brazilian ICUs were screened for inclusion in the study. POPCs were defined as the presence of acute pulmonary oedema, nosocomial pneumonia, and extubation failure in the postoperative period. RESULTS: Of the 581 patients enrolled, 110 (19%) had at least one POPC, of whom 5% had acute pulmonary oedema, 10% extubation failure while 10% had pneumonia. Most cases of pulmonary oedema occurred in the first week after surgery, while pneumonia was more frequently a later occurrence. The mortality rate was significantly higher in the group with POPCs compared to the group of patients without POPCs (62% vs. 11%, RR: 5.1, 95% CI: 4.23-7.69; P < 0.001). A low functional capacity (RR: 4.6, 95% CI: 2.1-10.0), major surgery (RR: 3.6, 95% CI: 1.2-10.7), preoperative hemodynamic instability (RR: 3.4, 95% CI: 1.1-10.6), alcoholism (RR: 3.3, 95% CI: 1.0-10.7), unplanned surgery (RR: 2.3, 95% CI: 1.0-5.2), the SOFA score (RR: 1.1, 95% CI: 1.0-1.2), and increased central venous pressure (RR: 1.1, 95% CI: 1.0-1.1) were independent predictors of POPCs. CONCLUSIONS: Pulmonary complications are common in intensive care units after major non-cardiac surgeries. Awareness of the risk factors for POPCs may help multidisciplinary teams develop strategies to prevent these complications.

Efficient and automated large-scale detection of structural relationships in proteins with a flexible aligner.

BACKGROUND: The total number of known three-dimensional protein structures is rapidly increasing. Consequently, the need for fast structural search against complete databases without a significant loss of accuracy is increasingly demanding. Recently, TopSearch, an ultra-fast method for finding rigid structural relationships between a query structure and the complete Protein Data Bank (PDB), at the multi-chain level, has been released. However, comparable accurate flexible structural aligners to perform efficient whole database searches of multi-domain proteins are not yet available. The availability of such a tool is critical for a sustainable boosting of biological discovery. RESULTS: Here we report on the development of a new method for the fast and flexible comparison of protein structure chains. The method relies on the calculation of 2D matrices containing a description of the three-dimensional arrangement of secondary structure elements (angles and distances). The comparison involves the matching of an ensemble of substructures through a nested-two-steps dynamic programming algorithm. The unique features of this new approach are the integration and trade-off balancing of the following: 1) speed, 2) accuracy and 3) global and semiglobal flexible structure alignment by integration of local substructure matching. The comparison, and matching with competitive accuracy, of one medium sized (250-aa) query structure against the complete PDB database (216,322 protein chains) takes about 8 min using an average desktop computer. The method is at least 2-3 orders of magnitude faster than other tested tools with similar accuracy. We validate the performance of the method for fold and superfamily assignment in a large benchmark set of protein structures. We finally provide a series of examples to illustrate the usefulness of this method and its application in biological discovery. CONCLUSIONS: The method is able to detect partial structure matching, rigid body shifts, conformational changes and tolerates substantial structural variation arising from insertions, deletions and sequence divergence, as well as structural convergence of unrelated proteins.

Prevalencia de helicobacter pylori en un grupo de pacientes pediátricos infectados por el virus de la inmunodeficiencia humana / Prevalence of helicobacter pylori in a sample of pediatric patients infected by human inmunodeficiency virus

Se realizó un estudio cuantitativo, descriptivo transversal y no experimental sobre la prevalencia de Helicobacter pylori en pacientes pediátricos infectados por el virus de inmunodeficiencia humana (VIH), internados en el Hospicio San José, Santa Lucía Milpas Altas, Sacatepéquez, Guatemala, durante los meses de noviembre 2012 a enero 2013. La población completa fue conformada por 40 pacientes pediátricos de ambos sexos, entre los 3 y 12 años de edad, que padecen infección por VIH. Para el diagnóstico de infección por H. pylori se utilizó la detección de antígeno en heces por inmunocromatografía. Se encontró un resultado positivo en el 35%, con una mayor incidencia en varones, correspondiendo al 71.4% de los casos. En cuanto a la distribución por edades, el rango de edad con más casos positivos fue el comprendido entre los 7 y 8 años, con un 66.7% de los casos. La prevalencia de H. pylori en la población pediátrica VIH positiva estudiada fue mayor que la reportada en poblaciones similares, pero menor a la reportada en la población pediátrica VIH negativo. Se recomienda realizar un estudio multicéntrico para confirmar la prevalencia de H. pylori en la población pediátrica guatemalteca VIH positivo.

Aquantitative, descriptive, transversal, non experimental study was conducted on the prevalence of Helicobacter pylori in pediatric patients infected with the human immunodeficiency virus (HIV), who were admitted in the Hospice San Jose, Santa Lucia Milpas Altas, Sacatepequez, Guatemala, during November 2012 through January 2013. The study population included pediatric patients of both sexes, aged 3 to 12 years, who are infected with HIV. For the diagnosis of H. pylori infection an antigen stool test by immunochromatography was used. The population in the study period amounted to 40 patients in whom a positive result of 35% was found, 71.4% from male patients. In the age distribution it was found that the age range with more positive cases (66.7%) was between 7 and 8 years. The prevalence of H. pylori in the studied HIV positive pediatric population was higher than reported in similar populations, yet lower than reported in the HIV negative pediatric population. It is recommended that a multicenter study confirm the prevalence of H. pylori in the HIV positive Guatemalan pediatric population.