Estimation of the economic impact of heat stress on the Chilean dairy regions by using two comfort thermal indices.

The study aimed to estimate economic losses associated with heat stress in the eight dairy production regions (DPR), defined by the Dairy Chilean Consortium, using two comfort thermal indices, namely, the temperature-humidity index (THI) and the THI adjusted for solar radiation and wind speed (THIa). Hourly records from 19 weather stations (Nov - Mar 2017-2022) were collected to estimate the comfort thermal indices. The economic impact was estimated considering a critical threshold of 65 for both indices and the effect of higher values on loss in milk yield, days open, culling rate, and deaths. There were differences in the number of hours above the threshold among DPRs, independent of the thermal index used (P < 0.01). The greatest values were observed in DPRs I, II, and VIII, which concentrate most dairy cows. Average losses in milk yield were between 2.0 and 6.4 times higher when THIa was used instead of THI, which also depends on the DPR (P < 0.01). These estimations coincide with those observed empirically by producers. The lowest average economic losses per cow during the summer season (5 seasons average) occurred in DPR VI (US $ 91.5), and the highest losses were observed in DPR I (US $ 184.2) both using THIa. At the country level, economic losses fluctuate between US $ 29.0 and 108.4 million per summer season, depending on the comfort thermal index used. Finally, heat stress impacts negatively and significantly the Chilean dairy sector, which is highly dependent on the DPR.

Effects of a multistrain Bacillus-based direct-fed microbial on gastrointestinal permeability and biomarkers of inflammation during and following feed restriction in mid-lactation Holstein cows.

Objectives were to evaluate the effects of a multistrain Bacillus-based (Bacillus subtilis and Bacillus pumilus blend) direct-fed microbial (DFM) on production, metabolism, inflammation biomarkers and gastrointestinal tract (GIT) permeability during and following feed restriction (FR) in mid-lactation Holstein cows. Multiparous cows (n = 36; 138 ± 53 DIM) were randomly assigned to 1 of 3 dietary treatments: 1) control (CON; 7.5 g/d rice hulls; n = 12), 2) DFM10 (10 g/d Bacillus DFM, 4.9 × 109 cfu/d; n = 12) or 3) DFM15 (15 g/d Bacillus DFM, 7.4 × 109 cfu/d; n = 12). Before study initiation, cows were fed their respective treatments for 32 d. Cows continued to receive treatments during the trial, which consisted of 3 experimental periods (P): P1 (5 d) served as baseline for P2 (5 d), during which all cows were restricted to 40% of P1 dry matter intake (DMI), and P3 (5 d), a "recovery" where cows were fed ad libitum. On d 4 of P1 and on d 2 and 5 of P2, GIT permeability was evaluated in vivo using the oral paracellular marker chromium (Cr)-EDTA. As anticipated, FR decreased milk production, decreased insulin, glucagon, and BUN but increased nonesterified fatty acids. During recovery, DMI rapidly increased on d 1 then subsequently decreased (4.9 kg) on d 2 before returning to baseline whereas milk yield slowly increased but remained decreased (13%) relative to P1. DFM10-fed cows had increased DMI and milk yield relative to DFM15 during P3 (10%). Overall, milk lactose content was increased in DFM cows relative to CON (0.10 percentage units), and DFM10 cows tended to have increased lactose yield relative to CON and DFM15 during P3 (8 and 10%, respectively). No overall treatment differences were observed for other milk composition variables. Circulating glucose was quadratically increased in DFM10 cows compared with CON and DFM15 during FR and recovery. Plasma Cr area under the curve was increased in all cows on d 2 (9%) and 5 (6%) relative to P1. Circulating lipopolysaccharide binding protein (LBP), serum amyloid A (SAA), and haptoglobin (Hp) increased in all cows during P2 compared with baseline (31%, 100%, and 9.0-fold, respectively). Circulating Hp concentrations continued to increase during P3 (274%). Overall, circulating LBP and Hp tended to be increased in DFM15 cows relative to DFM10 (29 and 81%, respectively), but no treatment differences were observed for SAA. Following feed reintroduction during P3, fecal pH initially decreased (0.62 units), but returned to baseline levels whereas fecal starch markedly increased (2.5-fold) and remained increased (82%). Absolute quantities of a fecal Butyryl-CoA CoA transferase (But) gene associated with butyrate synthesis, collected by fecal swab were increased in DFM10 cows compared with CON and DFM15-fed cows. In summary, FR increased GIT permeability, caused inflammation, and decreased production. Feeding DFM10 increased some key production and metabolism variables and upregulated a molecular biomarker of microbial hindgut butyrate synthesis, while DFM15 appeared to augment immune activation.

