Striatal projection neurons coexpressing dopamine D1 and D2 receptors modulate the motor function of D1- and D2-SPNs.

The role of the striatum in motor control is commonly assumed to be mediated by the two striatal efferent pathways characterized by striatal projection neurons (SPNs) expressing dopamine (DA) D1 receptors or D2 receptors (D1-SPNs and D2-SPNs, respectively), without regard to SPNs coexpressing both receptors (D1/D2-SPNs). Here we developed an approach to target these hybrid SPNs in mice and demonstrate that, although these SPNs are less abundant, they have a major role in guiding the motor function of the other two populations. D1/D2-SPNs project exclusively to the external globus pallidus and have specific electrophysiological features with distinctive integration of DA signals. Gain- and loss-of-function experiments indicate that D1/D2-SPNs potentiate the prokinetic and antikinetic functions of D1-SPNs and D2-SPNs, respectively, and restrain the integrated motor response to psychostimulants. Overall, our findings demonstrate the essential role of this population of D1/D2-coexpressing neurons in orchestrating the fine-tuning of DA regulation in thalamo-cortico-striatal loops.

Laparoscopic Management of Cholecystoduodenal and Cholecystocolic Fistula: A Clinical Case Report.

Biliary fistula is a rare (less than 8%) cholecystectomy complication, internal fistulae being the most common of them (mainly colonic and duodenal). However, the presence of two fistulas at the same time is extremely rare, with a small number of cases reported in the literature to date. Symptoms tend to be non-specific, leading to a difficult preoperative diagnosis. The standard treatment for bilioenteric fistulas is open cholecystectomy and subsequent closure of the fistula. Nonetheless, modern techniques including laparoscopic and endoscopic approaches have been reported lately for their treatment with favorable results. We present a case of concomitant cholecystoduodenal and cholecystocolic fistula successfully treated with subtotal cholecystectomy and primary closure of the fistulous tracts by laparoscopic approach in a female Hispanic patient.

Effect of shade and precipitation on germination and seedling establishment of dominant plant species in an Andean arid region, the Bolivian Prepuna.

Germination and seedling establishment are two critical processes in the life cycle of plants. Seeds and seedlings must pass through a series of abiotic and biotic filters in order to recruit as members of their communities. These processes are part of the regeneration niche of the species. In arid regions, the regeneration niche is frequently associated to facilitation by shade. Facilitation is a positive interaction between plants, in which one of them acts as a benefactor (the nurse) of the other (the beneficiary). The result of this interaction can be reflected in the increased growth, survival, and/or reproduction of the beneficiary plant. In this study, we determined experimentally the effect of shade and irrigation on the germination and early survival of dominant species of a semi-arid Andean region, the Bolivian Prepuna. An experiment with Acacia feddeana, Prosopis ferox, Cercidium andicola (woody species), Parodia maassii, and Oreocereus celsianus (cactus species) was carried out at an experimental garden in La Paz, Bolivia, with a bifactorial design, considering shaded and unshaded pots, subjected to two irrigation treatments (≈50 and 80 mm of rainfall during the whole study period). Microenvironmental conditions did not affect the seed germination of the woody species. However, they showed differences in seedling survival: A. feddeana survived better under shade, whereas P. ferox and C. andicola survived better without shade. Cercidium andicola, compared to P. ferox, was more affected by shade and low irrigation. Although germination success of cacti was low, both species germinated better under shade and with high irrigation. These results showed differences in the regeneration niche of dominant species of the Prepuna which may favor their coexistence and which may be characteristic of other dry Andean regions.

Caracterización de estudiantes ingresados durante la pesquisa de COVID-19 en el municipio "10 de Octubre" / Characterization of students admitted during the COVID-19 pandemic in 10 de Octubre Municipality

Introducción: Las labores de pesquisa activa realizadas por estudiantes de Ciencias Médicas, algunos de los cuales constituyeron objeto de aislamiento y cuarentena, se iniciaron en Cuba, con la aparición de la COVID-19. Objetivo: Describir características clínicas y epidemiológicas de los estudiantes ingresados durante la pesquisa de COVID-19 en 10 de Octubre. Material y Métodos: Se realizó un estudio epidemiológico, observacional descriptivo, transversal, entre el 18 de marzo y el 31 de julio de 2020. La muestra se seleccionó por muestreo no probabilístico, quedando 82 estudiantes objeto de ingreso en el periodo y lugar. Se aplicaron medidas de resumen, porcentaje y tasa. Resultados: Los estudiantes de la carrera de Medicina constituyeron el 70,73 por ciento, el sexo femenino estuvo representado con un 65,85 por ciento. El 61 por ciento de los estudiantes fueron ingresados en el hogar. El policlínico Luis de la Puente Uceda (LPU) constituyó el área de mayor riesgo global con una tasa de 81,71 por 100 mil habitantes. El 67 por ciento estuvo en cuarentena por haber sido contacto indirecto. El 2,43 por ciento de la muestra resultó positivo al SARS-CoV-2. Conclusiones: La vigilancia de los contactos indirectos se realizó en ingreso en el hogar y los casos positivos ingresaron en hospitales. La trasmisión fue mínima en zonas de muy alto Riesgo Global y nula entre contactos de los casos positivos. En los confirmados no existió preferencia por algún sexo y no se presentaron complicaciones de la enfermedad(AU)

