Genetic susceptibility for retinopathy of prematurity and its associated comorbidities.

BACKGROUND: Retinopathy of prematurity (ROP) is one of the leading cause of child blindness. Preterm newborns of very low gestational age (GA) and very low birth weight are at the greatest risk. Our objective was to evaluate the role of genetic variants associated with ROP risk and its comorbidities in an Argentinian sample of premature infants. METHODS: A sample of 437 preterm infants <33 weeks GA, born at a maternity hospital in Tucumán, Argentina, 2005-2010, was analyzed. Environmental factors, perinatal outcomes, and fourteen single nucleotide polymorphisms associated with ROP were evaluated, comparing ROP with non-ROP newborns. A lasso logistic regression was performed to select variables; then, a conditional logistic regression was used to identify ROP maternal and perinatal risk factors adjusting by maternal and gestational ages, respectively. RESULTS: ROP maternal risk factors were alcohol intake, periodontal infections, and severe stress. Respiratory distress, sepsis, and intracranial hemorrhage were the ROP perinatal risk factors. Markers rs186085 of EPAS1 and rs427832 of AGTR1 were significantly associated with ROP newborns. CONCLUSION: We identified three maternal and three perinatal risk factors associated with ROP. Genes EPAS1 and AGTR1, involved in angiogenesis and vascularization, were identified to be of risk for ROP. IMPACT: Genetic and environmental risk factors associated with ROP and its comorbidities are evaluated in a Latin American population. Genes EPAS1 and AGTR1, involved in angiogenesis and vascularization, were identified to be of risk for ROP. Three maternal and three perinatal risk factors associated with ROP were also identified. A matrix of significant relationships among genetic markers and comorbidities is presented. Reported data may help develop more effective preventive measures for ROP in the Latin American region.

Emergency surgery workforce and its inverse relationship with multidimensional poverty in Colombia.

PURPOSE: General surgeons, anesthesiologists, obstetricians and gynecologists (ob-gyns), and orthopedic surgeons are the vital disciplines to provide emergency surgery within a healthcare system. This paper aims to examine the relationship (if any) between multidimensional poverty (MDP) and GDP per-capita with the emergency surgery workforce density in Colombia. METHODS: We performed an ecological study, where the observation units were the 32 Colombian departments. The total numbers of general surgeons, anesthesiologists, ob-gyns, and orthopedic surgeons were obtained from the "Registro Unico Nacional de Talento Humano en Salud" (ReTHUS) registry. The 2020 population projections, the incidence of MDP and the GDP per capita were obtained from the Colombian National Administrative Department of Statistics. A spearman's correlation coefficient was calculated to measure the strength of the correlations between the surgical workforce density with MDP and GDP per-capita. RESULTS: There were significant moderate inverse linear correlations between the incidence of multidimensional poverty and workforce density. The correlation coefficients for the incidence of multidimensional poverty and the workforce density were - 0.5273, - 0.5620, - 0.4704, and - 0.4612 for surgeons, anesthesiologists, ob-gyns, and orthopedic surgeons, respectively. Conversely, the correlation coefficients for the GDP per-capita and the workforce density were 0.4045, 0.3822, 0.4404, and 0.3742 for surgeons, anesthesiologists, ob-gyns, and orthopedic surgeons, respectively. CONCLUSION: This study found that Colombian trauma and emergency surgery workforce density was inversely and directly correlated with multidimensional poverty and GDP per-capita levels, respectively. The relationship of these economic indicators with the surgical capacity deserves further investigation.

Leiomioma parasitario retroperitoneal: reporte de un caso / Retroperitoneal parasitic leiomioma: A case report

Resumen ANTECEDENTES: Los leiomiomas parasitarios son una variante poco común de la miomatosis uterina. Se han identificado en la pared abdominal, intestino delgado, muñón cervical o vaginal, vasos iliacos, ovarios, colon sigmoides y en el omento mayor. OBJETIVO: Reportar un caso clínico de leiomioma parasitario retroperitoneal y revisar la bibliografía al respecto. CASO CLÍNICO: Paciente de 57 años, con diagnóstico de NIC-III y hemorragia uterina anormal. Acudió a consulta debido a una sensación de masa y dolor abdominal, pérdida de peso subjetiva, hiporexia, disfagia y plenitud gástrica de cuatro meses de evolución. En los estudios de extensión se documentó una masa retroperitoneal grande y elevación de los marcadores tumorales Ca 125 y Ca 19-9. La resección de la masa se efectuó mediante laparotomía, con hallazgo histopatológico de mioma parasitario. CONCLUSIÓN: Los leiomiomas parasitarios deben considerarse en el diagnóstico diferencial de pacientes con antecedente de histerectomía o miomectomía, sobre todo en el contexto de la morcelación. El tratamiento consiste en cirugía o inhibidores de la aromatasa y análogos de la hormona liberadora de gonadotropina (leiomiomatosis peritoneal diseminada).

