External validation of two clinical prediction models for mortality in COVID-19 patients (4C and NEWS2), in three centers in Medellín, Colombia: Assessing the impact of vaccination over time.

OBJECTIVES: External validation of the 4C and NEWS2 scores for the prediction of in-hospital mortality in COVID-19 patients, and evaluation of its operational performance in two time periods: before and after the start of the vaccination program in Colombia. METHODS: Retrospective cohort in three high complexity hospitals in the city of Medellín, Colombia, between June 2020 and April 2022. RESULTS: The areas under the ROC curve (AUC) for the 4C mortality risk score and the NEWS2 were 0.75 (95% CI 0.73-0.78) and 0.68 (95% CI 0.66-0.71), respectively. For the 4C score, the AUC for the first and second periods was 0.77 (95% CI 0.74-0.80) and 0.75 (95% CI 0.71-0.78); whilst for the NEWS2 score, it was 0.68 (95% CI 0.65-0.71) and 0.69 (95% CI 0.64-0.73). The calibration for both scores was adequate, albeit with reduced performance during the second period. CONCLUSIONS: The 4C mortality risk score proved to be the more adequate predictor of in-hospital mortality in COVID-19 patients in this Latin American population. The operational performance during both time periods remained similar, which shows its utility notwithstanding major changes, including vaccination, as the pandemic evolved.

Inhibitor activity of Lactiplantibacillus plantarum LP5 on thermotolerant campylobacter with different biofilm-forming capacities.

AIMS: To evaluate the biofilm-forming capacity of thermotolerant Campylobacter (TC) strains from poultry production and to analyse the inhibitory capacity of Lactiplantibacillus plantarum LP5 against TC on different materials. METHODS AND RESULTS: Biofilm-forming capacity by Campylobacter jejuni and Campylobacter coli was analysed by cell adhesion in polystyrene plates. TC were classified as non-biofilm-forming (NBF, 1.3%), weak biofilm-forming (WBF, 68.4%), moderate biofilm-forming (MBF, 27.6%), and strong biofilm-forming (SBF, 2.7%). The inhibitory capacity of L. plantarum LP5 against TC was tested on stainless-steel, nylon, aluminium, and glass disks (treated group) and compared with biofilm-forming TC (control group). Lactiplantibacillus plantarum LP5 was inoculated, and then TC. Biofilm was removed in both experimental groups and TC and LP5 bacterial counts were performed. The L. plantarum LP5 presence reduced the formation of TC biofilm (P < 0.001). The material type and strain category influenced biofilm formation, with stainless-steel and the SBF strain being the material and TC having the highest adhesion (P < 0.001). Lactiplantibacillus plantarum LP5 formed a similar biofilm on all materials (P = 0.823). CONCLUSIONS: This trial showed very promising results; L. plantarum LP5 could be incorporated as a bio-protector of TC on different surfaces.

Enhanced antitumor activity induced by a DNA vaccine encoding E7 antigen fused to an ERAD-targeting sequence.

The endoplasmic reticulum (ER) is a key organelle in cell homeostasis and cell health through antigen presentation to immune cells. Thus, the ER has become a therapeutic target to induce cellular immune responses. We previously reported the antitumor effect of a DNA vaccine that expresses the E7 antigen fused to the cyclooxygenase-2 (COX-2) protein. This inflammation-related enzyme contains a degradation cassette associated with the endoplasmic reticulum-associated degradation (ERAD) pathway. To avoid the use of full-length COX-2 and any risk of adverse effects due to the activity of its catalytic site, we designed new versions of the fusion protein. These new constructs encode the E7 antigen fused to the signal peptide and the ERAD sequence of COX-2 with or without the membrane-binding domain (MBD) as well as deletion of the catalytic site. We evaluated the antigen-specific antitumor effect of these DNA constructs in murine prophylactic and therapeutic cancer models. These assays showed that the ERAD cassette is the minimum sequence in the COX-2 protein that induces an antitumor effect when fused to the E7 antigen with the advantage of eliminating any potential adverse effects from the use of full-length COX-2.

Cold-adapted strains as plant growth-promoting bacteria on soybean seeds and biocontrol agents against Macrophomina phaseolina.