Introduction: With the appearance of COVID-19 pandemic, medical students began to carry out active research work in Cuba. However, some of them were subjected to isolation or quarantine. Objective: To describe the clinical and epidemiological characteristics of the students admitted during the COVID-19 pandemic in 10 de Octubre Municipality. Material and Methods: An epidemiological, observational, descriptive, cross-sectional study was conducted between March 18 and July 31, 2020. Non-probabilistic sampling was used in the selection of the sample, leaving 82 students admitted in the period and place under investigation. Percentages, rates and summary measures were applied. Results: Medical students represented 70.73 percent of the sample, of whom 65.85 percent were women. Sixty-seven percent were admitted to home because of indirect contact with infected people. The Luis de la Puente Uceda (LPU) Polyclinic was the area of highest global risk with an incidence rate of 81,71 per 100 thousand inhabitants. Also, 2.43 percent of the sample was positive for SARS-CoV-2. Conclusions: Surveillance of indirect contacts was carried out on admission to home and positive cases were admitted to hospitals. There was minimal transmission in areas of very high global risk. The results of the tests were negative in almost all the students. In those confirmed cases, there was no sex preference and there were no complications of the disease(AU)

Lupus eritematosos sistémico en la epidemia VIH/SIDA. Reporte inicial de casos en Cuba / Systemic lupus erythematous in the HIV / AIDS epidemic. Initial report of cases in Cuba

El lupus eritematoso sistémico clasifica como una compleja, multisistémica enfermedad autoinmune que evoluciona por brotes de actividad, con diferentes grados de severidad, determinante de daño crónico irreversible. Las infecciones constituyen un capitulo particular en pacientes con lupus eritematoso sistémico, y estos pacientes pueden asociar sus manifestaciones autoinmune-reumáticas a la infección por VIH/SIDA, aunque no existen muchos reportes a nivel mundial sobre esta asociación. Existen diferencias en cuanto a los mecanismos patogénicos que obran en ambas entidades, no obstante presentan homologías en el orden clínico las cuales en ocasiones hacen difícil establecer el diagnóstico diferencial entre estas entidades. Nuestro objetivo estuvo dirigido a reportar dos casos de féminas de 47 y 36 años de edad, con esta asociación en el marco de la epidemia cubana VIH-SIDA. Una de ellas desarrolló la infección varios años después del diagnóstico de lupus, y ha presentado luego del VIH brotes aislados de actividad; desarrollado daño renal y severas lesiones discoideas en cuero cabelludo todo ello aunado a infecciones urinarias. La segunda paciente desarrolló la infección VIH, y luego de varios años en tratamiento antirretroviral, tórpidamente presentó criterios clínicos e inmunológicos para lupus: debutó con un síndrome febril, toma del estado general, lesiones importantes vasculíticas de miembros inferiores complicadas con ulceraciones infectadas que remedaban pioderma gangrenosa así como serositis lúpica e infección respiratoria grave. Ambos casos contaban con tratamiento antirretroviral, y un buen conteo de células T CD4+, con carga viral indetectable. Se logró en ambos casos yugular los brotes de actividad e infecciones intercurrentes. Metodológicamente desarrollamos una amplia revisión por Medline, PubMed-Lilacs entre otros motores de búsqueda. No conocemos de otros estudios que establezcan una descripción clínica y analítica de este tipo de pacientes en Cuba(AU)