Abstract BACKGORUND: Parasitic leiomyomas are a rare entity, defined as an unusual variant of uterine myomatosis. Have been documented in the abdominal wall, small intestine, cervical or vaginal stump, iliac vessels, ovaries, sigmoid colon, and greater omentum. OBJECTIVE: To report a clinical case of retroperitoneal parasitic leiomyoma and review the literature. CLINICAL CASE: A 57-year-old patient with a diagnosis of CIN-III and secondary abnormal uterine bleeding, who consulted for a sensation of abdominal mass and pain, subjective weight loss, hyporexia, dysphagia and gastric fullness, of four months of evolution. Extension studies document a large retroperitoneal mass and elevation of tumor markers Ca 125 and Ca 19-9. We practice surgical management of her gynecological pathology and resection of the mass by laparotomy, with histopathological finding of myoma. CONCLUSION: Parasitic leiomyomas should be suspected in patients with a detected mass and a history of hysterectomy or myomectomy, especially in the context of morcellation. The treatment of this condition is surgical and, in cases of disseminated peritoneal leiomyomatosis, pharmacological treatments have been used with aromatase inhibitors and gonadotropin-release hormone analogues.

Prognostic Factors in Hospitalized COVID-19 Patients at the Start of the Pandemic in Colombia: A Retrospective Cohort Study.

Introduction Different factors are critical when assessing COVID-19 mortality, and can explain why severity differs so widely among populations. However, there is little information regarding prognostic factors and mortality in COVID-19 from Latin American countries. Objectives To determine prognostic factors in hospitalized COVID-19 patients and to evaluate the impact of tocilizumab use in patients with hyperinflammatory syndrome and severe disease defined by the National Early Warning Score 2 (NEWS2) with a value greater than or equal to seven points. Materials and methods This retrospective cohort study included hospitalized COVID-19 patients from May to July 2020. A multivariate logistic regression analysis was performed to determine independent factors associated with mortality. Results A total of 136 patients required hospital admission. In-hospital mortality was 39.7%. Mortality was observed to be potentiated by older age, LDH serum levels and the presence of type 2 diabetes mellitus. Lymphopenia and lower PaO2/FiO2 ratio were more common in these patients. Similarly, patients who died were classified more frequently with severe disease. The independent factors associated with in-hospital mortality were age greater than 65 years, type 2 diabetes mellitus, NEWS2 greater than or equal to seven points and LDH greater than 400U/L. The use of Tocilizumab alone was not related with decreased in-hospital mortality. Subgroup analysis performed in patients with hyperinflammation and severe disease showed similar results. Conclusions COVID-19 mortality in hospitalized patients was high and mainly related with older age, comorbidities, LDH and the severity of disease at hospital admission.

Consenso Colombiano para la prevención, diagnóstico y manejo de condiciones trombóticas en pacientes adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE / Colombian consensus for the prevention, diagnosis and treatment of thrombotic conditions in adult patients with COVID-19: applying GRADE Evidence to Decision (EtD) Frameworks

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Abstract Recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. In this context, the aim was to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: A rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: Recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

Evaluación de una clave taxonómica, para la identificación de los géneros de helechos (Monilophyta), en Guatemala / Evaluation of a taxonomic key, for the identification of fern genera (Monilophyta), in Guatemala

El desarrollo de las tecnologías de la información y la comunicación han llevado a un cambio en la manera en que se realizan las actividades de diferentes disciplinas, incluso de las más tradicionalistas, como la taxonomía botánica. Se documentó la revisión y validación colaborativa de la primera versión de una clave dicotómica para la identificación taxonómica de los géneros de helechos en Guatemala. Con este esfuerzo, se fundamentó la elaboración de una clave mejorada, su segunda versión, la cual se espera sea accesible para usuarios entrenados en morfología botánica, pero no especializados en la taxonomía específica de los helechos. La segunda versión supera las dificultades que fueron analizadas sobre la primera, y agrega contenido útil para la identificación más precisa de los géneros. Se presentan, además, los siguientes documentos suplementarios en versión electrónica: la versión más actualizada de la clave dicotómica, una lista anotada de la taxonomía supra específica de helechos en Guatemala y una lista de algunos sinónimos taxonómicos de los nombres científicos actuales, respecto a los utilizados en la Flora Mesoamericana. Esta experiencia representa un avance en la transformación de la botánica taxonómica, ya que trasciende de ser una disciplina practicada por pocos, donde prevalece sobre todo el criterio de una autoridad casi incuestionable, a una práctica colaborativa, donde el conocimiento se difunde desde la formulación y revisión de los instrumentos taxonómicos. Se espera que todos estos documentos puedan continuar siendo actualizados de manera dinámica, como un avance de la aplicación de las nuevas tecnologías a la taxonomía botánica.

