An Evaluation of the El Centro de la Causa Library and Information Center: August 1973 through July 1974. Final Report.

ERIC Educational Resources Information Center

Michael, Mary Ellen; Encarnacion, Leticia

An evaluation of Chicago's El Centro de la Causa Library and Information Center was undertaken by the University of Illinois Library Research Center in 1974. Evaluation methods included: (1) a survey of user and nonuser characteristics and attitudes concerning library services; (2) a survey of the needs and information-seeking behavior of people…

Infant mortality by color or race from Rondônia, Brazilian Amazon.

PubMed

Gava, Caroline; Cardoso, Andrey Moreira; Basta, Paulo Cesar

2017-04-10

To analyze the quality of records for live births and infant deaths and to estimate the infant mortality rate for skin color or race, in order to explore possible racial inequalities in health. Descriptive study that analyzed the quality of records of the Live Births Information System and Mortality Information System in Rondônia, Brazilian Amazonian, between 2006-2009. The infant mortality rates were estimated for skin color or race with the direct method and corrected by: (1) proportional distribution of deaths with missing data related to skin color or race; and (2) application of correction factors. We also calculated proportional mortality by causes and age groups. The capture of live births and deaths improved in relation to 2006-2007, which required lower correction factors to estimate infant mortality rate. The risk of death of indigenous infant (31.3/1,000 live births) was higher than that noted for the other skin color or race groups, exceeding by 60% the infant mortality rate in Rondônia (19.9/1,000 live births). Black children had the highest neonatal infant mortality rate, while the indigenous had the highest post-neonatal infant mortality rate. Among the indigenous deaths, 15.2% were due to ill-defined causes, while the other groups did not exceed 5.4%. The proportional infant mortality due to infectious and parasitic diseases was higher among indigenous children (12.1%), while among black children it occurred due to external causes (8.7%). Expressive inequalities in infant mortality were noted between skin color or race categories, more unfavorable for indigenous infants. Correction factors proposed in the literature lack to consider differences in underreporting of deaths for skin color or race. The specific correction among the color or race categories would likely result in exacerbation of the observed inequalities. Analisar a qualidade dos registros de nascidos vivos e de óbitos infantis e estimar a taxa de mortalidade infantil segundo cor ou raça, a fim de explorar iniquidades étnico-raciais em saúde. Estudo descritivo que analisou a qualidade dos registros do Sistema de Informações sobre Nascidos Vivos e do Sistema de Informações sobre Mortalidade em Rondônia, Amazônia brasileira, entre 2006-2009. As taxas de mortalidade infantil foram estimadas nas categorias de cor ou raça, pelo método direto, e corrigidas por: (1) distribuição proporcional dos óbitos com cor ou raça ignorada; e (2) aplicação de fatores de correção. Efetuou-se também o cálculo da mortalidade proporcional por causas e grupos etários. Entre 2008-2009, a captação de nascimentos e óbitos melhorou em relação aos anos de 2006-2007, requerendo fatores de correção menores para estimar a taxa de mortalidade infantil. O risco de morte de crianças indígenas (31,3/1.000 nascidos vivos) foi maior que o registrado nos demais grupos de cor ou raça, excedendo em 60% a mortalidade infantil média no estado (19,9/1.000 nascidos vivos). As crianças pretas apresentaram as maiores taxas de mortalidade infantil neonatal, enquanto as indígenas apresentaram as maiores taxas de mortalidade infantil pós-neonatal. Observou-se que 15,2% dos óbitos indígenas foram por causas mal definidas, enquanto nos demais grupos não ultrapassaram 5,4%. A mortalidade infantil proporcional por doenças infecciosas e parasitárias foi maior entre indígenas, ao passo que entre crianças pretas, sobressaíram as causas externas (8,7%). Observaram-se expressivas iniquidades na mortalidade infantil entre as categorias de cor ou raça, com situação mais desfavorável às crianças indígenas. Os fatores de correção propostos na literatura não consideram diferenças na subenumeração de óbitos entre as categorias de cor ou raça. A correção específica entre as categorias de cor ou raça provavelmente resultaria em exacerbação das iniquidades observadas.

A tribute to Achim Trebst at the time of his doctor honoris causa, University of Düsseldorf.

PubMed

Strotmann, Heinrich

2009-06-01

On June 9, 2009, we celebrate the 80th birthday of Achim Trebst. I present below the "Tribute" (Laudatio) that I read on February 11, 2000 on the occasion of his receiving Doctor honoris causa of the Faculty of Mathematics and Natural Sciences of the Heinrich Heine University in Düsseldorf. The text below is a translation from the original German to English with minor editorial changes by Govindjee.

Edades relativas de cúmulos globulares

NASA Astrophysics Data System (ADS)

Miller Bertolami, M.; Forte, J. C.

El trabajo de Rossemberg et al (1999), estudia las edades relativas de cúmulos globulares galácticos mediante el análisis de ciertos parámetros morfológicos de los diagramas color-magnitud de dichos cúmulos. Este trabajo se centra en tres puntos: analizar la consistencia de los resultados obtenidos por Rossemberg et al (1999) al emplear observaciones en el sistema fotométrico de Washington, más precisamente, las magnitudes C y T1 en lugar de las magnitudes V e I utilizadas por dichos autores. De la existencia de colores integrados, metalicidad y edad (relativa) para 21 de los cúmulos utilizados en dicho trabajo, se analiza la consistencia de estos resultados con las dependencias de color integrado como función de la edad y la metalicidad que se desprenden de los modelos teóricos de luz integrada por Worthey (1994), Schulz (2002) y Lee et al (2002). Por último se lleva a cabo una breve comparación de la morfología de los diagramas color-magnitud de los cúmulos globulares y de las isocronas utilizadas, a fin de intentar identificar algunas de las posibles causas de las diferencias observadas en los incisos anteriores.

[N. Leonicenus interpretes of Galen on causa coniuncta].

PubMed

Mugnai, Daniela

2010-01-01

The philosopher and physician Nicolò Leoniceno, one of the most important members of the Medical Humanism, in the N. Leoniceni in libros Galeni e Graeca in linguam Latinam a se translatos Praefatio communis (1508) discusses his emendation to Galens's Ars Medicinalis (28, 4 Boudon = I 381 Kühn, [see text]). In spite of the debatable conjecture, it is a significant effort to solve a serious contradiction in Galen's text. Leoniceno rejects the solutions proposed by the Arabic and Medieval Latin commentators and offers the right interpretation of causa coniuncta in Galen's concept of disease.

INFLUENCE OF HEPATOCELLULAR CARCINOMA ETIOLOGY IN THE SURVIVAL AFTER RESECTION.

PubMed

Lopes, Felipe de Lucena Moreira; Coelho, Fabricio Ferreira; Kruger, Jaime Arthur Pirolla; Fonseca, Gilton Marques; Araujo, Raphael Leonardo Cunha de; Jeismann, Vagner Birk; Herman, Paulo

2016-01-01

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and its incidence is increasing around the world in the last decades, making it the third cause of death by cancer in the world. Hepatic resection is one of the most effective treatments for HCC with five-year survival rates from 50-70%, especially for patients with a single nodule and preserved liver function. Some studies have shown a worse prognosis for HCC patients whose etiology is viral. That brings us to the question about the existence of a difference between the various causes of HCC and its prognosis. To compare the prognosis (overall and disease-free survival at five years) of patients undergoing hepatectomy for the treatment of HCC with respect to various causes of liver disease. Was performed a review of medical records of patients undergoing hepatectomy between 2000 and 2014 for the treatment of HCC. They were divided into groups according to the cause of liver disease, followed by overall and disease-free survival analysis for comparison. There was no statistically significant difference in the outcomes of the groups of patients divided according to the etiology of HCC. Overall and disease-free survival at five years of the patients in this sample were 49.9% and 40.7%, respectively. From the data of this sample, was verified that there was no prognostic differences among the groups of HCC patients of the various etiologies. O carcinoma hepatocelular (CHC) é o mais frequente tipo de câncer primário do fígado e a sua incidência vem aumentando nas últimas décadas, tornando-o hoje a terceira causa de morte por câncer no mundo. A ressecção hepática é um dos tratamentos mais eficazes para ele com taxas de sobrevida em cinco anos de 50-70%, especialmente para pacientes com nódulo único e função hepática preservada. Alguns estudos mostraram pior prognóstico para os pacientes com CHC cuja causa é a infecção por vírus B ou C. Isso leva à questão sobre a existência de possível diferença entre as diversas causas e o prognóstico. Comparar o prognóstico (sobrevida global e livre de doença em cinco anos) de pacientes submetidos à hepatectomia para o tratamento do CHC com relação às diversas causas da hepatopatia. Foi realizado levantamento de prontuários dos pacientes submetidos à hepatectomia entre 2000 e 2014 para tratamento de CHC. Eles foram divididos em grupos de acordo com a causa da hepatopatia, sendo feita análise de sobrevida para comparação. Não houve diferença estatisticamente significante de prognóstico entre os grupos de pacientes divididos conforme a causa do CHC. A sobrevida global e livre de doença em cinco anos foi de 49.9% e 40.7%, respectivamente. Pôde-se constatar que não houve diferença em relação ao prognóstico entre os grupos de pacientes das diversas causas de CHC.

[Not Available].

PubMed

Giner, Manel; Culebras, Jesús M; Meguid, Michael M

2016-03-01

En agosto de 1976, un joven llamado LeRoy cayó desde una cornisa fracturándose el fémur. Se sospechó una hemorragia interna importante. Durante una laparotomía se comprobó que todos los órganos internos estaban intactos y los cirujanos ortopédicos arreglaron la fractura. Treintadías después, LeRoy murió. Había comido poco; diariamente, tan solo había recibido tres litros de la glucosa, el equivalente a 510 calorías, por vía intravenosa. La glucosa fue insuficiente para satisfacer sus necesidades nutricionales, perdiendo más del 20% de su peso corporaldurante su estancia en el hospital. La causa de la muerte se debió a "desnutrición médicamente inducida". Mientras tanto, un artículo científico documentó que la prevalencia de desnutrición en los hospitales de Boston era del 44% y que la desnutrición en sí era un predictor de altas tasas de complicaciones y muerte.Como resultado, los médicos sensibilizados formaron una sociedad que creó programas de formación y alentó la formación de equipos de nutrición en los hospitales. La industria comercializó fórmulas de nutrición y catéteres. Las complicaciones en enfermos hospitalizados cayeron en picado, mientras que las tasas de supervivencia aumentaron. California aprobó una legislación para regular el soporte nutricional. Aunque la industria de la atención sanitaria reconoce la importancia de la nutrición en los cuidados al paciente, el Congreso no proporcionó apoyo fiscal para los equipos de nutrición. Como resultado, los hospitales disolvieron sus equipos de nutrición de reciente creación. La educación y las habilidades en nutrición disminuyeron, y las complicaciones hospitalarias y las tasas de mortalidad aumentaron de nuevo.

Influencia atmosférica en la rotación terrestre

NASA Astrophysics Data System (ADS)

Fernández, L. I.; Arias, E. F.; Brunini, C. A.

Las observaciones de los parámetros de la orientación terrestre han alcanzado en estos últimos años una exactitud sin precedentes gracias al uso de modernas técnicas de geodesia espacial. Estudios previos han establecido que las variaciones en la rotación terrestre con períodos iguales o menores que dos años obedecen a cambios en la circulación atmosférica global. Para estos períodos puede comprobarse que existe un gran acuerdo entre las fluctuaciones de la longitud del día (LOD) y los cambios del momento angular atmosférico terrestre (AAM). Sin embargo, no existe un acuerdo general acerca de las causas que provocan las variaciones de largo período de la rotación de la Tierra, también conocidas como ``variaciones decenales''. En nuestro análisis examinamos las correlaciones entre las variaciones de los valores de LOD y las fluctuaciones en la componente polar del momento angular atmosférico terrestre. Con este propósito utilizamos los siguientes juegos de datos: las series de AAM, estimado siguiendo la definición de Barnes et al.(1983) para 2825 días provientes del National Meteorological Center (NMC) y del European Centre for Medium Range Weather Forecast (ECMWF); y las series de LOD que contienen valores alisados espaciados a intervalos de un día elaborados por el International Earth Rotation Service (IERS). Mostraremos que para los cambios anuales e interanuales en la rotación de la Tierra la influencia atmosférica es asombrosa, mientras que, tanto en las escalas temporales más grandes y como en las más pequeñas, ambas series, geodésica y atmosférica, parecen diverger aún cuando poseemos observaciones obtenidas con las técnicas más modernas al presente.

CONTAMINACIÓN AMBIENTAL, VARIABILIDAD CLIMÁTICA Y CAMBIO CLIMÁTICO: UNA REVISIÓN DEL IMPACTO EN LA SALUD DE LA POBLACIÓN PERUANA

PubMed Central

Gonzales, Gustavo F.; Zevallos, Alisson; Gonzales-Castañeda, Cynthia; Nuñez, Denisse; Gastañaga, Carmen; Cabezas, César; Naeher, Luke; Levy, Karen; Steenland, Kyle

2015-01-01

RESUMEN El presente artículo es una revisión sobre la contaminación del agua, el aire y el efecto del cambio climático en la salud de la población peruana. Uno de los principales contaminantes del aire es el material particulado menor de 2,5 μ (PM 2,5), en la ciudad de Lima, anualmente 2300 muertes prematuras son atribuibles a este contaminante. Otro problema es la contaminación del aire domiciliario por el uso de cocinas con combustible de biomasa, donde la exposición excesiva a PM 2,5 dentro de las casas es responsable de aproximadamente 3000 muertes prematuras anuales entre adultos, con otro número desconocido de muertes entre niños debido a infecciones respiratorias. La contaminación del agua tiene como principales causas los desagües vertidos directamente a los ríos, minerales (arsénico) de varias fuentes, y fallas de las plantas de tratamiento. En el Perú, el cambio climático puede impactar en la frecuencia y severidad del fenómeno de El Niño oscilación del sur (ENSO) que se ha asociado con un incremento en los casos de enfermedades como cólera, malaria y dengue. El cambio climático incrementa la temperatura y puede extender las áreas afectadas por enfermedades transmitidas por vectores, además de tener efecto en la disponibilidad del agua y en la contaminación del aire. En conclusión, el Perú, pasa por una transición de factores de riesgo ambientales, donde coexisten riesgos tradicionales y modernos, y persisten los problemas infecciosos y crónicos, algunos de los cuales se asocian con problemas de contaminación de agua y de aire. PMID:25418656

El uso de la neuromodulación para el tratamiento del temblor

PubMed Central

Bendersky, Damián; Ajler, Pablo; Yampolsky, Claudio

2014-01-01

Introducción: El temblor puede ser un desorden incapacitante y el tratamiento de primera línea para estos pacientes es farmacológico. Sin embargo, este tratamiento puede llevar a una reducción satisfactoria del temblor en sólo el 50% de los pacientes con temblor esencial. La talamotomía era el tratamiento de elección para el temblor refractario al tratamiento médico hasta que comenzó a utilizarse la estimulación cerebral profunda (ECP) del núcleo ventral intermedio (Vim) del tálamo. En la actualidad, raramente se realiza la talamotomía. Métodos: Este artículo es una revisión no sistemática de las indicaciones, resultados, parámetros de programación y técnica quirúrgica de la ECP del Vim para el tratamiento del temblor. Resultados: Aunque los resultados clínicos son similares usando la talamotomía o la ECP del Vim, la primera causa más efectos adversos que la última. Además, la ECP puede ser usada bilateralmente, mientras que la talamotomía tiene un alto riesgo de causar disartria cuando se realiza de ambos lados. La ECP del Vim logró una adecuada mejoría del temblor en varias series de pacientes con temblor causado por temblor esencial, enfermedad de Parkinson o esclerosis múltiple. Además del Vim, hay otros blancos que están siendo usados por varios autores, tales como la zona incerta y las radiaciones prelemniscales. Conclusión: La ECP del Vim es un tratamiento útil para el temblor incapacitante refractario al tratamiento médico. Es esencial realizar una precisa selección de pacientes, así como utilizar una técnica quirúrgica correcta. Aún se desconoce el mejor blanco estereotáctico para el temblor, aunque el Vim es el más usado. PMID:25165613

[Methods for evaluating diagnostic tests in Enfermedades Infecciosas y Microbiología Clínica].

PubMed

Ramos, J M; Hernández, I

1998-04-01

In the field of infectious diseases and clinical microbiology, the evaluation of diagnostic tests (DT) is an important research area. The specific difficulties of this type of research has motivated that have not caught the severity methodological of others areas of clinical research. This article try to asses and characterize the methodology of articles about DT published in Enfermedades Infecciosas y Microbiología Clínica (EIMC) journal. Forty-five articles was selected in the EIMC journal during the 1990-1996 period, because of determinate the sensitivity and specificity of different DT. Methodological standards, extensively accepted was used. In all of articles, except one (98%) the gold standard was specified yours use, however in 4 studies (9%) include the DT in the gold standard (incorporation bias). The correct description of DT was reported in 75% of cases, but only in 11% cases the reproducibility of test was evaluated. The description of source of reference population, standard of inclusion and spectrum of composition was described in 58, 33 and 40% of articles, respectively. In 33% of studies presented workup bias, only 6% commented blind-analysis of results, and 11% presented indeterminate test results. Half of the studies reported test indexes for clinical subgroups, only one article (2%) provided numerical precision for test indexes, and only 7% reported receiver operating characteristics curves. The methodological quality of DT research in the EIMC journal may improve in different aspects of design and presentation of results.

ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?

PubMed

Passos, Márcio Alexandre Terra; Portari-Filho, Pedro Eder

2016-01-01

Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis. Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection. A colecistectomia laparoscópica eletiva apresenta risco muito baixo para complicações infecciosas, com média de infecção entre 0,4% a 1,1%. Muitos cirurgiões ainda utilizam de rotina profilaxia antibiótica. Avaliar a real necessidade de profilaxia antibiótica em colecistectomias laparoscópicas eletivas em pacientes de baixo risco para infecção do sítio cirúrgico. Estudo prospectivo, randomizado e duplo-cego, em pacientes submetidos à colecistectomia laparoscópica eletiva, envolvendo 100 pacientes em dois grupos: A (n=50), que receberam profilaxia com cefazolina 2 g intravenoso na indução anestésica; B (n=50), não foi utilizado antibiótico. O desfecho avaliado foi presença de complicações infecciosas de sítio cirúrgico. Os pacientes foram revisados em sete e 30 dias no pós-operatório. As taxas de complicações infecciosas foi de 2% no grupo A e de também 2% no grupo B. Não houve diferença estatisticamente significativa (p>0,05) entre os grupos que foram homogêneos e comparáveis. A antibioticoprofilaxia na colecistectomia laparoscópica em pacientes de baixo risco não apresenta nenhum benefício significativo na redução da incidência de infecção do sítio cirúrgico.

[Outbreak of Salmonella Typhimurium infections associated with consumption of chorizo in Bizkaia].

PubMed

Hernández Arricibita, Esther; Santamaria Zuazua, Rosaura; Ramos López, Gemma; Herrera-León, Silvia; Kárkamo Zuñeda, José Antonio; Muniozguren Agirre, Nerea

2016-11-01

A report is presented on an outbreak of Salmonella enterica serovar Typhimurium infection that affected six people. The epidemiological and laboratory investigation associated the outbreak with the consumption of homemade chorizo purchased at a local street market. The vendor and producer were informed that the sale of meat products without sanitary authorization is prohibited, and the product was withdrawn from sale. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Zika fever.

PubMed

Martínez de Salazar, Pablo; Suy, Anna; Sánchez-Montalvá, Adrián; Rodó, Carlota; Salvador, Fernando; Molina, Israel

2016-04-01

Zika fever is an arboviral systemic disease that has recently become a public health challenge of global concern after its spread through the Americas. This review highlights the current understanding on Zika virus epidemiology, its routes of transmission, clinical manifestations, diagnostic tests, and the current management, prevention and control strategies. It also delves the association between Zika infection and complications, such as microencephaly or Guillem-Barré syndrome. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary: Diagnosis and Treatment of Catheter-Related Bloodstream Infection: Clinical Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC).

PubMed

Chaves, Fernando; Garnacho-Montero, José; Del Pozo, José Luis; Bouza, Emilio; Capdevila, José Antonio; de Cueto, Marina; Domínguez, M Ángeles; Esteban, Jaime; Fernández-Hidalgo, Nuria; Fernández Sampedro, Marta; Fortún, Jesús; Guembe, María; Lorente, Leonardo; Paño, Jose Ramón; Ramírez, Paula; Salavert, Miguel; Sánchez, Miguel; Vallés, Jordi

2018-02-01

Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias). Short-term peripheral venous catheters, non-tunneled and long-term central venous catheters, tunneled catheters and hemodialysis catheters are covered by these guidelines. The panel identified 39 key topics that were formulated in accordance with the PICO format. The strength of the recommendations and quality of the evidence were graded in accordance with ESCMID guidelines. Recommendations are made for the diagnosis of CRBSI with and without catheter removal and of tunnel infection. The document establishes the clinical situations in which a conservative diagnosis of CRBSI (diagnosis without catheter removal) is feasible. Recommendations are also made regarding empirical therapy, pathogen-specific treatment (coagulase-negative staphylococci, Sthaphylococcus aureus, Enterococcus spp, Gram-negative bacilli, and Candida spp), antibiotic lock therapy, diagnosis and management of suppurative thrombophlebitis and local complications. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Proteomics in infectious diseases].

PubMed

Quero, Sara; Párraga-Niño, Noemí; García-Núñez, Marian; Sabrià, Miquel

2016-04-01

Infectious diseases have a high incidence in the population, causing a major impact on global health. In vitro culture of microorganisms is the first technique applied for infection diagnosis which is laborious and time consuming. In recent decades, efforts have been focused on the applicability of "Omics" sciences, highlighting the progress provided by proteomic techniques in the field of infectious diseases. This review describes the management, processing and analysis of biological samples for proteomic research. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Not Available].

PubMed

Corella Aznar, Elena Guadalupe; Ayerza Casas, Ariadna; Samper Villagrasa, Pilar; Rodríguez Vigil, Carmen; Jiménez Montañés, Lorenzo; Calvo Escribano, Carlota; Labarta Aizpun, José Ignacio

2016-06-30

Introducción: los supervivientes de leucemia aguda (LA) infantil presentan un riesgo incrementado de alteraciones metabólicas y cardiovasculares que aumentan su morbimortalidad a largo plazo.Objetivo: estimar la prevalencia de obesidad, resistencia a la insulina, dislipemia e hipertensión arterial como factores de riesgo cardiometabólico (FRCM) en un grupo de supervivientes de LA infantil, y analizar las posibles causas asociadas a su desarrollo.Material y métodos: estudio observacional retrospectivo en 47 supervivientes de LA tratados en un periodo de 4 años, que recibieron seguimiento durante 10 años.Resultados: el 40% de los participantes presentaron al menos un FRCM durante el seguimiento, siendo la dislipemia (aumento LDL) el más frecuente (38,3%), seguido de obesidad/sobrepeso (31,9%) y HTA sistólica (23,4%). El sexo femenino se estableció como factor de riesgo parael desarrollo de todos ellos (RR 1,6; RR 3,16; RR 1,69; p < 0,05). Ningún superviviente desarrolló diabetes mellitus, pero sí resistencia a la insulina el 19,4%. Los pacientes con leucemias de peor pronóstico presentaron mayor riesgo de desarrollar obesidad, resistencia a la insulina y aumento de LDL (RR 3,56; RR 4,08; RR 2,53; p < 0,05). Los pacientes tratados con trasplante de progenitores hematopoyéticos presentaron mayor riesgo de obesidad, aumento de LDL e HTA sistólica (RR 2,86; RR 2,39; RR 3,12; p<0,05). La radioterapia se asoció de igual modo con un incremento de resistencia a la insulina e hipertensión arterial sistólica (RR 2,47; RR 2,53; p < 0,05).Conclusiones: existe un aumento en la prevalencia de obesidad/sobrepeso, dislipemia, resistencia a la insulina y alteración de la tensión arterial sistólica en supervivientes de leucemia aguda infantil a lo largo del tiempo, especialmente en aquellos con enfermedades y tratamientos más agresivos.