Systemic lupus erythematous classifies as a complex, multisystemic autoimmune disease that evolves through outbreaks of activity, with different degrees of severity, determining irreversible chronic damage. Infections are a particular chapter in patients with systemic lupus erythematous, and these patients can associate their autoimmune-rheumatic manifestations with HIV / AIDS infection, although there are not many worldwide reports on this association. There are differences in the pathogenic mechanisms that work in both entities, however they present homologies in the clinical order which sometimes make it difficult to establish the differential diagnosis between these entities. Our objective was to report two cases of females aged 47 and 36 years old, with the association within the framework of the Cuban HIV-AIDS epidemic. One of them developed the infection several years after the diagnosis of lupus, has presented isolated HIV activity outbreaks and developed kidney damage and severe discoid lesions on the scalp and urinary tract infections. The second patient developed HIV infection, and after several years on antiretroviral treatment, she presented clinical and immunological criteria for lupus: She debuted with a febrile syndrome, taking the general condition, important vasculitic lesions of the lower limbs complicated by infected ulcerations mimicking pioderma, gangrenous as well as lupus serositis and severe respiratory infection. Both cases had ARV treatment, and a good CD4 + T cell count, with undetectable viral load. In both cases, the outbreaks of activity and intercurrent infections were achieved. Methodologically, we developed an extensive review by Med-Line, Pubmed-Lilacs among other search engines using the keywords lupus and VIH infections: We do not know of other studies that establish a clinical and analytical description of this type of patients in Cuba.We conclude with the presentation of two patients differents form of presentation, both with systemic lupus in asociation with VIH-aids infection, and hgih level of disease activity . The were safe with a good control of the diseases and the treatment wih antirretroviral drugs, antibiotics, an especific drugs like antimalarials, corticosteroids and others with satisfactory clinical evolutions(AU)

Genetic diversity and differentiation among Prosopis alba (Leguminosae) populations from dry valleys of Bolivia with different levels of human disturbance and altitude.

The fast expansion of human population around La Paz, Bolivia (3,200-4,100 m.a.s.l.) triggered new suburban settlements in nearby areas in valleys and mountain feet. The white mesquite, Prosopis alba Griseb. (Leguminosae), is a resource (originally used by native communities) that is strongly affected by changes in land use. A gradient in the level of disturbance is found moving away from the La Paz city toward less altitude areas. The main objective of this study was to characterize genetically three P. alba populations with different levels of human disturbance located at different altitudes in Bolivia, in order to provide some guidelines for management and conservation of these species. Based on 10 SSR loci, the populations showed high level of genetic diversity in comparison with other forest species. The population less disturbed and situated at the lowest altitude was the most variable (H e  = 0.51-0.42), whereas the less variable was the most disturbed and situated at the highest altitude. Heterozygote excess was observed in all populations. Most of genetic diversity (99%) is contained within populations. Genetic differentiation among populations is low (1%), suggesting low gene flow among populations. No evidence of recent bottlenecks events was detected. The estimates of the effective population size were low in all populations. The results are in agreement with the hypothesis that genetic diversity is reduced by the impact of anthropic disturbance in the population located at higher altitude in comparison with the lightly disturbed situated at lower altitude and farther from urban settlements.

Estado de control de pacientes en tratamiento con anticoagulantes orales antagonistas de la vitaminaK en atención primaria. Estudio ECOPAVIK / Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care

Introducción. En España, más del 80% de pacientes con fibrilación auricular (FA) reciben tratamiento anticoagulante oral (TAO), con un seguimiento dentro del ámbito de la atención primaria (AP) del 72% de los pacientes. Estudios recientes demuestran que existe un deficiente control de los pacientes con anticoagulantes orales (ACO). El objetivo de este estudio fue obtener un conocimiento más detallado del estado de control, así como de las patologías que lo indican y están en comorbilidad en los pacientes en tratamiento con ACO antagonistas de la vitaminaK (AVK). Metodología. Estudio observacional retrospectivo/transversal en el que participaron pacientes de una zona básica de salud incluidos dentro del programa TAO durante 2014. Se consideró que el control de INR en pacientes en tratamiento con ACO era inadecuado cuando el porcentaje de tiempo en rango terapéutico (TRT) era inferior al 65% durante un periodo de valoración de al menos 6meses. Resultados. Se incluyeron 368 pacientes, en los que la patología con indicación de anticoagulación oral más prevalente fue la FA no valvular. Se realizaron 5.128 controles, de los cuales 2.359 (46%) estaban fuera de rango terapéutico y 2.769 (54%) estaban en rango terapéutico. El 91% de los pacientes en tratamiento con ACO AVK presentaban un riesgo muy elevado de tromboembolismo. Conclusiones. La indicación de anticoagulación en nuestra población es correcta, asumiendo un riesgo hemorrágico bajo/intermedio en la mayoría de los pacientes. La medición del TRT mediante el método de Rosendaal indica que existe un deficiente control de los pacientes en tratamiento con ACO AVK (AU)

Background. In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases. Methods. This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months. Results. A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC. Conclusions. The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient (AU)

Enhanced facilitation at the extreme end of the aridity gradient in the Atacama Desert: a community-level approach.