The procedures of several scientific disciplines are changing with the spreading of new information and communication technologies, even the most traditional, like botanical taxonomy. Here we document the review and validation, by collaborative efforts, on the first version of the taxonomic key for the identification of the fern genera in Guatemala. An upgraded version was composed which is easier to follow and more precise. It is intended to be accessible for a wide range of interested people, more than just the fern specialists. Along with this paper, electronic supplementary documents are published too, including the most recent version of the key, an annotated list of taxonomic categories of ferns of Guatemala in the supra-specific levels, and some lists of taxonomic synonymy of the currently valid names, with reference to the old names used in Flora Mesoamericana. With this experience a new milestone has been reached by the national taxonomy, getting over the old paradigm in which taxonomy was an exclusive practice, endeavored by few authorities, to become a more inclusive discipline, embracing the development and revision of its instruments. In the future, we hope to maintain updated all these documents in a more dynamic way, applying new technologies to the taxonomic botany practices.

Hepatic steatosis as an independent risk factor for severe disease in patients with COVID-19: A computed tomography study.

Background and Aim: Hepatic steatosis (HS) is associated with diabetes, hypertension, and obesity, comorbidities recently related to COVID-19 severity. Here, we assessed if tomographic HS is also a risk factor for severe COVID-19 pneumonia. Methods: We included 213 patients with a positive real time polymerase chain reaction (RT-PCR) test and chest computed tomography (CT) from an out-hospital facility and a hospital. We obtained information on demographics; weight; height; smoking history; diabetes; hypertension; and cardiovascular, lung, and renal disease. Two radiologists scored the CO-RADs system (COVID-19 Reporting and Data System) (1 = normal, 2 = inconsistent, 3-4 = indeterminate, and 5 = typical findings) and the chest CT severity index (≥20 of 40 was considered severe disease). They evaluated the liver-to-spleen ratio (CTL/S) and defined tomographic steatosis as a CTL/S index ≤0.9. We used descriptive statistics, χ2 and t student tests, logistic regression, and reported odds ratio (OR) with 95% confidence interval (CI). Results: Of the patients, 61% were men, with a mean age of 51.2 years, 48.3% were CO-RADs 1 and 51.7% CO-RADs 2-5. Severe tomographic disease was present in 103 patients (48.4%), all CO-RADs 5. This group was older; mostly men; and with a higher prevalence of obesity, hypertension, diabetes, and HS (69.9 vs 29%). On multivariate analysis, age (OR 1.058, 95% CI 1.03-1.086, P < 0.0001), male gender (OR 1.9, 95% CI 1.03-3.8, P = 0.04), and HS (OR 4.9, 95% CI 2.4-9.7, P < 0.0001) remained associated. Conclusion: HS was independently associated with severe COVID pneumonia. The physiopathological explanation of this finding remains to be elucidated. CTL/S should be routinely measured in thoracic CT scans in patients with COVID-19 pneumonia.

Neumonía y síndrome de insuficiencia respiratoria progresiva aguda por SARS-CoV-2 en la Ciudad de México / Pneumonia and SARS-CoV-2 Acute Respiratory Distress Syndrome in Mexico City / Pneumonia e Síndrome da Insuficiencia Respiratória Progressiva Aguda devido à SARS-CoV-2 na Cidade do México

Resumen: Durante la pandemia de SARS-CoV-2 se presenta el caso clínico de un hombre joven de 43 años, sin comorbilidades, quien asiste a un concierto en la Ciudad de México y seis días después inicia con un cuadro infeccioso de vías respiratorias altas que evoluciona en seis días a una neumonía con síndrome de insuficiencia respiratoria progresiva aguda (SIRPA) grave. Se confirma infección por SARS-CoV-2 y sobreinfección bacteriana por Staphylococcus aureus meticilino resistente, requiriendo asistencia ventilatoria invasiva y cuidados en la Unidad de Terapia Intensiva del Hospital Bité Medica de la Ciudad de México por un grupo interdisciplinario. El paciente evoluciona favorablemente con hidroxicloroquina y lopinavir/ritonavir, esteroide sistémico, linezolid, estrategias ventilatorias de protección pulmonar y cuidados críticos generales sin desarrollar falla de otros órganos o sistemas.