Transmission scenarios of major vector-borne diseases in Colombia, 1990-2016.

PubMed

Padilla, Julio César; Lizarazo, Fredy Eberto; Murillo, Olga Lucía; Mendigaña, Fernando Antonio; Pachón, Edwin; Vera, Mauricio Javier

2017-03-29

Introducción. Las enfermedades transmitidas por vectores representan más de 17 % de todas las enfermedades infecciosas y causan anualmente un millón de defunciones a nivel mundial. En Colombia, la malaria, el dengue, la enfermedad de Chagas y las leishmaniasis son condiciones endemoepidémicas persistentes.Objetivo. Determinar el comportamiento epidemiológico de las enfermedades transmitidas por vectores en zonas urbanas y rurales de Colombia entre 1990 y 2016.Materiales y métodos. Se hizo un estudio descriptivo del comportamiento epidemiológico de las principales enfermedades transmitidas por vectores en zonas urbanas y rurales de Colombia entre 1990 y 2016, con la información proveniente de fuentes oficiales secundarias.Resultados. En el periodo estudiado se registraron 5'360.134 casos de enfermedades transmitidas por vectores, de los cuales 54,7 % fueron de malaria y 24,9 % de dengue. Estos casos concentraron el 80 % de la carga acumulada de casos de enfermedades transmitidas por vectores. Las medianas de las tasas de incidencia fueron 1.371 y 188 por 100.00 habitantes para malaria y dengue, respectivamente. Además, los casos de chikungunya fueron 774.831 desde su introducción en el 2014 y, los de Zika, 117.674 desde su aparición en 2015. En las zonas rurales predominaron las enfermedades parasitarias transmitidas por vectores como la malaria, las leishmaniasis y la enfermedad de Chagas. A nivel urbano, predominaron el dengue, el chikungunya y el Zika.Conclusiones. La transmisión en Colombia de estas enfermedades es persistente en las zonas urbanas y en las rurales, y de tipo endemoepidémico en los casos de malaria, dengue, leishmaniasis y enfermedad de Chagas. Dicha transmisión se ha dado de manera focalizada y con patrones variables de intensidad. Asimismo, se mantienen las condiciones que han favorecido la transmisión emergente de nuevas arbovirosis.

[Gender analysis among articles published in Enfermedades Infecciosas y Microbiología Clínica (2001-2005)].

PubMed

Aleixandre-Benavent, Rafael; González-Alcaide, Gregorio; Alonso-Arroyo, Adolfo; Castellano-Gómez, Miguel; Valderrama-Zurián, Juan Carlos

2007-12-01

There is growing concern for promoting equality between sexes and full integration of women in research activities. The purpose of this study is to identify the bibliometric characteristics of articles published during the 2001-2005 period in Enfermedades Infecciosas y Microbiología Clínica (EIMC) from the perspective of gender. EIMC records for 2001-2005 were obtained from the Science Citation Index database and differences according to sex were calculated for the following indicators: year of publication, type of document, number and order of author signatures, number of collaborators, and the signature/article index at the institutional and geographical level. A total of 2,163 authors were identified, 1,220 (56.4%) men and 943 (43.6%) women. The greatest of contribution from women was in original articles (42.32% of signatures). Excluding the Centro Nacional de Microbiología (Spanish National Center for Microbiology), the participation of women was lower than men in the most productive institutions. There were significant differences regarding the number of papers published and the number of collaborators; with greater productivity for men and a higher rate of collaboration for women. Studies on scientific activity according to gender provide essential information to establish the basis for a policy of equality in this regard. A yearly increase of almost 1% was seen in the number of female authors contributing articles to the EIMC, which, if the trend continues, will result in parity in coming years. Nevertheless, the presence of women in positions of high productivity remains low. The causes of this difference should be identified and corrected.

Do Allergies Cause Asthma?

MedlinePlus

... Safe Videos for Educators Search English Español Do Allergies Cause Asthma? KidsHealth / For Parents / Do Allergies Cause ... Las alergias son la causa del asma? Do Allergies Cause Asthma? Allergies don't cause asthma. But ...

Perfis de temperatura eletrônica em regiões HII

NASA Astrophysics Data System (ADS)

Copetti, M. V. F.

2003-08-01

As flutuações de temperatura eletrônica em regiões HII, inicialmente propostas para explicar as discrepâncias entre os valores de temperatura obtidos por diferentes métodos, têm sido apontadas como a causa mais provável das enormes diferenças encontradas entre as abundâncias químicas medidas através de linhas excitadas colisionalmente e de linhas de recombinação. Recentemente têm sido reportadas tentativas de detecção e quantificação diretas das flutuações de temperatura eletrônica através de medidas ponto a ponto, obtidas por meio de espectroscopia de fenda longa, das razões de linhas [OIII]l4263/l5007 e [NII]l5755/l6584, principais sensores de temperatura. Neste trabalho, utilizamos o código numérico de fotoionização Cloudy para avaliar a confiabilidade desse procedimento. Concluímos que, para valores de densidade eletrônica e de temperatura efetiva da estrela ionizante típicos das regiões HII, os perfis superficiais de temperatura obtidos via medidas do sensor [OIII]l4263/l5007 são bons traçadores dos gradientes internos de temperatura eletrônica. Já os perfis de temperatura eletrônica medidos por meio da razão [NII]l5755/l6584 não reproduzem os gradientes verdadeiros de temperatura.

Terapia fibrinolítica sistêmica no tromboembolismo pulmonar

PubMed Central

Ceresetto, José Manuel; Marques, Marcos Arêas

2017-01-01

Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central. PMID:29930636

[Not Available].

PubMed

Norte Navarro, Aurora Isabel; Sansano Perea, Miriam; Martínez Sanz, José Miguel; Sospedra López, Isabel; Hurtado Sánchez, José Antonio; Ortiz Moncada, Rocío

2016-06-30

Introducción y objetivos: las enfermedades cardiovasculares (ECV) son la principal causa de muerte mundial, por ello el objetivo de este estudio es analizar los factores de riesgo de ECV en los trabajadores de la Universidad de Alicante.Material y métodos: estudio transversal descriptivo. Muestra aleatoria (n = 124), 46,6% mujeres y 53,4% hombres, de edades entre 25-68 años. Recogida de datos mediante cuestionario online autocumplimentado. sociodemográficas, peso y talla autorreferidos, consumo de tabaco, actividad física, consumo diario de aceite de oliva, hortalizas-verduras, mantequilla-margarina-nata y consumo semanal de repostería comercial y frutos secos. Se realizó un análisis descriptivo con el paquete estadístico SPSS 19.0.Resultados: el 12% de mujeres y el 10,5% de los hombres mayores de 44 años presentan obesidad; además, el 32% de mujeres y el 23,7% de los hombres no realizan actividad física. Consume aceite de oliva a diario el total de la muestra a estudio.Conclusión: los hábitos alimentarios de los estudiados se asemejan a los patrones dietéticos mediterráneos considerados saludables. Destacar el cumplimiento de las recomendaciones de consumo de aceite de oliva y la realización de actividad física habitual como protectores de las ECV. El entorno laboral de la población estudiada favorece unos hábitos saludables.

Intellectual Disability

MedlinePlus

... discapacidad intelectual puede ser la consecuencia de un problema que comienza antes de que el niño nazca ... causa puede ser una lesión, enfermedad o un problema en el cerebro. En muchos niños no se ...

Postinfectious bronchiolitis obliterans

PubMed

2018-06-01

La bronquiolitis obliterante es una enfermedad pulmonar crónica infrecuente y grave producto de una lesión del tracto respiratorio inferior. En nuestro país, es más frecuente observarla secundaria a una lesión viral grave, en especial, por adenovirus. La bronquiolitis obliterante se caracteriza por la oclusión parcial o total del lumen de los bronquiolos respiratorios y terminales por tejido inflamatorio y fibrosis, que produce la obstrucción crónica de la vía aérea. Este consenso discute el estado actual del conocimiento en las diferentes áreas de la bronquiolitis obliterante secundaria a una lesión infecciosa.

Characterization of multidrug-resistant diabetic foot ulcer enterococci.

PubMed

Semedo-Lemsaddek, Teresa; Mottola, Carla; Alves-Barroco, Cynthia; Cavaco-Silva, Patrícia; Tavares, Luís; Oliveira, Manuela

2016-02-01

Diabetes mellitus is a highly prevalent chronic progressive disease with complications that include diabetic-foot ulcers. Enterococci isolated from diabetic-foot infections were identified, evaluated by macro-restriction analysis, and screened for virulence traits and antimicrobial resistance. All isolates were considered multidrug-resistant, cytolysin and gelatinase producers, and the majority also demonstrated the ability to produce biofilms. These results indicate the importance of enterococci in diabetic-foot infection development and persistence, especially regarding their biofilm-forming ability and resistance to clinically relevant antibiotics. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

A bone tissue engineering strategy based on starch scaffolds and bone marrow cells cultured in a flow perfusion bioreactor

NASA Astrophysics Data System (ADS)

Gomes, Maria Manuela Estima

A Engenharia de Tecidos e uma area cientifica em continua expansao. Os desenvolvimentos conseguidos por esta area tem contribuido significativamente para diversos avancos no campo da Medicina Regenerativa. Esta ciencia interdisciplinar combina os conhecimentos de diversas outras areas, tao distintas como a Engenharia de Materiais e a Biologia, com o objectivo de desenvolver substitutos sinteticos para tecidos humanos. Para se atingir este objectivo utilizam-se, de uma forma generica, combinacoes especificas de celulas e de um material de suporte tridimensional com propriedades adequadas, gerando um material hibrido cujas caracteristicas podem ainda ser moduladas atraves do sistema de cultura usado. A presente tese e centrada no desenvolvimento de estrategias de engenharia de tecido osseo baseadas na cultura in vitro de celulas previamente "semeadas" num suporte tridimensional ("scaffold"). Esta estrategia permite que as celulas adiram ao suporte, proliferem e segreguem matriz extracelular especifica do tecido osseo, ate se obter um substituto artificial funcional com caracteristicas do tecido original, que pode finalmente ser transplantado para tratar o defeito em causa. Para que uma estrategia deste tipo seja bem sucedida, pelo menos tres componentes fundamentais devem ser cuidadosamente estudados: o material de suporte (scaffold), as celulas a usar e o sistema de cultura in vitro. Dai que os principais objectivos desta tese estejam relacionados com estes tres aspectos, nomeadamente: • Desenvolvimento de scaffolds biodegradaveis a partir de polimeros a base de amido de milho que induzam a adesao e proliferacao celular e que apresentem propriedades adequadas, tais como a porosidade e interconectividade entre poros, de forma a proporcionar um ambiente que favoreca o desenvolvimento in vitro de um material hibrido com caracteristicas similares ao osso humano. • Estudo da utilizacao de celulas da medula ossea como uma potencial fonte de celulas para engenharia do tecido osseo, uma vez que estas celulas podem ser facilmente recolhidas do proprio paciente a tratar por metodos nao-invasivos (bioppsia) e em quantidades suficientes. Alem disso, tratando-se de uma fonte de celulas autologas (obtidas do proprio paciente) permitem evitar os riscos de transmissao de doencas contagiosas e/ou de rejeicao pelo sistema imunologico. • Estudo da influencia das condicoes de cultura in vitro geradas por um bioreactor de perfusao (em comparacao com os metodos tradicionais de cultura em condicoes estaticas) no desenvolvimento dos materiais hibridos, compostos pelas celulas e scaffolds, assim como as interaccoes do ambiente proporcionado por este sistema de cultura com as diferentes estruturas/arquitecturas e porosidades dos scaffolds utilizados. Estes objectivos convergem para o objectivo geral desta tese que consistiu no desenvolvimento de uma terapia de engenharia do tecido osseo alternativa as existentes e com potencial para vir a ser posteriormente utilizada na pratica clinica. Este objectivo foi avaliado atraves do estudo da funcionalidade dos materiais hibridos obtidos em diferentes condicoes de cultura in vitro (e utilizando diferentes scaffolds), partindo do principio que o sistema de perfusao poderia eventualmente superar as limitacoes de difusao tipicas dos sistema de cultura estatica e simultaneamente proporcionar estimulos mecânicos as celulas, semelhantes aos encontrados em condicoes fisiologicas. (Abstract shortened by ProQuest.).

Comparison of clinical categories for Escherichia coli harboring specific qnr and chromosomal-mediated fluoroquinolone resistance determinants according to CLSI and EUCAST.

PubMed

Machuca, Jesús; Briales, Alejandra; Díaz-de-Alba, Paula; Martínez-Martínez, Luis; Rodríguez-Martínez, José-Manuel; Pascual, Álvaro

2016-03-01

EUCAST breakpoints are more restrictive than those defined by CLSI. This study highlights the discrepancies between CLSI and EUCAST in a well characterized isogenic Escherichia coli collection and their correlations with specific quinolone resistance mechanisms. The greatest number of discrepancies was observed in strains containing 2-4 resistance mechanisms (MIC values on the borderline of clinical resistance). Bearing in mind that quinolones are concentration dependent antimicrobial agents, small changes in MIC may have relevant consequences for treatment outcomes. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Efeitos do binarismo não resolvido na determinação da função de massa de aglomerados

NASA Astrophysics Data System (ADS)

Kerber, L. O.; Santiago, B. X.

2003-08-01

Através de simulações numéricas buscamos quantificar os efeitos que o binarismo não resolvido causa na determinação da função de massa (MF) de aglomerados estelares. Geramos diagramas cor-magnitude (CMDs) artificiais simulando uma população única, caracterizada por estrelas de mesma idade e composição quí mica, com uma fração de binárias não resolvidas e distribuição em massa das estrelas dada por uma MF do tipo lei de potência. A presença de pares de estrelas não resolvidos faz com que a MF obtida da função de luminosidade (LF) tenha a têndencia de ser mais plana do que a MF que gerou o CMD artificial. Propomos um tratamento de correção para tal efeito. Outro efeito relacionado diz respeito ao alargamento do CMD, que apresenta-se como um indicador do número total de estrelas no domí nio de baixas massas (m < 0.6M¤). Todos os resultados acima possuem uma forte dependência com os erros fotométricos e estão baseados na hipótese de que ambas estrelas do par não resolvido são sorteadas de uma mesma MF de forma independente. O objetivo final é aplicarmos o tratamento aqui desenvolvido para implementarmos a análise da nossa amostra de aglomerados ricos da Grande Nuvem de Magalhães.

Darwin, Hume, Morgan, and the verae causae of psychology.

PubMed

Clatterbuck, Hayley

2016-12-01

Charles Darwin and C. Lloyd Morgan forward two influential principles of cognitive ethological inference that yield conflicting results about the extent of continuity in the cognitive traits of humans and other animals. While these principles have been interpreted as reflecting commitments to different senses of parsimony, in fact, both principles result from the same vera causa inferential strategy, according to which "We ought to admit no more causes of natural things, than such as are both true and sufficient to explain their appearances". Instead, the conflict stems from Darwin's and Morgan's views about the true causes of human psychology. Darwin holds a thoroughly Humean philosophy of the human mind, from which he infers significant continuity between human and animal minds. In contrast, Morgan argues that Humean cognitive mechanisms cannot account for a class of uniquely human behaviors, and therefore, he concludes that there is a significant discontinuity between human and animal cognition. This historical debate is informative for current controversies in comparative psychology. Copyright © 2016 Elsevier Ltd. All rights reserved.

What Causes Hiccups?

MedlinePlus

... Español What Causes Hiccups? KidsHealth / For Kids / What Causes Hiccups? Print en español ¿Cuál es la causa del hipo? "Hic!" You've just hiccuped for what seems like the tenth time since you finished your big dinner. Wonder where these funny noises are coming ...

Honoris Causa

ERIC Educational Resources Information Center

Cronin, Blaise

2002-01-01

A reasonable estimate puts the number of living American holders of honorary degrees at about 150,000. This inflated figure and a general lack of seriousness--Kermit the Frog, for instance, delivered the commencement address at Southampton College in 1996--trouble the author of this article. He suggests that the practice might somehow be adjusted…

La Causa Chicana. The Movement for Justice.

ERIC Educational Resources Information Center

Mangold, Margaret M., Ed.

The intent of this book is to present information about Chicanos to social workers and members of other helping professions so they may become involved in the Mexican Americans' movement to obtain first-class citizenship. Articles reflect the perspectives of persons working in various settings, geographical regions, and disciplines. Some of the…

[Profile of tropical diseases in Portugal].

PubMed

Ventura, F A

1996-01-01

The increased incidence of Imported Tropical Diseases in Portugal is correlated to a recent higher standard of living, influence of media and a consequent expansion of tourism, and above all to the close relationship existing between Portugal and Africa. The number and pathology (parasitic diarrhoeas, protozoal and helminthic infections) of in-patients with Tropical Diseases at the Unidade de Doenças Infecciosas, Parasitárias e de Medicina Tropical (UDIP-MT) were described, with special emphasis on Malaria (155 in-patients during the period from 1989 to 1993) and on Sleeping Sickness, where Eflornitin (DFMO) was for the first time used in Portugal. Finally, the impact of HIV epidemic on incidence and different clinical presentations of parasitic and other tropical pathology was also evaluated.

Presence of quinolone resistance to qnrB1 genes and blaOXA-48 carbapenemase in clinical isolates of Klebsiella pneumoniae in Spain.

PubMed

Rodríguez Martínez, J M; Díaz-de Alba, P; Lopez-Cerero; Ruiz-Carrascoso, G; Gomez-Gil, R; Pascual, A

2014-01-01

A study is presented on the presence of quinolone resistance qnrB1 genes in clinical isolates belonging to the largest series of infections caused by OXA-48-producing Klebsiella pneumoniae in a single-centre outbreak in Spain. Evidence is also provided, according to in vitro results, that there is a possibility of co-transfer of plasmid harbouring blaOXA-48 with an other plasmid harbouring qnrB1 in presence of low antibiotic concentrations of fluoroquinolones, showing the risk of multi-resistance screening. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Extremist Media and the Rise of Terrorism: The Argentine Case.

ERIC Educational Resources Information Center

Day, J. Laurence

In the 20 months that Isabel Peron served as the first female chief of state of a South American country, the mass media in Argentina underwent extreme stress. The Montoneros, a militant leftist organization, called for mass demonstrations against the orthodox Peronist people in their tabloid "La Causa Peronista." The tabloid's…

Pleuroparenchymal fibroelastosis: report of two cases in Brazil.

PubMed

Gomes, Paula Silva; Shiang, Christina; Szarf, Gilberto; Coletta, Ester Nei Aparecida Martins; Pereira, Carlos Alberto de Castro

2017-01-01

Pleuroparenchymal fibroelastosis (PPFE) is a rare lung disease. It can be idiopathic or associated with any one of various conditions. To our knowledge, this is the first report of two cases of PPFE in Brazil. Our first patient presented with pleural and subpleural fibrosis in the upper lobes; a spiculated nodule in the left upper lobe; and a mild reticular pattern in the lower lobes. Surgical lung biopsy revealed PPFE in the upper lobes, including the nodule, and unclassified interstitial pneumonia in the left lower lobe. Our second patient had a history of exposure to domestic birds, indicating a risk of hypersensitivity pneumonitis, and presented with advanced lung disease, predominantly in the upper lobes, together with subpleural fibrosis.That patient underwent lung transplantation. In the explant specimen, PPFE and granulomas were identified, suggesting hypersensitivity pneumonitis as an associated cause. RESUMO A fibroelastose pleuroparenquimatosa (FEPP) é uma doença pulmonar rara, podendo ser idiopática ou associada a diversas condições. Pelo que sabemos, este é o primeiro relato de dois casos de FEPP no Brasil. Nosso primeiro paciente apresentava fibrose pleural e subpleural nos lobos superiores, um nódulo espiculado no lobo superior esquerdo e um padrão reticular discreto nos lobos inferiores. A biópsia pulmonar cirúrgica demonstrou FEPP nos lobos superiores, incluindo no nódulo, e pneumonia intersticial não classificada no lobo inferior esquerdo. Nosso segundo paciente tinha história de exposição a aves domésticas, indicando um risco de pneumonite de hipersensibilidade, e doença pulmonar avançada predominando em lobos superiores, com fibrose subpleural. Esse paciente foi submetido a transplante pulmonar. No espécime do explante, FEPP e granulomas foram identificados, sugerindo pneumonite de hipersensibilidade como causa associada.

PubMed

Müller Velázquez, Lucía; Bobadilla, Fernando; Novosak, Marina; Cortese, Iliana; Laczeski, Margarita

2018-03-20

Streptococcus agalactiae (SGB) es causa de infecciones severas en menores de tres meses. Meningitis, neumonía y sepsis son los principales cuadros en estos niños. Estas infecciones se encuentran entre las más graves que puede sufrir un individuo en sus primeras doce horas de vida. El niño adquiere la infección por transmisión vertical de la madre colonizada. Para prevenir la enfermedad neonatal se recomienda penicilina como droga de elección en la profilaxis intraparto (PIP) en embarazadas colonizadas. Sin embargo, actualmente se han detectado cepas con sensibilidad disminuida a penicilina por lo que resulta importante realizar la vigilancia de la sensibilidad al mismo para asegurar su utilidad durante la profilaxis. El objetivo de este trabajo fue determinar la sensibilidad a penicilina en cepas de SGB recuperados de mujeres embarazadas de 35-37 semanas de gestación. Se estudiaron 96 aislamientos y se determinó la sensibilidad por método epsilométrico Etest® (LIOFILCHEM, Italia), siguiendo las recomendaciones del Clinical Laboratory Standards Institute (CLSI). Se obtuvo la Concentración Inhibitoria Mínima (CIM) para cada aislamiento bacteriano. El 100% (96) de las cepas estudiadas fue sensible a penicilina con valores de CIM comprendidos entre 0,012 y 0,094 µg mL-1. Estos resultados indican que penicilina sigue siendo el antimicrobiano de elección durante la profilaxis intraparto, para la prevención de la enfermedad neonatal causada por SGB en nuestra región. Se destaca la importancia de la vigilancia epidemiológica de la sensibilidad a penicilina y a otros antimicrobianos para alertar sobre nuevos mecanismos de resistencia y adecuar estrategias de tratamiento.

[Monitoring respiratory syncytial virus through the Spanish influenza surveillance system, 2006-2014].