Plant facilitation is now recognized as an important process in severe environments. However, there is still no agreement on how facilitation changes as conditions become increasingly severe. The classic stress gradient hypothesis (SGH) predicts a monotonic increase in facilitation, which rises in frequency as conditions approach the extreme end of the environmental gradient. However, few studies have evaluated the validity of the SGH at the community level, the level at which it was formulated. Moreover, few studies have tested the SGH at either extreme of the gradient, and very few have excluded the effect of livestock on community response to stress. In line with the SGH, we hypothesized that several spatial pattern summary statistics would change monotonically from the least to the most arid sites, indicating increasingly aggregated patterns. In this study, we performed an evaluation of the SGH both within communities of shrub species and across a large portion of the Atacama Desert, and we isolated the abiotic component of the SGH. Our environmental gradient covered an extreme aridity gradient (< 20-130 mm annual precipitation). To perform point pattern analysis, we established 13 sites with environmental conditions representing four distinct levels of this gradient. Further, we conducted species co-occurrence analyses at 19 sites along the gradient. Both sets of analyses showed stronger positive spatial associations among plants at the most extreme end of the gradient. This was true regardless of whether we included all individuals, only small individuals located around large ones, or individuals in species pairs. Moreover, species tended to show greater co-occurrence as environmental severity increased. This increase in aggregation in the plant community seems to correlate with an increase in the strength of positive interspecific interactions, rather than greater clustering within each species. These monotonic increases in species co-occurrence and spatial association in more severe environments are consistent with some of the predictions of SGH, and collectively these results suggest that as the climate becomes more arid, positive species pairs interactions tend to be prevalent in the community.

Hiperparatiroidismo secundario al déficit de vitamina D / Secondary hyperparathyroidism due to vitamin D deficiency

Introducción: Cada vez está más demostrado el papel de la vitamina D en múltiples patologías, una de ellas el desarrollo de un hiperparatiroidismo secundario al déficit de vitamina D. Los métodos de laboratorio de cuantificación de vitamina D en suero no estaban bien estandarizados hasta ahora, por lo que no podía establecerse con certeza a partir de qué niveles de vitamina D se producían determinadas anomalías como la elevación de la PTH. Nuestro estudio pretende determinar por debajo de qué niveles de vitamina D nos encontraremos con niveles de PTH anormalmente elevados, realizando la determinación de vitamina D en el laboratorio con una técnica debidamente estandarizada y fiable. Métodos: El estudio descriptivo y retrospectivo se realizó con pacientes mayores de 18 años en los que se hicieron simultáneamente determinaciones de PTH, 25(OH) vitamina D (25OHD) y que además tuvieran valores normales de calcio, filtrado glomerular y fósforo. Para la determinación de vitamina D se utilizó un método de electroquimioluminiscencia estandarizado con respecto a la técnica de gases-masas. Por el programa estadístico Stava versión 11 se calculó el valor de 25OHD para el que la PTH se elevaba por encima de 70 pg/ml con la mayor sensibilidad y especificidad. Resultados: Se incluyeron 4.083 pacientes, de los que 2.858 eran mujeres (70%) y 1.225 (30%) varones. La edad media de la población estudiada fue 60,60 años (desviación estándar, 15,29). El 74% de la población tenía una PTH en suero por debajo de 70 pg/ml (valores considerados normales) y el 26% mayor de 70 pg/ml. Al construir la curva de ROC de los niveles de 25OHD, en función de valores de PTH por debajo o por encima de 70 pg/ml, el área bajo la curva fue 0,5962 (p<0,0001). El punto de corte teniendo en cuenta conjuntamente la sensibilidad y la especificidad que determinaban los valores de vitamina D para predecir los valores de PTH por encima de 70 pg/ml fue 24 ng/ml. De los pacientes con PTH normal, el 71% tenían valores de vitamina D normales, mientras que, de los pacientes con PTH elevada (mayor de 70 pg/ml), casi la mitad presentaban una vitamina D menor de 24 ng/ml, porcentaje que aumentaba según se iba elevando la PTH. Conclusiones: El valor de 25OHD que muestra una mejor especificidad y sensibilidad para predecir valores anormalmente elevados de PTH es 24 ng/ml, valor superior al presentado en trabajos anteriores (alrededor de 18 ng/ml). Con los resultados de este estudio, realizado con un método debidamente calibrado, se puede decir que el 44,9% de pacientes con valores de vitamina D menores de 24 ng/ml presenta niveles de PTH anormalmente elevados, con una función renal normal y valores de calcio y fósforo normales. Este porcentaje es menor entre los 18 y 40 años (24%) y llega al 49% por encima de los 60 años. Estos pacientes podrían tratarse con vitamina D para evitar un posible hiperparatiroidismo secundario al déficit de dicha vitamina. Es importante tener en cuenta que el método de determinación de vitamina D utilizado debe estar debidamente estandarizado con respecto al método de gases-masas (AU)