Abstract: During the SARS-CoV-2 Pandemic, a clinical case of a 43-year-old young man is presented, who after six days of attending a concert in Mexico City developed an infectious of the upper respiratory tract that evolved to a pneumonia with severe acute respiratory distress syndrome (ARDS), confirming SARS CoV2 infection and bacterial superinfection with resistant methicillin Staphylococcus aureus, requiring invasive ventilatory assistance and care in the Intensive Care Unit of the Hospital Bité Medica, Mexico City by an interdisciplinary group. The patient improved with hydroxychloroquine and lopinavir/ritonavir, systemic steroid, linezolid, ventilatory strategies for pulmonary protection, and general critical care without developing failure of other organs or systems.

Resumo: Durante a pandemia de SARS CoV 2, é apresentado o caso clínico de um jovem de 43 anos que assiste a um concerto na Cidade do México e seis dias depois começa com um quadro infeccioso do trato respiratório superior que evolui em seis dias para pneumonia com síndrome do desconforto respiratório agudo grave, confirmando infecção por SARS CoV2 e superinfecção bacteriana com meticilina resistente Staphylococcus aureus, exigindo assistência ventilatória invasiva e cuidados na Unidade de Terapia Intensiva do Hospital Bitémedica, Cidade do México por um grupo interdisciplinar. O paciente progride para melhora com hidroxicloroquina e lopinavir/ritonavir, esteróide sistêmico, linezolida, estratégias ventilatórias para proteção pulmonar e cuidados críticos em geral, sem desenvolver falha de outros órgãos ou sistemas.

Niveles de orientación empática en estudiantes de medicina de la Universidad Metropolitana de Barranquilla (Colombia) / Empathy levels in medicine students of Metropolitana University of Barranquilla (Colombia)

Resumen Objetivo: Evaluar el nivel de orientación empática de los estudiantes del Programa de Medicina de la Universidad Metropolitana según género y niveles de enseñanza. Materiales y Métodos: Trabajo de tipo exploratorio con análisis transversal, regido por las normas de Helsinki. La población estuvo formada por los estudiantes de primero a sexto año académico de la carrera de Medicina de la Universidad Metropolitana (Barranquilla, Colombia) (N=2061) de la cual se tomó una muestra (n = 1581) estratificada por año, así: primero: 219; segundo: 324; tercero: 258; cuarto: 278; quinto: 359 y sexto: 143. En el factor Género, la composición muestral fue la siguiente: femenino: 1146 y masculino: 435. La recolección de datos se realizó en julio de 2016. A los participantes se les aplicó la Escala de Empatía Médica de Jefferson (EEMJ) en la versión en español para estudiantes de medicina (versión S), validada en México y Chile. Antes de ser aplicada la EEMJ fue sometida a criterio de jueces (tres académicos de profesión médico) con el objeto de verificar la validez cultural y de contenido. La comprensión de los estudiantes de la escala adaptada culturalmente se realizó mediante una prueba piloto. Resultados: En el factor "Años Académicos" los resultados fueron significativos, no siendo así para el "Género" y la interacción. Se observó que la media disminuyó hasta tercer año, mostrando un leve incremento en cuarto año, bajando en el quinto y aumentando nuevamente en sexto año, siendo el comportamiento semejante en ambos géneros.

Abstract Objective: To assess the level of empathy of the students of the medical program of the Metropolitan University according to sex and levels of education. Subjects and methods: Is an exploratory and cross-sectional research. The population included students from first to sixth academic year of Medicine School (n = 1581 N =2061) and was distributed per year: first: 219; second: 324; third: 258; fourth 278; fifth: 359 and sixth: 143. Regarding gender, the sample composition was 435 (male) and female (435) = 1146. Data collection was conducted in July 2016. Participants were administered the Scale of Physician Empathy Jefferson (JSPE) in the Spanish version for medical students (S). Before being applied, the JSPE was subject to the discretion of judges in order to verify cultural and content validity. Results: In "Academic Years", results were significant, not being so for "Gender" and interaction. It was observed that the average decreased until the third year, showing a slight increase in the fourth year, to fall again and increase again in the sixth year. Behavior is similar in both genders and both decline from first to third, showing and a slight increase begins from the fourth year.

