Etiología y perfil de resistencia antimicrobiana en pacientes con infección urinaria adquirida en la comunidad / Etiology and antimicrobial resistance profile in patients with community-acquired urinary infections

Las infecciones del tracto urinario afectan al ser humano a lo largo de su vida y son frecuentes tanto en el ámbito comunitario como en el nosocomial. El objetivo de este estudio fue Identificar los principales agentes etiológicos y el perfil de resistencia a los antibióticos, presentado por los microorganismos más frecuentemente aislados de los urocultivos de pacientes con infección urinaria que acudieron al Laboratorio "Luis Razetti" Mérida -Venezuela, entre enero y junio de 2015. Este estudio fue de tipo observacional, de corte transversal y descriptivo. La población y muestra estuvo conformada por 149 pacientes de ambos sexos, cuyas muestras de orina fueron procesadas utilizado el método del asa calibrada y la identificación bacteriana mediante pruebas bioquímicas convencionales. La susceptibilidad antimicrobiana se determinó a través del método de difusión del disco en agar. Escherichia coli predominó en un 84,6 %, seguido de Proteus mirabilis y Enterococcus faecalis, ambos con (4,7 %). Los porcentajes más altos de resistencia para los aislados de E. coli, se observaron para ampicilina (92,06 %), ampicilina/sulbactam (68,25 %), ácido nalidíxico (38,89 %), ciprofloxacina (38,89 %) y trimetroprim­sulfametoxazol (54,76 %); y presentaron altos niveles de sensibilidad a Nitrofurantoína (80,95 %). El 5,15 % de las cepas de E. coli se mostraron fenotípicamente productoras de belalactamasa de espectro extendido y el 35,29 % de las otras Enterobacteriaceae aisladas, presentaron un perfil fenotípico compatible con la producción de la enzima Inhibitory-resistant TEM (IRT). Es importante destacar que estos estudios permiten conocer la etiología a de infecciones urinarias en la comunidad, así como los perfiles de resistencia y sensibilidad a nivel local, datos relevantes para establecer pautas de tratamiento empírico adaptadas a cada medio.

Urinary tract infections affect the human being throughout his life and are among the most frequent in both the community and nosocomial settings. The Aim of this study was to Identify the main etiological agents and antibiotic resistance profile presented by isolated microorganisms in the urocultures of patients with urinary tract infection who attended the Laboratory "Luis Razetti" Mérida -Venezuela, between January and June 2015. This study was observational, cross-sectional and descriptive. The population and sample consisted of 149 patients of both sexes, whose urine samples were processed using the calibrated handle method and bacterial identification through conventional biochemical tests. The antimicrobial susceptibility is determined through the disk diffusion method in agar. Escherichia coli dominated by 84.6 %, followed by Proteus mirabilis and Enterococcus faecalis, both with (4.7 %). The highest percentages of resistance for E. coli were observed for ampicillin (92.06 %), ampicillin/sulbactam (68.25 %), nalidixic acid (38.89 %), ciprofloxacin (38.89 %) trimetroprim-sulfamethoxazole (54.76 %); and had high levels of sensitivity to Nitrofurantoin (80.95 %). 5.15 % of E. coli strains were phenotypically producing extended-spectrum belalactamase and 35.29 % of others Enterobacteriaceae isolated had a phenotypic profile compatible with the production of the Enzyme Inhibitoryresistant TEM (IRT). It is important to note that these studies allow knowing the etiology of urinary tract infections in the community as well as resistance and sensitivity profiles at the local level, relevant data to establish empirical processing guidelines tailored to each medium.

Wearable Sensor System Powered by a Biofuel Cell for Detection of Lactate Levels in Sweat.

An NAD+-dependent enzymatic sensor with biofuel cell power source system for non-invasive monitoring of lactate in sweat was designed, developed, and tested. The sensor component, based on lactate dehydrogenase, showed linear current response with increasing lactate concentrations with limits of detection from 5 to 100 mM lactate and sensitivity of 0.2 µA.mM-1 in the presence of target analyte. In addition to the sensor patch a power source was also designed, developed and tested. The power source was a biofuel cell designed to oxidize glucose via glucose oxidase. The biofuel cell showed excellent performance, achieving over 80 mA at 0.4 V (16 mW) in a footprint of 3.5 × 3.5 × 0.7 cm. Furthermore, in order to couple the sensor to the power source, system electronic components were designed and fabricated. These consisted of an energy harvester (EH) and a micropotentiostat (MP). The EH was employed for harvesting power provided by the biofuel cell as well as up-converting the voltage to 3.0 V needed for the operation of the MP. The sensor was attached to MP for chronoamperometric detection of lactate. The Sensor Patch System was demonstrated under laboratory conditions.