Introduction: Vitamin D is increasingly recognized as playing a significant role in combatting many diseases. One is the development of secondary hyperthyroidism due vitamin D deficiency. To date, laboratory quantification methods of serum vitamin D were not well standardized. It could not be established with certainty from which levels of vitamin D certains abnormalities take place, like an elevation of PTH. The present study was aimed at determining below what vitamin D levels we will find abnormally high levels of PTH, carrying out the vitamin D determination in the laboratory with a standardized, reliable technique. Methods: This descriptive, retrospective study was conducted with patients over 18 years in which determinations were made simultaneously with PTH, 25 (OH) vitamin D (25OHD) and which also have normal values of calcium, glomerular filtration rate and phosphorus. For determining vitamin D, standardized electrochemiluminescence method was used with gas chromatography- mass spectrometry method. Using the Stava version 11 statistical program, the 25OHD was calculated where PTH value was above 70 pg/ml with greater sensitivity and specificity. Results: In all, 4,083 patients were included, of whom 2,858 were women (70%) and 1,225 (30%) males. The mean age of the study population was 60.60 years (standard deviation, 15.29). 74% of the population had a serum PTH under 70 pg/ml (normal values) and 26% had a serum PTH higher tan 70 ng/ml. By constructing the ROC curve levels of 25OHD, depending on PTH values below or above 70 pg/ml, the area under the curve was 0.5962 (p<0.0001). The cut having jointly account the sensitivity and specificity that determined vitamin D levels to predict PTH values above 70 pg/ml was 24 ng/ml. Of the patients with normal PTH, 71% presented normal vitamin D values, while patients with elevated PTH (Greater than 70 pg/ml), almost half had a vitamin D below 24 ng / ml, which increased as the PTH percentage was elevated. Conclusions: The 25OHD value that presents better specificity and sensitivity to predict abnormally high PTH is 24 ng/ml, which is higher than the level reported in previous work, (about 18 ng/ml) value. The results of this study, carried out with an appropriately calibrated method, showed that 44.9% of patients with vitamin D values of less than 24 ng/ml PTH had abnormally high levels, with a normal value of calcium and phosphorus and normal renal function. This percentage is less in those individuals between 18 and 40 years (24%) and reaches 49% beyond 60 years. These patients could be treated with vitamin D to prevent possible secondary hyperparathyroidism due to vitamin deficiency. It is noteworthy that the method of determining vitamin D used must be properly standardized with respect to gas chromatography-tandem mass spectrometry method (AU)

Comparación entre dos inmunoensayos automatizados por quimioluminiscencia para la cuantificación de 25(OH) vitamina D / Comparison between two automated chemiluminescence immunoassays for quantifying 25 (OH) vitamin D

Introducción: La cuantificación de 25(OH) vitamina D total en sangre es el marcador más preciso del estado de vitamina D en un individuo. La técnica patrón-oro para su medición es la cromatografía líquida/ espectrometría de masas en tándem (LC-MS/MS), aunque actualmente los laboratorios clínicos utilizan de rutina técnicas de quimioluminiscencia. El objetivo del estudio fue comparar las concentraciones de 25(OH) vitamina D obtenidas mediante dos métodos automatizados comerciales y estudiar la correlación de dichos métodos con la técnica de referencia LC-MS/MS. Material y método: Se cuantificaron los niveles de 25(OH) vitamina D en 1.000 muestras de suero del laboratorio de Bioquímica de la Fundación Jiménez Díaz mediante 2 métodos automatizados comerciales por detección de quimioluminiscencia: ADVIA CENTAURO® (SIEMENS) y LUMIPULSE® G1200 (FUJIREBIO). Entre todas las muestras analizadas, las 50 más discordantes entre sí se enviaron para ser evaluadas por la técnica de referencia LC-MS/MS. Resultados: Los resultados obtenidos indican que existe una buena correlación entre los dos métodos: CCI=0,923 (0,914-0,932), siendo los valores de LUMIPULSE® G1200 un 10% superiores a los de CENTAURO ®. Con respecto a las 50 muestras seleccionadas, podemos observar que existe una buena correlación entre los dos inmunoensayos con la técnica LC-MS/MS, aunque ambos métodos infraestiman considerablemente los resultados de 25(OH) vitamina D con respecto al patrón-oro. Discusión: Aunque ambas técnicas son adecuadas para su utilización, habría que plantearse si la «epidemia» mundial de hipovitaminosis D se debe a la metodología de análisis utilizada. Esta variabilidad entre inmunoensayos se solucionaría estandarizando las diferentes técnicas comerciales con los materiales de referencia elaborados por el NIST (AU)