Ciclo gametogénico del erizo marino Echinometra lucunter (Echinometra: Echinoidea) en el Noriente de Venezuela / Gametogenic cycle of the rock boring urchin Echinometra lucunter (Echinodermata: Echinoidea) in northeastern Venezuela

Resumen El ciclo gametogénico y el índice gonadosomático (IG) del erizo negro Echinometra lucunter fue examinado entre junio de 2010 y noviembre de 2011 en el noreste de Venezuela (Isla de Lobos, Península de Araya y Ensenada de Turpialito, Golfo de Cariaco). Las gónadas están integradas por extensos acinos ramificados, recubiertos por tejido conectivo, seguido de una capa delgada de células que se diferencian en fagocitos nutritivos y gametos, los cuales cambian en sus proporciones y tamaños con los estadios de maduración. Generalmente, en ambas localidades se presentaron varios estadios de maduración, con desoves simultáneos. En Isla Lobos predominaron los individuos en estado de reserva con un corto período de madurez sexual, mientras que en la Ensenada de Turpialito predominaron organismos maduros y desovados. El IG sugiere que los desoves están asociados a las precipitaciones estacionales de la región; mostrando una estrategia reproductiva conservadora, acumulando reservas energéticas en el periodo de mayor producción primaria asociada a los periodos de surgencia costera, cuando la energía de los fagocitos nutritivos es transferida a los gametos hasta su maduración y expulsión al medio ambiente. Las características biológicas y reproductivas de los organismos en Turpialito mostraron elevados IG y mayor tejido gonadal para consumo comercial.

Abstract Several species of sea urchins are a potential resource for the production of gonads for consumption in Venezuela. We studied the gametogenic cycle and the gonadosomatic index (GSI) of the rock boring urchin Echinometra lucunter between June 2010 and November 2011 in northeastern Venezuela (Isla Lobos, Península de Araya and Turpialito, Gulf of Cariaco). The gonads are composed of long ramified acini, covered by connective tissue, followed by a thin layer of cells that differentiate into nutritive phagocytes and gametes, which change in their proportion and size with the maturity stage. Generally, several maturity stages were observed in both locations, showing simultaneous spawning. At Isla de Lobos the individuals in reserve stage predominated with a short period of sexual maturity, while mature and spawned individuals predominated in Turpialito. The GSI suggests that the greatest spawning activity is associated to the rainy season; showing a conservative reproductive activity, accruing energetic reserves during the period of higher primary productivity associated to coastal upwelling, when the energy of nutritive phagocytes is transferred to gametes, for gamete development and spawning. The biological and reproductive characteristics of individuals at Turpialito showed higher GSI having more gonadal tissue for commercial consumption. Rev. Biol. Trop. 63 (Suppl. 2): 273-283. Epub 2015 June 01.

Dieta del erizo negro Echinometra lucunter (Echinometra: Echinoidea) en el Nororiente de Venezuela / Diet of the black sea urchin Echinometra lucunter (Echinometra: Echinoidea) in the northeast of Venezuela

Resumen Mensualmente entre junio 2010 y agosto 2011 en la ensenada de Turpialito, Golfo de Cariaco, Venezuela, se recolectaron macroalgas e identificaron, y ejemplares de Echinometra lucunter con diámetro de testa 41.04 ± 6.60 mm para examinar el contenido estomacal y el índice de llenado. Se identificaron 65 especies de macroalgas, pertenecientes a los Phylla Rhodophyta, Heterokontophyta y Chlorophyta. La mayor biomasa anual la presentaron Halimeda opuntia (56.5 g.m-2), Acanthophora spicifera (15.94 g.m-2), Sargassum vulgare (15.28 g.m-2) y Centroceras clavulatum (12.26 g.m-2). Los ítems alimenticios más frecuentes fueron las macroalgas filamentosas: Sphacelaria sp. (546) y Herposiphonia sp. (441) y la foliácea Dictyota sp. (410), y entre los invertebrados esponjas (155), moluscos bivalvos (70) y crustáceos cirrípedos (65). El ID osciló entre 0.8 y 6.0% (2.6 ± 1.21 %), con máximos en diciembre 2010 (6.0 ± 2.21 %), abril (4.3 ± 0.34 %) y junio 2011 (4.0 ± 1.79 %), con oscilaciones mensuales asociadas a los períodos de surgencia y estratificación. El conocimiento de las características principales de la dieta, es necesaria para proponer planes de cultivo y de conservación de la especie.