PubMed

Jiménez-Jorge, Silvia; Delgado-Sanz, Concepción; de Mateo, Salvador; Pozo, Francisco; Casas, Inmaculada; Larrauri, Amparo

2016-02-01

The aim of the study is to analyze the information on respiratory syncytial virus (RSV) obtained through the Spanish Influenza Surveillance System (SISS) and to study its usefulness as supplementary information for the characterization of influenza epidemics. The temporal patterns of both RSV and influenza viruses were analyzed by patterns comparing the weekly viral detection rates from 2006 to 2014. In general, the RSV circulation was characterized by showing a peak between 52-1 weeks, and circulated from 2 to 8 weeks before/prior to influenza viruses. RSV information obtained from the SISS is useful for the characterization of influenza epidemics in Spain. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Microbiological diagnosis of HIV infection].

PubMed

López-Bernaldo de Quirós, Juan Carlos; Delgado, Rafael; García, Federico; Eiros, José M; Ortiz de Lejarazu, Raúl

2007-12-01

Currently, there are around 150,000 HIV-infected patients in Spain. This number, together with the fact that this disease is now a chronic condition since the introduction of antiretroviral therapy, has generated an increasing demand on the clinical microbiology laboratories in our hospitals. This increase has occurred not only in the diagnosis and treatment of opportunistic diseases, but also in tests related to the diagnosis and therapeutic management of HIV infection. To meet this demand, the Sociedad de Enfermedades Infecciosas y Microbiología Clinica (Spanish Society of Infectious Diseases and Clinical Microbiology) has updated its standard Procedure for the microbiological diagnosis of HIV infection. The main advances related to serological diagnosis, plasma viral load, and detection of resistance to antiretroviral drugs are reviewed in this version of the Procedure.

Urinary tract infection in kidney transplant recipients.

PubMed

Chacón-Mora, Natalia; Pachón Díaz, Jerónimo; Cordero Matía, Elisa

2017-04-01

Infectious complications remain a major cause of morbidity and mortality among transplant recipients. Urinary tract infection (UTI) is the most common infectious complication in kidney transplant recipients with a reported incidence from 25% to 75%, varies widely likely due to differences in definition, diagnostic criteria, study design, and length of observation. We sought reviews the incidence and importance of urinary tract infection on graft survival, the microbiology with special emphasis on multidrug resistant microorganisms, the therapeutic management of UTI and the prophylaxis of recurrent UTI among solid organ transplant recipients, highlighting the need for prospective clinical trials to unify the clinical management in this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Geohelminths].

PubMed

Prieto-Pérez, Laura; Pérez-Tanoira, Ramón; Cabello-Úbeda, Alfonso; Petkova-Saiz, Elizabet; Górgolas-Hernández-Mora, Miguel

2016-01-01

Millions of people in in rural areas and deprived tropical and subtropical regions are infected by soil-transmitted helminths: Ascaris lumbricoides, Trichuris trichiura, hookworms (Ancylostoma duodenale and Necator americanus), and Strongyloides stercoralis. Large migratory flows have made their worldwide distribution easier. Besides being debilitating and producing a significant mortality, they cause high morbidity, leading to physical and intellectual impairment in millions of children who live in poverty. Along with the use of benzimidazoles (albendazole and mebendazole), large-scale international campaigns for treatment and prevention have decreased the number of affected individuals. However, re-infestations and benzimidazole-resistance are frequent, so there needs to be awareness about the importance and consequences of these neglected parasites. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Rapid diagnosis of sexually transmitted infections.

PubMed

Otero-Guerra, Luis; Fernández-Blázquez, Ana; Vazquez, Fernando

Sexually transmitted infections (STIs) are responsible for an enormous burden of morbidity and mortality. Worldwide, millions of cases of STIs, such as syphilis, chlamydia, or gonorrhoea occur every year, and there is now an increase in antimicrobial resistance in pathogens, such as gonococcus. Delay in diagnosis is one of the factors that justifies the difficulty in controlling these infections. Rapid diagnostic tests allow the introduction of aetiological treatment at the first visit, and also leads to treating symptomatic and asymptomatic patients more effectively, as well as to interrupt the epidemiological transmission chain without delay. The World Health Organisation includes these tests in its global strategy against STIs. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Microbiological diagnosis of bacterial infection associated with delivery and postpartum].

PubMed

Padilla-Ortega, Belén; Delgado-Palacio, Susana; García-Garrote, Fernando; Rodríguez-Gómez, Juan Miguel; Romero-Hernández, Beatriz

2016-05-01

The newborn may acquire infections during delivery due to maternal colonization of the birth canal, by microorganisms such as Streptococcus agalactiae that caused early neonatal infection, or acquisition through the placenta, amniotic fluid or birth products. After birth, the newborn that needs hospitalization can develop nosocomial infections during their care and exceptionally through lactation by infectious mastitis or incorrect handling of human milk, which does not require to stop breastfeeding in most cases. It is important and necessary to perform microbiological diagnosis for the correct treatment of perinatal infections, especially relevant in preterm infants with low or very low weight with high mortality rates. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Infection due to Rothia mucilaginosa. A respiratory pathogen?].

PubMed

Ramos, José M; Mateo, Ignacio; Vidal, Inmaculada; Rosillo, Eva M; Merino, Esperanza; Portilla, Joaquín

2014-05-01

To describe the spectrum of infections caused by Rothia mucilaginosa. Retrospective study of 20 cases diagnosed with R. mucilaginosa from 2009 to 2012. Pulmonary infection was the most frequent clinical presentation (n=14, 70%): bronchiectasis infected (10), followed by pleural empyema (2), pneumonia (1) and acute bronchitis (1). Two episodes were of gastrointestinal origin: cholangitis secondary to biliary drainage and secondary peritonitis. Two episodes included bacteremia in patients with hematological malignancy. One patient had a surgical wound infection with bacteremia, and another had a bacteremic urinary tract infection in a patient with nephrostomy. R. mucilaginosa may be responsible for infections of the lower respiratory tract in predisposed patients. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Measles, mumps, and rubella vaccine. Resurgence of measles in Europe].

PubMed

Garcés-Sánchez, María; Renales-Toboso, María; Bóveda-García, María; Díez-Domingo, Javier

2015-12-01

Measles is a rash illness of moderate severity and high risk of serious complications, with recovery in several weeks. It is a viral disease caused by one of the most infectious and contagious pathogens that exists, whose only known reservoir is human. In 1998, the European Region of the WHO set a target of eliminating measles by 2010. This goal has not been achieved. Furthermore, it has been observed the resurgence of the disease in some parts of Europe. We review the disease and its vaccines as well as the epidemiological and social factors that have so far prevented the total control of the disease. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Risk factors for antimicrobial-resistant Neisseria gonorrhoeae and characteristics of patients infected with gonorrhea.

PubMed

Fuertes de Vega, Irene; Baliu-Piqué, Carola; Bosch Mestres, Jordi; Vergara Gómez, Andrea; Vallés, Xavier; Alsina Gibert, Mercè

2018-03-01

There are very few data available regarding risk factors associated with antibiotic resistant-Neisseria gonorrhoeae. A study was conducted on 110 samples from 101 patients with gonococcal infection, in order to describe their characteristics and compare them with the antimicrobial susceptibility profile of their samples. An association was observed between resistant infections and heterosexual men, older age, concurrent sexually transmitted infection, and unsafe sexual behaviors. There is a need for improved data on the risk factors associated with antibiotic resistant gonococcal infection in order to identify risk groups, and to propose public health strategies to control this infection. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Death of Napoleon Bonaparte].

PubMed

Camici, M

2003-06-01

The causa mortis of Napoleon Bonaparte has been vexata quaestio for a long time. The author tries to outline a picture of Napoleon from a sanitary point of view. From the report of doctor Francesco Antonmarchi who performed the autopsy, the author tries to understans the cause of death: gastric perforation due to malignant ulcer and subsequent peritonitis with pulmonary tubercolosis.

Cesar Chavez and La Causa: Books for Children and Teenagers.

ERIC Educational Resources Information Center

Garza de Cortes, Oralia

1995-01-01

Evaluates biographies of Cesar Chavez for children and teenagers and provides descriptions of recent books on the children of migrant farm workers. The books, mostly published in the 1990s, cover Chavez's rise as a farm worker activist and include several new works that address the social history of Chavez and the farm workers' struggle. (GR)

El Plan de Santa Barbara; A Chicano Plan for Higher Education.

ERIC Educational Resources Information Center

Chicano Coordinating Council on Higher Education, Santa Barbara, CA.

Published by La Causa Publications, the document is a Chicano plan for higher education in the universities and colleges in California. The manifesto found in the booklet states that "the self-determination of our community is now the only acceptable mandate for social and political action; it is the essence of Chicano commitment....Chicanos…

Revista de Saúde Pública in scientific publications on Violence and Health (1967-2015).

PubMed

Schraiber, Lilia Blima; Barros, Claudia; d'Oliveira, Ana Flávia Pires Lucas; Peres, Maria Fernanda Tourinho

2016-11-10

This article retrieved the publications from the Revista de Saúde Pública journal (from 1967 to 2015) on violence and health, on the SciELO and PubMed bases, by searching for the terms "violence", "suicide", "aggression", "bullying", and "external causes", registered in any part of the text. We found 130 articles (the first one published in 1974). We observed: increase of publications over time, with decrease in the last five years; similar production volume in lethal and non-lethal violence; later publication of the latter; few studies in qualitative research; mostly descriptive production; and visualization of the problem more by the acts than by contexts or motivations and aggressors. Social markers were little approached, appearing, from largest to smallest frequency, social class, gender, race/ethnicity, and generation. Human rights were little used and only recently used as analytical framework, connected more to gender than to social class. Although Revista de Saúde Pública has registered the theme in its publications, consolidating it as scientific production line, there is still great explanatory theoretical rarefaction and little intersectionality between violence, social inequalities, and human rights. RESUMO A produção da Revista de Saúde Pública (de 1967 até 2015) sobre violência e saúde foi recuperada nas bases SciELO e PubMed utilizando-se os termos "violência", "suicídio", "agressões", "bullying" e "causas externas", registrados em qualquer parte do texto. Foram encontrados 130 artigos (o primeiro deles publicado em 1974). Constatou-se: aumento das publicações no tempo, com decréscimo nos últimos cinco anos; volume similar de produção em violência letal e não letal; publicação mais tardia desta última; poucos estudos em pesquisa qualitativa; produção majoritariamente descritiva; e visibilização do problema, mais pelos atos que pelos contextos ou motivações e agressores. Os marcadores sociais foram pouco tematizados, aparecendo da maior para a menor frequência, classe social, gênero, raça/etnia e geração. Direitos humanos foi pouco, e apenas recentemente, usado como referencial analítico, conectado mais ao gênero do que à classe social. Embora a Revista de Saúde Pública tenha inscrito o tema em suas publicações, consolidando-o como linha de produção científica, há, ainda, grande rarefação teórica explicativa e pouca interseccionalidade entre violência, desigualdades sociais e direitos humanos.

Evolution of three tandem copies of the interleukin-1 receptor-like 1 gene in salmonid fish and their contribution to rainbow trout bacterial cold water disease resistant phenotype

USDA-ARS?s Scientific Manuscript database

Rainbow trout exhibit extensive phenotypic variation in innate disease resistance. Five generations of family based selection has resulted in rainbow trout lines with either increased or reduced survival following exposure to the gram-negative bacterium, Flavobacterium psychrophilum (Fp), the causa...

3 CFR 8953 - Proclamation 8953 of March 29, 2013. Cesar Chavez Day, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

..., Cesar Chavez knew hard work and hardship from an early age. He labored long hours for little pay, taking... rallied a generation of workers around “La Causa,” marching and fasting and boycotting for fair pay and... attention to his cause, he received a telegram from Dr. Martin Luther King, Jr. “As brothers in the fight...

Response to Johannsen, Rump, and Linder's Penetrating a wall of introspection: a critical attrition analysis

NASA Astrophysics Data System (ADS)

Rushton, Gregory T.; Criswell, Brett A.

2013-03-01

In Penetrating a Wall of Introspection: A Critical Attrition Analysis, Johannsen, Rump, and Linder strive to give a voice to those whose thoughts might otherwise be unheard: students representing the casualties in the conflict surrounding the practices of STEM education, specifically those in the field of physics. Beyond giving those students a voice, they try to filter out and amplify a message that the seven individuals themselves may not have recognized: that the cause of their struggles in their physics programs might not be something innate ( causa materialis in the authors' framework), but might be found outside the individuals ( causa efficiens in the authors' framework). In our response, we attempt to extend the conversation regarding the issues these authors have raised by (1) considering the conditions within the physics community that might exacerbate this situation and (2) exploring from a different perspective the nature of the discourses that will either perpetuate or ameliorate such circumstances. In so doing we seek to provide a more holistic description of the features of the educational system that help to construct the wall of introspection and that might, in turn, be redressed in order to help tear it down—and positively impact attrition rates.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2011].

PubMed

Ruiz de Gopegui Bordes, Enrique; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

2013-02-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2011 controls. Overall, the results obtained in 2011 confirm the excellent skill and good technical standards found in previous years. Nevertheless, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls, such as those offered by the SEIMC program, in order to ensure maximal quality of microbiological tests. Copyright © 2013 Elsevier España, S.L. All rights reserved.

[Emerging viral infections and hepatotropic virus].

PubMed

Arsuaga, Marta; de la Calle-Prieto, Fernando; Negredo Antón, Ana; Vázquez González, Ana

2016-10-01

Environmental degradation, population movements and urban agglomerations have broken down the borders for infectious diseases. The expansion of microorganisms has entered an increasing area of transmission vectors. The lack of immunity of the population leads to an increased risk of spreading infectious diseases. Furthermore, the decline in vaccination rates in developed countries and socio-economic difficulties in large regions has meant that diseases in the process of eradication have re-emerged. That is why health care workers must be trained to avoid delaying in diagnosis and to accelerate the implementation of public health measures. A great deal of education and health prevention should fall under the responsibilities of travellers who move around different regions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia.

PubMed

Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

2014-11-01

Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.Fundamento: Estudos têm demonstrado a acurácia diagnóstica e o valor prognóstico da ecocardiografia com estresse físico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela ecocardiografia com estresse físico em pacientes com teste ergométrico positivo para isquemia miocárdica. Métodos: Trata-se de uma coorte retrospectiva em que foram estudados 866 pacientes consecutivos, com teste ergométrico positivo para isquemia miocárdica, submetidos à ecocardiografia com estresse físico. Os pacientes foram divididos em dois grupos: ecocardiografia com estresse físico negativa (G1) ou positiva (G2) para isquemia miocárdica. Os desfechos avaliados foram mortalidade por qualquer causa e eventos cardíacos maiores, definidos como óbito cardíaco e infarto agudo do miocárdio não fatal. Resultados: O G2 constituiu-se de 205 (23,7%) pacientes. Durante o seguimento médio de 85,6 ± 15,0 meses, ocorreram 26 óbitos, sendo seis por causa cardíaca, e 25 casos de infarto agudo do miocárdio não fatais. Os preditores independentes de mortalidade foram idade, diabetes melito e a ecocardiografia com estresse físico + (hazard ratio: 2,69; intervalo de confiança de 95%: 1,20 - 6,01; p = 0,016), com os seguintes eventos cardíacos maiores: idade, doença arterial coronária prévia, ecocardiografia com estresse físico + (hazard ratio: 2,75; intervalo de confiança de 95%: 1,15 - 6,53; p = 0,022) e ausência do incremento de 10% na fração de ejeção. A mortalidade por qualquer causa e os eventos cardíacos maiores foram significativamente superiores no G2 (p < 0, 001 e p = 0,001, respectivamente). Conclusão: A ecocardiografia com estresse físico oferece informações prognósticas adicionais em pacientes com teste ergométrico positivo para isquemia miocárdica.

Evaluating bronchodilator response in pediatric patients with post-infectious bronchiolitis obliterans: use of different criteria for identifying airway reversibility.

PubMed

Mattiello, Rita; Vidal, Paula Cristina; Sarria, Edgar Enrique; Pitrez, Paulo Márcio; Stein, Renato Tetelbom; Mocelin, Helena Teresinha; Fischer, Gilberto Bueno; Jones, Marcus Herbert; Pinto, Leonardo Araújo

2016-01-01

Post-infectious bronchiolitis obliterans (PIBO) is a clinical entity that has been classified as constrictive, fixed obstruction of the lumen by fibrotic tissue. However, recent studies using impulse oscillometry have reported bronchodilator responses in PIBO patients. The objective of this study was to evaluate bronchodilator responses in pediatric PIBO patients, comparing different criteria to define the response. We evaluated pediatric patients diagnosed with PIBO and treated at one of two pediatric pulmonology outpatient clinics in the city of Porto Alegre, Brazil. Spirometric parameters were measured in accordance with international recommendations. We included a total of 72 pediatric PIBO patients. The mean pre- and post-bronchodilator values were clearly lower than the reference values for all parameters, especially FEF25-75%. There were post-bronchodilator improvements. When measured as mean percent increases, FEV1 and FEF25-75%, improved by 11% and 20%, respectively. However, when the absolute values were calculated, the mean FEV1 and FEF25-75% both increased by only 0.1 L. We found that age at viral aggression, a family history of asthma, and allergy had no significant effects on bronchodilator responses. Pediatric patients with PIBO have peripheral airway obstruction that is responsive to treatment but is not completely reversible with a bronchodilator. The concept of PIBO as fixed, irreversible obstruction does not seem to apply to this population. Our data suggest that airway obstruction is variable in PIBO patients, a finding that could have major clinical implications. A bronquiolite obliterante pós-infecciosa (BOPI) é uma entidade clínica que tem sido classificada como obstrução fixa e constritiva do lúmen por tecido fibrótico. Entretanto, estudos recentes utilizando oscilometria de impulso relataram resposta ao broncodilatador em pacientes com BOPI. O objetivo deste estudo foi avaliar a resposta broncodilatadora em pacientes pediátricos com BOPI, comparando critérios diferentes para a definição da resposta. Foram avaliados pacientes pediátricos com diagnóstico de BOPI tratados em um de dois ambulatórios de pneumologia pediátrica na cidade de Porto Alegre (RS). Parâmetros espirométricos foram medidos de acordo com recomendações internacionais. Foram incluídos 72 pacientes pediátricos com BOPI no estudo. As médias dos valores pré- e pós-broncodilatador foram claramente inferiores aos valores de referência para todos os parâmetros, especialmente FEF25-75%. Houve uma melhora pós-broncodilatador. Quando medidos como aumentos percentuais médios, VEF1 e FEF25-75% melhoraram em 11% e 20%, respectivamente. Entretanto, quando os valores absolutos foram calculados, as médias de VEF1 e FEF25-75% aumentaram somente em 0,1 l. Verificamos que a idade da agressão viral, história familiar de asma e alergia não tiveram efeitos significativos na resposta ao broncodilatador. Pacientes pediátricos com BOPI têm uma obstrução das vias aéreas periféricas que responde ao tratamento, mas não uma reversão completa com o broncodilatador. O conceito de BOPI como obstrução fixa e irreversível parece não se aplicar a essa população. Nossos dados sugerem que a obstrução de vias aéreas em pacientes com BOPI é variável, e esse achado pode ter importantes implicações clínicas.

"Compromising "La Causa"?": The Ford Foundation and Chicano Intellectual Nationalism in the Creation of Chicano History, 1963-1977

ERIC Educational Resources Information Center

MacDonald, Victoria-Maria; Hoffman, Benjamin Polk

2012-01-01

In the early 1970s the first large cohorts of Chicano PhD scholars entered academia, often hired into faculty positions at newly created Chicano departments or centers. The academic identities of the first Chicano PhD scholars were firmly grounded in "Chicanismo," a term which emphasizes ethnic nationalism, political and economic equity, and…

Teaching as a Healing Craft: Decolonizing the Classroom and Creating Spaces of Hopeful Resistance through Chicano-Indigenous Pedagogical Praxis

ERIC Educational Resources Information Center

Villanueva, Silvia Toscano

2013-01-01

This paper builds upon the edict for self-determination in El Plan de Santa Barbara: a Chicano plan for higher education (1969), which calls for "strategic use of education," by placing value on needs of the community (La Causa, p. 9). For me, this passage translates into valuing needs of community-college students entering my classes…

Curvas de fusión de regiones genómicas específicas: una herramienta prometedora para el diagnóstico y tipificación de las especies causantes de la leishmaniasis cutánea en Colombia.

PubMed

Marin, Johana; Urrea, Daniel; Muskus, Carlos; Echeverry, María Clara; Mejía, Ana María; Triana, Omar

2017-12-01

Introducción. La leishmaniasis cutánea es una enfermedad causada por parásitos del género Leishmania que tiene gran incidencia en Colombia. El diagnóstico y la identificación de la especie infecciosa son factores críticos en el momento de escoger e iniciar el tratamiento. Actualmente, los métodos de diagnóstico y tipificación requieren procedimientos complejos, por lo que es necesario validar nuevos marcadores moleculares y métodos que simplifiquen el proceso.Objetivo. Desarrollar una herramienta basada en la reacción en cadena de la polimerasa (PCR) con curvas de fusión (High Resolution Melting; PCR-HRM) para el diagnóstico y tipificación de las tres especies de Leishmania de importancia epidemiológica en casos de leishmaniasis cutánea en Colombia.Materiales y métodos. Los genomas de Leishmania panamensis, L. braziliensis y L. guyanensis se compararon mediante métodos bioinformáticos. Las regiones específicas de especie identificadas se validaron mediante PCR. Para los marcadores seleccionados se diseñó una PCR-HRM y se estimaron algunos parámetros de validez y seguridad usando aislamientos de pacientes colombianos caracterizados previamente mediante PCR y análisis de polimorfismos en la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism - RFLP; PCR-RFLP) del gen hsp70.Resultados. El análisis genómico comparativo mostró 24 regiones específicas de especie. Sin embargo, la validación mediante PCR solo identificó un marcador específico para cada especie de Leishmania. Los otros marcadores mostraron amplificación cruzada. El límite de detección para los tres marcadores seleccionados fue de un parásito, mientras que la sensibilidad, la especificidad, el valor predictivo positivo y el negativo fueron de 91,4, 100, 100 y 75 %, respectivamente.Conclusiones. Las tres regiones seleccionadas pueden emplearse como marcadores moleculares en el diagnóstico y tipificación de las especies causantes de la leishmaniasis cutánea en Colombia.