Dynamics of anti-Toxoplasma gondii antibodies and seroconversion during pregnancy and lactation in naturally infected goats.

The objective of this work was to evaluate the dynamics of anti-T. gondii antibodies and seroconversion in naturally infected goats from the last third of pregnancy to 100 days of lactation and relate it to hematological and dehydration parameters. Blood samples were obtained from 56 goats in the different physiological states (pregnancy, kidding and lactation) as in different years (2019, 2021 and 2022). A total of 266 serum samples were obtained and evaluated by indirect fluorescent antibody test (IFAT) to end titer. The overall T. gondii seropositivity was 80.4% (45/56), with titers ranging from 100 to 25.600. The goats older than 3 years (4967 ± 1329) had significantly higher IFAT titers than the younger goats (2705 ± 681). The highest rate of positive seroconversion 31.1% (14/45) was found between kidding and 70 days of lactation; and of negative seroconversion 28.9% (13/45) between late pregnancy and kidding. The highest proportion of slightly dehydrated animals was found in the last third of pregnancy (14/25) and kidding (9/28). The correlation between seroconversion and T. gondii antibody titers was negative to the established dehydration index. These data suggest that in all physiological states and at different ages of goats, there is seroconversion which is not related to hydration status. Pregnancy, kidding and peak of lactation are stressful physiological periods, facilitating the reactivation of chronic T. gondii infections which are expressed by higher antibodies titers.

Desert dust intrusions and their incidence on airborne biological content. Review and case study in the Iberian Peninsula.

Desert dust intrusions cause the transport of airborne particulate matter from natural sources, with important consequences for climate regulation, biodiversity, ecosystem functioning and dynamics, human health, and socio-economic activities. Some effects of desert intrusions are reinforced or aggravated by the bioaerosol content of the air during these episodes. The influence of desert intrusions on airborne bioaerosol content has been very little studied from a scientific point of view. In this study, a systematic review of scientific literature during 1970-2021 was carried out following the standard protocol Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After this literature review, only 6% of the articles on airborne transport from desert areas published in the last 50 years are in some way associated with airborne pollen, and of these, only a small proportion focus on the study of pollen-related parameters. The Iberian Peninsula is affected by Saharan intrusions due to its proximity to the African continent and is seeing an increasing trend the number of intrusion events. There is a close relationship among the conditions favouring the occurrence of intrusion episodes, the transport of particulate matter, and the transport of bioaerosols such as pollen grains, spores, or bacteria. The lack of linearity in this relationship and the different seasonal patterns in the occurrence of intrusion events and the pollen season of most plants hinders the study of the correspondence between both phenomena. It is therefore important to analyse the proportion of pollen that comes from regional sources and the proportion that travels over long distances, and the atmospheric conditions that cause greater pollen emission during dust episodes. Current advances in aerobiological techniques make it possible to identify bioaerosols such as pollen and spores that serve as indicators of long-distance transport from remote areas belonging to other bioclimatic and biogeographical units. A greater incidence of desert intrusion episodes may pose a challenge for both traditional systems and for the calibration and correct validation of automatic aerobiological monitoring methods.

Cáncer colorrectal ­ diagnóstico y tratamiento: revisión bibliográfica / Colorectal cancer ­ diagnosis and treatment: literature review

Colorectal cancer (CRC) is the third most prevalent cancer worldwide. Although improvements in detection and treatment have been implemented; CRC incidence, prevalence, and mortality remain high, even in developed countries. The risk of developing this cancer is related to poor eating habits, smoking, inflammatory bowel disease, polyps, genetic factors, and aging. There are several methods for detecting colorectal cancer, including the guaiac test, stool immunochemical test, stool DNA test, sigmoidoscopy, colonoscopy, and barium enema. The stage at which the cancer is detected determines the patient's prognosis, survival, and treatment. Treatments include endoscopic and surgical local excision, preoperative radiation therapy and systemic downstage therapy, extensive surgery for locoregional and metastatic disease, local ablative therapies for metastases, and palliative, targeted chemotherapy and immunotherapy.