Introduction: Quantifying total blood 25 (OH) vitamin D is the most accurate marker of an individual’s vitamin D status. The gold standard technique for measurement is liquid chromatography tandem mass spectrometry (LC-MS/MS), although currently clinical laboratories tend to use chemiluminescence techniques. The objective of this study was to compare 25 (OH) vitamin D concentrations obtained by two commercially-produced automated methods and study the correlation of these methods with the LC-MS/MS reference technique. Material and methods: The 25(OH) vitamin D levels were quantified in 1,000 serum samples from the Jimenez Diaz Biochemistry Foundation Laboratory using 2 automated methods for chemiluminescence detection: ADVIA CENTAURO® (SIEMENS) and LUMIPULSE® G1200 (Fujirebio). Among all the samples tested, the 50 most discordant to each other were sent to be evaluated by LC-MS/MS reference technique. Results: The results indicate that there is good correlation between the two methods: CCI=0.923 (0.914-0.932), with the G1200 LUMIPULSE® values 10% being higher than CENTAURO®. Regarding the 50 samples selected, we can see that there is a good correlation between the two immunoassays with LC-MS/MS, although both methods significantly underestimate 25 (OH) vitamin D results with respect to the gold standard. Discussion: Although both techniques are suitable for use, it is worth considering whether the worldwide vitamin D deficiency epidemic is due to the analysis methodology used. This variability between immunoassays could be solved by standardizing the different commercial techniques in line with NIST produced reference materials (AU)

[Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care]. / Estado de control de pacientes en tratamiento con anticoagulantes orales antagonistas de la vitaminaK en atención primaria. Estudio ECOPAVIK.

BACKGROUND: In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases. METHODS: This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months. RESULTS: A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC. CONCLUSIONS: The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient.

Características relacionadas con escaldaduras en menores de 5 años en un Hospital Pediátrico en la Ciudad de México, 2011 / Features related with scalds in children under 5 years old in a pediatric hospital in Mexico City, 2011.

Introducción: Las quemaduras son lesiones de los tejidos producidas por una agresión cutánea de energía térmica cuya clasificación varía de acuerdo a la gravedad. Representan un problema de salud pública especialmente en los niños por su elevada letalidad y los años de vida perdidos por discapacidad. Objetivo: Identificar las características relacionadas con la ocurrencia de escaldaduras en niños menores de 5 años, en un Hospital Pediátrico de la Ciudad de México, 2011. Material y Métodos: Se empleó un diseño de casos-autocontroles en 60 niños menores de 5 años que presentaron escaldadura. La evaluación de algunas variables se obtuvo mediante el diligenciamiento de un cuestionario estructurado por parte de los cuidadores. Se definieron dos periodos de estudio; el primero denominado "periodo de riesgo" que incluyó la evaluación de los eventos ocurridos 15 minutos previos a la escaldadura y el segundo, denominado "periodo de control" que evaluó las 24 horas previas a la ocurrencia del evento. Resultados: La muestra estuvo conformada por 60 menores, 70% (n=42) de los participantes fueron varones. El promedio de edad fue 2.2 años (ds=1.2). El 95% de las escaldaduras ocurrieron en el hogar, 61.4% se presentaron en la cocina y 15.8% en el baño. Cerca del 70% de los participantes tenía bajo nivel socioeconómico, 86.7% vivía en condiciones de hacinamiento. El rango horario en el cual se presentaron con mayor frecuencia fue entre las 12 a 18 horas. La única asociación encontrada se dio cuando el cuidador estaba cocinando (OR 6.8, IC95% 1.9-24.9) Conclusiones: Identificar las características relacionadas con las escaldaduras en menores de cinco años es fundamental para impulsar medidas preventivas que reduzcan el riesgo de vivir con secuelas derivados de estas lesiones. Los cuidadores deben mejorar la supervisión de los niños a su cargo, en especial al interior de las cocinas.