Honduran-U.S. Relations

DTIC Science & Technology

2009-06-08

and congressional approval of 3 “Un 57 Pct de Hondureños Aprueba Gestión Presidente ...DR), by J. F. Hornbeck; and CRS Report R40135, Mérida Initiative for Mexico and Central America: Funding and Policy Issues, by Clare Ribando Seelke...elections loom,” Latin American Economy & Business, May 2009. 17 “Desempleo aumentará a causa de crisis económica,” La Prensa (Honduras), May 22, 2009. 18

PubMed

Wanden-Berghe Lozano, Carmina; Campos Martín, Cristina; Cuerda Compes, Cristina; Gómez Candela, Carmen; Burgos Peláez, Rosa; Moreno Villares, José Manuel; Pereira Cunill, José Luis; Pérez de la Cruz, Antonio; Virgili Casas, Nuria; Martinez Faedo, Ceferino; Álvarez Hernández, Julia; Garde Orbaiz, Carmen; Penacho Lázaro, Mª Ángeles; Sánchez Martos, Eva Ángeles; Sanz Paris, Alejandro; Gonzalo Marín, Montserrat; Zugasti Murillo, Ana; Matía Martín, Pilar; Martín Folgueras, Tomás; Carabaña Pérez, Fátima; Díaz Guardiola, Patricia; Tejera Pérez, Cristina; De Luis Román, Daniel; Luengo Pérez, Luis Miguel; Santacruz Carmona, Nieves; Apezetxea Celaya, Antxón; Ponce González, Miguel Ángel; Urgeles Planella, Juan Ramón; Laborda González, Lucía; Martinez Olmos, Miguel Ángel; Sánchez-Vilar Burdiel, Olga; Joaquín Ortiz, Clara; Martínez Costa, Cecilia; Suárez Llanos, José Pablo; Calleja Fernández, Alicia; Leyes García, Pere; Gil Martinez, Mª Carmen; Mauri Roca, Silvia; García Zafra, Maria Victoria; Carrera Santaliestra, María José; Nadya-Senpe, Grupo

2016-11-29

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE del años 2015.Material y métodos: Recopilación de los datos de NPD del registro "on-line" del grupo de Nutrición Artificial Domiciliaria y Ambulatoria (NADYA) desde el 1 de enero de 2015 al 31 de diciembre de 2015.Resultados: Se registraron 236 pacientes, con 243 episodios de NPD procedentes de 40 hospitales. Lo que representa una tasa de 5,08 pacientes/millón de habitantes/ año 2015. La patología más frecuente en los adultos fue "otros" (26,3%) seguido por "oncológico paliativo" (21,6%).  La complicación más frecuente fue la séptica relacionada con el catéter que presentó una tasa de 0,53 infecciones/1000 días de NPD. Finalizaron 64 episodios, la principal causa fue el fallecimiento (43,7%) y el 'paso a la vía oral' (32,8%).Conclusiones: constatamos el aumento de los centros y profesionales colaboradores, dando respuesta a la cantidad progresivamente mayor de pacientes con soporte nutricional parenteral en domicilio. Se mantienen estables las principales indicaciones para el establecimiento de NPD y las causas de finalización del tratamiento.

[Osteoarticular pneumococcal infections observed in a tertiary hospital over a period of 11 years].

PubMed

Fernández-García, Magdalena; Casado-Díez, Amaia; Salas-Venero, Carlos Antonio; Hernández-Hernández, José Luis

2015-04-01

Osteoarticular pneumococcal infection is an infrequent complication of pneumococcal bacteremia, due to the advances in antibiotic therapy and in the pattern of immunization. A retrospective study was conducted on patients diagnosed with osteoarticular pneumococcal infection between January 2003 and December 2013 in the University Hospital Marqués de Valdecilla in Santander. Five out of 321 patients diagnosed with pneumococcal bacteremia had osteoarticular infection. All of them had at least one chronic underlying disease and had been immunized according to the standard vaccination schedule. Hip and vertebra were the most common joints involved. Outcome was favorable in all cases. The clinical findings of pneumococcal osteoarticular infection should be borne in mind. Its optimal prevention in high-risk patients should include the 13V conjugate vaccine. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Diagnosis and therapeutic approach of latent tuberculosis infection.

PubMed

Domínguez, José; Latorre, Irene; Santin, Miguel

2018-05-01

Detection and treatment of latent tuberculosis infection (LTBI) is an essential measure for tuberculosis (TB) control in low-incidence countries. However, such strategy is limited by the low predictive ability of the diagnostic tests for the development of active TB among infected people and the long-term and toxic treatment regimens. The in vitro interferon-gamma release assays are more specific and sensitive than the tuberculin skin test (TST), and enable a better selection of cases requiring treatment. Nonetheless, their capacity to predict development of TB is still poor. In addition, treatment regimens for LTBI are long, and compliance rates are low. This review discusses the use of the available diagnostic tests and the new approaches to the diagnosis of LTBI, as well as its management in different clinical scenarios. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Microbiota and Human Health: characterization techniques and transference.

PubMed

Del Campo-Moreno, Rosa; Alarcón-Cavero, Teresa; D'Auria, Giuseppe; Delgado-Palacio, Susana; Ferrer-Martínez, Manuel

2018-04-01

The human microbiota comprises all the microorganisms of our body, which can also be categorised as commensals, mutualists and pathogens according to their behaviour. Our knowledge of the human microbiota has considerably increased since the introduction of 16S rRNA next generation sequencing (16S rDNA gene). This technological breakthrough has seen a revolution in the knowledge of the microbiota composition and its implications in human health. This article details the different human bacterial ecosystems and the scientific evidence of their involvement in different diseases. The faecal microbiota transplant procedure, particularly used to treat recurrent diarrhoea caused by Clostridium difficile, and the methodological bases of the new molecular techniques used to characterise microbiota are also described. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Expression of gamma interferon during HPV and Chlamydia trachomatis infection in cervical samples].

PubMed

Colín-Ferreyra, María Del Carmen; Mendieta-Zerón, Hugo; Romero-Figueroa, María Del Socorro; Martínez-Madrigal, Migdania; Martínez-Pérez, Sergio; Domínguez-García, María Victoria

2015-02-01

The aim of this study was to mesure the expression of gamma interferon in HPV and Chlamydia trachomatis infection in squamous intraepithelial lesions. Samples from 100 patients diagnosed by colposcopy with or without squamous intraepithelial lesions were used in the present study. Each patient was found to be infected by HPV and C.trachomatis. Relative gamma interferon mRNA expression was assessed using a real-time reverse transcriptase PCR assay (RT-PCR). The relative units of expression of gamma interferon mRNA were 13, 1.8 and 0.3, for HPV and C.trachomatis co-infection, or HPV or C.trachomatis infection, respectively. HPV and C.trachomatis could overstimulate the expression of gamma interferon. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Methods for determining the antimicrobial susceptibility of mycobacteria.

PubMed

Alcaide, Fernando; Esteban, Jaime; González-Martin, Julià; Palacios, Juan-José

2017-10-01

Mycobacteria are a large group of microorganisms, multiple species of which are major causes of morbidity and mortality, such as tuberculosis and leprosy. At present, the emergence and spread of multidrug-resistant strains of Mycobacterium tuberculosis complex are one of the most serious health problems worldwide. Furthermore, in contrast to M. tuberculosis and Mycobacterium leprae, non-tuberculous mycobacteria (NTM) are more frequently isolated and, in many cases, treatment is based on drug susceptibility testing. This article is a review of the different methods to determine the in vitro drug susceptibility of M. tuberculosis complex and the most relevant NTM isolates. The molecular techniques currently used for rapid detection of resistance of clinical specimens are also analysed. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Microbiological diagnosis of human immunodeficiency virus infection].

PubMed

Álvarez Estévez, Marta; Reina González, Gabriel; Aguilera Guirao, Antonio; Rodríguez Martín, Carmen; García García, Federico

2015-10-01

This document attempts to update the main tasks and roles of the Clinical Microbiology laboratory in HIV diagnosis and monitoring. The document is divided into three parts. The first deals with HIV diagnosis and how serological testing has changed in the last few years, aiming to improve diagnosis and to minimize missed opportunities for diagnosis. Technological improvements for HIV Viral Load are shown in the second part of the document, which also includes a detailed description of the clinical significance of low-level and very low-level viremia. Finally, the third part of the document deals with resistance to antiretroviral drugs, incorporating clinical indications for integrase and tropism testing, as well as the latest knowledge on minority variants. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Consensus statement on the clinical management of non-AIDS defining malignancies. GeSIDA expert panel].

PubMed

Santos, Jesús; Valencia, Eulalia

2014-10-01

This consensus document has been prepared by a panel of experts appointed by GeSIDA. This paper reviews the recommendations on the most important non-AIDS defining malignancies that can affect patients living with AIDS. Lung cancer, hepatocellular carcinoma, anal carcinoma and other less frequent malignancies such as breast, prostate, vagina or colon cancers are reviewed. The aim of the recommendations is to make clinicians who attend to this patients aware of how to prevent, diagnose and treat this diseases. The recommendations for the use of antiretroviral therapy when the patient develops a malignancy are also presented. In support of the recommendations we have used the modified criteria of the Infectious Diseases Society of America. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Safety in the Microbiology laboratory].

PubMed

Rojo-Molinero, Estrella; Alados, Juan Carlos; de la Pedrosa, Elia Gómez G; Leiva, José; Pérez, José L

2015-01-01

The normal activity in the laboratory of microbiology poses different risks - mainly biological - that can affect the health of their workers, visitors and the community. Routine health examinations (surveillance and prevention), individual awareness of self-protection, hazard identification and risk assessment of laboratory procedures, the adoption of appropriate containment measures, and the use of conscientious microbiological techniques allow laboratory to be a safe place, as records of laboratory-acquired infections and accidents show. Training and information are the cornerstones for designing a comprehensive safety plan for the laboratory. In this article, the basic concepts and the theoretical background on laboratory safety are reviewed, including the main legal regulations. Moreover, practical guidelines are presented for each laboratory to design its own safety plan according its own particular characteristics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Microbiological methods for surveillance of carrier status of multiresistant bacteria.

PubMed

Oteo, Jesús; Bou, Germán; Chaves, Fernando; Oliver, Antonio

2017-12-01

The presence of colonised patients is one of the main routes for the spread of multiresistant bacteria, and its containment is a clinical and public health priority. Surveillance studies are essential for early detection of colonisation by these bacteria. This article discusses the different microbiological methods, both based on culturing and molecular methods, for detection of carriers of multiresistant bacteria. Those species with a high clinical/epidemiological impact or generating therapeutic difficulties are included: Methicillin-resistant Staphylococcus aureus, Enterococcus spp. resistant to glycopeptides, enterobacteriaceae producing extended spectrum β-lactamases and plasmid-mediated AmpC, carbapenemases producing enterobacteriaceae, Acinetobacter baumannii and multiresistant Pseudomonas aeruginosa. The information in this document should be considered as a structure matrix to be tailored to the specific needs of each centre. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Molecular methods for septicemia diagnosis.

PubMed

Marco, Francesc

2017-11-01

Septicemia remains a major cause of hospital mortality. Blood culture remains the best approach to identify the etiological microorganisms when a bloodstream infection is suspected but it takes long time because it relies on bacterial or fungal growth. The introduction in clinical microbiology laboratories of the matrix-assisted laser desorption ionization time-of-flight mass spectrometry technology, DNA hybridization, microarrays or rapid PCR-based test significantly reduce the time to results. Tests for direct detection in whole blood samples are highly desirable because of their potential to identify bloodstream pathogens without waiting for blood cultures to become positive. Nonetheless, limitations of current molecular diagnostic methods are substantial. This article reviews these new molecular approaches (LightCycler SeptiFast, Magicplex sepsis real time, Septitest, VYOO, PCR/ESI-MS analysis, T2Candida). Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary: Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.

PubMed

Iribarren, José Antonio; Rubio, Rafael; Aguirrebengoa, Koldo; Arribas, Jose Ramón; Baraia-Etxaburu, Josu; Gutiérrez, Félix; Lopez Bernaldo de Quirós, Juan Carlos; Losa, Juan Emilio; Miró, José Ma; Moreno, Santiago; Pérez Molina, José; Podzamczer, Daniel; Pulido, Federico; Riera, Melchor; Rivero, Antonio; Sanz Moreno, José; Amador, Concha; Antela, Antonio; Arazo, Piedad; Arrizabalaga, Julio; Bachiller, Pablo; Barros, Carlos; Berenguer, Juan; Caylá, Joan; Domingo, Pere; Estrada, Vicente; Knobel, Hernando; Locutura, Jaime; López Aldeguer, José; Llibre, Josep Ma; Lozano, Fernando; Mallolas, Josep; Malmierca, Eduardo; Miralles, Celia; Miralles, Pilar; Muñoz, Agustín; Ocampo, Agustín; Olalla, Julián; Pérez, Inés; Pérez Elías, Ma Jesús; Pérez Arellano, José Luis; Portilla, Joaquín; Ribera, Esteban; Rodríguez, Francisco; Santín, Miguel; Sanz Sanz, Jesús; Téllez, Ma Jesús; Torralba, Miguel; Valencia, Eulalia; Von Wichmann, Miguel Angel

2016-10-01

Opportunistic infections continue to be a cause of morbidity and mortality in HIV-infected patients. They often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an opportunistic infection. The present article is an executive summary of the document that updates the previous recommendations on the prevention and treatment of opportunistic infections in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. The article also addresses immune reconstitution inflammatory syndrome. This document is intended for all professionals who work in clinical practice in the field of HIV infection. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.

PubMed

Iribarren, José Antonio; Rubio, Rafael; Aguirrebengoa, Koldo; Arribas, Jose Ramón; Baraia-Etxaburu, Josu; Gutiérrez, Félix; Lopez Bernaldo de Quirós, Juan Carlos; Losa, Juan Emilio; Miró, José Ma; Moreno, Santiago; Pérez Molina, José; Podzamczer, Daniel; Pulido, Federico; Riera, Melchor; Rivero, Antonio; Sanz Moreno, José; Amador, Concha; Antela, Antonio; Arazo, Piedad; Arrizabalaga, Julio; Bachiller, Pablo; Barros, Carlos; Berenguer, Juan; Caylá, Joan; Domingo, Pere; Estrada, Vicente; Knobel, Hernando; Locutura, Jaime; López Aldeguer, José; Llibre, Josep Ma; Lozano, Fernando; Mallolas, Josep; Malmierca, Eduardo; Miralles, Celia; Miralles, Pilar; Muñoz, Agustín; Ocampo, Agustín; Olalla, Julián; Pérez, Inés; Pérez Elías, Ma Jesús; Pérez Arellano, José Luis; Portilla, Joaquín; Ribera, Esteban; Rodríguez, Francisco; Santín, Miguel; Sanz Sanz, Jesús; Téllez, Ma Jesús; Torralba, Miguel; Valencia, Eulalia; Von Wichmann, Miguel Angel

2016-10-01

Despite the huge advance that antiretroviral therapy represents for the prognosis of infection by the human immunodeficiency virus (HIV), opportunistic infections (OIs) continue to be a cause of morbidity and mortality in HIV-infected patients. OIs often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an OI. The present article updates our previous guidelines on the prevention and treatment of various OIs in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. The article also addresses immune reconstitution inflammatory syndrome. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Role of the hospital environment and equipment in the transmission of nosocomial infections].

PubMed

López-Cerero, Lorena

2014-01-01

The hospital environment is both a reservoir and source of infection for the hospital patient. Several areas around the patient should be considered: air, toilet water coming into contact with the patient, staff and medical devices, food, surfaces, and instruments contacting the patient's skin and mucosa, and sterile solutions. There are pathogens classically associated with each mode of transmission and environmental reservoir, but multi-resistant microorganisms have also been recently been associated with environmental acquisition. Protocols are currently available for the prevention of some classic environmental pathogens, as well as recommendations for the prevention of contamination in some procedures. However, these situations do not cover all forms of transmission, and most investigations of reservoirs or environmental sources are restricted to outbreak situations. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Practical considerations for high resolution anoscopy in patients infected with human immunodeficiency virus].

PubMed

Iribarren-Díaz, Mauricio; Ocampo Hermida, Antonio; González-Carreró Fojón, Joaquín; Alonso-Parada, María; Rodríguez-Girondo, Mar

2014-12-01

Anal cancer is uncommon in the general population, however its incidence is increasing significantly in certain risk groups, mainly in men who have sex with men, and particularly those infected with human immunodeficiency virus. High resolution anoscopy technique is currently considered the standard in the diagnosis of anal intraepithelial neoplasia, but at present there is no agreed standard method between health areas. High resolution anoscopy is an affordable technique that can be critical in the screening of anal carcinoma and its precursor lesions, but is not without difficulties. We are currently studying the most effective strategy for managing premalignant anal lesions, and with this article we attempt to encourage other groups interested in reducing the incidence of an increasing neoplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Guidelines for the diagnosis and treatment of patients with bacteriemia. Guidelines of the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica].

PubMed

Cisneros-Herreros, José Miguel; Cobo-Reinoso, Javier; Pujol-Rojo, Miquel; Rodríguez-Baño, Jesús; Salavert-Lletí, Miguel

2007-02-01

Bacteremia is a complex clinical syndrome in constant transformation that is an important, growing cause of morbidity and mortality. Even though there is a great deal of specific information about bacteremia, few comprehensive reviews integrate this information with a practical AIM. The main objective of these Guidelines, which target hospital physicians, is to improve the clinical care provided to patients with bacteremia by integrating blood culture results with clinical data, and optimizing the use of diagnostic procedures and antimicrobial testing. The document is structured into sections that cover the epidemiology and etiology of bacteremia, stratified according to the various patient populations, and the diagnostic work-up, therapy, and follow-up of patients with bacteremia. Diagnostic and therapeutic decisions are presented as recommendations based on the grade of available scientific evidence.

[Recommendations for the diagnosis, treatment and follow-up of the pregnant woman and child with Chagas disease. Sociedad Española de Infectología Pediátrica. Sociedad de Enfermedades Infecciosas y Microbiología Clínica. Sociedad Española de Ginecología y Obstetricia].

PubMed

González-Tomé, María Isabel; Rivera Cuello, Mercedes; Camaño Gutierrez, Isabel; Norman, Francesca; Flores-Chávez, María Delmans; Rodríguez-Gómez, Leire; Fumadó, Victoria; García-López Hortelano, Milagros; López-Vélez, Rogelio; González-Granado, Luis Ignacio; García-Burguillo, Antonio; Santos Sebastian, María Del Mar; Avila Arzanegui, Olatz

2013-10-01

Congenital transmission of Chagas disease now occurs in areas where the disease is non-endemic, and also from one generation to another. According to epidemiological data from Latin America, the prevalence of the disease in pregnant women is 0.7%-54%, and the prevalence of vertical transmission is around 5%-6%. Congenital T. cruzi infection is an acute infection in newborns that should be treated with anti-parasitic therapy. The treatment of pregnant women could also have an impact on the control of the disease. This article has been prepared following the recommendations suggested by a group of experts in Infectious Diseases, Microbiology, Gynaecology and Paediatrics. Copyright © 2012 Elsevier España, S.L. All rights reserved.

[Meningococcal vaccines. Global epidemiological situation and strategies for prevention by vaccination].

PubMed

Rivero Calle, Irene; Rodriguez-Tenreiro Sánchez, Carmen; Martinón-Torres, Federico

2015-04-01

N. meningitidis is a major cause of meningitis and septicemia and a major public health problem in many countries. The disease, that can be fulminant, has a high mortality and may cause serious sequelae, even in cases of apparently optimal medical treatment. Chemoprophylaxis may prevent secondary cases among those in close contact with the ill, but, since secondary cases represent only 1%-2% of all meningococcal disease, chemoprophylaxis has a small impact when fighting most of endemic and epidemic forms. Given that al least 5% -15% of children and young adults are carriers, the fight against meningococcal disease based on chemotherapeutic elimination of nasopharyngeal colonization is virtually impossible. Therefore, immunization is the only rational way to combat this disease. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Epidemiological investigation of the first human brucellosis case in Spain due to Brucella suis biovar 1 strain 1330.

PubMed

Compés Dea, Cecilia; Guimbao Bescós, Joaquín; Alonso Pérez de Ágreda, Juan Pablo; Muñoz Álvaro, Pilar María; Blasco Martínez, José María; Villuendas Usón, María Cruz

2017-03-01

No cases of human brucellosis caused by Brucella suis has been reported in Spain. This study involved interviews with the case and his co-workers, inspection of their workplace, checking infection control measures, and typing the Brucella strain isolated in the blood culture. Brucella suis biovar 1 strain 1330 was isolated from a patient who worked in a waste treatment plant. Food borne transmission, contact with animals, and risk jobs were ruled out. An accidental inoculation with a contaminated needle from a research laboratory waste container was identified as the most probable mode of transmission. There should be controls to ensure that waste containers are sealed. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary. Management of urinary tract infection in solid organ transplant recipients: Consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI).

PubMed

Vidal, Elisa; Cervera, Carlos; Cordero, Elisa; Armiñanzas, Carlos; Carratalá, Jordi; Cisneros, José Miguel; Fariñas, M Carmen; López-Medrano, Francisco; Moreno, Asunción; Muñoz, Patricia; Origüen, Julia; Sabé, Núria; Valerio, Maricela; Torre-Cisneros, Julián

2015-12-01

Urinary tract infections (UTI) are one of the most common infections in solid organ transplant (SOT) recipients. A systematic review was performed to assess the management of UTI in SOT recipients. Recommendations are provided on the management of asymptomatic bacteriuria, and prophylaxis and treatment of UTI in SOT recipients. The diagnostic-therapeutic management of recurrent UTI and the role of infection in kidney graft rejection or dysfunction are reviewed. Finally, recommendations on antimicrobials and immunosuppressant interactions are also included. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Malaria and intestinal protozoa].

PubMed

Rojo-Marcos, Gerardo; Cuadros-González, Juan

2016-03-01

Malaria is life threatening and requires urgent diagnosis and treatment. Incidence and mortality are being reduced in endemic areas. Clinical features are unspecific so in imported cases it is vital the history of staying in a malarious area. The first line treatments for Plasmodium falciparum are artemisinin combination therapies, chloroquine in most non-falciparum and intravenous artesunate if any severity criteria. Human infections with intestinal protozoa are distributed worldwide with a high global morbid-mortality. They cause diarrhea and sometimes invasive disease, although most are asymptomatic. In our environment populations at higher risk are children, including adopted abroad, immune-suppressed, travelers, immigrants, people in contact with animals or who engage in oral-anal sex. Diagnostic microscopic examination has low sensitivity improving with antigen detection or molecular methods. Antiparasitic resistances are emerging lately. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Collection, transport and general processing of clinical specimens in Microbiology laboratory.

PubMed

Sánchez-Romero, M Isabel; García-Lechuz Moya, Juan Manuel; González López, Juan José; Orta Mira, Nieves

2018-02-06

The interpretation and the accuracy of the microbiological results still depend to a great extent on the quality of the samples and their processing within the Microbiology laboratory. The type of specimen, the appropriate time to obtain the sample, the way of sampling, the storage and transport are critical points in the diagnostic process. The availability of new laboratory techniques for unusual pathogens, makes necessary the review and update of all the steps involved in the processing of the samples. Nowadays, the laboratory automation and the availability of rapid techniques allow the precision and turn-around time necessary to help the clinicians in the decision making. In order to be efficient, it is very important to obtain clinical information to use the best diagnostic tools. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

A two-hour antibiotic susceptibility test by ATP-bioluminescence.

PubMed

March Rosselló, Gabriel Alberto; García-Loygorri Jordán de Urries, María Cristina; Gutiérrez Rodríguez, María Purificación; Simarro Grande, María; Orduña Domingo, Antonio; Bratos Pérez, Miguel Ángel

2016-01-01

The antibiotic susceptibility test (AST) in Clinical Microbiology laboratories is still time-consuming, and most procedures take 24h to yield results. In this study, a rapid antimicrobial susceptibility test using ATP-bioluminescence has been developed. The design of method was performed using five ATCC collection strains of known susceptibility. This procedure was then validated against standard commercial methods on 10 strains of enterococci, 10 staphylococci, 10 non-fermenting gram negative bacilli, and 13 Enterobacteriaceae from patients. The agreement obtained in the sensitivity between the ATP-bioluminescence method and commercial methods (E-test, MicroScan and VITEK2) was 100%. In summary, the preliminary results obtained in this work show that the ATP-bioluminescence method could provide a fast and reliable AST in two hours. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Tuberculosis and immigration].