El cáncer colorrectal (CCR) es el tercer cáncer más prevalente a nivel mundial. A pesar de que se han implementado mejoras en la detección y el tratamiento; la incidencia, la prevalencia y la mortalidad del CCR siguen siendo altas, incluso en países desarrollados. El riesgo de desarrollar este cáncer está relacionado con malos hábitos alimentarios, tabaquismo, enfermedad inflamatoria intestinal, pólipos, factores genéticos y envejecimiento. Existen varios métodos para detectar el cáncer colorrectal, como la prueba de guayaco, la prueba inmunoquímica de heces, la prueba de ADN en heces, la sigmoidoscopia, la colonoscopia y el enema de bario. El estadio en el que se detecta el cáncer determina el pronóstico, la supervivencia y el tratamiento del paciente. Los tratamientos incluyen escisión local endoscópica y quirúrgica, radioterapia preoperatoria y terapia sistémica de reducción del estadio, cirugía extensa para enfermedad locorregional y metastásica, terapias ablativas locales para metástasis y quimioterapia paliativa, terapia dirigida e inmunoterapia.

Calidad de vida posterior a reconstrucción de vía biliar / Quality of life of patients who underwent a bile duct reconstruction

BACKGROUND: Bile duct reconstruction (BDR) secondary to bile duct injury during cholecystectomy (BDIC) is a complex surgery, and an important issue is the quality of life (QL) after the procedure. AIM: To compare the QL of a cohort of patients who underwent BDR due to BDIC with a cohort of patients who underwent a cholecystectomy without incidents. MATERIAL AND METHODS: The cohort was composed of 32 patients aged 47 ± 18 years (78% women) who underwent BDR due to BDIC. For purposes of comparison, a cohort of patients who underwent a cholecystectomy without incident was chosen. These cohorts were paired 1:1 by age (± 1 year), gender and type of surgery. The SF-36 quality of life survey was applied in person or by telephone. The score was calculated as proposed by the RAND group. RESULTS: The cohort of BDR patients was comprised of 32 patients, with an average age of 47 ± 17.6 years, with a predominance of women (78%). The mean number of hospitalization days among BDR patients was 20 ± 11.8. The average follow-up was 7 ± 5 years. The mean score of patients undergoing RVB or cholecystectomy without complications was evaluated, without finding differences in the score of the different domains of the SF-36 scale. Conclusions: In the present study no significant differences were found in QL between the patients with BDIC who underwent BDR and patients who underwent a cholecystectomy without complications.

Application of the diagnostic criteria for Common Variable Immunodeficiency in resource-limited settings

Introduction: Common variable immunodeficiency (CVID) is the most prevalent symptom-atic humoral deficiency; however, its heterogeneous presentation makes the diagnosis diffi-cult. The present study is aimed to verify the CVID diagnostic criteria as established by the European Society for Immunodeficiencies in 42 CVID patients from our outpatient clinic. Methods: Information was collected from their medical records and when needed, lymphocyte subpopulations in peripheral blood (PB) were performed by flow cytometry. Results: All the patients fulfilled the clinical working definition for CVID and showed decreased serum IgG and IgA at diagnosis. Over two-thirds of the patients had decreased memory B cell percentages. However, the remaining patients exhibited other quantitative B cell defects in PB. Evaluation of vaccination responses was only found in 13 records and 69% were not respon-sive. None of the patients were subjected to vaccination studies to both, T-cell dependent and independent antigens. The two required tests to evaluate T cell responses were performed in 84.2% of the patients and reported normal. Without the support of third-party payers, only 34.2% of our patients would have completed the required evaluations. Conclusions: Further efforts are needed to speed up CVID diagnosis in low-resourced settings, increasing the availability of the required resources and optimizing the healthcare supply chain (AU)

[Quality of life of patients who underwent a bile duct reconstruction]. / Calidad de vida posterior a reconstrucción de vía biliar.