AIM: The aim was to characterize cold-adapted bacteria by testing their PGP features and antagonistic activity against Macrophomina phaseolina, both in vitro and coating soybean seeds (Glycine max [L.] Merr.). METHODS AND RESULTS: Burkholderia gladioli MB39, Serratia proteamaculans 136 and Serratia proteamaculans 137 were evaluated. In vitro tests showed that S. proteamaculans 136 and 137 produce siderophore and indole-acetic acid (IAA), solubilize phosphate and fix nitrogen. Additionally, B. gladioli MB39 and S. proteamaculans 137 showed hydrolase activity and potent antifungal effects. The biocontrol efficacy over soybean seeds was evaluated using in vitro and greenhouse methods by immersing seeds into each bacterial suspension. As a result, S. proteamaculans 136 has improved the performance in all the seed germination evaluated parameters. In addition, S. proteamaculans 137 and B. gladioli MB39 strongly inhibited M. phaseolina, reducing the infection index values to 10% and 0%, respectively. CONCLUSION: Serratia proteamaculans 136, 137 and Burkholderia gladioli MB39 showed plant growth promotion features and inhibition of Macrophomina phaseolina infection by producing different antifungal compounds. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results reinforce the application of cold-adapted Serratia proteamaculans and Burkholderia gladioli bacterial strains as candidates for developing microbial formulation to promote plant growth and guarantee antifungal protection in soybean crops.

Estados emocionales contrapuestos e inteligencia emocional en la adolescencia / Opposite emotional states and emotional intelligence in adolescence

Resumen Este trabajo tiene como objetivo fundamental estudiar los tipos y niveles de ansiedad, felicidad e inteligencia emocional, en función de la edad, el sexo, la cultura y el estrato socioeconómico, así como contemplar las relaciones que se pudieran dar entre ambas variables, para una población adolescente multicultural. Se contó con 811 participantes. En consideración a la cultura, el grupo de cultura/religión musulmana constituye el 71,6 % de la muestra, mientras que el 28,4 % pertenecían a la cultura/religión cristiana, de modo que son el 46,1 % varones y el resto de la muestra (53,9 %) mujeres. Como instrumentos de evaluación, se han empleado el inventario de ansiedad estado-rasgo para niños (State-Trait Anxiety Inventory for Children [STAIC]) , un cuestionario elaborado para evaluar la felicidad, junto con otro para medir la inteligencia emocional. Los resultados reflejan niveles medio-bajos en ansiedad y medio-altos en felicidad. En ambas variables, influyen la edad, el sexo, la cultura/religión y el estatus, de forma inversa. Se halló relación estadísticamente significativa entre ansiedad y felicidad, de modo que es inversamente proporcional, lo que hace que sí se puedan considerar estados emocionales contrapuestos. En IE influyen edad, sexo, cultura/religión y estatus socioeconómico-cultural. No se ha halló relación estadísticamente significativa entre ansiedad e IE, pero sí en el caso de la felicidad.

Abstract This work has as main objective to analyze the types and levels of Anxiety, Happiness and Emotional Intelligence, according to age, gender, culture and socioeconomic, as well as the relationships that could be given between both variables. To make it possible we focused on 811 participants; 71.6% of the total were Muslims and 28.4% belonged to the Christian religion, 46.1% were male and 53.9% female. The techniques used in this survey were the State-Trait Anxiety Inventory for Children (STAIC, Spielberger, 2001), a Happiness questionnaire, as well as an EI questionnaire, built for their use. The results reflect medium-low levels in Anxiety and medium-high in Happiness. Both variables are influenced in a very different way by the sociodemographic factors of age, gender, culture and socioeconomic conversely. We found an statistically significant relationship between Anxiety and Happiness. This relationship was inversely proportional. So, it is possible to consider this variables opposite emotional states. Emotional Intelligence is influenced in a very different way by the sociodemographic factors of age, gender, culture and socioeconomic. There is no statistically significant relationship between Anxiety and Emotional Intelligence but we found it between Emotional Intelligence and Happiness.

Antituberculosis drug resistance in isolates of Mycobacterium tuberculosis complex in southeast Spain.

OBJECTIVES: The aim of this study was to determine resistance to antituberculosis (anti-TB) drugs in Mycobacterium tuberculosis complex isolates from patients diagnosed with Tuberculosis (TB) in southeast Spain and to study related epidemiological factors. METHODS: This retrospective study analysed 5-year data (2012-2016) obtained in southeast Spain for a total equivalent population of 1 735 608 inhabitants. Clinical samples were examined from 557 patients with suspected pulmonary TB (n=470; 84.4%) or extrapulmonary TB (n=87; 15.6%), taking into account patient age, sex, human immunodeficiency virus (HIV) infection, country of birth and prior anti-TB treatment. RESULTS: TB was found more frequently in men than in women (66.6% vs. 33.4%), and the age group with the most cases (43.7%) was 36-55 years. Among the first-line anti-TB drugs, 7.0% of patients harboured isolates resistant to isoniazid (INH) and 1.6% to rifampicin (RIF); moreover, 1.4% of isolates were multidrug-resistant TB (MDR-TB) and 0.7% were extensively drug-resistant TB. There was a statistically significant relationship (P=0.028) between MDR-TB isolates and non-Spanish-born patients, but not between the latter and INH resistance. CONCLUSION: Resistance to INH and RIF was observed at levels similar to those published nationwide, with rates of MDR-TB being somewhat lower. Rates of HIV/TB co-infection have decreased considerably between 2012 and 2016.