Abstract Echinometra lucunter is relatively abundant in the Venezuela coast, however no details are known about its diet. We compare the stomach contents and repletion index of E. lucunter with macroalgae available in their environment (June 2010-August) and the nutrient cycle at the Golfo de Cariaco. Seventy-one species of macroalgae were identified: Rhodophyta (45), Heterokontophyta (11) and Chlorophyta (15). The mean testa diameter was 41.04 ± 6.60 mm. The food preferences included filamentous, siphonal and calcaeous macroalgae; main food items were the filamentous macroalgae Sphacelaria sp. and Herposiphonia sp., and foliose Dictyota sp., including invertebrates such as sponges, bivalves and barnacle crustaceans. The repletion index was 0.8 - 6.0 % (2.6 ± 1.21 %), maximum values were associated to primary productivity cycle, i.e. December 2010 (6.0 ± 2.21 %), April (4.3 ± 0.34 %), June 2011 (4.0 ± 1.79 %). Food preferences could be associated to the upwelling season and productivity cycle. Rev. Biol. Trop. 63 (Suppl. 2): 233-242. Epub 2015 June 01.

Características clínico-epidemiológicas de los pacientes con diagnóstico confirmado por PCR de Influenza AH1N1 hospitalizados en el Instituto Nacional de Salud del Niño durante todo el año 2009 / Clinical and epidemiological characteristics of patients with confirmed diagnosis of Influenza AH1N1 PCR hospitalized at the National Institute of Child Health for all by 2009

Introducción: En la primavera del 2009, un brote de neumonía severa fue reportado en México y se aisló el nuevo virus influenza A (H1N1), ampliamente conocido como la gripe porcina. Los subtipos de A (H1N1) raramente habrían predominado desde la pandemia de 1957. Este nuevo virus se propagó rápidamente a través del hemisferio Sur incluyendo Perú, causando un amplio rango de síntomas en niños desde una infección de vías aéreas superiores hasta una neumonía severa y fatal. Objetivo: Describir las características clínicas-epidemiológicas de los pacientes con diagnóstico confirmado por PCR de influenza A H1N1 hospitalizados en el Instituto Nacional de Salud del Niño durante todo el año 2009. Así mismo identificar los síntomas y signos de mayor sensibilidad los antecedentes fisiológicos y patológicos, y determinar las complicaciones más frecuentes. Método: Es un estudio de tipo retrospectivo, serie de casos y descriptivo, no experimental, fueron revisadas 38 historias clínicas de pacientes pediátricos con diagnostico comprobado de Influenza AH1N1 hospitalizados en el INSTITUTO NACIONAL DE SALUD DEL NIÑO durante todo el año 2009. Los datos fueron recogidos en una ficha clínica de recolección donde se evalúan las variables para la realización del estudio. Se procesaron los datos usando el programa estadístico Statistical Package for the Social Sciences (SPSS 15). Resultados: En el grupo de estudio la edad promedio de hospitalización de los pacientes con fue de 44.98 meses de edad. Se contó con 19 mujeres y 19 varones El tiempo de hospitalización fue de 17.47 días. En los antecedentes patológicos, 6 de los 38 pacientes no sufrieron enfermedades previas ni presentaban cornorbllidades...

Background In the spring of 2009, an outbreak of severe pneumonia was reported in conjunction with the concurrent isolation of a novel swine-origin influenza A (H1N1) virus (S-OIVL widely known as swine flu, in Mexico. Influenza A (H1Nl) subtype viruses have rarely predominated since the 1957 pandemic. This new virus rapi91y spread throughout the Southern Hemisphere including Peru, causing a wide range' of symptoms in children, ranging from respiratory infections to severe pneumonia and death. Objective To describe the clinical and eplderniologlcal characteristics in patients with a confirmed diagnosis of AH1Nl by Influenza Viral PCR, hospitalized at "INSTITUTO NACIONAL DE SALUD DEL NIÑO" during 2009. Also, identify signs and symptoms, physiological and preexisting conditions, and determine frequent complications. Methods This is a retrospective study, descriptive and non experimental, case report 38 clinical charts were reviewed from pediatric patients with confirmed AH1N1 diagnosis, hospitalized at "INSTITUTO NACIONAL DE SALUD DEL NIÑO" in 2009. The data was processed using the Statistical Package for the Social Sciences (SPSS). Results The study group was conformed by 19 boys and 19 girls. The median age of these hospitalized patients was 44.98 months. The average hospitalization period was 17.47 days. 6 out of the 38 patients had no preexisting diseases. Regarding the clinical examination, 17 patients had Respiratory Distress, 28(73.7per cent) Fever>38 C, 32 (84.2 per cent) Cough, 18 (47.4 per cent) Rhinorrhea, 2 (5.3 per cent) Odynophagia, 2 (5.3 per cent) Myalgias, 2 (5.3 per cent) Head he, _ (23.7 per cent) Vomits, 7 (18.4 per cent) Diarrhea, 1 (2.6 per cent) Rash, 14 (36.8 per cent) Weakness.Complicatjons: 30 (78.9 per cent) Pneumonia, 7 (18.4 per cent) Sibilant Rales, 6 (15,8 per cent) died, 18 (47.4 per cent required 02, 1 (2.3 per cent) Pneumothorax, 8 (21.1 per cent) Hypoxemia, and 16 (42.1) presented other complications...

