Atmospheric Warming Drives Growth in Arctic Sea Ice: A Key Role for Snow.

A number of feedbacks regulate the response of Arctic sea ice to local atmospheric warming. Using a realistic coupled ocean-sea ice model and its adjoint, we isolate a mechanism by which significant ice growth at the end of the melt season may occur as a lagged response to Arctic atmospheric warming. A series of perturbation simulations informed by adjoint model-derived sensitivity patterns reveal the enhanced ice growth to be accompanied by a reduction of snow thickness on the ice pack. Detailed analysis of ocean-ice-snow heat budgets confirms the essential role of the reduced snow thickness for persistence and delayed overshoot of ice growth. The underlying mechanism is a snow-melt-conductivity feedback, wherein atmosphere-driven snow melt leads to a larger conductive ocean heat loss through the overlying ice layer. Our results highlight the need for accurate observations of snow thickness to constrain climate models and to initialize sea ice forecasts.

Errores en el proceso de medicación de pacientes internados en el hospital público materno infantil de Salta / Errors in the medication-process in hospital público materno infantil of Salta

INTRODUCCIÓN Los errores de medicación son causa de eventos adversos en la atención sanitaria. Su registro constituye una estrategia clave para el aprendizaje orientado a la prevención. OBJETIVOS Conocer la epidemiología de los errores en el proceso de medicación del Hospital Público Materno Infantil. MÉTODOS Los errores fueron identificados a partir de la validación farmacéutica de las prescripciones recibidas en farmacia desde el 1 de noviembre de 2012 al 31 de enero de 2013. Se construyeron bases de datos para conocer las tasas de error, y se analizaron asociaciones entre ocurrencia de error y factores relacionados al paciente, al tratamiento farmacológico y al recurso humano que intervino en el proceso. RESULTADOS Se validaron 18 203 prescripciones médicas en las que se detectaron 2989 (95,3%) errores de prescripción, 79 (2,5%) de administración, 6 (0,2%) de transcripción y 18 (6%) de dispensación. La tasa de error del Área Perinatológica fue de 13,06 cada 100 días-paciente con elevada frecuencia de prescripciones con omisión de dosis (30%) y dosis incorrecta (23%). En el Área Pediátrica la tasa fue de de 8,6 cada 100 días-paciente, con predominio de prescripción de dosis incorrecta (55%), asociada a la edad del niño. Los grupos farmacoterapéuticos involucrados fueron los analgésicos antiinflamatorios no esteroideos, drogas del aparato digestivo y circulatorio, y antiinfecciosos. Entre estos últimos se destacaron las cefalosporinas de tercera generación. La mayor parte de los errores se produjo con drogas de uso habitual, con consecuencias potencialmente significativas para los pacientes. La tasa de error fue similar para médicos en formación y de planta. DISCUSIÓN La farmacovigilancia intensiva del error permitió identificar un número elevado de deficiencias. Su caracterización será útil para establecer estrategias dirigidas a la prevención en el ámbito hospitalario.

Role of generation, architecture, pH and ionic strength on successful siRNA delivery and transfection by hybrid PPV-PAMAM dendrimers.

Small interfering RNA (siRNA) constitutes an excellent way of knocking down genes. However, it requires the use of delivery systems to reach the target cells, especially to neuronal cells. Dendrimers are one of the most widely used synthetic nanocarriers for siRNA delivery. However, due to the complexity of the dendrimer-siRNA interactions, when a new dendritic carrier is designed it is difficult to predict its efficiency to bind and to deliver siRNA. At the same time it is not easy to understand the origin of eventual limited functionalities. We have modeled the interactions between two dendrimers (TDG-G1 and TDG-G2) and siRNA using molecular dynamics (MD) simulation. The results were compared to experimental physico-chemical parameters such as siRNA complexation, complex stability, size, and zeta potentials and biological effects such as down-regulation of a specific RNA expression in cortical neurons in culture. Data indicate that the combination of rigid core and flexible branches guarantees strong siRNA binding, which is important to have a good transfection profile. However, the successful nanocarrier for siRNA delivery (TDG-G1) is identified not only by a high affinity for siRNA, but by a favorable equilibrium between a strong binding and the ability to release siRNA to exert its biological action. The conditions under which the dendriplex is formed are also relevant for transfection efficiency and biological activity.