Influencia de las variables sociodemográficas sobre la ansiedad y el rendimiento académico adolescente: el contexto pluricultural de Ceuta / Influence of Sociodemographic Variables on Anxiety and Academic Achievement in Adolescence: The Pluricultural Context of Ceuta

Resumen Este trabajo tiene como objetivo fundamental analizar la ansiedad y el rendimiento académico, sus tipos y niveles en función de edad, género, cultura y estrato socioeconómico, así como contemplar las relaciones entre ambas. Se contó con 811 participantes. El 71.6% de la muestra eran musulmanes, mientras que el 28.4% eran cristianos; el 46.1% hombres y el 53.9% mujeres. Como instrumentos de evaluación se empleó el STAIC (Spielberger, 2001) y las calificaciones del alumnado. Se reflejan niveles medio-bajos en ansiedad y medios en rendimiento académico. En la ansiedad influyen edad, género, cultura/religión y estatus socio-económico-cultural. Sobre el rendimiento actúan la edad, la cultura y el estatus. No se halló relación estadísticamente significativa entre ansiedad y rendimiento académico.

Abstract The main objective of this paper is to analyze the types and levels of Anxiety and Academic Achievement according to age, gender, culture and socioeconomic and cultural, as well as the relationships between both variables. We focused on 811 participants 71.6% of whom were Muslims and 28.4% Christian; 46.1% male and 53.9% female. The techniques used in this survey were the STAIC (Spielberger, 2001) as well as the students' grades. The results reflect medium-low levels in Anxiety and medium levels in Achievement. Anxiety is influenced by age, gender, culture and status. Academic Achievement is influenced by age, culture and socioeconomic and cultural. There is no statistically significant relationship between Anxiety and Achievement, except in Mathematics, increasing as the Anxiety scores are lower.

Prediciendo el Rendimiento Académico Infantil a través de la Inteligencia Emocional / Predicting children's academic achievement through emotional intelligence

No se deben obviar las emociones y resulta fundamental en la vida saber reaccionar de manera adecuada ante ellas. Esta realidad se convierte en un arma muy importante con la que afrontar de manera exitosa la vida. Por esta razón este trabajo tiene como objetivo fundamental analizar los predictores de inteligencia emocional (IE) y rendimiento académico, considerando la edad, género, cultura y estatus socioeconómico, así como contemplar las relaciones que se pudieran dar entre las variables para una población infantil multicultural. Para ello se ha contado con 764 participantes de siete centros en los que se imparte formación perteneciente a la etapa primaria. Considerando la cultura, el grupo mayoritario es el de participantes pertenecientes a la cultura-religión musulmana. Estos constituyen el 74.2% de la muestra, mientras que el 25.8% de la misma pertenecía a la cultura-religión cristiana, siendo el 53.2% varones y el resto de la muestra (46.8%) mujeres. Como instrumentos de evaluación se han empleado un cuestionario elaborado para evaluar la IE y las calificaciones de los alumnos. En IE aparecen tres predictores, como son edad, estatus y género. Para el rendimiento académico aparecen tres predictores, como son cultura, edad y estatus. Se halló una fuerte relación directamente proporcional entre IE y rendimiento académico, actuando cada uno como principal predictor del otro

Emotions should not be ignored and it is fundamental in life to know how to react appropriately to them. This reality, which has traditionally been considered as an element that could make people weaker, becomes a very important weapon with which to face life successfully. For this reason, this work has as main objective to the predictors of emotional intelligence (EI) and academic achievement, according to age, gender, culture, and socioeconomic status, as well as the possible relationships between all the variables for a multicultural children sample. To make it possible, we focused on 764 participants from seven educational centers; 74.2% of the total were Muslims and 25.8% were Christians; 53.2% were males and 46.8% females. The techniques used in this survey were an ad hoc EI questionnaire and the students’ grades. The results reflect that the predictors of EI were age, status, and gender. Academic achievement was predicted by culture, age, and status. A strong and directly proportional relationship between EI and academic achievement was found. Each one acts as the main predictor of the other