PubMed

Salas-Coronas, Joaquín; Rogado-González, M Cruz; Lozano-Serrano, Ana Belén; Cabezas-Fernández, M Teresa

2016-04-01

The incidence of tuberculosis worldwide is declining. However, in Western countries this decline is slower due to the impact of immigration. Tuberculosis in the immigrant population is related to health status in the country of origin and with overcrowding and poverty conditions in the host country. Immigrants with tuberculosis are younger, have a higher prevalence of extrapulmonary forms, greater proportion of drug resistance and higher treatment default rates than those of natives. New molecular techniques not only reduce diagnostic delay time but also allow the rapid identification of resistances and improve knowledge of transmission patterns. It is necessary to implement measures to improve treatment compliance in this population group like facilitating access to health card, the use of fixed-dose combination drugs, the participation of cultural mediators and community health workers and gratuity of drugs. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Como Lo Hago Yo: Mielomeningocele En Bolivia

PubMed Central

Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

2014-01-01

Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusión: En esta serie, el diagnóstico prenatal del MMC fue ocasional y la derivación al HUJ de los recién nacidos con esta malformación fue generalmente tardía. No hubo predominio de género y la mayoría de los casos presentaron sus lesiones en la región lumbar y lumbosacra. La mortalidad general y postoperatoria fue similar a la reportada en la literatura. Pocos enfermos realizaron controles posteriores al alta hospitalaria. Igual que otros países de Sudamérica, las falencias en el sistema público de salud y el nivel sociocultural, son factores determinantes para un mal pronóstico en estos niños. Por sus múltiples complicaciones, el MMC requiere de una especial atención gubernamental, sobre todo de carácter preventivo mediante el uso de ácido fólico en mujeres fértiles, como también de un equipo profesional multidisciplinario, a fin de realizar un tratamiento adecuado y oportuno. Al mismo tiempo, trabajos multicéntricos en hospitales de América Latina, ayudarán al mejor manejo de estos pacientes. PMID:24791220

Nursing Diagnosis Based on Signs and Symptoms of Patients With Heart Disease.

PubMed

da Costa, Cíntia; da Costa Linch, Graciele Fernanda; Nogueira de Souza, Emiliane

2016-10-01

The aim was to identify the main signs and symptoms of cardiac patients hospitalized in a unit of intensive cardiology care in order to infer the main nursing diagnoses (NDs). We performed a cross-sectional study; the sample consisted of 77 randomly selected records. Those records included only patients hospitalized for cardiovascular causes and with electronic chart available. Signs and symptoms identified at admission were psychic (40.3%), compressive dressing on arterial puncture site (33.8%), chest pain (29.9%), tachycardia (22.1%), and hemodynamic instability (20.8%). According to the data collected, we were able to infer that acute pain, excess of fluid volume, decreased cardiac output, spontaneous ventilation impaired, anxiety and impaired skin integrity are priority for the NDs in the studied population. OBJETIVO: identificar os principais sinais e sintomas de pacientes cardíacos internados em uma unidade de cuidados intensivos de cardiologia, visando inferir os diagnósticos de enfermagem prioritários. MÉTODO: Estudo transversal; a amostra foi composta por 77 registros selecionados aleatoriamente. Incluíram-se apenas pacientes internados por causa cardiovascular e com registro eletrônico disponível. Os sinais e sintomas identificados na admissão foram psíquicos (40,3%), curativo compressivo em sítio de punção arterial (33,8%), dor torácica (29,9%), taquicardia (22,1%) e instabilidade hemodinâmica (20,8%). CONCLUSÕES E IMPLICAÇÕES PARA A PRÁTICA: De acordo com os dados levantados foram inferidos Dor Aguda, Volume de Líquidos Excessivo, Débito Cardíaco Diminuído, Ventilação Espontânea Prejudicada, Ansiedade e Integridade da Pele Prejudicada como diagnósticos de enfermagem prioritários para a população estudada. © 2016 NANDA International, Inc.

Victory, Stalemate and Defeat During the Spanish Caribbean Insurgencies of 1868-1878

DTIC Science & Technology

2015-05-01

Press of America, Inc., 2009. Bell, Ian. The Dominican Republic. Boulder: Westview Press, 1981. de Navascues y Aisa , Nicasio. "Parte de la Alcaldia de...2006. Jimenez de Wagenheim, Olga. El grito de Lares sus causas y sus hombres. 4th Edition . Rio Piedras, Puerto Rico: Ediciones Huracan, Inc., 1999...1987. Marti, Jose. Our America: Writing on Latin America and the Struggle for Cuban Independence. Edited by Philip S. Foner. Translated by Elinor

The United States and Brazil: Opening a New Dialogue,

DTIC Science & Technology

1984-01-01

Alexandre de Barros, Ŕ Coroamento De Uma Politica Extema Criativa [The Coronation of a Creative External Policy]," Jornal Do Brasil, 3 October 1982...August 1982, p. 7. 19. Ŕ Avango Da Estatizagho: A Causa Principal Das Mazel as Da Economia (The Advance of Estatizatlon: The Principal Cause of the...Wounds of the Economy]," Visdo-Quemn t Quem Na Economia Brasiilra, August 1962, pp. 6-13. 20. Cecilla Costa, "A Mfigica Que 0 Gov6rno Faz Para Cobrir Seu

Pylephlebitis: incidence and prognosis in a tertiary hospital.

PubMed

Belhassen-García, Moncef; Gomez-Munuera, Mercedes; Pardo-Lledias, Javier; Velasco-Tirado, Virginia; Perez-Persona, Ernesto; Galindo-Perez, Inmaculada; Alvela-Suárez, Lucia; Romero-Alegría, Angela; Muñoz-Bellvis, Luis; Cordero-Sánchez, Miguel

2014-01-01

Septic thrombophlebitis of the portal vein or its branches, most often secondary to intra-abdominal infection is known as pylephlebitis. The frequency and the prognosis of this complication are unknown. The aim of this study was to determine the global and relative incidence of the most frequent intra-abdominal infections and the real prognosis of this disease. An observational retrospective study was conducted in a tertiary care hospital (University Hospital of Salamanca, Spain) from January 1999 to December 2008. A total of 7796 patients with intra-abdominal infection were evaluated, of whom 13 (0.6%) had been diagnosed with pylephlebitis. Diverticulitis was the most frequent underlying process, followed by biliary infection. Early mortality was 23%. Survivors had no recurrences, but one of them developed portal cavernomatosis. Pylephlebitis is a rare complication of intra-abdominal infection, with a high early mortality, but with a good prognosis for survivors. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Self-assessment of patterns of antibiotic use in a university hospital].

PubMed

Gómez, J; García-Vázquez, E; Bonillo, C; Hernández, A; Bermejo, M; Canteras, M

2014-10-01

A questionnaire was used to determine the knowledge, attitudes and practices of antibiotic prescribing among doctors at a university hospital. An anonymous questionnaire was directly distributed by a staff member of the Infectious Diseases Department. A total of 316 questionnaires were distributed with 100% response rate; antibiotic dose, route of administration, and treatment duration were always adjusted according to site of infection and underlying conditions in 65, 68 and 45%, respectively. Antibiotic de-escalation was recognized as usual practice in 20%; 31 and 10% considered potential microbiological resistances and economical-cost when taking prescription decisions, respectively; 16% admitted often prescribing antibiotics with no clinical indication. There were no major significant differences between staff and training physicians, or between surgical or medical specialists. The self-perception of physicians and residents in our hospital is that they make improper use of antimicrobials. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[HIV infection and immigration].

PubMed

Monge, Susana; Pérez-Molina, José A

2016-01-01

Migrants represent around one third of patients newly diagnosed with HIV in Spain and they constitute a population with higher vulnerability to its negative consequences due to the socio-cultural, economical, working, administrative and legal contexts. Migrants are diagnosed later, which worsens their individual prognosis and facilitates the maintenance of the HIV epidemic. In spite of the different barriers they experience to access healthcare in general, and HIV-related services in particular, access to antiretroviral treatment has been similar to that of the autochthonous population. However, benefits of treatment have been not, with women in general and men from Sub-Saharan Africa exhibiting the worse response to treatment. We need to proactively promote earlier diagnosis of HIV infection, the adoption of preventive measures to avoid new infections, and to deliver accessible, adapted and high-quality health-care. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Level of impact on the public health of universal human immunodeficiency virus screening in an Emergency Department.

PubMed

Reyes-Urueña, Juliana; Fernàndez-López, Laura; Force, Luis; Daza, Manel; Agustí, Cristina; Casabona, Jordi

The aim of this study was to determine the prevalence of HIV and the acceptability of rapid testing in an emergency department (ED), Barcelona (6/07/2011 to 8/03/2013). A convenience sample was used, depending on nurse availability in the ED. Participants signed an informed consent. Results were confirmed by conventional methods. A total of 2,140 individuals were offered testing, and 5% rejected taking part (107/2,140). Three subjects (3/2,033 [0.15%]) had confirmed reactive test. Individuals with a higher education were more likely to perform a rapid HIV test in ED (P<.005). A low prevalence of new HIV diagnoses was found among participants, although there was a high acceptability rate to perform rapid testing in the ED. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Fast methods of fungal and bacterial identification. MALDI-TOF mass spectrometry, chromogenic media.

PubMed

Siller-Ruiz, María; Hernández-Egido, Sara; Sánchez-Juanes, Fernando; González-Buitrago, José Manuel; Muñoz-Bellido, Juan Luis

2017-05-01

MALDI-TOF mass spectrometry is now a routine resource in Clinical Microbiology, because of its speed and reliability in the identification of microorganisms. Its performance in the identification of bacteria and yeasts is perfectly contrasted. The identification of mycobacteria and moulds is more complex, due to the heterogeneity of spectra within each species. The methodology is somewhat more complex, and expanding the size of species libraries, and the number of spectra of each species, will be crucial to achieve greater efficiency. Direct identification from blood cultures has been implemented, since its contribution to the management of severe patients is evident, but its application to other samples is more complex. Chromogenic media have also contributed to the rapid diagnosis in both bacteria and yeast, since they accelerate the diagnosis, facilitate the detection of mixed cultures and allow rapid diagnosis of resistant species. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

First case of imported Zika virus infection in Spain.

PubMed

Bachiller-Luque, Pablo; Domínguez-Gil González, Marta; Álvarez-Manzanares, Jesús; Vázquez, Ana; De Ory, Fernando; Sánchez-Seco Fariñas, M Paz

2016-04-01

We report a case of Zika virus (ZIKV) infection in a patient with diarrhea, fever, synovitis, non-purulent conjunctivitis, and with discreet retro-orbital pain, after returning from Colombia in January 2016. The patient referred several mosquito bites. Presence of ZIKV was detected by PCR (polymerase chain reaction) in plasma. Rapid microbiological diagnosis of ZIKV infection is needed in European countries with circulation of its vector, in order to avoid autochthonous circulation. The recent association of ZIKV infection with abortion and microcephaly, and a Guillain-Barré syndrome highlights the need for laboratory differentiation of ZIKV from other virus infection. Women with potential risk for Zika virus infection who are pregnant or planning to become pregnant must mention that fact during prenatal visits in order to be evaluated and properly monitored. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Management of Infection and Febrile Neutropenia in Patients with Solid Cancer.

PubMed

Aguado, José María; Cruz, Juan Jesús; Virizuela, Juan Antonio; Aguilar, Manuela; Carmona, Alberto; Cassinello, Javier; Gudiol, Carlota; Jiménez Fonseca, Paula; Lizasoain, Manuel; Marco, Francesc; Ruiz, Isabel; Ruiz, Maribel; Salavert, Miguel; Vicente, David; Carratalà, Jordi

A group of experts from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Medical Oncology (SEOM) have reviewed in this paper the main aspects to be considered in the evaluation of patients with solid cancer and infectious diseases. They have established a series of recommendations on the prevention of the most prevalent infections in these patients, the use of vaccines, the control measures of vascular catheter infection and prevention of infections before certain surgical procedures. Also the criteria for management of febrile neutropenia and the use of colony-stimulating factors were revised. Finally they provide a series of recommendations for the treatment of cancer patients with severe infection. The document is completed with a series of measures for the control of hospital infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Vaccination for international travelers].

PubMed

Arrazola, M Pilar; Serrano, Almudena; López-Vélez, Rogelio

2016-05-01

Traveler's vaccination is one of the key strategies for the prevention of infectious diseases during international travel. The risk of acquiring an infectious disease is determined in each case by the characteristics of the traveler and the travel, so the pre-departure medical advice of the traveler must be individualized. The World Health Organization classifies travelerś vaccines into three groups. - Vaccines for routine use in national immunization programs: Haemophilus influenzae type b, hepatitis B, polio, measles-mumps-rubella, tetanus-diphtheria-whooping a cough, and chickenpox. - Vaccinations required by law in certain countries before to enter them: yellow fever, meningococcal disease and poliomyelitis. - Vaccines recommended depending on the circumstances: cholera, japanese encephalitis, tick-borne encephalitis, meningococcal disease, typhoid fever, influenza, hepatitis A, hepatitis B, rabies and BCG. This review is intended to introduce the reader to the field of international vaccination. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Infectious diseases in the adult population admitted to a general hospital].

PubMed

Ramos, José M; Pinargote, Héctor; Torrús, Diego; Sánchez-Martínez, Rosario; Merino, Esperanza; Portilla, Joaquín

2015-10-01

To determine the infectious diseases (ID) that led to hospital admission of the foreign population>14 years. A retrospective study of foreign patients admitted to hospital (2000-2012). A total of 3,087 foreigners were admitted with infectious diseases. Of these, 73.6% were from low income countries, and 26.4% from high income countries. Most of them (86.9%) were admitted with common ID, 11.8% with transmissible ID, and 1.6% with tropical ID. Tropical ID and transmissible ID were higher in patients from low income countries (14.7%) than from high income countries (9.7%, p<0.001). The main tropical ID was malaria (74%). The main transmissible ID were tuberculosis (40.3%), hepatitis (27.8%), and HIV/AIDS (27.5%). Common ID were the main reason for admission in foreign population. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Haemophilus influenzae pneumonia in human immunodeficiency virus-infected patients. The Grupo Andaluz para el Estudio de las Enfermedades Infecciosas.

PubMed

Cordero, E; Pachón, J; Rivero, A; Girón, J A; Gómez-Mateos, J; Merino, M D; Torres-Tortosa, M; González-Serrano, M; Aliaga, L; Collado, A; Hernández-Quero, J; Barrera, A; Nuño, E

2000-03-01

Although Haemophilus influenzae is a common etiologic agent of pneumonia in patients infected with human immunodeficiency virus (HIV), the characteristics of this pneumonia have not been adequately assessed. We have prospectively studied features of H. influenzae pneumonia in 26 consecutive HIV-infected inpatients. Most of these patients were severely immunosuppressed; 73.1% had a CD4+ cell count <100/microL. A subacute clinical presentation was observed in 27% of the patients and was associated with a higher degree of immunosuppression (P=.04). Bilateral lung infiltrates were noted radiographically in 57.7% of the cases. The mortality attributable to H. influenzae pneumonia was 11.5%. Thus, pneumonia caused by H. influenzae affects mainly patients with advanced HIV disease, and since its clinical and radiological features may be diverse, this etiology should be considered when pneumonia occurs in patients with advanced HIV infection. The mortality rate associated with H. influenzae pneumonia is not higher than that occurring in the general population.

[Consensus document for the treatment of bacteremia and endocarditis caused by methicillin-resistent Staphylococcus aureus. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica].

PubMed

Gudiol, Francisco; Aguado, José María; Pascual, Alvaro; Pujol, Miquel; Almirante, Benito; Miró, José María; Cercenado, Emilia; Domínguez, María de Los Angeles; Soriano, Alex; Rodríguez-Baño, Jesús; Vallés, Jordi; Palomar, Mercedes; Tornos, Pilar; Bouza, Emilio

2009-02-01

Bacteremia and endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) are prevalent and clinically important. The rise in MRSA bacteremia and endocarditis is related with the increasing use of venous catheters and other vascular procedures. Glycopeptides have been the reference drugs for treating these infections. Unfortunately their activity is not completely satisfactory, particularly against MRSA strains with MICs > 1 microg/mL. The development of new antibiotics, such as linezolid and daptomycin, and the promise of future compounds (dalvabancin, ceftobiprole and telavancin) may change the expectatives in this field.The principal aim of this consensus document was to formulate several recommendations to improve the outcome of MRSA bacteremia and endocarditis, based on the latest reported scientific evidence. This document specifically analyzes the approach for three clinical situations: venous catheter-related bacteremia, persistent bacteremia, and infective endocarditis due to MRSA.

[Pneumococcal vaccines. New conjugate vaccines for adults].

PubMed

Campins Martí, Magda

2015-11-01

Pneumococcal infections are a significant cause of morbidity and mortality, and are one of the 10 leading causes of death worldwide. Children under 2 years have a higher incidence rate, followed by adults over 64 years. The main risk group are individuals with immunodeficiency, and those with anatomical or functional asplenia, but can also affect immunocompetent persons with certain chronic diseases. Significant progress has been made in the last 10 years in the prevention of these infections. Until a few years ago, only the 23-valent non-conjugate pneumococcal vaccine was available. Its results were controversial in terms of efficacy and effectiveness, and with serious limitations on the type of immune response induced. The current possibility of using the 13-valent conjugate vaccine in adults has led to greater expectations in improving the prevention of pneumococcal disease in these age groups. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Galactomannan enzyme immunoassay and quantitative Real Time PCR as tools to evaluate the exposure and response in a rat model of aspergillosis after posaconazole prophylaxis.

PubMed

Cendejas-Bueno, Emilio; Forastiero, Agustina; Ruiz, Isabel; Mellado, Emilia; Buitrago, María José; Gavaldà, Joan; Gomez-Lopez, Alicia

2016-11-01

A steroid-immunosuppressed rat model of invasive pulmonary aspergillosis was use to examine the usefulness of galactomannan enzyme immunoassay (GM) and quantitative real time PCR (RT-PCR) in evaluating the association between response and exposure after a high dose of prophylactic posaconazole. Two different strains of Aspergillus fumigatus with different in vitro posaconazole susceptibility were used. Serum concentrations demonstrated similar posaconazole exposure for all treated animals. However, response to posaconazole relied on the in vitro susceptibility of the infecting strain. After prophylaxis, galactomannan index and fungal burden only decreased in those animals infected with the most susceptible strain. This study demonstrated that both biomarkers may be useful tools for predicting efficacy of antifungal compounds in prophylaxis. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Serratia marcescens outbreak due to contaminated 2% aqueous chlorhexidine.

PubMed

de Frutos, Mónica; López-Urrutia, Luis; Domínguez-Gil, Marta; Arias, Marta; Muñoz-Bellido, Juan Luis; Eiros, José María; Ramos, Carmen

2017-12-01

An outbreak of Serratia marcescens infections outbreak is described, as well as the epidemiological study that linked the outbreak to the use of 2% aqueous chlorhexidine antiseptic. In late November 2014 an increasing incidence of S. marcescens isolates was detected in patients treated in the emergency department. It was considered a possible outbreak, and an epidemiological investigation was started. S. marcescens was isolated in 23 samples from 16 patients and in all new bottles of two lots of 2% aqueous chlorhexidine. The contaminated disinfectant was withdrawn, and the Spanish Drugs Agency was alerted (COS 2/2014). The epidemiological study showed that strains isolated from clinical samples and from chlorhexidine belonged to the same clone. No further isolates were obtained once the disinfectant was withdrawn. The suspicion of an outbreak and the epidemiological study were essential to control the incidence. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Diagnosis and treatment of imported malaria in Spain: Recommendations from the Malaria Working Group of the Spanish Society of Tropical Medicine and International Health (SEMTSI)].

PubMed

Muñoz, Jose; Rojo-Marcos, Gerardo; Ramírez-Olivencia, Germán; Salas-Coronas, Joaquín; Treviño, Begoña; Perez Arellano, José Luis; Torrús, Diego; Muñoz Vilches, Maria Jose; Ramos, Jose Manuel; Alegría, Iñaki; López-Vélez, Rogelio; Aldasoro, Edelweiss; Perez-Molina, Jose Antonio; Rubio, Jose Miguel; Bassat, Quique

2015-01-01

Malaria is a common parasitic disease diagnosed in the returned traveler. Mortality in travelers with imported malaria is around 2-3%, and one of the main factors associated with poor prognosis is the delay in the diagnosis and treatment. Imported malaria cases usually present with fever, headache and myalgia, but other symptoms may appear. The diagnosis should be performed as soon as possible, using thick smear or rapid diagnostic tests, and a blood smear. Treatment should be initiated urgently. In cases of severe malaria, the use of intravenous artemisinins has proved to be superior to intravenous quinine. This document reviews the recommendations of the expert group of the Spanish Society of Tropical Medicine and International Health (SEMTSI) for the diagnosis and treatment of imported malaria in Spain. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Proposal of a five MIRU-VNTR panel to screen clinical isolates of Mycobacterium tuberculosis in Mexico].

PubMed

Bolado-Martínez, Enrique; Candia-Plata, Maria Del Carmen; Zenteno-Cuevas, Roberto; Mendoza Damián, Fabiola; Avilés-Acosta, Magali; Álvarez-Hernández, Gerardo

2015-11-01

Tuberculosis is a public health problem across Mexico. This paper aims to select a panel, with a minimum number of repetitive elements (MIRU-VNTR) for genotypic characterization of Mycobacterium tuberculosis (M. tuberculosis) clinical isolates. In this study, a full panel of 24 MIRU-VNTR loci was used to discriminate 65 clinical isolates of M. tuberculosis from three different geographical regions of Mexico. Those loci with the highest discriminatory power were subsequently selected. The panel, including five loci, was obtained by selecting the highest values of allelic diversity among the genotypes obtained. The dendrogram, generated by the panel MIRU-VNTR 5, showed a high discriminatory power with 65 unique genotype profiles and formed clusters according to the geographical region of origin. The panel MIRU-VNTR 5 can be useful for characterizing clinical isolates of M. tuberculosis in Mexico. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Factors associated with mortality in patients undergoing coronary artery bypass grafting.

