The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study. / Sistema Progetto Nazionale Emorragia Digestiva (PNED) vs. escala de Rockall como predictores de mortalidad en pacientes con hemorragia de tubo digestivo alto no variceal: un estudio multicéntrico prospectivo.

BACKGROUND: The predictive scale for mortality risk in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) proposed by Italy's PNED (Progetto Nazionale Emorragia Digestiva) group has not been validated in Latin America since its original publication. AIM: To compare the PNED system and the Rockall score as mortality predictors in patients hospitalized for NVUGIB. MATERIAL AND METHODS: A multicenter, prospective, cross-sectional, analytic study was conducted that recruited patients diagnosed with nonvariceal upper gastrointestinal bleeding within the time frame of 2011 to 2015. Six Mexican hospital centers participated in the study. The Rockall and PNED system scores were calculated, classifying the patients as having mild, moderate, or severe disease. The association between mortality and risk was determined through the chi-square test and relative risk (RR) calculation. Statistical significance was set at a P<.05. RESULTS: Information on 198 patients was collected. Only 8 patients (4%) died from causes directly associated with bleeding. According to the Rockall score, 46 patients had severe disease (23.2%), 5 of whom died, with a RR of 5.5 (CI 1.35-22.02, P=.006). In relation to the PNED, only 8 patients had severe disease (4%), 5 of whom died, with a RR of 38.7 (CI 11.4-137.3, P=.001). CONCLUSIONS: The PNED system was more selective for classifying a case as severe, but it had a greater predictive capacity for mortality, compared with the Rockall score.

Protection of trivalent inactivated influenza vaccine against hospitalizations among pandemic influenza A (H1N1) cases in Argentina.

The aim of this study was to estimate the effectiveness of 2009 seasonal trivalent inactivated vaccine in reducing hospitalizations due to the novel influenza A H1N1 virus among positive cases. Data collected from Argentina's national epidemiological surveillance system were analyzed. All patients had a clinical diagnosis and underwent positive serological tests for pandemic influenza A H1N1. Logistic regression was used to estimate vaccine effectiveness to prevent severe cases of the disease, measured as hospitalizations. The adjusted effectiveness of the vaccine was 50% (95% CI: 40-59%). Vaccination was significantly associated with hospitalizations in all age groups, and within groups that had and had not received antiviral treatment. These results suggest that seasonal influenza vaccine might have conferred partial protection against severe cases due to the novel pandemic influenza.

Assessment of the ozone-nitrogen oxide-volatile organic compound sensitivity of Mexico City through an indicator-based approach: measurements and numerical simulations comparison.

The ozone (O3) sensitivity to nitrogen oxides (NOx, or nitric oxide [NO] + nitrogen dioxide [NO2]) versus volatile organic compounds (VOCs) in the Mexico City metropolitan area (MCMA) is a current issue of scientific controversy. To shed light on this issue, we compared measurements of the indicator species O3/NOy (where NOy represents the sum of NO + NO2 + nitric acid [HNO3] + peroxyacetyl nitrate [PAN] + others), NOy, and the semiempirically derived O3/NOz(surrogate) (where NOz(surrogate) is the derived surrogate NOz, and NOz represents NOx reaction products, or NOy - NOx) with results of numerical predictions reproducing the transition regimes between NOx and VOC sensitivities. Ambient air concentrations of O3, NOx, and NOy were measured from April 14 to 25, 2004 in one downwind receptor site of photochemically aged air masses within Mexico City. MCMA-derived transition values for an episode day occurring during the same monitoring period were obtained through a series of photochemical simulations using the Multiscale Climate and Chemistry Model (MCCM). The comparison between the measured indicator species and the simulated spatial distribution of the indicators O3/ NOy, O3/NOz(surrogate), and NOy in MCMA suggest that O3 in this megacity is likely VOC-sensitive. This is in opposition to past studies that, on the basis of the observed morning VOC/NOx ratios, have concluded that O3 in Mexico City is NOx-sensitive. Simulated MCMA-derived sensitive transition values for O3/NOy, hydrogen peroxide (H2O2)/HNO3, and NOy were found to be in agreement with threshold criteria proposed for other regions in North America and Europe, although the transition crossover for O3/NOz and O3/HNO3 was not consistent with values reported elsewhere. An additional empirical evaluation of weekend/weekday differences in average maximum O3 concentrations and 6:00- to 9:00-a.m. NOx and NO levels registered at the same site in April 2004 indirectly confirmed the above results. A preliminary conclusion is that additional reductions in NOx emissions in MCMA might cause an increase in presently high O3 levels.

Genetic variability in Guadalupe fur seals.

The Guadalupe fur seal (Arctocephalus townsendi) population underwent one or two severe bottlenecks due to commercial sealing in the late 19th century. Since then the protected population has been growing steadily around their only rookery, Isla de Guadalupe, Mexico. We probed both nuclear and mitochondrial genomes using multilocus nuclear DNA profiling and mitochondrial DNA sequencing to estimate the level of genetic variability of the present population. Unlike other pinniped populations that have experienced similar historical bottlenecks, such as Hawaiian monk seals and northern elephant seals, high levels of genetic variability were found.

Comportamiento epidemiológico de las defunciones maternas en República Dominicana / Epidemiologic behavior of maternal disfunctions in the Dominican Republic

Se realizó un estudio descriptivo retrospectivo en los archivos de la división de estadísticas de la Secretaría de Estado de Salud Pública y Asistencia Social (SESPAS), con el propósito de determinar el comportamiento epidemiológico de la mortalidad materna en la República Dominicana durante el período 1981-1990. Las informaciones obtenidas que la mortalidad materna aparenta ser de difícil evaluación en función de las potenciales muertes por abortos clandestinos que no se registran como tales. La misma se consideró como elevada, obteniéndose cifras de mortalidad materna que aumentaron de cinco a diecinueve por diez mil (5-19 x 10,000) durante la década pasada, observándose una tendencia decreciente a partir del año 1990. Siendo dicha mortalidad mayor en menores de veinte (20) años y de veinte a treinta y cuatro (20-34) años. La cifra promedio de mortalidad materna para la década pasada fue de diez punto cuatro por diez mil (10.4 x 10,000). Por último se destaca, que a pesar del subregistro, la toxemia, las hemorragias y los abortos siguen siendo las causas más importantes de mortalidad materna en la República Dominicana