Predictores de la Felicidad y la Inteligencia Emocional en la Educación Secundaria / Predictors of Happiness and Emotional Intelligence in Secondary Education / Preditores da Felicidade e da Inteligência Emocional na Educação Secundária

Resumen Este trabajo tiene como objetivo fundamental analizar los predictores de felicidad e inteligencia emocional, considerando edad, género, cultura y estatus, así como contemplar las relaciones entre las variables. Se contó con 811 participantes, de los cuales el 71.6% fueron musulmanes y el 28.4% cristianos, siendo el 46.1% varones y el 53.9% mujeres. Como instrumentos se han empleado un cuestionario para evaluar la felicidad y otro para valorar la inteligencia emocional. Los resultados reflejan que los predictores de la felicidad fueron edad, cultura, estatus y género, mientras que los de inteligencia emocional fueron edad, cultura y género. Se halló una relación estadísticamente significativa y directamente proporcional entre felicidad e inteligencia emocional.

Abstract This study analyzed predictors of happiness and emotional intelligence taking into account age, sex, culture and status and the relationship among these variables. 811 persons participated; 71.6% were Muslims and 28.4% Christians, with 46.1% males and 53.9% females. One questionnaire was used to evaluate happiness and another to evaluate emotional intelligence. The results indicate that predictors of happiness are age, culture, status and sex, while those of emotional intelligence are age, culture and sex. The study found that there is a statistically significant and direct correlation between happiness and emotional intelligence.

Resumo Este trabalho tem como objetivo fundamental analisar os preditores de felicidade e inteligência emocional, considerando idade, gênero, cultura e status, bem como abranger as relações entre as variáveis. Contou-se com 811 participantes, dos quais 71.6 % foram muçulmanos e 28.4 % cristãos; 46.1 % homens e 53.9 % mulheres. Como instrumentos, utilizaram-se um questionário para avaliar a felicidade e outro para avaliar a inteligência emocional. Os resultados refletem que os preditores da felicidade foram idade, cultura e gênero. Constatou-se uma relação estatisticamente significativa e diretamente proporcional entre felicidade e inteligência emocional.

Propiedades psicométricas de un instrumento en construcción para evaluar la inteligencia emocional en alumnos de secundaria y la universidad / Psychometric properties of a test under construction to assess emotional intelligence in high school and college students

Resumen Existe un enorme interés por el desarrollo de programas de educación emocional, programas que deben ser evaluados de manera adecuada. Por eso este trabajo tiene como objetivo elaborar un cuestionario para evaluar la Inteligencia Emocional (IE), siguiendo el modelo que la considera como un conjunto de habilidades, utilizando como referencia el MSCEIT (Mayer Salovey y Caruso, 2009) y destinado a una muestra de alumnos de Secundaria y la universidad. Para esto se contó con 782 participantes, procedentes de 5 centros distintos. El 60.6% fueron chicas, el 39.4% varones, el 53.7% musulmanes, el 46.3% cristianos. Como instrumentos de evaluación se emplearon un test elaborado para la evaluación de la IE, junto con una adaptación propia de la EHS (Gismero, 2000). Los resultados obtenidos reflejan niveles de fiabilidad aceptables y las dimensiones teóricas esperadas para ambos cuestionarios, apareciendo intercorrelaciones positivas entre los totales y las dimensiones que los conforman. Las correlaciones fueron también positivas y significativas entre ambas escalas. Este cuestionario se muestra como instrumento adecuado para evaluar estas capacidades tras realizar algunas modificaciones en trabajos futuros.

Abstract In the field of education there is high interest in emotional education programs. These programs must be evaluated to check their efficiency. The objective of this work is to develop a questionnaire to assess Emotional Intelligence (EI), following the model which conceives it as a set of skills, using the MSCEIT (Mayer et al., 2009) as reference; this questionnaire used a sample of high school and college students. We focused on 782 participants from 5 different centers; 39.4% are boys and 60.6% girls; 53.7% are Muslim and 46.3% Christian. The techniques used were a test developed to assess EI in teenagers and a similar adaptation of EHS (Gismero, 2000). The results show acceptable levels of reliability and also our expectations about theoretical dimensions were confirmed for both questionnaires. There are positive correlations between totals and their constituent dimensions. We found positive and significant correlations between both scales. Therefore, this questionnaire is an appropriate tool to evaluate these capabilities after making some modifications in future works.