PubMed

Koerich, Cintia; Lanzoni, Gabriela Marcellino de Melo; Erdmann, Alacoque Lorenzini

2016-08-08

to investigate the factors associated with mortality in patients undergoing coronary artery bypass grafting in a cardiovascular referral hospital in Santa Catarina. quantitative, exploratory, descriptive and retrospective study. The medical records of 1447 patients, from 2005 to 2013, were analyzed for statistically related variables, these being: profile, hospitalization diagnosis, risk factors for coronary artery disease, complications recorded during the hospitalization, length of hospitalization and cause of death. the mortality rate was 5.3% during the study period. Death was more common in females and those of black skin color, with a mean age of 65 years. Acute myocardial infarction was the most common hospitalization diagnosis. The majority of the complications recorded during hospitalization were characterized by changes in the cardiovascular system, with longer hospitalization periods being directly related to death from septic shock. the data provide subsidies for nursing work with preventive measures and early detection of complications associated with coronary artery bypass grafting. This reinforces the importance of using the data as quality indicators, aiming to guarantee care guided by reliable information to guide managers in planning patient care and high complexity health services. conhecer os fatores associados à mortalidade de pacientes submetidos à cirurgia de revascularização do miocárdio em hospital referência cardiovascular em Santa Catarina. estudo quantitativo, exploratório, descritivo e retrospectivo. Foram analisados os prontuários de 1447 pacientes, entre 2005 e 2013, e as variáveis relacionadas estatisticamente, sendo estas: perfil, diagnóstico da internação, fatores de risco para doença arterial coronariana, intercorrências registradas na internação, tempo de internação e causa do óbito. a taxa de mortalidade foi de 5,3% no período do estudo. Os óbitos foram mais frequentes em negros, do sexo feminino e média de idade de 65 anos. O infarto agudo do miocárdio foi o diagnóstico de internação que apresentou maior representatividade. A maioria das intercorrências registradas durante a internação caracterizou-se por alterações do sistema cardiovascular e o maior tempo de internação teve relação direta com óbito por choque séptico. os dados fornecem subsídios para a enfermagem atuar com medidas preventivas e identificação precoce de intercorrências associadas à cirurgia de revascularização do miocárdio. Reforça-se a importância da utilização dos dados como indicadores de qualidade objetivando garantir um cuidado pautado em informações confiáveis que orientem gestores no planejamento da assistência ao paciente e dos serviços de saúde de alta complexidade. conocer los factores asociados a la mortalidad de pacientes sometidos a cirugía de revascularización del miocardio en un hospital de referencia cardiovascular en el estado de Santa Catarina. estudio cuantitativo, exploratorio, descriptivo y retrospectivo. Fueron analizados las fichas médicas de 1.447 pacientes, entre 2005 y 2013; las variables relacionadas estadísticamente fueron: perfil, diagnóstico de la internación, factores de riesgo para enfermedad arterial coronariana, complicaciones registradas en la internación, tiempo de internación y causa de la muerte. la tasa de mortalidad fue de 5,3%, en el período del estudio. Las muertes fueron más frecuentes en negros, sexo femenino y promedio de edad de 65 años. El infarto agudo del miocardio fue el diagnóstico de internación que presentó mayor representatividad. La mayoría de las complicaciones registradas durante la internación se caracterizó por alteraciones del sistema cardiovascular; el mayor tiempo de internación tuvo relación directa con muerte por choque séptico. los datos suministran informaciones para que la enfermería pueda actuar con medidas preventivas e identificar precozmente complicaciones asociadas a la cirugía de revascularización del miocardio. Se refuerza la importancia de la utilización de datos como indicadores de calidad, objetivando garantizar un cuidado guiado por informaciones confiables que orienten a los administradores en la planificación de la asistencia al paciente y en los servicios de salud de alta complejidad.

Modelo analítico del efecto de PRS sobre satélites GPS

NASA Astrophysics Data System (ADS)

Meza, A.; Brunini, C.; Usandivaras, J. C.

El sistema GPS (Global Position System) es, hoy en día, la herramienta de navegación y posicionamiento más potente y lo será sin duda en la próxima década. Gran parte de su valiosa utilidad se debe a la alta precisión que permite lograr y ésta, a su vez, depende, entre otras causas, de la precisión con que se conocen las órbitas de los satélites. La presión de radiación solar (PRS) fija el límite de la precisión con que pueden calcularse en la actualidad las efemérides satelitarias. El objetivo de este trabajo es proponer una mejor resolución de este fenómeno. El modelo analítico aquí presentado, se basa en el análisis del comportamiento de los residuos de un ajuste por mínimos cuadrados en el que se utiliza el modelo de PRS propuesto por Beutler. El mismo consiste en un modelo determinista del fenómeno con dos parámetros libres. Los resultados obtenidos ponen de manifiesto que, aún después de aplicar dichos parámetros, prevalecen en los residuos efectos semidiurnos en las componentes radial,tangencial y normal. Estos resultados obtenidos se comparan con los de un trabajo desarrollado por el Instituto de Berne (Beutler et al., 1994), en el que se utilizaron como pseudo-observaciones las órbitas precisas del IGS (CODE). El intervalo de integración escogido por este centro fueron las semanas 680 y 681. En resumen se tienen arcos de 14 días para todos los satélites, donde las efemérides precisas de los mismos para los 14 días fueron utilizados como pseudo-observaciones. El modelo de fuerza que empleó dicho centro fue básicamente el tradicional en lo que respecta al modelo de las fuerzas gravitacionales, y para la PRS utilizo el modelo standard de Beutler. Los parámetros de este modelo junto con las 6 condiciones iniciales (posición y velocidad) fueron ajustados por el método general de mínimos cuadrados. Los residuos en la componente radial, tangencial y normal, para los satélites con un buen comportamiento, presentan una componente semidiurna. El modelo analítico planteado en este trabajo, predice el comportamiento de los residuos que se observan en las publicaciones más recientes. Esto abre el camino para plantear una estimación distinta de las incógnitas del problema, basado en el método de colocación por mínimos cuadrados. Ello requiere modelar estadísticamente la señal debida a las componentes de la PRS que no son tomadas en cuenta en el modelo determinista.

Effects of H sub 2 S addition on the performance of fresh vs. used CoMo catalysts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rankel, L.A.

1991-01-01

When a Co/Mo catalyst is used for processing vanadium-containing heavy oils, vanadium deposits on the catalyst. As the amount of vanadium on the CoMo catalyst increases, the catalytic effects of CoMo decline and the presence of vanadium starts to influence the hydroprocessing products. Model feeds have been used to explore the changes in the catalytic activity of CoMo, aged CoMo, and VS{sub x} on alumina. Desulfurization, denitrogenation, deoxygenation, aromatics hydrogenation, and metals removal were monitored. This paper reports that, upon the addition of hydrogen sulfide to hydrogen, improvements in the catalysts for aromatics hydrogenation, denitrogenation and metals removal were observed.

Física e Arte nas Estações do Ano

NASA Astrophysics Data System (ADS)

Pessôa Queiroz, Glória; da Conceição Barbosa Lima, Maria; Navarro Vasconcellos das Mercês, Maria

2004-12-01

The paper deals with the subject of the Four Seasons, exploring elements of Science and the Art in order to motivate students or public of museums of science and technology to understand it from their current cultural experiences and of old times. Physics joins to Astronomy to explain the phenomenon, while the use of Music and Painting make possible the immersion in the subject in way to many trips to the imagination capable to awake emotions.A proposal didactic is presented and justified for some consensus of the research in the area of teaching-learning of science, since that related to the persistent alternative conceptions concerning the causes of the changes observed at the different times of the year until the qualitative modelling of phenomena that appeals three-dimensional pedagogical models. Such proposal was developed in the activity named " Hiper interesting Talk: The Four Seasons, Science and Art" in the first Sunday of August/2003 in the Museum of Astronomy, MAST. O artigo trata do tema das Estações do Ano, explorando elementos da Ciência e da Arte como forma de motivar estudantes ou público de museus de ciência e tecnologia a compreendê-lo a partir de vivências culturais atuais e de outras épocas. A Física se junta à Astronomia para explicar o fenômeno, enquanto a Música e a Pintura possibilitam a imersão no tema em meio a muitas viagens à imaginação capazes de despertar emoções.Uma proposta didática é apresentada e justificada por consensos das muitas pesquisas na área de ensino-aprendizagem de ciências, desde os que se referem às persistentes concepções alternativas acerca das causas das mudanças observadas nas diferentes épocas do ano até à modelagem qualitativa de fenômenos que recorre a modelos pedagógicos tridimensionais. Tal proposta foi desenvolvida na atividade "Bate papo Hiperinteressante: As Quatro Estações, Ciência e Arte" realizada no primeiro domingo do mês de agosto de 2003 no Museu de Astronomia.

Cholesterol and prevention of atherosclerotic events: limits of a new frontier.

PubMed

Macedo, Luís Eduardo Teixeira de; E, Faerstein

2017-01-12

Control of atherosclerotic cardiovascular disease - a highly prevalent condition and one of the main causes of mortality in Brazil and worldwide - is a recurrent subject of great interest for public health. Recently, three new guidelines on dyslipidemia and atherosclerosis prevention have been published. The close release of these important publications is a good opportunity for comparison: the Brazilian model has greater sensitivity, the English model does not work with risk stratification, and the American model may be overestimating the risk. This will allow reflection on current progress and identification of controversial aspects which still require further research and debate. It is also an opportunity to discuss issues related to early diagnosis and its efficiency as a preventive strategy for atherosclerotic disease: the transformation of risk into disease, the gradual reduction of cut-off points, the limitations of the screening strategy, and the problem of overdiagnosis. RESUMO O controle da doença cardiovascular aterosclerótica - morbidade de alta prevalência e uma das principais causas de mortalidade no Brasil e no mundo - continua sendo tema de grande interesse para a Saúde Pública. Recentemente, três novas diretrizes sobre dislipidemia e prevenção da aterosclerose foram divulgadas. A convergência no tempo dessas importantes publicações constitui boa oportunidade para sua comparação: o modelo brasileiro tem maior sensibilidade, o inglês não trabalha com risco estratificado e o norte-americano parece estar superestimando o risco.Isso permitirá reflexões acerca dos avanços que já foram alcançados e identificação de aspectos ainda controversos, que seguem exigindo novas pesquisas e debates. É também uma oportunidade para discutir questões relacionadas ao diagnóstico precoce e sua eficiência como estratégia preventiva da doença aterosclerótica: as transformações do risco em doença, a diminuição progressiva de pontos de corte, as insuficiências da estratégia de rastreamento e o problema do sobrediagnóstico.

Descompresión microvascular en espasmo hemifacial: Reporte de 13 casos y revisión de la literatura

PubMed Central

Campero, Alvaro; Herreros, Isabel Cuervo-Arango; Barrenechea, Ignacio; Andjel, Germán; Ajler, Pablo; Rhoton, Albert

2016-01-01

Objetivo: El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial (EHF), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde Junio de 2005 a Mayo de 2014, 13 pacientes con diagnóstico de EHF fueron intervenidos quirúrgicamente, realizando una DMV. Se evaluó: edad, sexo, tiempo de evolución de la sintomatología, hallazgos intraoperatorios y resultados postoperatorios. Resultados: De los 13 pacientes intervenidos, 7 fueron mujeres y 6 varones. La media de edad fue de 53 años. El tiempo medio entre el inicio de la sintomatología y la intervención quirúrgica osciló entre 3 y 9 años. En todos los casos el EHF era típico, uno de ellos con neuralgia trigeminal concomitante, observándose en todos compresión neurovascular intraoperatoria. Por orden decreciente de frecuencia la causa de la compresión fue arteria cerebelosa anteroinferior, arteria cerebelosa posteroinferior, arteria dolicomega basilar y arteria dolicomega vertebral. El seguimiento postoperatorio fue en promedio de 24 meses. El 62% presentó desaparición postquirúrgica inmediata de la sintomatología preoperatoria, el 30% desaparición tras un período de 3 semanas a 2 meses (8% con mejoría parcial), y en el 8% no hubo mejoría. En cuanto a las complicaciones postoperatorias: 3 pacientes presentaron paresia facial II-III en la escala de House-Brackman (se recuperaron en un período de 6 meses), y 1 paciente presentó fístula de líquido cefalorraquídeo. Ninguno de los pacientes de la serie presentaron hipoacusia transitorio o permanente. Conclusión: La DMV como tratamiento del EHF es un procedimiento efectivo y seguro, que permite la resolución completa de la patología en la mayoría de los casos. PMID:27127708

Descripción del coronógrafo a ser instalado en Argentina (MICA)

NASA Astrophysics Data System (ADS)

Stenborg, G.; Francile, C.; Schwenn, R.; Epple, A.; Rovira, M.

El ``Coronógrafo de espejo para Argentina'' es un telescopio solar terrestre a ser colocado en el Observatorio Astronómico Félix Aguilar (El Leoncito), antes de finalizar 1996, como parte de un programa de ciencia bilateral entre Alemania y Argentina. Eclipses fotográficos de alta resolución han revelado que la corona solar es altamente estructurada y variable. De hecho, está contínuamente deformada y moldeada por los movimientos convectivos de los extremos de los arcos magnéticos en la fotosfera, estando, en muchas oportunidades, afectada por explosivas liberaciones de energía. MICA, en conjunción con otros telescopios solares espaciales y terrestres, tratará de contribuir al entendimiento de cuestiones fundamentales de la física solar. Entre ellas: cómo la corona está siendo calentada, dónde y cómo el viento solar es acelerado, qué causa los transitorios coronales, etc. Para ello investigará la distribución de los parámetros del plasma y su evolución con el tiempo, la estructura espacial de la corona en fina y gran escala, procesos que ocurren en los transitorios coronales y factores que los disparan, etc. Para responder a estas cuestiones MICA observará la atmósfera solar por sobre el limbo entre 1.1 y 2 radios solares aproximadamente, usando un nuevo tipo de sistema coronográfico que permite suprimir el brillo del disco solar suficientemente bien, tomando las imágenes con una cámara CCD de 1024x1024 pixels, codificada en 12 bits, pudiendo el mismo ser operado en forma remota. En la presente exposición describiremos las características del instrumento, cómo será controlado y qué esperamos observar basados en las imágenes obtenidas por los telescopios de similares características LASCO C1 a bordo del SOHO y PICO (ubicado en el Observatorio de Pic du Midi, Francia).

Interview with Irving W Wainer.

PubMed

Wainer, Irving W

2013-08-01

Irving W Wainer, Senior Investigator in the Intramural Research Program at the National Institute on Aging/NIH received his PhD degree in chemistry from Cornell University and did postdoctoral doctoral studies in molecular biology (University of Oregon) and clinical pharmacology (Thomas Jefferson Medical School). He worked for the US FDA and held positions at St Jude's Children's Research Hospital, at McGill University as Professor in the Department of Oncology, and as a Professor of Pharmacology at Georgetown University. Wainer has published over 350 scientific papers, 10 books, 25 book chapters and holds 11 patents. His awards include: 'A.J.P. Martin Medal' presented by the Chromatographic Society; Doctor HonorisCausa awarded by the Medical University of Gdansk (Gdansk, Poland, 2006), Doctor HonorisCausa awarded by the Department of Medicine, University of Liege (Liege, Belgium, 2012), and the 2013 Eastern Analytical Symposium Award for Outstanding Contributions to the Fields of Analytical Chemistry. Wainer's research includes the development of new therapeutic agents for the treatment of congestive heart failure, cancer, pain and depression, many of which are in the later stages of drug development. His laboratory has also continued the development of cellular membrane affinity chromatography technology, and recent work includes the development of columns containing immobilized forms of the breast cancer resistance protein found in cellular and nuclear membranes and mitochondrial membrane columns. Wainer's laboratory has also continued its study of the effect of disease progression and aging on drug metabolism in critically ill and terminal patients. Interview was conducted by Lisa Parks, Assistant Commissioning Editor of Bioanalysis.

Selling antimicrobials without prescription - Far beyond an administrative problem.

PubMed

Guinovart, Maria C; Figueras, Albert; Llor, Carles

2018-05-01

Selling antibiotics without prescription is common in many countries; beyond the administrative restrictions, this practice is a risk for patients and society. The aim of the study was to evaluate the information provided by the staff of the pharmacy to a simulated patient requesting an antibiotic. A prospective study was carried out in January 2013 - February 2014 in the Health Region of Tarragona, in which a mystery shopper visited 220 pharmacies requesting an antibiotic to be sold. The actress was not asked about allergies in 73.9% of cases and never was asked about possible pregnancy. Recommendation to see a doctor was observed in 36.1% of cases. When antibiotics were not sold, the explanation provided by the staff was reasoned only in 9.9% of the cases. It is necessary and urgent to improve the training of pharmacists in dispensing antibiotics but also strengthen basic health knowledge among the population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Typhoid fever causing haemophagocytic lymphohistiocytosis in a non-endemic country - first case report and review of the current literature.

PubMed

Sánchez-Moreno, Paula; Olbrich, Peter; Falcón-Neyra, Lola; Lucena, Jose Manuel; Aznar, Javier; Neth, Olaf

2018-06-07

Development of secondary haemophagocytic lymphohistiocytosis (sHLH) in the context of typhoid fever (TF) is a very rare but serious complication. Description of the first pediatric case of typhoid fever acquired in a non-endemic area complicated by sHLH. A systematic literature review of sHLH in the context of TF was performed with extraction of epidemiological, clinical and laboratory data. The literature search revealed 17 articles (22 patients). Fifteen patients were eligible for data analysis (53.4% children). All patients had fever and pancytopenia. Transaminases and LDH were frequently elevated (46.6%). Salmonella typhi was detected mainly by blood culture (64.3%). All the patients received antibiotics whereas immunomodulation (dexamethasone) was used in two cases. A high suspicion index for this condition is needed even in non-endemic areas. The addition of immunmodulation to standard antimicrobial therapy should be considered in selected cases. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Antibiotic resistance: A global crisis].

PubMed

Alós, Juan-Ignacio

2015-12-01

The introduction of antibiotics into clinical practice represented one of the most important interventions for the control of infectious diseases. Antibiotics have saved millions of lives and have also brought a revolution in medicine. However, an increasing threat has deteriorated the effectiveness of these drugs, that of bacterial resistance to antibiotics, which is defined here as the ability of bacteria to survive in antibiotic concentrations that inhibit/kill others of the same species. In this review some recent and important examples of resistance in pathogens of concern for mankind are mentioned. It is explained, according to present knowledge, the process that led to the current situation in a short time, evolutionarily speaking. It begins with the resistance genes, continues with clones and genetic elements involved in the maintenance and dissemination, and ends with other factors that contribute to its spread. Possible responses to the problem are also reviewed, with special reference to the development of new antibiotics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of management of prosthetic joint infections. Clinical practice guidelines by the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).

PubMed

Ariza, Javier; Cobo, Javier; Baraia-Etxaburu, Josu; Benito, Natividad; Bori, Guillermo; Cabo, Javier; Corona, Pablo; Esteban, Jaime; Horcajada, Juan Pablo; Lora-Tamayo, Jaime; Murillo, Oscar; Palomino, Julián; Parra, Jorge; Pigrau, Carlos; Del Pozo, José Luis; Riera, Melchor; Rodríguez, Dolores; Sánchez-Somolinos, Mar; Soriano, Alex; Del Toro, M Dolores; de la Torre, Basilio

2017-03-01

The incidence of prosthetic joint infection (PJI) is expected to increase in the coming years. PJI has serious consequences for patients, and high costs for the health system. The complexity of these infections makes it necessary to organize the vast quantity of information published in the last several years. The indications for the choice of a given surgical strategy and the corresponding antimicrobial therapy are specifically reviewed. The authors selected clinically relevant questions and then reviewed the available literature in order to give recommendations according to a pre-determined level of scientific evidence. The more controversial aspects were debated, and the final composition was agreed at an ad hoc meeting. Before its final publication, the manuscript was made available online in order that all SEIMC members were able to read it and make comments and suggestions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Strategies for the cure of HIV infection.

PubMed

Rodríguez-Muñoz, Jesús; Moreno, Santiago

2018-03-03

The disadvantages of the long-term administration of antiretroviral therapy as well as the huge number of affected persons have placed the cure of HIV as a primary goal of Public Health. HIV may persist in the organism by at least four mechanisms: a latently infected cellular reservoir, the persistent replication of HIV in spite of ART, anatomic sanctuaries, and the immune dysfunction. Several strategies directed against these mechanisms have been developed. With all this, a complete eradication of HIV has been achieved in a patient using the transplantation of haemopoietic stem cells that were resistant to HIV-infection, and there are examples of functional cure either spontaneously (elite controllers) or after antiretroviral therapy (post-treatment controllers). However, no strategies have been successful in reducing the reservoir size, nor in achieving constant, uniform remissions. The failure of isolated strategies makes it likely that the combination of several of them may be the future solution. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Microbiological diagnosis of human papilloma virus infection.

PubMed

Mateos-Lindemann, Maria Luisa; Pérez-Castro, Sonia; Rodríguez-Iglesias, Manuel; Pérez-Gracia, Maria Teresa

2017-11-01

Infection with human papillomavirus (HPV) is the leading cause of sexually transmitted infection worldwide. This virus generally causes benign lesions, such as genital warts, but persistent infection may lead to cervical cancer, anal cancer, vaginal cancer, and oropharyngeal cancer, although less frequently. Cervical cancer is a severe disease with a high mortality in some countries. Screening with cytology has been very successful in the last few years, but nowadays there are numerous studies that confirm that cytology should be replaced with the detection of HPV as a first line test in population based screening. There are several commercially available FDA approved tests for screening of cervical cancer. A new strategy, based on individual detection of the high risk genotypes HPV16 and HPV18, present in 70% of cervical cancer biopsies, has been proposed by some experts, and is going to be implemented in most countries in the future. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Recommendations from MENSURA for selection of antimicrobial agents for susceptibility testing and criteria for the interpretation of antibiograms].

PubMed

2000-03-01

This document includes the recommendations from the Spanish antibiogram committee (The MENSURA group, Mesa Española de Normalización de la Sensibilidad y Resistencia a los Antimicrobianos, under the auspices of the Sociedad Española de Quimioterapia and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica) for the selection of antimicrobials for susceptibility testing. Separate tables for each group of organism with proposed susceptibility and resistance breakpoints are updated and comparatively presented with those of other groups, such us NCCLS, CA-SFM and BSAC. The susceptibility breakpoint tends to identify the fully susceptible population, which probably lacks any specific resistance mechanism. The analysis of MIC distributions for different homogeneous populations (same species) is used to define breakpoints for susceptibility. The resistance breakpoint is based on pharmacological and clinical data obtained when the corresponding antibiotic is administered with a conventional schedule. The primary objective of the Spanish MENSURA group is to contribute to the international consensus on the establishment of breakpoints.

Implementing and expanding HIV testing in immigrant populations in Europe: Comparing guideline's recommendations and expert's opinions.

PubMed

Álvarez-Del Arco, Débora; Monge, Susana; Rivero-Montesdeoca, Yaiza; Burns, Fiona; Noori, Teymur; Del Amo, Julia

2017-01-01

Immigrant populations, especially those from endemic countries, living in the European Union (EU) suffer a disproportionate burden of HIV, delayed diagnosis and poorer access to antiretroviral treatment. While International Organisations are developing recommendations aimed at increasing the uptake of HIV testing, the feasibility and real outcomes of these measures remain unexplored. The aim of this review was, firstly to identify the recommendations of the main International Organisations (IO) on HIV testing in immigrants. Secondly, to describe the challenges for implementing and expanding HIV testing and counselling interventions targeting immigrants by interviewing key informants. The importance of HIV testing in immigrants is discussed, along with the appropriateness of universal HIV testing approaches vs most at risk targeted approaches. Also addressed is, pre- and post-HIV test counselling characteristics and community initiatives suitable to reach this population and, finally the legal issues regarding access to treatment for illegal immigrants. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of the GeSIDA/National AIDS Plan consensus document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2018).