Introduction: Burns are injuries of tissues caused by skin aggression thermal energy. Their classification varies according to gravity. Such injuries are a public health problem especially in children because of its high fatality rate and years of life lost due to disability. Objective: Identify the characteristics associated with the occurrence of scalds in children under 5 years in a Pediatric Hospital in Mexico City, 2011 Methodology: We employed a case crossover design on a sample of 60 children under 5 years old with scalding, to whom we applied a structured questionnaire to their caregivers. We defined two study periods: risk period, 15 minutes pre-scald and control period 24 hours prior to the occurrence of the event. Results: Of the sample of 60 children, 70% (n:42) were male, mean age 2.2 years (sd:1.2); 95% of scalds occurred at home, 61.4% occurred in the kitchen and 15.8% in the bathroom. About 70% of them had low socioeconomic status, 86.7% were living in overcrowded conditions. The times of higher occurrence of events were between 12 to 18 hours. The only association found was when the caregiver was cooking (OR 6.8, CI 95% 1.9 - 24.9). Conclusions: To identify the risk factors and characterize the scald in children under than five years old are fundamentals aspects to promote promotion and preventive program to reduce risk of live with physical and psychological disability from these causes of injuries. The caregiver should to have more attention to the children they supervise, in special within kitchen.

Co-occurrence patterns along a regional aridity gradient of the subtropical Andes do not support stress gradient hypotheses.

The stress gradient hypothesis posits that facilitation and stress are positively correlated. The hump-shaped hypothesis, on the contrary, proposes that facilitation is greater at intermediate stress levels. The relationship between facilitation and environmental stress is commonly studied at small spatial scales and/or considering few species; thus, the implications of facilitation at a community level remain poorly understood. Here, we analyzed local co-occurrence patterns of all plant species at 25 sites within the subtropical Andes to evaluate the role of facilitation and competition as drivers of community structure. We considered a wide latitudinal gradient (19-26°S) that incorporates great variation in aridity. No previous studies have attempted to study these patterns across such a broad scale in warm deserts. Each locality was sampled at two scales (quadrat and patch), and co-occurrence was analyzed via null models. Furthermore, we tested for a relationship between plant co-occurrences and environmental aridity. Resulting patterns depended on life form. When all species were considered, negative associations were found, indicating competition. Woody/cactus life forms tended to be associated across communities, suggesting that there is facilitation between these life forms. Additionally, and unlike previous studies, we found positive associations among shrubs. The strength of the association between woody species changed non-monotonically with aridity. Herbs showed an inverted hump-shaped relationship, albeit ranging mostly among neutral values. Independent of the association type exhibited by different life forms, our community level results do not support current stress gradient hypotheses.

Variación de la presión arterial con latemperatura ambiente: ¿aumenta o disminuye? / Variation of the blood pressure with room temperature? Does it increase or diminish?

Objetivo: En estudios anteriores se ha comprobado el incremento de la presión arterial (PA) con el descenso de la temperatura y el cambio estacional de ésta, máxima en invierno y mínima en verano, pero no se ha estudiado convenientemente el tipo de relación que mantienen, sobre todo qué ocurre conforme va aumentando la temperatura, que es lo que se investiga en este trabajo. Método: Estudio observacional de una cohorte dinámica formada por 1.017 individuos, durante 2 años en una farmacia comunitaria, con registro de los valores de PA (un total de 6.014 mediciones), edad y sexo. Resultados: Se observa una relación no lineal entre la PA y la temperatura, con una variación en J, descrita mejor con parametrización cuadrática y cúbica (coeficiente de determinación R2 para la PA sistólica de 0,010 en la relación lineal, y de 0,023 tanto en la cuadrática como en la cúbica), y más acusada para la PA sistólica que para la PA diastólica. Conclusiones: Por el tipo de diseño del estudio, no podemos confirmar si este tipo de relación observada es causal o artefactual, con argumentos tanto a favor de la una (el tipo de relación se mantiene con los 179 individuos observados en las cuatro estaciones) como de la otra (no ha sido una cohorte cerrada con seguimientos programados), en el contexto de una observación natural (AU)

Objetive: The increase of the blood pressure (BP) has been verified in previous studies with the decrease of the temperature and its seasonal change, maximum in winter and minimumin summer, but the type of relation that they keep has not been studied conveniently, especially what happens as the temperature increases, and this is what is investigated in our work. Method: Observational study of a dynamic cohort made up of 1017subjects, during two years in a Community Pharmacy, with record of the BP values (a total of 6014 measurements), age and gender. Results: A non linear relation is observed between the BP and the temperature, with a variation in J, better described with quadratic and cubic parameterization (coefficient of determination R - squared for systolic BP 0.010 for linear and 0.023both for quadratic and for cubic) and more marked for the systolic BP than for the diastolic BP. Conclusions: For the study design type, we cannot confirm if this type of observed relation is causal or art factual, with arguments so much in favor of one (the relation type is kept with179 subjects who are observed during the four seasons) than of the other (it has not been a closed cohort with scheduled follow-ups), in the context of a natural observation (AU)

Aneurisma micótico por Salmonella en un paciente con síndrome de inmunodeficiencia adquirida y riñón en herradura / Mycotic aneurysm due to Salmonella in a patient with acquired immunodeficiency syndrome and horseshoe kidney

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The role of nurse plants in the establishment of shrub seedlings in the semi-arid subtropical Andes.