Predictores de la ansiedad y la inteligencia emocional en la adolescencia / No disponible

Este trabajo tiene como objetivo fundamental analizar los predictores de ansiedad e inteligencia emocional, considerando la edad, género, cultura y estrato socioeconómico, así como contemplar las relaciones que se pudieran dar entre ambas variables, para una población adolescente multicultural. Para ello, se ha contado con 811 participantes, de seis centros en los que se imparte formación perteneciente a la Etapa Secundaria. Considerando la cultura, el grupo mayoritario es el de participantes pertenecientes a la cultura-religión musulmana. Estos constituyen el 71’6% de la muestra, mientras que el 28’4% de la misma pertenecía a la cultura-religión cristiana, siendo el 46’1% varones y el resto de la muestra (53’9%) mujeres. Como instrumentos de evaluación se han empleado el Inventario de Ansiedad Estado-Rasgo para Niños (STAIC, Spielberger, 2001) y un cuestionario elaborado para evaluar la inteligencia emocional como conjunto de habilidades. Los resultados reflejan que los predictores de la ansiedad son la edad y el género. Para la inteligencia emocional aparecen tres predictores, edad, cultura y género. No se ha halló relación directa entre ansiedad e inteligencia emocional, dado que ninguna actúa como predictora de la otra. La única excepción son los factores preocupaciones y dificultades y miedo, pertenecientes a la ansiedad, que actúan como predictores tanto de la inteligencia emocional como de todos sus factores

This work has as main objective to analyze the predictors of Anxiety and Emotional Intelligence, according to age, gender, culture and socioeconomic and cultural, as well as the relationships that could be given between both variables, for a multicultural adolescent sample. To make it possible we focused on 811 participants from six educational centers; 71.6% of the total was Muslims and 28.4% belonged to the Christian religion, 46.1% were male and 53.9% female. The techniques used in this survey were the State-Trait Anxiety Inventory for Children (STAIC, Spielberger, 2001) as well as an Emotional Intelligence questionnaire, built for its use. The results reflect that the predictors of Anxiety are Age and Gender. For Emotional Intelligence, there are three predictors, such as Age, Culture and Gender. No relationship was found between Anxiety and Emotional Intelligence, since none acts as a predictor of the other. The only exceptions are two Anxiety factors: Problems and difficulties and Fear, which act as predictors of both EI and all its factors

Validación del Inventario de Miedo para Niños II en estudiantes de primaria y secundaria / Validating the Fear Schedule Survey for Children II in a Primary and Secondary students sample

Resumen: En el actual sistema educativo, existe una enorme preocupación por el bajo rendimiento en las diferentes áreas académicas, lo que promueve la búsqueda de nuevas fórmulas de actuación docente. Esta búsqueda exige que el alumnado deba aprender nuevas habilidades y capacidades con el fin de adaptarse a este proceso en continua evolución. Desde esta perspectiva, con preocupación por los escasos logros académicos, se pone de relieve la enorme importancia que pueden llegar a tener las emociones y su adecuado control para la mejora del mismo. Este trabajo tiene como objetivo validar un cuestionario para evaluar el miedo, utilizando como referencia el Fear Survey Schedule for Children II (FSSC-II) (Ascensio et al., 2012) y destinado a una muestra de estudiantes desde educación primaria hasta bachillerato en la ciudad de Ceuta. Para esto se contó con 961 participantes, procedentes de 8 centros distintos (4 Centros de Educación Infantil y Primaria [CEIP] y 4 Institutos de Enseñanza Secundaria [IES]). El 53.4% fueron mujeres, el 46.6% varones, el 66.3% musulmanes, el 33.7%, con edades comprendidas entre los 6 y los 18 años. Considerando la muestra por cultura, el 66.3% fueron musulmanes y el 33.7% cristianos. Como instrumento de evaluación se empleó el FSSC-II, adaptado al castellano por Ascensio et al. (2012). Se reflejan niveles de fiabilidad altos así como las dimensiones esperadas (5) para el cuestionario, apareciendo intercorrelaciones positivas entre los totales y las dimensiones que lo conforman. Este cuestionario se muestra como instrumento adecuado para evaluar estas capacidades en la población adolescente en un contexto diferente al del trabajo de referencia.