Resistant cytomegalovirus in intestinal and multivisceral transplant recipients.

BACKGROUND: Intestinal and multivisceral transplantation can be complicated by cytomegalovirus (CMV)-related viremia and disease. Intravenous ganciclovir (GCV) and oral valganciclovir remain the treatment of choice in this setting. Limited data are available on GCV-resistant (GCV-R) CMV infection in small intestine and multivisceral transplant recipients. METHOD: A retrospective review was performed on all patients who underwent small intestine or multivisceral transplantation from November 8, 2003 through November 30, 2008. Those with CMV viremia and invasive disease were identified. GCV resistance was suspected in patients who continued to have viremic episodes or invasive disease despite appropriate GCV treatment. Genotypic analyses were performed to detect the presence of GCV resistance genes UL97 and UL54. RESULTS: During the study period, 88 small intestine or multivisceral transplants were performed on 85 patients. Of the 88 transplantations, 16 patients developed CMV viremia with or without end-organ disease (18.2%) and 5.7% developed GCV-R CMV infection. In patients diagnosed with CMV infection, 31.3% (5/16) had GCV-R CMV infection. Of patients with GCV-R CMV infection, 80% (4/5) developed CMV allograft enteritis, resulting in allograft explantation in 3 patients. All patients with GCV-R CMV infection were CMV donor positive/recipient negative. Patients with tissue-invasive CMV disease were 18 times more likely to be infected with GCV-R CMV (95% confidence interval 1.24-260.93; P-value 0.0341). CONCLUSION: Small intestinal and multivisceral transplant recipients have a higher rate of GCV-R CMV infection compared with other solid organ transplant recipients, which is often associated with tissue-invasive disease and allograft loss.

Bioactive magnetic nanoparticles of Fe-Ga synthesized by sol-gel for their potential use in hyperthermia treatment.

Hyperthermia is one of the most recents therapies for cancer treatment using particles with nanometric size and appropriate magnetic properties for destroying cancer cells. Magnetic nanoparticles (MNP's) of Fe-Ga and synthesized using a polycondensation reaction by sol-gel method were obtained. MNP's of Fe(1.4)Ga(1.6)O(4) that possess an inverse spinel structure were identified by X-Ray Diffraction, Transmission Electron Microscopy, Scanning Electron Microscopy and Energy Dispersive Spectroscopy. The results showed that the MNP's are composed only by Fe, Ga and O and their size is between 15 and 20 nm. The magnetic properties measured by Vibration Sample Magnetometry demonstrated a saturation magnetization value of 37.5 emu/g. To induce the MNP's bioactivity, a biomimetic method was used which consisted in the immersion of MNP's in a Simulated Body Fluid (SBF) for different periods of time (7, 14 and 21 d) along with a wollastonite disk. The formation of a bioactive layer, which closely resembles that formed on the existing bioactive systems and with a Ca/P atomic ratio within a range of 1.37-1.73 was observed on the MNP's. Cytotoxicity of MNP's was evaluated by in vitro hemolysis testing using human red blood cells at concentrations between 0.25 and 6.0 mg/mL. It was found that the MNP's were not cytotoxic at none of the concentrations used. The results indicate that Fe-Ga MNP's are potential materials for cancer treatment of both hard and soft tissue by hyperthermia and drug carriers, among other applications.

Synthesis and characterization of zinc and calcium nanoferrites.

In this work, Zn(1-x)CaxFe(2)O(4) nanoparticles (x = 0, 0.5 and 1) have been synthesized by sol-gel method followed by heat treatment at a temperature within the range of 300-700 °C. The samples with appropriate saturation magnetization (Ms), low coercivity and remanence were Zn(0)Ca(1)Fe(2)O(4) treated at 300 °C (Ms ~ 25 emu/g), Zn(0)Ca(1)Fe(2)O(4) treated at 400 °C (Ms ~ 40 emu/g) and Zn(0.50)Ca(0.50)Fe(2)O(4) treated at 400 °C (Ms ~ 31 emu/g). These samples were analyzed by scanning electron microscopy, energy dispersive spectroscopy, X-ray diffraction and transmission electron microscopy. The heating ability of selected nanoparticles was evaluated under a magnetic field using a solid state induction heating equipment. The obtained nanoferrites showed a particle size within the range of 13-14 nm. The Zn(0)Ca(1)Fe(2)O(4) treated at 400 °C was able to heat the nanoferrite particles/water suspension (10 mg/2 ml) at a temperature of 44 °C under the selected magnetic field (10.2 kA/m and frequency 362 kHz). Additionally, in vitro bioactivity assessment was performed by immersing samples in a simulated body fluid for different periods of time at physiological conditions of pH and temperature. The samples showed an appropriate bioactivity. These nanoferrites are highly potential materials for hyperthermia treatment.

