Incidence and factors associated with delayed graft function in renal transplantation at Carlos Van Buren Hospital, January 2000 to June 2008.

Delayed graft function (DGF) is defined as the need for dialysis within the first week after renal transplantation, and slow graft function as persistence of serum creatinine concentration of at least 3 mg/dL on day 5 after the procedure. In the present study, we analyzed the incidence and risk factors for DGF at our center. This retrospective study included 106 patients who underwent renal transplantation between January 2000 and June 2008. Of these, 11 patients were excluded. Two of the remaining 95 patients received organs from living donors, and 93 received cadaver organs. Variables analyzed included donor age, cause of death, cause of chronic renal failure, recipient age, method and time of long-term renal replacement therapy, residual diuresis, panel of reactive antibodies (PRA), HLA mismatch, sex compatibility, cold and warm ischemia times, biopsy-confirmed episodes of acute rejection, urine output in the operating room and in the first 24 hours after the procedure, and intraoperative induction therapy. Data were analyzed using the chi(2) and Fisher exact tests and analysis of variance, and are given as mean (SD) and frequency. Variables associated with DGF at univariate analysis (P < .05) were divided between risk factors and predictors of DGF for inclusion in logistic regression models. The incidence of DGF was 32.6%; slow graft function, 16.8%; and immediate graft function, 50.5%. Cold ischemia time longer than 20 hours (P = .02) and donor age (P = .008) were directly associated with DGF. Twenty-four-hour urine output was a strong predictor of DGF. Patients with DGF demonstrated a 25% incidence of an episode of acute rejection before discharge from the hospital. No difference in DGF was observed for use of intraoperative induction therapy.

Antimicrobial properties of moderately halotolerant bacteria from cenotes of the Yucatan peninsula.

AIMS: Isolation and antimicrobial evaluation of aquatic bacterial strains from two cenotes. METHODS AND RESULTS: A total of 258 bacterial strains were isolated from the water and sediment of two cenotes in the Yucatan peninsula, all of which were screened against six pathogenic micro-organisms. Antimicrobial activity was detected in 46 of the isolated strains against at least one of the target strains tested. Antimicrobially active isolates were identified as: Aeromonas, Bacillus, Burkholderia, Photobacterium, Pseudomonas, Serratia, Shewanella, Stenotrophomonas genera, and 13 remained unidentified. All antimicrobially active strains were able to grow in salt medium at a concentration of 75 g l(-1), thus classifying as moderately halotolerant bacteria. Most of the antimicrobially active strains exhibited a broad action spectrum, where 61% was because of uncharacterized antimicrobial substances, 25% because of bacteriocins and 13% because of siderophores. Ten strains were able to biosynthesize biosurfactant metabolites. CONCLUSIONS: Native bacteria from the Yucatan peninsula showed an interesting antimicrobial activity, diverse mode of action and moderate halotolerance to salt. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report on bacterial isolates from cenotes of the Yucatan peninsula and their antimicrobial characterization, with great potential for future biotechnological applications.

La enfermedad de chagas induce una supersensibilidad colinergica muscarinica en ventrículo derecho de ratas chagásicas sprague dawley / Chagas's disease induce a muscarinie cholinergic supersensibility in right ventricle of chagas rats spargue dawley

La Enfermedad de Chagas constituye un problema de salud pública en Venezuela, cuyas alteraciones están representadas fundamentalmente por el desarrollo de miocardiopatías incapacitantes. En la actualidad, las causas de las miocardiopatías no son realmente conocidasy tampoco existe tratamiento; sin embargo, dentro de la teoria neurogénica se ha postulado que el Sistema Colinérgico est  involúcrado en su desarrollo. Con el fin de dilucidar el estado de Receptor Colinérgico Muscarínico (RCM) en ésta enfermedad, se establecieron dos grupos de animales: Control (ratas sanas) y Experimental (ratas con Enfermedad de Chagas en etapa crónica), posteriormente las ratas fueron sacrificadas, disecando en corazón Ventrículo Izquierdo (VI), Ventrículo Derecho (VD), Tabique Interventricular (TIV), Aurícula (Au) y en el encéfalo Tronco Encefálico (TE). Se determinó la cantidad de proteínas mediante el método de Lowry, la densidad de RCM y los efectos de agonistas (Carbacol) y antagonistas selectivos (Pirenzepina, Metoctramina, 4-DAMP y Tropicamida) por medio de ensayos de radioligandos usando [³H]-QNB como marcador radioactivo. Los resultados mostraron en TE una disminución significativa de la cantidad de proteínas en ratas con Enfermedad de Chagas; en VD se encontró una supersensibilidad significativa del RCM en ratas Chagásicas, mientras que en TIV, VI y Au no se observaron diferencias significativas entre ambos grupos. En las curvas de desplazamiento de [³H]-QNB por agonistas y antagonistas selectivos, no se encontraron diferencias significativas en el perfil de desplazamiento y en los valores de CI50, al comparar los dos grupos. En conclusión la expresión de proteínas y del RCM se encuentran alteradas en TE y VD, respectivamente.

[Meningitis caused by Candida in a premature infant]. / Meningitis por Candida en un prematuro.

A case of Candida meningitis in a premature infant treated with amphotericin B IV for 41 days, resulted in negative CSF cultures after 5 days of therapy. Amphotericin B was also given intraventricularly for 21 days; purulent meningitis was a complication from this kind of therapy. Psychometric evaluation showed a mental age of 3 months in a chronological age of 7 months. Only one premature infant has been reported in the literature with intraventricular amphotericin B treatment. A review of Candida meningitis diagnosed before death in infants less than 1 year of age and a discussion of the modern therapy is presented.