Abstract: In the current educational system, an enormous preoccupation by the low yield in the different academic areas exists, which promotes the search of new formulas of educational performance. This search cause that the pupils must learn new abilities and capacities with the purpose of conforming itself to this process in continuous evolution. From this perspective, with preoccupation by the little academic profits, the enormous importance is put of relief that can get to have the emotions and their suitable control for the improvement of himself. Socio-emotional states are starting to become more relevant and are now part of a reality in the field of Education. In this field there is high interest in emotional education programs, especially in earlier stages. These programs must be evaluated to check this efficiently. The objective of this paper is to validate a questionnaire to assess Fear, using as reference the Fear Survey Schedule for Children II (FSSC-II) (Ascensio et al., 2012) aimed at a sample of students from Primary to the end of Secondary Education. We focused on 961 participants from 8 different centers (4 schools and 4 high schools) that clearly reflect the city's pluricultural features. Considering age we focused on children from 6 to 18 years old. Considering gender, the 46.6% of them are boys and the 53.4% are girls. If we consider culture and custom religion, 66.3% are Muslims and 33.7% Christians. The technique used in this survey is a test developed to assess Fear (FSSC-II) adapted for its use in the Spanish language by Ascensio et al. (2012). The results show high levels of reliability. Our expectations about dimensions (5) were confirmed for the questionnaire. There are positive correlations between totals and the dimensions of the questionnaire. Therefore this questionnaire is an appropriate tool to evaluate the Fear in a teenager sample in our context.

Predictors of early mortality in very elderly patients with bacteremia: a prospective multicenter cohort.

OBJECTIVES: The proportion of very elderly people in the population is increasing, and infectious diseases in this patient group may present with specific characteristics. The objective of this study was to investigate the outcome predictors of bacteremia among the very elderly. METHODS: This was a multicenter prospective cohort study of bloodstream infections (BSI) in patients ≥ 80 years old in 15 hospitals in Spain. The outcome variables were 14-day and 30-day mortality. Multivariate analysis was performed. RESULTS: One hundred and twenty episodes were included. Mortality was 22% (n = 26) on day 14 and 28% (n = 34) on day 30. In the univariate analysis, the variables associated with mortality were neutropenia, recent surgery, Pitt score ≥ 2, intensive care unit (ICU) admission, severe sepsis or shock, and abdominal, unknown, and respiratory tract sources. In the multivariate analysis, variables associated with mortality on day 14 were high-risk source (abdominal, unknown, and respiratory tract sources; odds ratio (OR) 7.9, 95% confidence interval (CI) 1.8-33.9), Pitt score ≥ 2 (OR 5.6, 95% CI 1.3-23.3), inadequate empirical treatment (OR 11.24, 95% CI 1.6-80.2), and severe sepsis or shock at presentation (OR 5.3, 95% CI 1.4-20.7); the interaction between empiric treatment and high-risk source was significant. On day 30, mortality was independently related to a high-risk source (OR 2.92, 95% CI 1.1-7.5) and presentation with severe sepsis or shock (OR 3.81, 95% CI 1.2-12.4). CONCLUSIONS: Presentation with severe sepsis or shock and a high-risk source of BSI were independent predictors of 14-day and 30-day mortality. Inadequate empirical treatment was also a predictor of early mortality in patients with a high-risk source.

Miedo y habilidades sociales en el contexto pluricultural de Ceuta / No disponible

Este trabajo tiene como objetivo fundamental conocer los tipos, niveles y relaciones del Miedo y las Habilidades Sociales del alumnado de la ciudad de Ceuta. Se contó con 1186 participantes, de 9 centros educativos distintos, que reflejan la pluriculturalidad de la ciudad; de los cuales, el 57’8% son niñas y el 42’2% varones, y el 58’9% de cultura/ religión musulmana y el 41’1% cristianos. Como instrumentos de evaluación se emplearon la adaptación de Ascensio, Vila, Robles-García, Páez, Fresán y Vázquez (2012) del Inventario de Miedo para Niños (FSSC-II) y la de Matesanz (2006) del Inventario de Temores (FSS), junto con la EHS (Escala de Habilidades Sociales, Gismero, 2000). Los resultados reflejan niveles medios de Miedo y medio-altos en las Habilidades Sociales, influyendo en ellas las sociodemográficas de edad, sexo, cultura/religión y estatus socio-económico-cultural. Existe relación entre Miedo y las Habilidades Sociales, aumentado estas últimas a medida que descienden las puntuaciones en Miedo

The main objective of this paper is to reflect the types and levels of Fear and Social Skills, and the influence over each other, of students in the city of Ceuta. We focused on 1186 participants from 9 different educational institutions; 42.2% are boys and 57.8% girls; 58.9% are Muslims and 41.1% Christians. The techniques used in this survey are Fear Survey Schedule for Children (FSSC-II), adapted for its use in the Spanish language by Ascensio, et al. (2012),the Matesanz, (2006) adaptation of Fear Survey Schedule, as well as the EHS (Gismero, 2000).The results show medium levels on Fear and medium-high levels on Social Skills, and they are influenced by the sociodemographic factors of age, gender, customs/religion and socioeconomic and cultural. We have also found a relationship between Fear and Social Skills

Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study.