BACKGROUND: Bile duct reconstruction (BDR) secondary to bile duct injury during cholecystectomy (BDIC) is a complex surgery, and an important issue is the quality of life (QL) after the procedure. AIM: To compare the QL of a cohort of patients who underwent BDR due to BDIC with a cohort of patients who underwent a cholecystectomy without incidents. MATERIAL AND METHODS: The cohort was composed of 32 patients aged 47 ± 18 years (78% women) who underwent BDR due to BDIC. For purposes of comparison, a cohort of patients who underwent a cholecystectomy without incident was chosen. These cohorts were paired 1:1 by age (± 1 year), gender and type of surgery. The SF-36 quality of life survey was applied in person or by telephone. The score was calculated as proposed by the RAND group. RESULTS: The cohort of BDR patients was comprised of 32 patients, with an average age of 47 ± 17.6 years, with a predominance of women (78%). The mean number of hospitalization days among BDR patients was 20 ± 11.8. The average follow-up was 7 ± 5 years. The mean score of patients undergoing RVB or cholecystectomy without complications was evaluated, without finding differences in the score of the different domains of the SF-36 scale. CONCLUSIONS: In the present study no significant differences were found in QL between the patients with BDIC who underwent BDR and patients who underwent a cholecystectomy without complications.

Eleven years of Toxoplasma gondii serological follow-up in a goat herd and association of toxoplasmosis with reproductive losses.

Toxoplasmosis is considered one of the most important causes of abortion in small ruminants. The aim of this study was to evaluate the relationship between Toxoplasma gondii antibody titres and reproductive losses over an 11 year period in a goat farm located in Buenos Aires province, Argentina. Blood samples were obtained from 85 goats, representing three breeds, during the last third of gestation (n = 165 gestations), in consecutive pregnancies (2008-2019), and from 51 goats during kidding to analyze seroconversion. Serum was evaluated by IFAT with T. gondii antigen, using 1:100 dilution as the cut-off titre and processed to end titre. An overall reproductive loss of 31% (51/165) was detected, including 16.4% (27/165) abortions and 14.6% (24/165) perinatal deaths. The seropositivity to T. gondii was 100% (85/85) with all animals positive in successive samplings and, therefore, considered chronically infected. Antibody titres showed average values greater than 1100 in each year and breed group. Differences in antibody levels were associated with breed and were lower in those that were predominately Creole and higher in those that were predominately Saanen. Seroconversion was detected in 16.2% (6/37) and 57.1% (8/14) of goats from the Creole and Sannen breed groups, respectively. There were no significant differences in the antibody titre average between goats with reproductive losses and those with healthy kids, although the goats with perinatal deaths had a significantly higher titre average. These results suggest reinfection or reactivation, although no association with reproductive losses was observed. Higher antibody titres were associated with perinatal deaths. The high T. gondii antibody titres in a farm with 100% seroprevalence did not allow for association with reproductive losses, particularly abortion, to be assessed.

Derivation of multivariate indices of milk composition, coagulation properties, and curd yield in Manchega dairy sheep.

This study approaches the interrelation patterns between composition of milk and whey, curd yield, chromaticity, syneresis, and technological quality of Manchega sheep milk using multivariate factor analysis. In addition, the effect of the main husbandry components (flock, prolificacy, season of the year, stage of lactation, and parity) on the common latent factors that define the pattern of variation of Manchega milk was assessed. For this purpose, 1,200 individual Manchega ewe milk samples from 4 different flocks registered under the Protected Designation of Origin Queso Manchego were analyzed (50 ewes/flock). Samples were collected in 2 different seasons of the year (spring and autumn) and at 3 time points per season: early, mid-, and late lactation. The obtained results suggested that curd yield mainly depends on milk composition, and the retention of water in the curd is related to coagulation traits. Thus, composition and moisture content could be useful indicators to assess the efficiency and quality of milk intended for cheesemaking, regardless of the analysis of coagulation properties. Finally, in terms of husbandry, a direct effect of flock and stage of lactation was observed on all analyzed factors, with a lower influence of season and parity.