Colgajos de peroorantes principios básicos y aplicaciones clínicas / Perforator flps basic principles and clinical applications / Realhos perfuranntes princípios básicos e aplicações cínnicas

Los colgajos de perforantes se han constituido en el escalón reconstructivo de mayor refinamiento quirúrgico por sus beneficios al dejar mínima morbilidad en las áreas donantes y permitir el tallado de los tejidos más precisos a los defectos a reconstruir, permitiendo al mismo tiempo la transferencia de varios tipos de tejidos, constituyéndose así en una herramienta versátil para casos complejos, con defectos tridimensionales y necesidades tisulares específicas. El presente artículo realiza una revisión de los aspectos clínicos, así como la presentación de pacientes manejados con esta opción que dentro del campo de la microcirugía reconstructiva se posiciona como la primera elección al contemplar las diferentes posibilidades de tratamiento.

Perforator flaps have turned into the reconstructive step with the highest surgical refinement because of its benefits by limiting the donor site morbidity and allowing more accurate tissue graving in the defects to be reconstructed while allowing the transference of several types of tissues, thus becoming a versatile tool for complex cases with tridimensional defects and specific tissue needs. This article reviews the clinical features as well as the presentation of patients managed through this option, which, in the field of reconstructive microsurgery, has been positioned as the leading election when the different possibilities of treatment are considered.

Os retalhos de perfurantes constituemse no degrau reconstrutivo de maior refinamento cirúrgico por seus benefícios ao deixar mínima morbilidade nas áreas doadoras e permitir esculpir os tecidos de forma mais precisa no momento de corrigir defeitos e reconstruir, permitindo ao mesmo tempo a transferência de vários tipos de tecidos, constituindose assim em uma ferramenta versátil para casos complexos, com defeitos tridimensionais e necessidades tissulares específicas. O presente artigo faz uma revisão dos aspectos clínicos, bem como a apresentação de pacientes tratados com esta opção que dentro do campo da microcirurgia reconstrutiva se posiciona como a primeira escolha ao considerar as diferentes possibilidades de tratamento.

Morphometric and molecular characterization of the series Guyanensis (Diptera, Psychodidae, Psychodopygus) from the Ecuadorian Amazon Basin with description of a new species.

Several populations of the series Guyanensis (Diptera, Psychodidae, Psychodopygus) were collected from the Yasuní National Park in the Ecuadorian Amazon region. The specimens comprised the species Psychodopygus geniculatus, Psychodopygus luisleoni and Psychodopygus corossoniensis. Within Ps. geniculatus, we observed two populations, one with a narrow paramere and relatively short genital filaments and the other characterized by a wider coxite and longer genital filaments. A multiple approach combining morphology, morphometry and DNA sequencing of the ribosomal internal transcribed spacer 2 (ITS2) and the mitochondrial cytochrome b gene was carried out. Morphological, morphometric and molecular data strongly suggested the presence of two populations within Ps. geniculatus. The lack of intermediate forms within these populations supported the proposal of two sympatric species. This report describes Psychodopygus francoisleponti n. sp.

Mielopatía necrotizante subaguda asociada a lupus eritematoso sistémico: reporte de un caso y revisión de la literatura / Subacute necrotizing myelopathy associated to SLE: case report and review of literature

Las mielopatías agudas representan un grupo heterogéneo de enfermedades, de distintas etiologías, hallazgos clínicos y radiológicos diferentes, y particular pronóstico. La Mielitis transversa (MT), es el prototipo del grupo, en el cual, un proceso inmunitario causa el daño neural en la médula espinal, resultando en varios grados de paresia, alteraciones sensitivas, y disfunción autonómica. La MT puede existir como parte de una enfermedad del Sistema nervioso Central multifocal (Esclerosis múltiple) enfermedad multisistémica (Lupus Eritematoso Sistémico), o aislada, como una entidad idiopática. En este artículo, presentamos un caso clínico, y revisamos recientes esquemas diagnósticos, que permiten sistematizar el diagnóstico y tratamiento de los pacientes con mielopatía aguda. Adicionalmente, resumimos el estado actual del conocimiento acerca de la epidemiología, historia natural de la enfermedad, inmunopatogénesis, y estrategias terapéuticas para pacientes con Mielitis transversa. El conocimiento actual sobre la clasificación, diagnóstico, patogénesis y tratamiento de la Mielitis Transversa, ha sufrido recientemente cambios y nuevos aportes, especialmente con el desarrollo de la neuroinmunopatología. Actualmente podemos iniciar tratamientos oportunos para muchos de éstos pacientes, y mejorar el pronóstico a largo plazo de ésta rara, pero discapacitante noxa.