BACKGROUND: Healthcare-associated (HCA) bloodstream infections (BSI) have been associated with worse outcomes, in terms of higher frequencies of antibiotic-resistant microorganisms and inappropriate therapy than strict community-acquired (CA) BSI. Recent changes in the epidemiology of community (CO)-BSI and treatment protocols may have modified this association. The objective of this study was to analyse the etiology, therapy and outcomes for CA and HCA BSI in our area. METHODS: A prospective multicentre cohort including all CO-BSI episodes in adult patients was performed over a 3-month period in 2006-2007. Outcome variables were mortality and inappropriate empirical therapy. Adjusted analyses were performed by logistic regression. RESULTS: 341 episodes of CO-BSI were included in the study. Acquisition was HCA in 56% (192 episodes) of them. Inappropriate empirical therapy was administered in 16.7% (57 episodes). All-cause mortality was 16.4% (56 patients) at day 14 and 20% (71 patients) at day 30. After controlling for age, Charlson index, source, etiology, presentation with severe sepsis or shock and inappropriate empirical treatment, acquisition type was not associated with an increase in 14-day or 30-day mortality. Only an stratified analysis of 14th-day mortality for Gram negatives BSI showed a statically significant difference (7% in CA vs 17% in HCA, p = 0,05). Factors independently related to inadequate empirical treatment in the community were: catheter source, cancer, and previous antimicrobial use; no association with HCA acquisition was found. CONCLUSION: HCA acquisition in our cohort was not a predictor for either inappropriate empirical treatment or increased mortality. These results might reflect recent changes in therapeutic protocols and epidemiological changes in community pathogens. Further studies should focus on recognising CA BSI due to resistant organisms facilitating an early and adequate treatment in patients with CA resistant BSI.

Complicaciones biliares en pacientes trasplantados: comparación de dos métodos diagnósticos con la CPRE / Biliary complications in transplant patients: A comparison of two ERCP

Antecedentes: Las complicaciones biliares después del trasplante ortotópico de hígado (TOH) son una seria causa de morbilidad y mortalidad. Técnicas invasivas de colangiografía como la colangiografía retrógrada endoscópica (CPRE) o percutánea cursan con complicaciones asociadas al procedimiento. La resonancia magnética (RM) es un método no invasivo, seguro y preciso. Objetivo: El propósito de este estudio es evaluar el papel de la RM y del US para detectar las complicaciones biliares después del TOH y comparar los hallazgos con la CPRE como patrón de oro. Métodos: En el Hospital Pablo Tobón Uribe, Medellín-Colombia, el registro de 27 pacientes con TOH entre marzo de 2006 y enero de 2009 que presentaron evidencias clínicas y bioquímicas de complicaciones biliares fueron evaluados con US, CPRE y RM. Resultados: La presencia de complicaciones biliares se confirmó en 26 pacientes (92,6%); las estenosis anastomóticas en 24 (88,9%). Estenosis isquémicas o difusas intrahepáticas en 2 pacientes (7,4%) y coledocolitiasis en uno (3,7%). A todos los pacientes se les hizo CPRE, en 25 US (92,5%) y en 13 RM (48,1%). Hubo una relación de concordancia significativa entre los hallazgos de la CPRE y la RM pero no con el US. LA sensibilidad y especificidad de la RM fue de 80% y 50%, para el US fue de 55,6% y 50% respectivamente, los valores predictivos positivos y negativos para la RM fueron de 92,3% y 25%, para el US fueron de 93,7% y 7,79% respectivamente. Conclusiones: La RM es una útil herramienta en la evaluación de las complicaciones de la vía biliar post-TOH. Recomendamos la RM como el método diagnóstico de elección, reservando la CPRE para los procedimientos terapéuticos

The ß-barrel assembly machinery (BAM) is required for the assembly of a primitive S-layer protein in the ancient outer membrane of Thermus thermophilus.

The ancient bacterial lineage Thermus spp has a primitive form of outer membrane attached to the cell wall through SlpA, a protein that shows intermediate properties between S-layer proteins and outer membrane (OM) porins. In E. coli and related Proteobacteria, porins are secreted through the BAM (ß-barrel assembly machinery) pathway, whose main component is BamA. A homologue to this protein is encoded in all the Thermus spp so far sequenced, so we wondered if this pathway could be responsible for SlpA secretion in this ancient bacterial model. To analyse this hypothesis, we attempted to get mutants on this BamA(th) of T. thermophilus HB27. Knockout and deletion mutants lacking the last 10 amino acids were not viable, whereas its depletion by means of a BamA antisense RNA lead defective attachment to the cell wall of its OM-like envelope. Such defects were related to defective folding of the SlpA protein that was more sensitive to proteases than in a wild-type strain. A similar phenotype was found in mutants lacking the terminal Phe of SlpA. Further protein-protein interaction assays confirmed the existence of specific binding between SlpA and BamA(th). Taking together, these data suggest that SlpA is secreted through a BAM-like pathway in this ancestral bacterial lineage, supporting an ancient origin of this pathway before the evolution of the Proteobacteria.

