[Clinical features of patients with influenza-like illness who went to a third level center in the winter of 2013-2014]. / Características clínicas de pacientes que acudieron por enfermedad tipo influenza a un centro de tercer nivel en el invierno de 2013-2014.

BACKGROUND: Between October 2013 and April 2014, the Centers for Disease Control and Prevention reported a high incidence of AH1N1 influenza cases. Not all suspicious cases of influenza are confirmed; however, all patients need treatment and generate additional costs to the institutions. Our objective was to describe the characteristics of the patients treated for influenza suspicion at Hospital de Especialidades in Centro Médico Nacional Siglo XXI during a new epidemic. METHODS: Cross-sectional study of all cases admitted at the Emergency Service (of the aforementioned hospital) for influenza-like illness, defined according to current guidelines. Based on these guidelines, we analyzed the risk factors that may have increased the severity of the infection. RESULTS: We registered a total of 109 patients with a mean age of 44 years, 78 % were under 60 years of age, 62 % were women, 75 % had at least one comorbidity, such as obesity (26 %) or hypertension (27 %). Only 65 patients had results from a confirmatory test, 33.8 % had positive diagnosis, and 21 % of them eventually died. CONCLUSIONS: The frequency of confirmed cases for influenza infection is low. The risk factors associated with complications and increased mortality are hypertension, leukocytosis and clinical presentation of severe acute respiratory syndrome.

Introducción: el Centro para el Control y Prevención de Enfermedades (CDC, por sus siglas en inglés) registró, entre octubre de 2013 y abril de 2014, el pico más alto de casos relacionados con la influenza AH1N1. No todos los casos sospechosos de influenza resultan positivos, pero todos les generan costos a las instituciones. Nuestro objetivo fue describir las características de la población que acude con sospecha de influenza al Hospital de Especialidades del Centro Médico Nacional Siglo XXI durante una nueva epidemia. Métodos: estudio transversal de casos admitidos al servicio de Urgencias del hospital mencionado por sospecha de influenza de acuerdo con las guías de práctica clínica. Con base en estas se analizaron los factores asociados a la severidad de la infección. Resultados: se registraron 109 pacientes con promedio de 44 años edad; el 78 % de ellos tenía menos de 60 años; el 62 % fueron mujeres; 75 % tenía por lo menos un factor de riesgo como obesidad (26 %) o hipertensión (27 %). Solo 65 pacientes tuvieron prueba confirmatoria, 33.8 % fueron diagnóstico positivo y 21 % de ellos fallecieron. Conclusiones: la frecuencia de casos confirmados de influenza es baja. Los factores asociados a mortalidad en los casos confirmados son la presencia de hipertensión, de leucocitosis y la presentación clínica de insuficiencia respiratoria aguda grave (IRAG).

Development of a method for the quantitative analysis of urinary stones, formed by a mixture of two components, using infrared spectroscopy.

OBJECTIVES: The analysis of urinary stones is used for the diagnosis of the etiology of an episode of nephrolithiasis. The technique considered as standard for this purpose is infrared spectroscopy (IR). However, when the urinary stone is formed by a mixture of components, only semi-quantitative information can be achieved using IR. The objective of this work is the development of a quantitative method. DESIGN AND METHODS: Bands in the IR spectra of several mixtures were studied, in order to design a calibration model useful to determine the quantitative composition of the urinary stones. For mixtures of two components, four mathematical models were proposed. To assess the validity of these models, nine series of mixtures of two components were prepared, using the most frequently compounds found in urinary stones, for analyzing by ATR-FTIR spectroscopy (Attenuated Total Reflection Fourier Transformed Infrared). RESULTS: Nine series of nine mixtures of two components were prepared for this work. The IR spectrum was recorded for each mixture and the absorbance intensities at selected wave numbers were used to apply the proposed mathematical models. There were good linear correlations between the analytical signals (IR absorbances) and the analytical responses (weight fractions) using the calibration lines. The validity of the method was checked by the comparison between the weight fractions resulted from the calibration lines and the real weight fractions obtained by weighing, presenting good correlation parameters. CONCLUSIONS: The method developed in this work has been useful for the quantification of compounds which are commonly found in urinary stones. This method allows a total characterization of the urinary stones (qualitative and quantitative) by means of IR spectroscopy.

Falsos negativos en la detección de componentes monoclonales por electroforesis capilar / False negatives in the analysis of monoclonal components by capillary electrophoresis

La electroforesis capilar es una técnica rápida y automatizada que permite la detección de componentes monoclonales en suero con alta sensibilidad, estando ampliamente instaurada en los laboratorios clínicos. Se han descrito sin embargo, falsos positivos y negativos que plantean problemas a la hora de interpretar el trazado electroforético. Los falsos positivos son debidos fundamentalmente a sustancias exógenas no proteicas presentes en la muestra que absorben radiación en la región ultravioleta dando lugar a picos anómalos en el proteinograma. Los falsos negativos se deben en su mayoría a la baja concentración del componente monoclonal, aunque se han descrito también cuando se encuentran en alta concentración, debidos principalmente a las propiedades físico-químicas de la paraproteína que provocan una separación incorrecta de la misma. Presentamos una serie de casos con componentes monoclonales de tipo IgA e IgM, detectados inicialmente por electroforesis de acetato de celulosa y presentes en la muestra en alta concentración, en los que la electroforesis capilar tuvo problemas para su detección (AU)

Capillary electrophoresis is a fast, automated and highly sensitive technique for the detection of monoclonal components in serum that is being increasingly introduced in clinical laboratories. Nevertheless, false negative and positive results have been reported, and thus the electrophoretic pattern may be difficult to interpret. False positive results are chiefly due to exogenous substances other than proteins present in serum, which absorb at UV wavelengths and can produce an abnormal spike. False negative results are mainly due to very low concentrations of monoclonal components. However, high concentration monoclonal components may not be correctly detected due to the physicochemical properties of the paraproteins, which may cause anomalous separation. In this work, we study three cases with high concentration monoclonal components of the IgA and IgM classes. They were initially detected on cellulose acetate electrophoresis, but the capillary electrophoresis was not able to correctly detect them (AU)

[Use of antioxidants in prevention of the cardiovascular disease: meta-analysis of clinical trials]. / Uso de antioxidantes para prevenir enfermedad cardiovascular. Metaanálisis de ensayos clínicos.

OBJECTIVE: to evaluate if used of medication with antioxidants, antiplatelets, statins and modulators of inflammation reduces effectively the risk of presenting a cardiovascular disease (CVD). METHODS: a search on clinical trials (randomized, double blind and controlled clinical studies) in which the use of antioxidants, antiplatelets, statins and modulators of inflammation were investigated for the primary and secondary prevention of CVD. The selected studies were analyzed by a systematic revision, applying the meta-analysis. RESULTS: 20 studies were included. In the subgroup of vitamin E 3623 events of the non fatal acute myocardial infarction (AMI) appeared, RR = 1 (0.93-1.06) IC 95 %, p = 0.01. In the subgroup of statins 2795 events of non fatal acute myocardial infarction (AMI) appeared, RR = 0.68 (0.63-0.73) IC 95 %, p = 0.02. In the subgroup of antiplatelets 1199 events of non fatal AMI appeared, RR = 0. 91 (0.81-1.02) IC 95 %, p = 0.42. In the subgroup of omega-3 fatty acids 434 events of the non fatal AMI appeared, RR = 0.93 (0.76-1.13) IC 95 %, p = 0.002. CONCLUSIONS: vitamin E did not show any benefit, in comparison with the antiplatelets, statins, and omega-3 fatty acids.