Identifying and managing patient–ventilator asynchrony: An international survey / Identificación y manejo de la asincronía paciente-ventilador: encuesta internacional

Objective To describe the main factors associated with proper recognition and management of patient–ventilator asynchrony (PVA). Design An analytical cross-sectional study was carried out. Setting An international study conducted in 20 countries through an online survey. Participants Physicians, respiratory therapists, nurses and physiotherapists currently working in the Intensive Care Unit (ICU). Main variables of interest Univariate and multivariate logistic regression models were used to establish associations between all variables (profession, training in mechanical ventilation, type of training program, years of experience and ICU characteristics) and the ability of HCPs to correctly identify and manage 6 PVA. Results A total of 431 healthcare professionals answered a validated survey. The main factors associated to proper recognition of PVA were: specific training program in mechanical ventilation (MV) (OR 2.27; 95%CI 1.14–4.52; p=0.019), courses with more than 100h completed (OR 2.28; 95%CI 1.29–4.03; p=0.005), and the number of ICU beds (OR 1.037; 95%CI 1.01–1.06; p=0.005). The main factor influencing the management of PVA was the correct recognition of 6 PVAs (OR 118.98; 95%CI 35.25–401.58; p<0.001). Conclusion Identifying and managing PVA using ventilator waveform analysis is influenced by many factors, including specific training programs in MV, the number of ICU beds, and the number of recognized PVAs. (AU)

Objetivo Describir los factores asociados al correcto reconocimiento y manejo de la asincronía paciente-ventilador (APV). Diseño Estudio analítico transversal. Ámbito Estudio internacional realizado en 20 países mediante una encuesta a través de Internet. Participantes Médicos, terapeutas respiratorios, enfermeras/os y fisioterapeutas que trabajan actualmente en unidades de cuidados intensivos (UCI). Principales variables de interés Se utilizó un análisis uni y multivariado para describir la asociación entre todas las variables (profesión, formación en ventilación mecánica, tipo de programa de formación, años de experiencia y características de la UCI en la cual trabajan los profesionales) con la correcta identificación y manejo de 6 APV. Resultados Un total de 431 profesionales respondieron una encuesta validada previamente. Los factores asociados a una correcta identificación de 6 APV fueron: haber completado un programa de formación específico sobre ventilación mecánica (OR: 2,27; IC 95%: 1,14-4,52; p=0,019), programa de formación con más de 100h (OR: 2,28; IC 95%: 1,29-4,03; p=0,005) y el número de camas de UCI (OR: 1,037; IC 95%: 1,01-1,06; p=0,005). El principal factor asociado a un adecuado manejo de la APV fue la correcta identificación de 6 APV (OR: 118,98; IC 95%: 35,25-401,58; p<0,001). Conclusiones La identificación y el manejo de la asincronía paciente-ventilador, mediante el análisis de las curvas del ventilador está influenciada por programas de formación, específicos sobre ventilación mecánica, el número de camas de la UCI y el número de asincronías identificadas. (AU)

Quistectomía laparoscópica en quiste hidatídico hepático / Laparoscopic cystectomy in hidatidid cyst

Resumen Objetivo: Describir resultados en términos de morbilidad y mortalidad del tratamiento de quistes hidatídicos hepáticos (QHH) por vía laparoscópica en una serie de pacientes consecutivos. Comparar calidad de vida (CV) de pacientes sometidos a quistectomía laparoscópica (QL) con pacientes llevados a colecistectomía laparoscópica. Materiales y Método: Serie de casos con seguimiento de pacientes con QHH, sometidos a QL. Analizamos datos con Stata® 10.0, mediante medidas de tendencia central y dispersión. Describimos 4 variables, realizando seguimiento con tomografía computada (TC) abdominal. Aplicamos encuesta de calidad de vida SF-36. Resultados: Incluimos 12 pacientes, 58,3% de género femenino. Número de quistes 2,02 ± 1,56, volumen quístico mayor 809,16 ± 766,05 ml, diámetro de quiste mayor 11,77 ± 4,33 cm, predominando en lóbulo hepático derecho (58%). Tiempo operatorio promedio 234,1 ± 52,9 minutos. Estadía hospitalaria promedio 11,5 ± 14,5 días. Morbilidad en 16,6%, sin mortalidad posoperatoria. Seguimiento con imágenes promedio fue 7,9 ± 4,3 meses, encontrando cavidades residuales pequeñas y asintomáticas en 50% de pacientes. No reportamos recidivas. Al comparar CV con grupo de colecistectomía sólo encontramos diferencia respecto a vitalidad (p = 0,04). Discusión: Aunque nuestra serie es pequeña y presenta mayor tiempo quirúrgico (por selección de pacientes) y mayor estancia hospitalaria que en otras series de QL, presenta menor porcentaje de recidivas, de fístulas biliares y no presenta mortalidad, concordando con otras series de QL que la recomiendan como opción terapéutica. Conclusiones: La QL para el tratamiento de los QHH resulta una cirugía aceptable, con morbilidad y mortalidad comparable con reportes de cirugía abierta.