Induction of a protective response with an IgA monoclonal antibody against Mycobacterium tuberculosis 16kDa protein in a model of progressive pulmonary infection.

Mycobacterium tuberculosis is a facultative intracellular pathogen for which cell-mediated immunity is considered the major component of the immune response. For many decades, the prevailing scientific view has been the antibodies have little or no role in modifying the course of M. tuberculosis infection. In recent years, several studies have challenged this dogma, and there is a body of evidence that supports a role of antibodies against M. tuberculosis. In the present work, we evaluated the protective activity of two monoclonal antibodies (TBA61 and TBA84). Here, we chose the intratracheal model of pulmonary infection to evaluate bacterial load and morphometric and histological changes in the lungs of treated mice. Data obtained revealed the reduction of bacterial load and milder morphometric and histopathological changes in mice treated with TBA61 at 21 days post-infection with M. tuberculosis H37Rv compared to those treated with TBA84 and control mice. These results allow continuing exploring the potential use of monoclonal antibodies as prophylactic and therapeutic agents against intracellular pathogens such as M. tuberculosis.

Specificity of RCN1-mediated protein phosphatase 2A regulation in meristem organization and stress response in roots.

Protein dephosphorylation by the serine/threonine protein phosphatase 2A (PP2A) modulates a broad array of cellular functions. PP2A normally acts as a heterotrimeric holoenzyme complex comprising a catalytic subunit bound by regulatory A and B subunits. Characterization of the regulatory A subunit isoforms (ROOTS CURL IN NAPHTHYLPHTHALAMIC ACID1 [RCN1], PP2AA2, and PP2AA3) of Arabidopsis thaliana PP2A has shown that RCN1 plays a primary role in controlling root and hypocotyl PP2A activity in seedlings. Here we show that hypocotyl and root growth exhibit different requirements for RCN1-mediated regulation of PP2A activity. Roots of rcn1 mutant seedlings exhibit characteristic abnormalities in cell division patterns at the root apical meristem, as well as reduced growth under ionic, osmotic, and oxidative stress conditions. We constructed chimeric A subunit genes and found that restoration of normal root tip development in rcn1 plants requires both regulatory and coding sequences of RCN1, whereas the hypocotyl elongation defect of rcn1 plants can be complemented by either RCN1 or PP2AA3 transgenes. Furthermore, the RCN1 and PP2AA3 proteins exhibit ubiquitous subcellular localization patterns in seedlings and both associate with membrane compartments. Together, these results show that RCN1-containing PP2A has unique functions that cannot be attributed to isoform-specific expression and localization patterns. Postembryonic RCN1 function is required to maintain normal auxin distribution and stem cell function at the root apex. Our data show that RCN1-regulated phosphatase activity plays a unique role in regulating postembryonic root development and stress response.

The ibreeding paradox in invasive species

Uno de los tópicos más relevantes en la biología de las invasiones se refiere a la paradoja de la consanguinidad: cómo especies exóticas, que generalmente invaden nuevos territorios en pequeños números, sufriendo por lo tanto los efectos de la consanguinidad, se convierten en invasores exitosos. Para explicar esta paradoja, se ha argumentado que en ocasiones han ocurrido altas frecuencias de migración e introducciones repetidas, que han superado la baja diversidad genética y la consanguinidad. Sin embargo, varios casos de introducciones simples de especies exóticas han ocurrido que no pueden ser explicados por esta hipótesis. Para intentar resolver esta paradoja consideramos que los invasores no solamente son capaces de modificar sus nuevos ambientes, sino que también sufren modificaciones bajo la influencia de estos ambientes. Se postula el posible papel de las adaptaciones epigenéticas y de las mutaciones adaptativas para explicar la adaptación exitosa de los invasores a sus nuevos ambientes

Experimental induction of heterotopic bone in abdominal implants.