PubMed

2018-05-11

This update to the document on antiretroviral therapy (ART) in adults, which has been prepared jointly by GeSIDA and the Spanish National AIDS Plan for the last two decades, supersedes the document published in 2017. 1 The update provides physicians treating HIV-1-infected adults with evidence-based recommendations to guide their therapeutic decisions. The main difference with respect to the previous document concerns recommended initial ART regimens, only three of which are maintained as preferential. All three include dolutegravir or raltegravir, together with emtricitabine/tenofovir alafenamide or abacavir/lamivudine. Other differences concern the section on switching ART in patients with suppressed viral replication, which now includes new two- and three-drug regimens, and the antiretroviral drugs recommended for pregnant women and patients with tuberculosis. A recommendation has also been added for patients who present with acute HIV infection after pre-exposure prophylaxis. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Rhabdomyolysis and severe hepatotoxicity due to a drug-drug interaction between ritonavir and simvastatin. Could we use the most cost-effective statin in all human immunodeficiency virus-infected patients?].

PubMed

Bastida, Carla; Also, Maria Antonia; Pericas, Juan Manuel; Letang, Emili; Tuset, Montse; Miró, Josep Maria

2014-11-01

Drugs like statins may induce rhabdomyolysis. Simvastatin and lovastatin have a high hepatic metabolism and their potential toxicity could be increased by interactions with other drugs that reduce their metabolism. A case-report is presented of an HIV-infected patient treated with antiretroviral drugs who developed a rhabdomyolysis-induced renal failure and liver toxicity when simvastatin was substituted for atorvastatin. A literature review is also presented. The patient required hospital admission and showed a favorable response after hydration and urine alkalinization. There were 4 additional cases published of which there was one death. Drug-drug interactions can increase the risk of statin induced rhabdomyolysis. In order to evaluate them properly, physicians at all levels of clinical care should be aware of all drugs prescribed to their patients and the contraindicated combinations. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Syphilis and human immunodeficiency virus infection: an endemic infection in men who have sex with men].

PubMed

González-Domenech, Carmen M; Antequera Martín-Portugués, Isabel; Clavijo-Frutos, Encarnación; Márquez-Solero, Manuel; Santos-González, Jesús; Palacios-Muñoz, Rosario

2015-01-01

to analyse epidemiological, clinical, and analytical features of HIV-infected men who have sex with men (MSM) diagnosed with syphilis in the Infectious Diseases Unit (Hospital Virgen de la Victoria, Málaga, Spain) during 2004-2013. An observational study was conducted on 196 syphilis episodes in 167 MSM infected with HIV (2004-2013). Epidemiological, clinical, and analytical data were collected. Annual syphilis incidence among HIV-MSM is calculated as the number of syphilis episodes among MSM in one year divided by the number of MSM followed up in that year. Incidence ranged from 1.2% (2007) to 7.8% (2012). There were asymptomatic episodes in 42.8% cases, and an HIV-syphilis coincident diagnosis in 28.5%. The annual incidence of syphilis has increased within HIV infected MSM. One third of the syphilis episodes were simultaneous to HIV diagnosis and near half of them were asymptomatic. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Recognition of excretory/secretory antigens of Anisakis type I and evolution of IgE in experimentally infected rats].

PubMed

Gómez-Mateos, Magdalena; Valero-López, Adela; de la Rubia-Nieto, Teresa; Romero-López, María Del Carmen; Díaz-Sáez, Victoriano

2014-10-01

Anisakis spp., during parasitism, release excretory-secretory antigens that, in contact with the human immune system, can trigger a hypersensitivity response mediated by IgE, causing various allergic symptoms. To evaluate the IgE response in Wistar rats after infection with L3 larvae of the parasite Anisakis spp. Some determining factors involved in the technique have been improved in this work, such as: the concentration of polyacrylamide used in the preparation of the gels, the antigen concentration used, and the temperature required for denaturation of proteins. Immune responses (Ag-Ab) observed by the immunoblotting technique showed a greater intensity with serum obtained after reinfection, which have recognized proteins that may correspond to the major antigen Ani s 1 and other polypeptides of interest in the diagnosis of human anisakiasis. This paper concludes that immunoblotting is a useful technique to detect IgE antibodies against Anisakis proteins. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Who and how many of the potential users would be willing to pay the current or a lower price of the HIV self-test? The opinion of participants in a feasibility study of HIV self-testing in Spain.

PubMed

Rosales-Statkus, M Elena; Belza-Egozcue, María J; Fernández-Balbuena, Sonia; Hoyos, Juan; Ruiz-García, Mónica; de la Fuente, Luis

2014-05-01

We estimate the proportion of participants willing to pay the US price (€30) or €20 for an HIV self-test and analyse their associated factors. In a street-based testing program, 497 participants in a feasibility self-test study answered the question, "What would be the maximum price you would be willing to pay for a similar test to this one so you can use it at your convenience?" Only 17.9% would pay ≥€30, while 40.0%, ≥€20. In the logistic regression, paying more was associated with being tested outside the campuses and having paid or been paid for sex. In Spain, self-testing would not have an impact unless it became more affordable to potential users. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Molecular aspects of the antiviral response against hepatitis C virus implicated in vaccines development].

PubMed

Llanes, María Soledad; Palacios, Natalia Soledad; Piccione, Magalí; Ruiz, María Guillermina; Layana, Carla

2015-04-01

Hepatitis C is a contagious liver disease caused by hepacivirus of the Flaviviridae family. It has a RNA genome, a unique highly variable molecule. It encodes ten proteins which are necessary to infect cells and multiply. Replication occurs only in hepatocytes. Because of its wide genomic variability and the absence of symptoms, it is difficult to make an early diagnosis and successful treatment. In this review we analyze the molecular mechanism by which the virus infects the hepatocytes and causes the disease. We focused the analysis on different therapies, with the possibility of improving treatment with the use of new specific vaccines. We highlight the use of new therapies based on nucleic acids, mainly DNA vectors. In the near future, once this treatment is adequately evaluated in clinical trials, and the costs are calculated, it could be a very beneficial alternative to conventional methods. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Comparison of the CT OligoGen kit with cobas 4800 assay for detection of Chlamydia trachomatis.

PubMed

Parra-Sánchez, Manuel; Marcuello-López, Ana; García-Rey, Silvia; Zakariya-Yousef, Ismail; Sivianes-Valdecantos, Nieves; Sierra-Atienza, Celestina; Bernal-Martínez, Samuel; Pueyo-Rodrígez, Isabel; Martín-Mazuelos, Estrella; Palomares-Folía, José Carlos

2015-12-01

A prospective study was designed to assess the performance of the new CT OligoGen kit and the cobas 4800 assay for detection of Chlamydia trachomatis. A set of samples that included urine samples (n=212), endocervical (n=167), rectal (n=53), pharyngeal (n=7) and urethral swabs (n=3). The samples were sent from a regional sexually transmitted diseases (STD) clinic in Seville, Spain, and were collected from 261 men and 181 women. Discordant results were re-analyzed and clinical data and other tests were reviewed in order to resolve them. Sensitivity, specificity, positive predicative value (PPV), negative predictive value (NPV) and kappa value for C. trachomatis detection using the CT OligoGen kit were 98.5%, 100%, 100%, 95.4% and 0.97, respectively. This new kit had a high sensitivity, specificity, PPV and NPV for C. trachomatis, therefore the performance profile confirms the usefulness and reliable results of this new assay. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of the consensus document on post-exposure prophylaxis against HIV, HBV and HCV in adults and children.

PubMed

Polo Rodriguez, Rosa; Lozano, Fernando; González de Castro, Pedro; Jiménez, Ma Alonso; Miró, Oscar; Ramón Blanco, Jose; Moreno, David; Dueñas, Carlos; Muñoz Platón, Enriqueta; Fernández Escribano, Marina; Sanz Sanz, Jesús; Fumaz, Carmina; Santos, Ignacio; García, Federico; Téllez, Ma Jesús; González Montero, Raúl; Vals Jimenez, Ma Victoria; Losa, Juan Emilio; Valle Robles, Ma Luisa; Iribarren, Jose Antonio; Ortega, Enrique

2016-02-01

Post-exposure prophylaxis (PEP) can be a secondary measure to prevent infection by human immunodeficiency virus (HIV) when primary prevention has failed. PEP is advised for people with sporadic and exceptional risk exposure to HIV. This consensus document about occupational and non-occupational PEP recommendations aims to be a technical document for healthcare professionals. Its main objective is to facilitate the appropriate use of PEP. To this end, some recommendations have been established to assess the risk of transmission in different types of exposure, situations where PEP should be recommended, special circumstances to take into account, antiretroviral (ARV) guidelines including start and end of the treatment, early monitoring of tolerance and adherence to the treatment, subsequent monitoring of people exposed, independently of having received PEP or not, and need of psychological support. This document is intended for all professionals who work in clinical practice in the field of HIV infection. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Pathogenesis of tuberculosis and other mycobacteriosis.

PubMed

Cardona, Pere-Joan

2018-01-01

The evolution between Mycobacterium tuberculosis infection and active tuberculosis is multifactorial and involves different biological scales. The synthesis of ESAT-6 or the induction of alveolar macrophage necrosis are key, but to understand it, it is necessary to consider the dynamics of endogenous and exogenous reinfection, drainage of lung parenchyma and respiratory mechanics, local fibrosis processes and blood supply. Paradoxically, the immune response generated by the infection is highly protective (90%) against active tuberculosis, although as it is essentially based on the proliferation of Th1 lymphocytes, it cannot prevent reinfection. Severe immunosuppression can only explain 10% of active tuberculosis cases, while the remainder are attributable to comorbidities, a proinflammatory environment and an unknown genetic propensity. The pathogenic capacity of environmental mycobacteria is discrete, linked to deficits in the innate and acquired immune response. The ability to generate biofilms and the ability of M. ulcerans to generate the exotoxin mycolactone is remarkable. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Identification of Streptococcus pneumoniae lytA, plyA and psaA genes in pleural fluid by multiplex real-time PCR.

PubMed

Sanz, Juan Carlos; Ríos, Esther; Rodríguez-Avial, Iciar; Ramos, Belén; Marín, Mercedes; Cercenado, Emilia

2017-08-14

The aim was to evaluate the utility of a multiplex real-time PCR to detect Streptococcus pneumoniae lytA, plyA and psaA genes in pleural fluid (PF). A collection of 81 PF samples was used. Sixty were considered positive for S. pneumoniae according to previous results (54 by an in-house lytA gene PCR and eight by universal rRNA PCR). The sensitivity for detection of the lytA, plyA and psaA genes by multiplex PCR was 100% (60/60), 98.3% (59/60) and 91.7% (55/60), respectively. The detection of all three genes was negative in 21 samples formerly confirmed as negative for S. pneumoniae (100% specificity) by the other procedures (9 by in-house lytA PCR and 12 by rRNA PCR). The use of this multiplex PCR may be a useful option to identify S. pneumoniae directly in PF samples. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

PubMed Central

Mendoza-Ticona, Alberto

2014-01-01

Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

Conocimiento de Energía: Principios Esenciales y Conceptos Fundamentales para la Educación de Energía (in Spanish)

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

This is the Spanish version of our Energy Literacy guidebook. Esta guía presenta conceptos de energía que, cuando se entienden y se aplican, ayudan a individuos y a comunidades a tomar decisiones sobre la energía con conocimiento de causa. No es un currículo sino que ofrece un marco sobre el cual puede basarse un plan de estudios. La guía se dirige a cualquier persona que participe en la educación de energía.

Trends in corrected lung cancer mortality rates in Brazil and regions.

PubMed

Malta, Deborah Carvalho; Abreu, Daisy Maria Xavier de; Moura, Lenildo de; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth

2016-06-27

To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. Descrever a tendência da mortalidade por câncer de pulmão no Brasil e regiões, antes e após as correções por sub-registro de óbitos, redistribuição de causas mal definidas e causas inespecíficas. Foram utilizados dados de óbitos por câncer de pulmão da população de 30 a 69 anos, notificados ao Sistema de Informação sobre Mortalidade, entre 1996 e 2011, corrigidos para sub-registro de óbitos, declaração de sexo e idade ignorados e causas com códigos mal definidos e inespecíficos segundo sexo, idade e região. Foram calculadas taxas padronizadas por idade para dados brutos e corrigidos. Realizou-se análise da tendência temporal da mortalidade por câncer de pulmão por meio do modelo de regressão com erros autorregressivos. O câncer de pulmão no Brasil apresentou taxas mais elevadas em homens que em mulheres e a região Sul foi a que apresentou maior risco de morte em 1996 e 2011. A mortalidade tendeu a reduzir para o sexo masculino e a aumentar para o sexo feminino. O câncer de pulmão no Brasil apresenta padrão de distribuição diferente segundo sexo, com taxas mais elevadas em homens e com redução da tendência de mortalidade para o sexo masculino e aumento das taxas para o sexo feminino.

A causa das estações do ano: modelos mentais

NASA Astrophysics Data System (ADS)

de Campos, J. A. S.; de Araujo, J. F. S.

2003-08-01

A década de 70 do século passado foi marcada pelo estudo das concepções alternativas que os alunos trazem para a sala de aula. A identificação destas concepções foi o ponto de partida para promover a mudança conceitual, onde as pré-concepções seriam trocadas pelas concepções científicas. Na década seguinte, surgiram muitas propostas de estratégias educacionais para facilitar esta troca, na sua maioria baseadas na idéia do conflito cognitivo, proposta por Piaget. Entretanto, os resultados pouco animadores conduziram à percepção de que a mudança conceitual é um processo mais complexo. Pelas idéias da Ciência Cognitiva, a mudança conceitual é uma mudança progressiva dos modelos mentais que o aluno tem sobre o mundo físico, através de enriquecimento e revisão. A causa das Estações do Ano é um tópico sobre o qual a maioria dos estudantes apresenta concepções alternativas. Os autores fizeram um levantamento sobre as pré-concepções encontradas em trabalhos sobre o tema (16 referências), procurando encontrar elementos comuns que indicassem a presença de modelos mentais específicos. As pré-concepções encontradas na literatura foram obtidas usando-se diversas metodologias (desde entrevistas clínicas até questionários de múltipla escolha) e envolvendo alunos e professores de diferentes regiões geográficas. A partir de uma análise aprofundada de cada trabalho, e utilizando-se a técnica das Redes Sistêmicas, chegou-se a conclusão que as diversas pré-concepções identificadas (em torno de 50), poderiam ser representadas por 6 modelos mentais, onde a explicação da causa das estações do ano tem um mecanismo causal responsável. Os mecanismos causais identificados foram: a dependência da distância, a dependência da orientação, a dependência conjunta da distância e orientação, a dependência da obstrução, a dependência da velocidade e a dependência da inclinação dos raios solares. Foram ainda identificadas associações alternativas, que são um conjunto de pré-concepções, onde não existe a idéia de um modelo científico completo mas, sim, fragmentos de observação do dia a dia das pessoas.

The Variation of Catalyst and Carrier Gas on Anisole Deoxygenation Reaction

NASA Astrophysics Data System (ADS)

Ariyani, D.; Dwi Nugrahaningtyas, Khoirina; Heraldy, E.

2018-03-01

This research aims to determine the best catalyst and carrier gas in anisole deoxygenation reaction. The reaction was carried out over a flow system with a variation of catalyst CoMo A (CoMo/USY reduction), CoMo B (CoMo/USY oxidation-reduction), and CoMo C (CoMo/ZAA oxidation-reduction). In addition, variation of carrier gas nitrogen and hydrogen was investigated. The result was analyzed using Gas Chromatography-Mass Spectroscopy (GC-MS). The deoxygenation anisole result showed that CoMo A catalyst with hydrogen as the carrier gas has the highest total product yield (50.72 %), intermediate product yield (38.49 % in phenol and 6.99 % in benzaldehyde), and deoxygenation yield (5.24 %). The CoMo C catalyst exhibited the most selective deoxygenation product. The nitrogen carrier gas with the CoMo C catalyst has the best selectivity of benzene product (93.92 %).

Evolución en el tiempo de las relaciones Masa-Luminosidad y Corrección Bolométrica y Temperatura Efectiva contra Índice de Color

NASA Astrophysics Data System (ADS)

Miloni, L. A.; Camperi, J. A.

Analizamos la evolución que en los últimos 70 años han tenido las relaciones M-L, BC vs CI y Teff vs CI. Se discuten las causas de esa evolución, se trata de incorporar los valores más modernos disponibles discutiendo su calidad y se deducen las relaciones que actualmente deberían ser las más confiables. Destacamos los puntos en los que estas relaciones continúan estando pobremente definidas y sería deseable mejorar en el futuro próximo.

Economic impact of rapid diagnostic methods in Clinical Microbiology: Price of the test or overall clinical impact.

PubMed

Cantón, Rafael; Gómez G de la Pedrosa, Elia

2017-12-01

The need to reduce the time it takes to establish a microbiological diagnosis and the emergence of new molecular microbiology and proteomic technologies has fuelled the development of rapid and point-of-care techniques, as well as the so-called point-of-care laboratories. These laboratories are responsible for conducting both techniques partially to response to the outsourcing of the conventional hospital laboratories. Their introduction has not always been accompanied with economic studies that address their cost-effectiveness, cost-benefit and cost-utility, but rather tend to be limited to the unit price of the test. The latter, influenced by the purchase procedure, does not usually have a regulated reference value in the same way that medicines do. The cost-effectiveness studies that have recently been conducted on mass spectrometry in the diagnosis of bacteraemia and the use of antimicrobials have had the greatest clinical impact and may act as a model for future economic studies on rapid and point-of-care tests. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Achromobacter xylosoxidans infection in an adult cystic fibrosis unit in Madrid.

PubMed

Llorca Otero, Laura; Girón Moreno, Rosa; Buendía Moreno, Buenaventura; Valenzuela, Claudia; Guiu Martínez, Alba; Alarcón Cavero, Teresa

2016-03-01

Achromobacter xylosoxidans is an emerging pathogen in cystic fibrosis (CF). Although the rate of colonization by this microorganism is variable, prevalence is increasing in CF units. A microbiological/clinical study was conducted on of adult CF patients harboring A. xylosoxidans. Identification and susceptibility testing were performed using MicroScan (Siemens). Decline in lung function was assessed using the variable, annual percentage loss of FEV1 (forced expiratory volume in 1s). A. xylosoxidans was isolated in 18 (19.8%) of 91 patients over a 14-year period. Mean age was 26.6 years (18-39 years). Nine patients (9.8%) were chronically colonized. Piperacillin/tazobactam and imipenem were the most active antibiotics. Mean annual decline in lung function in chronically colonized patients was 2.49%. A. xylosoxidans is a major pathogen in CF. A decreased lung function was observed among patients who were chronically colonized by A. xylosoxidans. Antibiotic therapy should be started early in order to prevent chronic colonization by this microorganism. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Detection of carbapenemases and other mechanisms of enzymatic resistance to β-lactams in Enterobacteriaceae with diminished susceptibility to carbapenems in a tertiary care hospital.

PubMed

Gómara, Marta; López-Calleja, Ana Isabel; Iglesia, Berta María Pilar Vela; Cerón, Isabel Ferrer; López, Antonio Rezusta; Pinilla, María José Revillo

2018-05-01

Our objective was to characterize the enzymatic β-lactam resistance in clinical Enterobacteriaceae isolates with diminished susceptibility to carbapenems from 2013 to 2014 at Hospital Universitario Miguel Servet. A total of 63 clinical isolates were analyzed for the presence of carbapenemases (KPC, OXA-48 and MBL), ESBLs and AmpC enzymes by combined disk methods and PCR detection of carbapenemase-encoding and beta-lactamase-encoding genes. Fifteen isolates had a phenotypic test compatible with carbapenemase production; two of these were confirmed by PCR as OXA-48 producers. ESBL detection was positive in 27 isolates (43%); plasmid-mediated AmpC was detected in nine isolates (14.2%) and derepressed AmpC β-lactamase was present in 18 isolates (28%). During the study period, the decreased susceptibility to carbapenems in Enterobacteriaceae in our area was not due to true carbapenemases but rather to β-lactamase activity (82.5% were ESBL or AmpC producers), probably in combination with decreased permeability of the outer membrane. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Pharmacokinetic/pharmacodynamic analysis in microbiology: a tool for the evaluation of the antimicrobial treatment].

PubMed

Canut Blasco, Andrés; Aguilar Alfaro, Lorenzo; Cobo Reinoso, Javier; Giménez Mestre, M José; Rodríguez-Gascón, Alicia

2015-01-01

The selection of multiresistant microorganisms, as a side-effect of the use of antimicrobials, together with the lack of new therapeutic drugs expected in the near future, forces to a rational use of antibiotics. The optimisation of antibacterial treatments based on pharmacokinetic/pharmacodynamic analysis (PK/PD) may contribute to prolong the life of antibiotics and to contain the bacterial resistance to them. A review is made of the importance of the appropriateness of the dose regimen selected, the application of PK/PD analysis of antimicrobials, the Monte Carlo simulation, PK/PD indices for efficacy, and PK/PD cut-off points. PK/PD analysis is also applicable to the prevention of bacterial resistance. Different methods have been used to study the factors that lead to its emergence and spread, such as in vitro and animal models, and resistance prevention studies (mutant selection window). Although the PK/PD analysis is a very useful tool for the selection of the most appropriate dose regimen of antibiotics, several problems limit its use in clinical practice. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models.

PubMed

Asencio Egea, María Ángeles; Huertas Vaquero, María; Carranza González, Rafael; Herráez Carrera, Óscar; Redondo González, Olga; Arias Arias, Ángel

2017-12-04

We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics. A time series study of resistant community-acquired E. coli isolates and their association with antibiotic use was conducted in a Primary Health Care Area from 2008 to 2012. A Poisson regression model was constructed to estimate the trend and seasonality of E. coli resistance. A significant increasing trend in mean E. coli resistance to cephalosporins, aminoglycosides and nitrofurantoin was observed. Seasonal resistance to ciprofloxacin and amoxicillin-clavulanic acid was significantly higher in autumn-winter. There was a delay of 7, 10 and 12 months between the use of cotrimoxazole (P<0.038), fosfomycin (P<0.024) and amoxicillin-clavulanic acid (P<0.015), respectively, and the occurrence of E. coli resistance. An average delay of 10 months between the previous use of amoxicillin-clavulanic acid, cotrimoxazole and fosfomycin and the appearance of resistant community-acquired E. coli strains was detected. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Procedure for the marketing authorization of an antibacterial agent].

PubMed

López Navas, Antonio; García-Escribano Ráez, Nuria; Flores Juberías, Ángela; Suárez Gea, María Luisa

2014-10-01

The marketing authorization of a new medicinal product is the first step before being placed on the market, and includes the full investigation programme. In order to ensure their quality, safety and efficacy, medicinal products are closely regulated from their initial phases of investigation to their use in clinical practice. For registration purposes, the results of all the clinical and preclinical studies, along with quality data and the description of the manufacturing process should be submitted. All information collected is presented for review by the competent authority. The European Medicines Agency regulates the registration of medicines in Europe, and national agencies in each EU member state are responsible for the assessment of the marketing authorisation application. To facilitate the development of clinical programmes, there is a common framework for the evaluation of an antibacterial, which includes guidelines and an addendum, detailing the specific requirements that must be carried out in clinical trials to assess the efficacy and safety for most of the infections. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Serological diagnosis of mumps: Value of the titration of specific IgG.