Aim: To describe results in morbidity and mortality terms of the hepatic hydatidosis (HHC) treatment by laparoscopic route in selected patients. In addition, compare the quality of life (QL) of cystomectized vs cholecystectomized patients, both laparoscopically. Materials and Method: Case series with follow-up of patients with HHC, undergoing laparoscopic cystectomy (LC). Data analysis, through measures of central tendency and dispersion, performed with Stata® 10.0. Analyzing 4 variables followed-up with abdominal computed tomography. A quality of life survey SF-36" was applied. Results: 12 patients were included, 58.3% female gender. Cysts number 2.02 ± 1.56, largest cystic volume 809.16 ± 766.05 ml, larger cyst diameter 11,77 ± 4,33 cm. Right hepatic lobe is predominantly 58%. Surgical time, 234.16 ± 52.95 minutes. Hospital stay, 11.58 ± 14.55 days. Morbidity 16.6%, with no postoperative mortality. Follow-up, performed at 7.9 ± 4.3 months, finding residual cavity in 50%, no recurrences were reported. At comparing QL with cholecystectomy group, we only found differences at the vitality item (p = 0,04). Discussion: Although our series is small and has a longer surgical time (by patient selection) and a longer hospital stay than in other LC series, it has a lower recurrences percentage, biliary fistulas, and no mortality, agreeing with other LC series that recommend it as a therapeutic option. Conclusions: The laparoscopic approach for the HHC treatment, is an acceptable surgery, with morbidity and mortality comparable to the reports of laparotomy surgery.

Identifying and managing patient-ventilator asynchrony: An international survey.

OBJECTIVE: To describe the main factors associated with proper recognition and management of patient-ventilator asynchrony (PVA). DESIGN: An analytical cross-sectional study was carried out. SETTING: An international study conducted in 20 countries through an online survey. PARTICIPANTS: Physicians, respiratory therapists, nurses and physiotherapists currently working in the Intensive Care Unit (ICU). MAIN VARIABLES OF INTEREST: Univariate and multivariate logistic regression models were used to establish associations between all variables (profession, training in mechanical ventilation, type of training program, years of experience and ICU characteristics) and the ability of HCPs to correctly identify and manage 6 PVA. RESULTS: A total of 431 healthcare professionals answered a validated survey. The main factors associated to proper recognition of PVA were: specific training program in mechanical ventilation (MV) (OR 2.27; 95%CI 1.14-4.52; p=0.019), courses with more than 100h completed (OR 2.28; 95%CI 1.29-4.03; p=0.005), and the number of ICU beds (OR 1.037; 95%CI 1.01-1.06; p=0.005). The main factor influencing the management of PVA was the correct recognition of 6 PVAs (OR 118.98; 95%CI 35.25-401.58; p<0.001). CONCLUSION: Identifying and managing PVA using ventilator waveform analysis is influenced by many factors, including specific training programs in MV, the number of ICU beds, and the number of recognized PVAs.