Induction of bone tissue requires three elements: osteoprogenitor cells, osteoinductive factors, and a supporting extracellular matrix. In this study, we report on an experimental model in dogs of heterotopic bone tissue production, based on the integration of these osteo-inductive factors into abdominal implants. The implants consist of either a type I collagen sponge wrapped with periosteum and omentum or a type I collagen sponge embedded with demineralized bone powder, platelet-rich plasma, thrombin, and calcium chloride wrapped with omentum, with or without periosteum. Automated histomorphometric analysis showed an efficient production of trabecular bone, which corresponded to 50-70% of the total tissue composition 4 months after implant formation. High expression of the osteoinductive cytokines transforming growth factor-beta and bone morphogenetic proteins-2 and -4 was shown by immunohistochemistry in macrophages, endothelial cells from neoformed capillaries, osteoblasts, osteoclasts, and the mesenchymal tissue around the bone trabeculae. These approaches are novel and efficient surgical procedures to produce mature trabecular bone that could be used as a potential source of bone tissue for autotransplantation.

Cáncer de sigmoides: comparación entre presentación de urgencia y electiva / Sygmoid colon cancer: comparison between elective and urgency surgery

El cáncer de sigmoides (CS) puede considerarse una entidad clínica distinta al cáncer (CA) de colon izquierdo, por sus características de presentación clínica. El objetivo de esta presentación es revisar en forma retrospectiva los resultados, comparando los de la cirugía de urgencia versus la electiva, tanto en su morbimortalidad como sobrevida quinquenal. Se analiza la historia clínica de 120 pacientes portadores de CA de localización sigmoidea tratados entre enero de 1980 y mayo de 2000 tanto en el Servicio de Urgencia como en el Servicio de Cirugía del Hospital Barros Luco-Trudeau: 53 pacientes (44 por ciento) fueron atendidos de urgencia y 67 pacientes (55 por ciento) electivamente. La sobrevida quinquenal calculada con el método actuarial de Edener fue de 38 por ciento para los pacientes intervenidos de urgencia y de 49 por ciento para los operados electivamente. Las neoplasias de sigmoides se presentan frecuentemente como urgencia, con predominancia de la forma obstructiva. La resecabilidad fue mejor en la cirugía electiva. En la cirugía de urgencia los resultados fueron mejores en la resección y anastomosis inmediata que en la diferida. La sobrevida quinquenal fue mayor en la cirugía electiva

Cáncer rectal con células en anillo de sello / Rectal cancer with signet ring cells

El adenocarcinoma rectal con células en anillo de sello (variedad poco frecuente del adenocarcinoma mucinoso) es un tumor de baja incidencia y con baja sobrevida. De 284 pacientes tratados con cáncer rectal 9 (3,2 por ciento), se presentaron con la variedad histológica de células en anillo de sello, 6 pacientes de sexo masculino y 3 femenino. La edad promedio fue de 42 años. El 67 por ciento de los tumores se localizó en recto inferior. Todos se presentaron como cánceres avanzados, 2 metastásicos, 2 con compromiso de tejido extrarrectal (C3) y 5 con compromiso de serosa y ganglionar (C2). Se efectuó tratamiento quirúrgico resectivo curativo en 6 pacientes. Cinco de los 6 pacientes resecados recibieron radioquimioterapia postoperatoria con una sobrevida actuarial de 5 años de 60 por ciento. Los 3 pacientes en quienes no se efectuó cirugía resectiva fallecieron antes de 3 meses. La sobrevida global actuarial de la serie a 5 años fue del 27 por ciento

Reconstitución de tránsito después de la operación de Hartmann con videolaparoscopia asistida / Transit reconstitution after Hartmann operation with assisted videolaparoscopy

Se revisan retrospectivamente los pacientes en quienes se realizó la intervención asistida con laparoscopia en forma consecutiva entre noviembre de 1992 y abril de 1997 y se comparan sus resultados con los de una serie histórica de pacientes intervenidos por los mismos autores con la técnica abierta. Se efectuó el procedimiento en 26 pacientes, 9 mujeres y 17 hombres, con una media de edad de 40 años. En 20 se completó la intervención con asistencia laparoscópica, verificándose la conversión de la cirugía en 6 pacientes (23 por ciento) principalmente por dificultades en el manejo del muñón rectal. No se presentó mortalidad en la serie. Al comparar los resultados con la serie histórica de 26 reconstituciones abiertas se comprobó una disminución significativa de la morbilidad y de la estadía hospitalaria. Se concluye que la asistencia laparoscópica en la reconstitución del tránsito después de la operación de Hartmann se puede considerar como una opción razonablemente segura