Resultados de la técnica de Regnauld para el tratamiento del hallux valgus y el hallux rigidus en 147 casos a los 3 años / Results at 3 years of Regnauld's technique for the treatment of hallux valgus and hallux rigidus in 147 cases

Objetivo: Evaluar los resultados radiológicos, clínicos y funcionales a los 3 años de evolución en pacientes intervenidos quirúrgicamente para la corrección del hallux valgus y el hallux rigidus mediante la técnica de Regnauld. Material y método: Estudio descriptivo retrospectivo de 131 pacientes (147 casos) intervenidos mediante la técnica de Regnauld entre los años 2003 y 2006. Se revisaron 101 mujeres, 30 varones, 16 bilaterales. Edad media de 70 años. Seguimiento medio de 3 años. Se asociaron otros gestos quirúrgicos en 73 casos. Antes y tras la cirugía se valoró el estado clínico y funcional con el test de la escala AOFAS (American Orthopaedic Foot & Ankle Society) y se midieron los ángulos metatarsofalángico (AMTF), intermetatarsal (IM) y DASA (distal articular set angle ‘ángulo articular distal’). Resultados: Corrección del AMTF: 16,6°, del IM: 2° y del DASA: 1,7°. La puntuación en la escala AOFAS mejoró de 39,6 a 85,4. Resultados: En la escala subjetiva, las valoraciones fueron excelentes (25%), buenas (68%), aceptables (5%) y malas (2%). Resultados En el 4,7% hubo recidivas; en el 2% hubo dolor moderado, sin casos de hallux rigidus, hallux varus ni infección; no hubo ninguna reintervención.ConclusionesLos resultados a medio plazo son satisfactorios, con un bajo porcentaje de complicaciones. La técnica permite acortar la primera falange, corregir rotaciones, reducir los AMTF y DASA, mantener la congruencia y la integridad articular y recuperar su funcionalidad (AU)

Purpose: To assess radiological, clinical and functional results at 3 years’ evolution of patients subjected to surgical correction of hallux valgus and hallux rigidus by means of the Regnauld technique. Materials and Methods: Descriptive retrospective study of 131 patients and 147 cases operated through the Regnauld technique between 2003 and 2006. One hundred and one females and 30 males were reviewed; 16 cases were bilateral. Mean age was 70 years. Mean follow-up was 3 years. Additional surgical maneuvers were used in 73 cases. Before and after surgery, an assessment was made of the patients’ clinical and functional status using both the AOFAS and a subjective scale; measurements were taken of the metatarsophalangeal (MTP), intermetatarsal (IM) and distal articular set angles (DASA). Results: The degrees of correction achieved were 16.6° for the MTP angle, 2° for the IM angle and 1.7° for the DASA angle. Scores on the AOFAS scale improved from 39.6 to 85.4 points. On the subjective scale, 25% of cases rated their result as excellent, 68% as good and 2% as poor. As far as complications were concerned, there were 4.7% recurrences, 2% instances of moderate pain with no cases of hallux rigidus, hallux varus or infection. There were no reoperations. Conclusions: The technique makes it possible to shorten the first phalanx, correct rotations, reduce the MTP and DASA angles, preserve the joint's congruence and integrity los AMTF y DASA and regain its function (AU)

Neumotórax catamenial asociado a endometriosis pelviana: a propósito de un caso / Catamenial pneumothorax associated with pelvis endometriosis: a propos of a case

Objetivo: Se presenta el caso de una paciente con neumotórax catamenial y nódulo endometriósico pleural derecho asociado a endometriosis pelviana difusa. Se realiza una revisión de las opciones terapéuticas empleadas en la actualidad. Material y método: Análisis descriptivo de un caso clínico. Caso clínico: Paciente de 28 años de edad que presenta neumotórax catamenial y dismenorrea severa. Se realiza estudio con tomografía axial computarizada de alta resolución, video toracoscopia y ecografía pelviana. Diagnosticada de endometriosis torácica se instaura tratamiento quirúrgico apropiado para la lesión local y se inicia tratamiento con análogos de la GnRH durante 6 meses y tratamiento add-back, cediendo, aunque no totalmente, la sintomatología. Discusión: Se hace una revisión de los tratamientos más aceptados en la actualidad y de aquellos que se plantean como una alternativa de futuro. Conclusiones: La endometriosis pulmonar es una entidad poco frecuente. A la hora de plantearnos el tratamiento, puesto que no vamos a curar la enfermedad, deberemos emplear aquellos que menos efectos secundarios vayan a producir, puesto que será un tratamiento a largo plazo

Objective: We present a patient with catamenial pneumothorax and right pleural endometriotic node associated to difuse pelvic endometriosis. The therapeutical medical options are reviewed. Material and method: A case report. Case report: A 28 years old patient with catamenial pneumothorax and intense dysmenorrhea. The complete case report, hight resolution CT, video thoracoscopy and pelvic ultrasound are analyzed. The apropiatted surgical treatment is used for the local lesion after the diagnostic of thoracic endometriosis. On a second time we used GnRH agonists for six months and add-back treatment to reduce the generalized disease; the symptoms reduced, but not completely. Discussion: The medical options for therapy used today and the new treatments are reviewed. Conclusions: Thoracic endometriosis is a rare entity. Certainly we will not cure the disease completely. Treatments with lesser secondary effects must be given, because it is a long term treatment

Adhesion of Lactobacillus vaginal strains with probiotic properties to vaginal epithelial cells.