Homogeneous incorporation of secondary cell wall polysaccharides to the cell wall of Thermus thermophilus HB27.

Regular surface protein layers (S-layers) from most Gram-positive bacteria and from the ancestral bacterium Thermus thermophilus attach to pyruvylated polysaccharides (SCWP) covalently bound to the peptidoglycan through their SLH domain. However, it is not known whether the synthesis of SCWP and S-layer is coordinated enough as to follow a similar pattern of incorporation to the cell wall during growth. In this work we analyse the localization of newly synthesized SCWP on the cell wall of T. thermophilus by immunoelectron microscopy. For this, we obtained mutants with a reduced amount of pyruvylated SCWP through mutation of the csaB gene encoding the SCWP-pyruvylating activity, and its upstream gene csaA, a putative sugar transporter. We hypothesized that CsaA would be required for the synthesis of the SCWP. However, we found that csaA mutants showed only a minor decrease in the amount of SCWP immunodetected on the cell walls in comparison with csaB mutants, revealing its irrelevance in the process. Complementation experiments of csaB mutants with CsaB expressed from inducible promoters revealed that newly synthesized SCWP was homogeneously distributed along the cell wall. Fusions with thermostable fluorescent protein revealed that CsaB was distributed also in homogeneous pattern associated with the membrane. These data support that synthesis of SCWP takes place in disperse and homogeneous form all over the cell surface, in contrast to the zonal incorporation at the cell centre recently demonstrated for SlpA.

Localized synthesis of the outer envelope from Thermus thermophilus.

In agreement with its distinct phylogenetic origin, the envelope of Thermus thermophilus consists of a complex pattern of layers with properties intermediate between those of Gram positives and Proteobacteria. Its cell wall of Gram positive composition is surrounded by an outer envelope that includes a crystalline layer scaffold built up by the SlpA protein, lipids and polysaccharides. The synthesis of this outer envelope has been studied by confocal microscopy. Available amino groups from the cell surface, mainly belonging to the SlpA protein, were covalently labelled in vivo with fluorescent dyes. Stained cells were able to grow without any apparent loss of viability, allowing the localization of the regions of new synthesis as dark nonfluorescent spots. Our results demonstrate that the outer envelope of T. thermophilus is synthesized from a central point in the cells, likely following a helical pattern. Cell poles and subpolar regions are basically inert and retain their label for generations.

Impact of inadequate empirical therapy on the mortality of patients with bloodstream infections: a propensity score-based analysis.

The impact of the adequacy of empirical therapy on outcome for patients with bloodstream infections (BSI) is key for determining whether adequate empirical coverage should be prioritized over other, more conservative approaches. Recent systematic reviews outlined the need for new studies in the field, using improved methodologies. We assessed the impact of inadequate empirical treatment on the mortality of patients with BSI in the present-day context, incorporating recent methodological recommendations. A prospective multicenter cohort including all BSI episodes in adult patients was performed in 15 hospitals in Andalucía, Spain, over a 2-month period in 2006 to 2007. The main outcome variables were 14- and 30-day mortality. Adjusted analyses were performed by multivariate analysis and propensity score-based matching. Eight hundred one episodes were included. Inadequate empirical therapy was administered in 199 (24.8%) episodes; mortality at days 14 and 30 was 18.55% and 22.6%, respectively. After controlling for age, Charlson index, Pitt score, neutropenia, source, etiology, and presentation with severe sepsis or shock, inadequate empirical treatment was associated with increased mortality at days 14 and 30 (odds ratios [ORs], 2.12 and 1.56; 95% confidence intervals [95% CI], 1.34 to 3.34 and 1.01 to 2.40, respectively). The adjusted ORs after a propensity score-based matched analysis were 3.03 and 1.70 (95% CI, 1.60 to 5.74 and 0.98 to 2.98, respectively). In conclusion, inadequate empirical therapy is independently associated with increased mortality in patients with BSI. Programs to improve the quality of empirical therapy in patients with suspicion of BSI and optimization of definitive therapy should be implemented.