Eventos adversos en recién nacidos hospitalizados en una Unidad de Cuidados Intermedios / Adverse events among newborns hospitalized in an Intermediate Care Unit / Eventos adversos em recém-nascidos hospitalizados em una Unidade de Cuidados Intermediários

Resumen Introducción: Los recién nacidos (RN) conforman uno de los grupos poblacionales más vulnerables. El riesgo de ocurrencia de un evento adverso durante su hospitalización se incrementa por diversos factores. Objetivo: Identificar los eventos adversos en recién nacidos hospitalizados en una unidad de cuidados intermedios en 2018. Metodología: Estudio de tipo descriptivo, diseño transversal y retrospectivo, realizado en la Unidad de Cuidados Intermedios Neonatales del Instituto Nacional Materno Perinatal durante el 2018. Se elaboró una ficha de recolección de datos que constó de nueve ítems correspondientes a procedimientos realizados por el personal de enfermería. Se utilizó un análisis univariado de los datos, presentados en tablas y gráficos. Resultados: Fueron analizados 73 eventos adversos, la menor edad gestacional fue de 32 semanas, con un máximo de 28 días de hospitalización. 60% de eventos se produjo en los RN más lábiles y con situación de salud compleja, de los cuales, 58% fueron infecciones asociadas a catéter percutáneo o periférico, cuyo germen frecuente fue Sthapylococcus coagulasa negativo. Solo 20.5% de eventos adversos fueron reportados. Discusión: Los resultados obtenidos coinciden con otras investigaciones en que los factores intrínsecos de los recién nacidos contribuyen en la aparición de eventos adversos; de igual manera concuerdan en la necesidad de prevenirlos y notificarlos. Conclusiones: La prematuridad, el tiempo de hospitalización en una unidad crítica y de exposición a diversos procedimientos, incrementaron el riesgo de ocurrencia de eventos adversos en recién nacidos. Detectar oportunamente estos acontecimientos es importante, así como fomentar la cultura de reporte, con el fin de evitarlos.

Abstract Introduction: Newborns are one of the most vulnerable populations, and their risk of suffering an adverse event during their hospital stay is influenced by diverse factors. Objective: To identify the adverse events among newborns hospitalized in an Intermediate Care Unit in 2018. Methodology: This is a descriptive, transversal, and retrospective study carried out in a Newborn Intermediate Care Unit of the Maternal and Perinatal National Institute during 2018. A data gathering chart with 9 items related to the corresponding nursing procedures was designed. A univariate data analysis was calculated, and the results were shown in tables and graphs. Results: 73 adverse events were analyzed. The lowest gestational age was 32 weeks, and the longest hospitalization was 28 days. 60% of these events were related to the more delicate and with the more complex situation newborns; and 58% of these were related to percutaneous or peripheral catheter infections and the most frequent pathogen was Coagulase-Negative Staphylococcus. Only 28.5% of the events were reported. Discussion: These findings are in line with the results of other research studies. Addressing the diverse factors which contribute to the adverse events in newborns in Intermediate Care Units is suggested. Conclusions: Being premature and the length of the hospital stay increase the risk of adverse events in newborns. It is critical to promote a culture of events reporting.

Resumo Introdução: Os recém-nascidos (RN) constituem um dos grupos populacionais mais vulneráveis. O risco de ocorrência de um evento adverso durante sua hospitalização é incrementado por diversos fatores. Objetivo: Identificar os eventos adversos em recém-nascidos hospitalizados em una unidade de cuidados intermediários em 2018. Metodologia: Estudo de tipo descritivo, desenho transversal e retrospectivo, realizado na Unidade de Cuidados Intermediários Neonatais do Instituto Nacional Materno Perinatal durante 2018. Foi elaborada uma ficha de coleta de dados que constou de nove itens correspondentes a procedimentos realizados pelo pessoal de enfermagem. Utilizou-se uma análise univariáda dos dados, apresentados em tabelas e gráficos. Resultados: Foram analisados 73 eventos adversos, a menor idade gestacional foi de 32 semanas, com máximo de 28 dias de internação. 60% dos eventos produziram-se nos RN mais lábeis e em situação de saúde complexa, dos quais, 58% foram infecções associadas a cateter percutâneo ou periférico, cujo germe frequente foi o Sthapylococcus coagulase negativo. Apenas 20.5% de eventos adversos foram relatados. Discussão: Os resultados obtidos coincidem com outras pesquisas em que os fatores intrínsecos dos recém-nascidos contribuem no aparecimento de eventos adversos; aliás, concordam com a necessidade de preveni-los e notificá-los. Conclusões: A prematuridade, o tempo de hospitalização em uma unidade crítica e de exposição a diversos procedimentos, incrementaram o risco de ocorrência de eventos adversos em recém-nascidos. É importante detectar estes acontecimentos oportunamente, assim como fomentar a cultura de notificação, a fim de evitá-los.