Differential progression of neonatal diethylstilbestrol-induced disruption of the hamster testis and seminal vesicle.

The synthetic estrogen diethylstilbestrol (DES) is now recognized as the prototypical endocrine disruptor. Using a hamster experimental system, we performed a detailed temporal assessment of how neonatal DES-induced disruption progresses in the testis compared to the seminal vesicle. Both morphological and Western blot analyses confirmed that neonatal DES exposure alters androgen responsiveness in the male hamster reproductive tract. We also determined that the disruption phenomenon in the male hamster is manifest much earlier in the seminal vesicle than in the testis and that testis disruption often occurs differently between the pair of organs in a given animal. In the neonatally DES-exposed seminal vesicle, histopathological effects included: (1) general atrophy, (2) lack of exocrine products, (3) epithelial dysplasia, (4) altered organization of stromal cells and extracellular matrix, and (5) striking infiltration with polymorphonuclear leukocytes. Also, the morphological disruption phenomenon in the seminal vesicle was accompanied by a range of up-regulation and down-regulation responses in the whole organ levels of various proteins.

Técnica de medición de la presión arterial utilizada por enfermeras auxiliares del Hospital Universitario de Caracas / Measurement technical of arterial pressure utilizated by assi of Hospital Universitario de Caracas

Se compararon las variables consideradas errores técnicos frecuentes cometidos durante el procedimiento de medición de la presión arterial a 50, entre un grupo de enfermeras auxiliares entrenadas (grupo control) y no entrenadas (grupo experimental). Con respecto al grupo control, en el 97 por ciento de las mediciones el manguito fue centrado correctamente en el brazo del paciente, en el 0 por ciento fue colocado sobre la ropa del mismo, en el 99 por ciento de los casos se utilizó el método palpatorio previa medición, en el 100 por ciento se palpó la arteria braquial y se usó la campana del estetoscopio, y en el 95 por ciento la velocidad de desinflado del manguito fue apropiada; los valores correspondientes al grupo experimental fueron 46 por ciento, 36 por ciento, 0 por ciento, 46 por ciento, 2 por ciento, y 18 por ciento, respectivamente (p<0,001 en todas las comparaciones). Se evaluaron las preferencias por dígitos terminales: en el grupo experimental hubo una preferencia absoluta por el dígito terminal cero para las presiones sistólicas, y casi absoluta para las presiones diastólicas, en el grupo control la distribución de dígitos terminales fue más homogénea. Valores convencionales como 120/80mmHg se registraron en el 14 por ciento de las mediciones del grupo experimental y solo en el 0,5 por ciento de las del grupo control (p<0,001). Las consecuencias de una técnica inadecuada sobre las decisiones terapéuticas son considerables, sobre todo por efectos aditivos de los errores. Esto se expresa en que el grupo experimental clasificó como hipertensos a 14 por ciento de los pacientes cuando no lo eran, y no clasificó como hipertensos a 4 por ciento cuando sí lo eran

Prevalencia de streptococcus pneumoniae resistente a penicilina en niños que asisten a jardines infantiles en Santiago / Penicillin resistant streptococcus pneumoniae among children attending day care centers

Las infecciones neumocócicas causan enfermedades graves en los niños. Se han observado cambios epidemiológicos en las infecciones por Streptococcus pneumoniae, como aumento de la incidencia, desarrollo creciente de resistencia antimicrobiana y brotes infecciosos epidérmicos.El estudio de portadores es útil para vigilar la aparición y desarrollo de la resistencia antimicrobiana y de los serotipos prevalentes. Con el propósito de determinar la prevalencia de cepas resistentes de S. pneumoniae en niños que asisten a jardines infantiles de Santiago y los serotipos más frecuentes en la nasofaringe, se efectuó cultivo de hisopado faríngeo y nasal obtenido entre noviembre de 1994 y agosto de 1995 de 200 de ellos, cuya edad era entre 3 meses y 4 años (97 < de 2 años y 103 > de 2 años). Las muestras fueron sembradas en agar sangre con 5 por ciento de sangre de cordero, con o sin gentamicina (5 µg/ml) e incubadas en ambiente con dióxido de carbono. La resistencia antimicrobiana se evaluó mediante disco de oxacilina,microdilución en caldo y E-test.En 60,2 por ciento de los casos se aisló S. pneumoniae de la nasofaringe; 28,4 por ciento de las cepas eran resistentes a penicilina (20,3 por ciento con resistencia moderada y 2,1 por ciento elevada), 2 por ciento eran resistentes a cloranfenicol. No se encontraron cepas resistentes a eritromicina, cefotaxima o vancomicina. La frecuencia de cepas resistentes a la penicilina fue similar en los niños menores y mayores de 2 años. E serotipo más frecuente fue el 6A