In the nurse plant syndrome, or nurse association, seedlings (beneficiaries) are associated with adult shrubs/trees (benefactors). This phenomenon has been documented in several regions of the planet. Abiotic stress amelioration (one mechanism of facilitation) is one of the causes of this association. Most of the studies addressing the nurse syndrome have been conducted on spatial scales of a few hectares and have focused on only one or a few species. Moreover, there is an almost complete lack of studies addressing the incidence and characteristics of the nurse phenomenon in the arid Andes of South America. We undertook a first approximation to the study of facilitation in these ecosystems. The study was conducted at local and regional scales and involved the assessment of the spatial distribution of juveniles (seedlings and saplings) of 51 populations of 16 shrub and 12 cactus species in relation to shrub cover at 20 localities of the Prepuna (subtropical Andes of Bolivia and Argentina, 20-26 degrees S). In terms of spatial distribution, the juveniles of most of the populations of shrubs studied were distributed both under the shrubs and in open spaces, thereby showing an apparent indifference to microhabitat. Globose and opuntioid cacti were preferentially distributed below the canopies of shrubs and were usually more associated with the dominant shrub species, which stood out as better potential nurses. The pattern was consistent throughout the region, including the more mesic and arid localities. The fact that Prepuna woody species are capable of establishing in open spaces would confer this region a greater resilience. Our findings further suggest that community dynamics in arid and semi-arid environments are more variable than previously thought.

Simazine dynamics in a vineyard soil at Casablanca valley, Chile.

Field dissipation, soil movement and laboratory leaching studies were performed to elucidate the effect of two rainfall amounts in the behaviour and environmental fate of simazine under climatic conditions at Casablanca Valley, Chile. Dissipation and soil movement were studied in a field vineyard with a sandy loam soil (Inceptisol; 74.08% sand; 14.87% silt and 11.04% clay). Simazine was applied to bare soil at 2.0 kg AI ha(-1), and its concentration was measured using immunoassay (ELISA) at 0, 10, 20, 40 and 90 days after application under two rainfall amounts, natural field conditions (39 mm) and modified conditions (39 + 180 mm). Simazine leaching was studied using soil core PVC lysimeters (0.9 m height; 0.22 m diameter). Field dissipation data were adjusted with a bi-exponential model. Half-life (DT(50)) values varied between 31.3 (+/-2.5) and 19.0 (+/-4.2) days under natural and modified conditions, respectively. Simazine K(d) varied from 0.42 to 2.15 (K(oc) 32.6-216.2) in the soil profile. Simazine was detected at a 90-cm soil depth in concentrations of 0.0085 (+/-0.0043) mg kg(-1) and 0.0321 (+/-0.001) mg kg(-1) under field and modified conditions, respectively. The maximum simazine leachate concentrations were 0.013 (+/-0.00084) mg litre(-1) (0.012% of total applied simazine) and 0.0084 (+/-0.00082) mg litre(-1) (0.11% of total applied simazine) for field and modified conditions respectively. These data indicate that water quantity has a significant effect on the DT(50) and the amount of simazine that moved through the soil profile, but not on the soil depth reached by this herbicide.

Consultas a bases de datos avales Dinamed / Es

Se diseño y programo el boletin electrónico de características farmaceúticas, que viene a ser formulado de gran ayuda para la edición, introducción y control de datos de productos calificados en la CFN, los mismos que comprenden el principio activo o nombre genérico, forma farmaceútica, concentración, propiedades, se realizo a crear consultas dinámicas internas y también cliente servidor en la web, primero en el sistema interno de la unidad mediante la búsqueda de productos farmaceúticos

Programación en base de datos Dinamed-Concamyt / Es

Se realizó las adecuaciones respectivas al sistema de control en base de datos del laboratorio, vale decir que se modifiquen la base de datos estructuradas de tablas de ingreso de datos recepción, muestreo y análisis, estos cambios afectaron a las pantallas de registro de datos, por ende se realizó nueva codificación acorde a las tablas actuales.(au)

Sistematización y programación en base de datos / En

Constituye un documento indispensable con la cual deben contar todos los medicamentos previo a su introducción en el mercado farmaceútico nacional, el cual de otorga despues de haber sido sometido cada uno de ellos a una estrictica evaluación técnico-científica, para garantizar la calidad de los productos en beneficio de la población, para controlar y facilitar este proceso la DINAMED ha sistematizado los procedimientos para obtener dicho Registro.(au)