The capability of lactobacilli to adhere to vaginal epithelial cells (VEC) has been found to be an important factor in the formation of a barrier to prevent colonization of pathogenic bacteria. The aim of this study was to examine the adhesion ability to VEC, of vaginal Lactobacillus which had been selected for their probiotic properties. A modification of the Mardh and Weströn method was employed for this purpose. Adherent bacteria were determined as CFU-grown using selective media. There was a slight degree of difference in the adhesion properties observed among vaginal and non-vaginal Lactobacillus. Different pH values of 4 and 7 did not affect adhesion (P < 0.70). Scanning and transmission electronic microscopy were performed to illustrate the adhesion of the self-aggregating L. salivarius CRL 1328.

Adhesion of Lactobacillus vaginal strains with probiotic properties to vaginal epithelial cells.

The capability of lactobacilli to adhere to vaginal epithelial cells (VEC) has been found to be an important factor in the formation of a barrier to prevent colonization of pathogenic bacteria. The aim of this study was to examine the adhesion ability to VEC, of vaginal Lactobacillus which had been selected for their probiotic properties. A modification of the Mardh and Westr÷n method was employed for this purpose. Adherent bacteria were determined as CFU-grown using selective media. There was a slight degree of difference in the adhesion properties observed among vaginal and non-vaginal Lactobacillus. Different pH values of 4 and 7 did not affect adhesion (P < 0.70). Scanning and transmission electronic microscopy were performed to illustrate the adhesion of the self-aggregating L. salivarius CRL 1328.

Characterization of a bacteriocin-like substance produced by a vaginal Lactobacillus salivarius strain.

A novel bacteriocin-like substance produced by vaginal Lactobacillus salivarius subsp. salivarius CRL 1328 with activity against Enterococcus faecalis, Enterococcus faecium, and Neisseria gonorrhoeae was characterized. The highest level of production of this heat-resistant peptide or protein occurred during the late exponential phase. Its mode of action was shown to be bactericidal. L. salivarius subsp. salivarius CRL 1328 could be used for the design of a probiotic to prevent urogenital infections.

Selection of vaginal H2O2-generating Lactobacillus species for probiotic use.

Lactobacilli are believed to contribute to the control of the vaginal microflora by different mechanisms such as production of antagonistic substances like lactic acid, bacteriocins, and H2O2. This paper describes the selection of H2O2-generating lactobacilli among 35 hydrophobic isolates from the human vagina. Lactobacillus crispatus F117, which generated the highest H2O2 level, was chosen to study: (a) the kinetics of H2O2 production considering different culture conditions, and (b) the effect of this metabolite on the growth of urogenital tract pathogens. The levels of H2O2 in L. crispatus supernatant increased during its growth and were maximum at the early stationary phase (3.29 mmol H2O2 L-1) under aerated conditions (agitated cultures). In nonagitated cultures there were no detectable levels of H2O2. L. crispatus F117 spent supernatant inhibited Staphylococcus aureus growth in plaque assay. Inhibition was due to H2O2 since catalase treatment of the supernatant suppressed inhibition. In mixed cultures performed with L. crispatus and S. aureus a significant decrease in pathogen growth was observed. The inhibitory effect depended on the initial inoculum of S. aureus. Further evaluation of the properties of L. crispatus F117 will be performed to consider its inclusion in a probiotic for local use in the vaginal tract.

Growth inhibition of Staphylococcus aureus by H2O2-producing Lactobacillus paracasei subsp. paracasei isolated from the human vagina.

H2O2 production by certain Lactobacillus strains is one of the mechanisms that helps to regulate the vaginal ecosystem. This paper describes the kinetics of H2O2 production by two different strains of Lactobacillus paracasei subsp. paracasei under different culture conditions and the effect of this metabolite on the growth of Staphylococcus aureus. L. paracasei F2 produced 2.72 mmol 1-1 H2O2 while L. paracasei F28 produced 1.84 mmol l(-1), both in agitated cultures. Although L. paracasei F2 produced a higher H2O2 concentration than L. paracasei F28, H2O2 production per number of live bacterial cells was 10-fold higher for F28. The latter also showed a faster decrease in viability during the stationary phase. There were no detectable levels of H2O2 in cultures without agitation. H2O2-producing lactobacilli inhibited growth of S. aureus in a plaque assay and in mixed cultures, depending on the initial inoculum of the pathogen.