No transmission of SARS-CoV-2 in a patient undergoing allogeneic hematopoietic cell transplantation from a matched-related donor with unknown COVID-19.

The Hematology Department and its Hematopoietic Cell Transplantation (HCT) program implemented several measures during COVID-19 outbreak in order to keep clinical activities with the maximum security for both donors and recipients. Nevertheless, there was a lack of evidence whether blood products and specifically bone marrow can cause transfusion-transmitted infection. Initially, there were many uncertainties and did not exist formal recommendations. Before official statements were available, we performed an allogeneic HCT in a 57-year-old male from a related matched donor in the incubation period of COVID-19 where the patient did not develop the disease. Actual epidemiology data suggest that transmission may occur early in the course of infection, even from asymptomatic patients in the incubation period. In our knowledge this is the first case report of an adult hematopoietic cell donor with COVID-19 in the incubation period where the transplant is successfully completed with no transmission of SARS-CoV-2. The low concentration of viral RNA in plasma of patients with COVID-19 could support the safety of blood products, including peripheral blood hematopoietic cells. In conclusion, blood products including hematopoietic stem cells are safe in the context of COVID-19 pandemic.

Association analysis in a Latin American population revealed ethnic differences in rheumatoid arthritis-associated SNPs in Caucasian and Asian populations.

Large genome-wide association studies (GWAS) have increased our knowledge of the genetic risk factors of rheumatoid arthritis (RA). However, little is known about genetic susceptibility in populations with a large admixture of Amerindian ancestry. The aim of the present study was to test the generalizability of previously reported RA loci in a Latin American (LA) population with admixed ancestry. We selected 128 single nucleotide polymorphisms (SNPs) in linkage equilibrium, with high association to RA in multiple populations of non-Amerindian origin. Genotyping of 118 SNPs was performed in 313 RA patients/487 healthy control subjects by mid-density arrays of polymerase chain reaction (PCR). Some of the identified associations were validated in an additional cohort (250 cases/290 controls). One marker, the SNP rs2451258, located upstream of T Cell Activation RhoGTPase Activating Protein (TAGAP) gene, showed significant association with RA (p = 5 × 10-3), whereas 18 markers exhibited suggestive associations (p < 0.05). Haplotype testing showed association of some groups of adjacent SNPs around the signal transducer and activator of transcription 4 (STAT4) gene (p = 9.82 × 10-3 to 2.04 × 10-3) with RA. Our major finding was little replication of previously reported genetic associations with RA. These results suggest that performing GWAS and admixture mapping in LA populations has the potential to reveal novel loci associated with RA. This in turn might help to gain insight into the 'pathogenomics' of this disease and to explore trans-population differences for RA in general.

Using multivariate analysis to explore the relationships between color, composition, hygienic quality, and coagulation of milk from Manchega sheep.

This study explores the relationships between composition, hygienic quality, and color values of milk to evaluate whether colorimetry could be used as a valid predictor of the quality of raw milk and its coagulation. For this purpose, we performed analyses in 1,200 individual samples of Manchega sheep milk from 4 flocks from the region of Castilla-La Mancha, Spain. Based on the measured variables, we determined the differences and similarities between coagulating and noncoagulating samples using discriminant analysis techniques. The variables with a higher discriminant ability were lactose content, somatic cell score, pH, and the color values lightness (L*) and red/green value (a*). The model based on color values showed a predictive ability similar to that found in the model based on milk composition and hygienic quality. Canonical correlation analysis allowed us to explore the relationships between both sets of variables. Canonical correlations for the first and second pair of canonical values were 0.794 and 0.438, respectively. Both values were significant and represented 92.82% of the observed variability. The correlation structure showed that color values had a strong correlation with fat and protein content and with total solids, and they had a weak correlation with lactose content and somatic cell score. The 2 first combinations of standardized canonical variability could be considered a predictable measure of the composition and, to a lesser extent, the hygiene of milk. Measurement of color values could be a rapid and effective means of supplementing standard analyses when determining the coagulation ability of Manchega sheep milk.