PubMed

Sanz, Juan Carlos; Ramos, Belén; Fernández, Aurora; García-Comas, Luis; Echevarría, Juan Emilio; de Ory, Fernando

2018-03-01

The aim of this study was to evaluate a cut-off point of the titration of IgG by ELISA in the diagnosis of mumps. A study was made of serum samples from 85 mumps cases (confirmed by PCR in saliva) and 2,351 controls of the general population of the Region of Madrid. The IgM detection was positive in 21 cases (sensitivity of 24.7%). The best cut-off point corresponded to IgG titres ≥4,900 (sensitivity of 64.7% and specificity of 86.1%). Among 42 patients immunised with at least one dose of measles mumps, rubella vaccine IgM was detected in 4 cases. However, the detection of IgG ≥4,900 was positive in 29 (sensitivity of 69.0%). An IgG result of ≥4.900 was almost 5 times more probable in a patient with mumps than in a non-infected patient. The detection of high titres of IgG against mumps could improve the IgM results in vaccinated people. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

A safe an easy method for building consensus HIV sequences from 454 massively parallel sequencing data.

PubMed

Fernández-Caballero Rico, Jose Ángel; Chueca Porcuna, Natalia; Álvarez Estévez, Marta; Mosquera Gutiérrez, María Del Mar; Marcos Maeso, María Ángeles; García, Federico

2018-02-01

To show how to generate a consensus sequence from the information of massive parallel sequences data obtained from routine HIV anti-retroviral resistance studies, and that may be suitable for molecular epidemiology studies. Paired Sanger (Trugene-Siemens) and next-generation sequencing (NGS) (454 GSJunior-Roche) HIV RT and protease sequences from 62 patients were studied. NGS consensus sequences were generated using Mesquite, using 10%, 15%, and 20% thresholds. Molecular evolutionary genetics analysis (MEGA) was used for phylogenetic studies. At a 10% threshold, NGS-Sanger sequences from 17/62 patients were phylogenetically related, with a median bootstrap-value of 88% (IQR83.5-95.5). Association increased to 36/62 sequences, median bootstrap 94% (IQR85.5-98)], using a 15% threshold. Maximum association was at the 20% threshold, with 61/62 sequences associated, and a median bootstrap value of 99% (IQR98-100). A safe method is presented to generate consensus sequences from HIV-NGS data at 20% threshold, which will prove useful for molecular epidemiological studies. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of the GeSIDA/National AIDS Plan consensus document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2014).

PubMed

Berenguer, Juan; Polo, Rosa; Lozano, Fernando; López Aldeguer, José; Antela, Antonio; Arribas, José Ramón; Asensi, Víctor; Blanco, José Ramón; Clotet, Bonaventura; Domingo, Pere; Galindo, María José; Gatell, José María; González-García, Juan; Iribarren, José Antonio; Locutura, Jaime; López, Juan Carlos; Mallolas, Josep; Martínez, Esteban; Miralles, Celia; Miró, José M; Moreno, Santiago; Palacios, Rosario; Pérez Elías, María Jesús; Pineda, Juan Antonio; Podzamczer, Daniel; Portilla, Joaquín; Pulido, Federico; Ribera, Esteban; Riera, Melchor; Rubio, Rafael; Santos, Jesús; Sanz, Jesús; Tuset, Montserrat; Vidal, Francesc; Rivero, Antonio

2014-01-01

In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The strength and grade of the recommendation varies with clinical circumstances, number of CD4 cells, comorbid conditions and prevention of transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load. Initial ART should always comprise a combination of 3 drugs, including 2 nucleoside reverse transcriptase inhibitors and a third drug from a different family (non-nucleoside reverse transcriptase inhibitor, protease inhibitor, or integrase inhibitor). This update presents the causes and criteria for switching ART in patients with undetectable plasma viral load and in cases of virological failure. An update is also provided for the specific criteria for ART in special situations (acute infection, HIV-2 infection, and pregnancy) and with comorbid conditions (tuberculosis or other opportunistic infections, kidney disease, liver disease, and cancer). Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Widespread increase of empirical carbapenem use in acute care hospitals in Catalonia, Spain.

PubMed

Grau, Santiago; Fondevilla, Esther; Echeverría-Esnal, Daniel; Alcorta, Amaia; Limon, Enric; Gudiol, Francesc

2018-04-24

The overall increase in the use of carbapenems could lead to the selection of carbapenem-resistant bacteria. The objectives of this study were to analyze carbapenem use from 2008 to 2015 and their prescription profile in 58 hospitals affiliated to the VINCat Programme (nosocomial infection vigilance system). Retrospective, longitudinal and descriptive study of carbapenem use. Consecutive case-series study, looking for carbapenem prescription characteristics, conducted in January 2016. Use was calculated in defined daily doses (DDD)/100 patient-days (PD); prescription profiles were assessed using a standardized survey. Carbapenem use increased 88.43%, from 3.37 DDD/100-PD to 6.35 DDD/100-PD (p<0.001). A total of 631 patients were included in the prescription analysis. Carbapenems were prescribed empirically in 76.2% of patients, mainly for urinary tract and intra-abdominal infections due to suspicion of polymicrobial mixed infection (27.4%) and severity (25.4%). A worrying increase in carbapenem use was found in Catalonia. Stewardship interventions are required to prevent carbapenem overuse. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Epidemiological and serological aspects in canine toxoplasmosis in animals with nervous symptoms.

PubMed

de Brito, Adriana Falco; de Souza, Luiz Carlos; da Silva, Aristeu Vieira; Langoni, Helio

2002-01-01

The presence of anti-Toxoplasma gondii IgM and IgG antibodies was studied in samples of blood serum taken from eighty dogs with nervous symptoms at the Serviço de Enfermidades Infecciosas dos Animais, Faculdade de Medicina Veterinária e Zootecnia, Unesp, Botucatu, São Paulo, Brazil. The frequency of IgG titers were 16 (13.7%), 64 (13.7%), and 256 (5%), and for IgM titers were 16 (7.5%), 64 (15%), and 256 (8.7%). Positive reactions were more frequent in the older animals, males, from a rural environment, in constant contact with small animals, principally birds and rodents. There was a higher frequency of a positive reaction in dogs fed with kitchen food, especially in those fed with raw ingredients. The most common neurological pictures were alterations in consciousness, in movement, and in the hand-cart test. The percentage of reagents with specific IgM antibodies was high, indicating active infections, but the possibility of co-infection with the distemper virus can not be discarded, and this may be a predisposing factor for toxoplasmosis infection, once the distemper virus has a potent immunosuppressive action.

[Executive summary of the recommendations on the evaluation and management of renal disease in human immunodeficiency virus-infected patients].

PubMed

Gorriz, José L; Gutiérrez, Félix; Trullàs, Joan C; Arazo, Piedad; Arribas, Jose R; Barril, Guillermina; Cervero, Miguel; Cofán, Frederic; Domingo, Pere; Estrada, Vicente; Fulladosa, Xavier; Galindo, María J; Gràcia, Sílvia; Iribarren, José A; Knobel, Hernando; López-Aldeguer, José; Lozano, Fernando; Martínez-Castelao, Alberto; Martínez, Esteban; Mazuecos, Maria A; Miralles, Celia; Montañés, Rosario; Negredo, Eugenia; Palacios, Rosario; Pérez-Elías, María J; Portilla, Joaquín; Praga, Manuel; Quereda, Carlos; Rivero, Antonio; Santamaría, Juan M; Sanz, José; Sanz, Jesús; Miró, José M

2014-11-01

The aim of this article is to update the 2010 recommendations on the evaluation and management of renal disease in human immunodeficiency virus (HIV)-infected patients. Renal function should be monitored in all HIV-infected patients. The basic renal work-up should include measurements of serum creatinine, estimated glomerular filtration rate by CKD-EPI, urine protein-to-creatinine ratio, and urinary sediment. Tubular function tests should include determination of serum phosphate levels and urine dipstick for glycosuria. In the absence of abnormal values, renal screening should be performed annually. In patients treated with tenofovir, or with risk factors for chronic kidney disease (CKD), more frequent renal screening is recommended. In order to prevent disease progression, potentially nephrotoxic antiretroviral drugs are not recommended in patients with CKD or risk factors for CKD. The document provides indications for renal biopsy and advises on the optimal time for referral of a patient to the nephrologist. The indications for and evaluation and management of dialysis and renal transplantation are also addressed. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Helminthosis and eosinophilia in Spain (1990-2015).

PubMed

Carranza-Rodríguez, Cristina; Escamilla-González, Miriam; Fuentes-Corripio, Isabel; Perteguer-Prieto, María-Jesús; Gárate-Ormaechea, Teresa; Pérez-Arellano, José-Luis

2018-02-01

The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Teaching infectious diseases in the Medical Degree within the European higher education area].

PubMed

Gutiérrez, Félix; Masiá, Mar

2016-01-01

During their medical studies, students must acquire basic competencies in different areas of knowledge, one of which is infectious diseases. Training in infectious diseases is essential for general medical practice and for academic or professional expertise in many areas of medicine, both medical and surgical. The vast amount of knowledge that is continuously generated about infectious diseases requires a well-structured undergraduate medical education program and framed in a setting dominated by globalization. The incorporation of Spain to the European higher education area has forced medical schools to adapt their curriculum and to establish the content and learning objectives of all courses of study. In this paper, we discuss the implications of the integration of the Spanish university system in the European higher education area («Bologna Process») in the teaching of infectious diseases in the Degree of Medicine, and describe the learning program in infectious diseases of the University Miguel Hernández of Elche (Alicante, Spain) based on learning outcomes and competencies. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Susceptibility to azithromycin and other antibiotics in recent isolates of Salmonella, Shigella and Yersinia].

PubMed

Martín-Pozo, Angeles; Arana, David M; Fuentes, Miriam; Alós, Juan-Ignacio

2014-01-01

Azithromycin represents an alternative option to treat bacterial diarrhea when the antibiotic therapy is indicated. Little is known regarding the susceptibility to azithromycin in enteropathogens in Spain. The MICs of azithromycin were determined by E-test against Salmonella non-typhi (SNT), Shigella and Yersinia isolates collected over the last three years (2010-2012). In addition, the susceptibility to other antibiotics usually used to treat gastrointestinal diseases was determined in these isolates by using a microdilution method. A total of 139 strains of SNT, Shigella and Yersinia were studied. All of them, except one strain, had a MIC≤16mg/L of azithromycin. In the adult population, 14.7% and 40.6% of SNT and Shigella isolates, respectively, were resistant to at least 2 of following antibiotics: amoxicillin, trimethoprim-sulfamethoxazole and ciprofloxacin. In the pediatric population, 10% of SNT clinical isolates and 28.6% (2/7) of Shigella isolates were resistant to amoxicillin and trimethoprim-sulfamethoxazole. In our experience, azithromycin would be a useful antibiotic alternative to treat bacterial diarrhea. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

To whom is HIV pre-exposure prophylaxis proposed?

PubMed

Ayerdi-Aguirrebengoa, Oskar; Vera-García, Mar; Puerta-López, Teresa; Raposo-Utrilla, Montserrat; Rodríguez-Martín, Carmen; Del Romero-Guerrero, Jorge

2017-05-01

HIV Pre-Exposure Prophylaxis (PrEP) consists of administering antiretroviral drugs to seronegative individuals with high risk practices. The aim of the study was to describe the characteristics of recent seroconverted HIV patients in order to determine the profile of the appropriate candidates for PrEP. A descriptive study of all patients diagnosed with HIV infection in 2014, and who had achieved a documented negative serology over the previous 12 months. A specific form was completed to determine the sociodemographic, behavioural, and clinical features, with complementary tests being performed for other sexually transmitted infections. Almost all (98.4%) of the 61 recent seroconverted were men who have sex with men, and aged between 20 to 39 years (88.5%). They also had a background of sexually transmitted infections (80.3%), performed multiple and unprotected sexual practices (82.7%), and under the effect of recreational drugs (87%). The evaluation of the risk factors for HIV infection in seronegative patients should enable the appropriate candidates for PrEP to be identified. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

The English as a Foreign Language/Lingua Franca Debate: Sensitising Teachers of English as a Foreign Language towards Teaching English as a Lingua Franca (El debate del inglés como lengua extranjera o como lengua franca: sensibilización de docentes de inglés como lengua extranjera hacia la enseñanza del inglés como lengua franca)

ERIC Educational Resources Information Center

Mansfield, Gillian; Poppi, Franca

2012-01-01

The function of English as a lingua franca for communication needs rethinking in the teaching of English as a foreign language classroom as a consequence of globalisation. The present contribution is an empirical study carried out in an Italian university environment which aims to show how teachers should take on board awareness raising activities…

High-energy asymmetric supercapacitors based on free-standing hierarchical Co-Mo-S nanosheets with enhanced cycling stability.

PubMed

Balamurugan, Jayaraman; Li, Chao; Peera, Shaik Gouse; Kim, Nam Hoon; Lee, Joong Hee

2017-09-21

Layered transition metal sulfides (TMS) are emerging as advanced materials for energy storage and conversion applications. In this work, we report a facile and cost-effective anion exchange technique to fabricate a layered, multifaceted, free standing, ultra-thin ternary cobalt molybdenum sulfide nanosheet (Co-Mo-S NS) architecture grown on a 3D porous Ni foam substrate. The unique Co-Mo layered double hydroxides are first synthesized as precursors and consequently transformed into ultra-thin Co-Mo-S NS. When employed as an electrode for supercapacitors, the Co-Mo-S NS delivered an ultra-high specific capacitance of 2343 F g -1 at a current density of 1 mA cm -2 with tremendous rate capability and extraordinary cycling performance (96.6% capacitance retention after 20 000 cycles). Furthermore, assembled Co-Mo-S/nitrogen doped graphene nanosheets (NGNS) in an asymmetric supercapacitor (ASC) device delivered an excellent energy density of 89.6 Wh kg -1 , an amazing power density of 20.07 kW kg -1 , and superior cycling performance (86.8% capacitance retention after 50 000 cycles). Such exceptional electrochemical performance of Co-Mo-S NS is ascribed to the good electrical contact with the 3D Ni foam, ultra-high contact area with the electrolyte, and enhanced architectural softening during the charging/discharging process. It is expected that the fabricated, unique, ultra-thin Co-Mo-S NS have great potential for future energy storage devices.

A sup 57 Co Moessbauer emission spectrometric study of some supported CoMo hydrodesulfurization catalysts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veen, J.A.R. van; Hendriks, P.A.J.M.; Beens, H.

1992-01-01

A suite of 11 CoMo/Al{sub 2}O{sub 4} (and one CoMo/SiO{sub 2}) catalysts has been prepared employing four preparation routes, viz. one sequential-impregnation route and three different coimpregnation routes. Speciation of the Co present in the oxidic precursors (octahedral vs tetrahedral Co) and in the activated, sulfided catalysts (CoMoS, Co{sub 9}S{sub 8}, and unsulfided Co) was effected with the aid of {sup 57}Co Moessbauer emission spectroscopy (MES). A linear relation between the thiophene-hydrodesulfurization (HDS) activity and wt% Co-in-CoMoS was observed for each preparation route, but no unique correlation was found to exist. This was traced to the fact that the preparationmore » routes differ in the amount of CoMoS I and CoMoS II they produce in the activated catalyst. Although these two phases differ in specific activity, CoMoS II being twice as active in thiophene HDS as CoMoS I, they cannot be distinguished on the basis of their Moessbauer parameters. It appears that octahedral Co is easier to sulfide than tetrahedral Co, but a substantial fraction of the latter is also found to be capable of entering CoMoS upon sulfidation. The reduced effectiveness of high-loading catalysts is traced to their being prone to CoMoO{sub 4} formation in the calcination step. A rationalization of this behavior is offered.« less

[Levels of trace elements in the fruits and vegetables from the so-called Land of fires in Campania Region (Southern Italy)].

PubMed

Esposito, Mauro; Cavallo, Stefania; Rosato, Guido; Chiaravalle, Eugenio; Miedico, Oto; Pellicanò, Roberta; Soprano, Vittorio; Baldi, Loredana

2016-01-01

INTRODUZIONE: una vasta area compresa tra le province di Napoli e Caserta nella regione Campania ha negli ultimi anni attirato l'attenzione dei mass media a causa degli interramenti illeciti di rifiuti di varia origine nei campi o del loro abbandono lungo le strade. A tali pratiche illecite si aggiunge il fenomeno dei roghi incontrollati di questo materiale, motivo per il quale la zona è stata soprannominata "Terra dei fuochi". OBIETTIVI: ricerca di elementi in tracce presenti nei prodotti alimentari di origine vegetale prodotti nella Terra dei fuochi. DISEGNO E SETTING: piano di monitoraggio per il rilevamento dei livelli di alcuni metalli tossici ed essenziali nei vegetali coltivati in Campania nella Terra dei fuochi. La determinazione dei microelementi è stata effettuata dopo mineralizzazione della sostanza organica mediante microonde, utilizzando la spettrometria di massa a plasma induttivamente accoppiato (ICP-MS). RISULTATI: durante l'attività di monitoraggio sono stati raccolti 65 campioni di ortaggi e 49 campioni di frutta in 43 comuni rientranti nella Terra dei fuochi. Il contenuto medio di metalli tossici, cadmio e piombo nei prodotti ortofrutticoli è risultato ben lontano dai limiti massimi fissati dalla normativa europea. I valori delle concentrazioni sono significativamente inferiori rispetto a quanto riscontrato in zone ad alto impatto ambientale a causa della presenza di impianti industriali. CONCLUSIONI: la presenza di elementi tossici o potenzialmente tali nei campioni vegetali prodotti nella Terra dei fuochi è attribuibile a una varietà di fattori ambientali rilevanti (caratteristiche geologiche dell'area, inquinamento del suolo, dell'atmosfera e delle acque di irrigazione, pratiche illecite di smaltimento dei rifiuti industriali); non sembra, tuttavia, sussistere un rischio per la salute dei consumatori. Resta comunque l'allerta per la loro presenza nell'ambiente e la necessità che le attività di monitoraggio continuino.

[The "diagnosis" in the light of Charles S. Peirce, Sherlock Holmes, Sigmund Freud and modern neurobiology].

PubMed

Adler, R H

2006-05-10

A diagnostic hypothesis is a causa ficta. It is an assumption, suitable to explain phenomena, which are not yet proven to be the only and valid explanation of the observed. One of Wilhelm Hauff's faitales illustrates how a hypothesis is generated. It is based on the interpretation of signs. Signs are of an ikonic, an indexical or a symbolic nature. According to S. Peirce, a hypothesis is created by abduction, to Conan Doyle's Sherlock Holmes by immersion into thoughts, and to S. Freud by free floating attention. The three procedures are alike. Neurobiological structures and functions, which correspond to these processes, are described; especially the emotional-implicite memory. The technique of hypothesis-generation is meaningful to clinical medicine.

CoMoS2/rGO/C3N4 ternary heterojunctions catalysts with high photocatalytic activity and stability for hydrogen evolution under visible light irradiation

NASA Astrophysics Data System (ADS)

Xu, Xuejun; Si, Zhichun; Liu, Liping; Wang, Zehao; Chen, Ze; Ran, Rui; He, Yonghong; Weng, Duan

2018-03-01

Noble metal free MoS2/g-C3N4 catalyst has attracted intense attentions for visible light photocatalytic hydrogen evolution as a result of its earth abundance, low cost and unique heterojunctions stacked with two dimensional sheets. However, the low charge separation efficiency resulted from the poor conductivity of g-C3N4 and MoS2, and lack of abundant active sites from coordinative unsaturated atoms in MoS2, restricts the photocatalytic hydrogen evolution activity and stability enhancement of MoS2/C3N4 composite catalysts. Herein, CoMoS2/rGO/g-C3N4 catalysts with ternary heterojunctions are prepared by facile solvothermal method, which exhibit high visible light photocatalytic activity and stability for hydrogen evolution. The optimal hydrogen evolution rate of CoMoS2/rGO/g-C3N4 catalysts is 684 μmol g-1 h-1 when the content of CoMoS2 is 2% and the content of rGO is 0.5%. The stability of CoMoS2/rGO/C3N4 catalysts just decrease about 3% after 4 cycling runs for 16 h. The good catalytic performances of catalysts are attributed to the synergistic effect among the g-C3N4 nanosheets, rGO nanosheets and CoMoS2 nanosheets. The high conductivity of rGO nanosheets enhances the electron-hole separation and charge transfer, and Co doping increases the active sites for hydrogen evolution due to the increase of unsaturated atoms in CoMoS2 nanosheets.

COMO: a numerical model for predicting furnace performance in axisymmetric geometries. Volume 1. Technical summary. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fiveland, W.A.; Oberjohn, W.J.; Cornelius, D.K.

1985-12-01

This report summarizes the work conducted during a 30-month contract with the United States Department of Energy (DOE) Pittsburgh Energy Technology Center (PETC). The general objective is to develop and verify a computer code capable of modeling the major aspects of pulverized coal combustion. Achieving this objective will lead to design methods applicable to industrial and utility furnaces. The combustion model (COMO) is based mainly on an existing Babcock and Wilcox (B and W) computer program. The model consists of a number of relatively independent modules that represent the major processes involved in pulverized coal combustion: flow, heterogeneous and homogeneousmore » chemical reaction, and heat transfer. As models are improved or as new ones are developed, this modular structure allows portions of the COMO model to be updated with minimal impact on the remainder of the program. The report consists of two volumes. This volume (Volume 1) contains a technical summary of the COMO model, results of predictions for gas phase combustion, pulverized coal combustion, and a detailed description of the COMO model. Volume 2 is the Users Guide for COMO and contains detailed instructions for preparing the input data and a description of the program output. Several example cases have been included to aid the user in usage of the computer program for pulverized coal applications. 66 refs., 41 figs., 21 tabs.« less

Múltiples estados de desorden en el etanol sólido

NASA Astrophysics Data System (ADS)

Fernández-Perea, R.

El diagrama de fases del etanol por debajo de los 169 K será presentado. Se mostrará que el etanol puede solidificarse en tres fases con diversos niveles de desorden,(como un vidrio(G), como un vidrio orientacional (OG) y como un cristal de fase rotora (RP)) además de en una fase totalmente cristalina. Las estructuras de estas tres fases serán presentadas tal y como se deducen a partir de diversas medidas de difracción de neutrones al igual que las proporciones de los isómeros de dicho material en las fases desordenadas y se compararán con los resultados de la fase cristalina y del líquido superenfriado. Igualmente diversas medidas sobre su dinámica serán presentadas, tanto de dispersión de neutrones, como de capacidad calorífica y de medidas dieléctricas y comparadas con modelos teóricos y simulaciones para tratar de explicar los procesos de relajación observados y las transiciones entre las diversas fases.

PubMed

Silva, Cristiane Gonçalves da; Santos, Alessandro Oliveira; Licciardi, Daniele Carli; Paiva, Vera; Parker, Richard

2008-01-01

Esse artigo descreve como jovens religiosos e autoridades religiosas de sua comunidade compreendem a sexualidade, considerando suas experiências pessoais e como membros de comunidades religiosas. A análise pretende contribuir para que políticas públicas dedicadas à promoção da saúde sexual da juventude considerem a religiosidade, no contexto de um estado laico e da promoção do direito à prevenção. Foram realizadas 26 entrevistas abertas e semidirigidas em diferentes comunidades da região metropolitana da cidade de São Paulo (comunidades católicas, da umbanda, do candomblé e de diferentes denominações evangélicas) sobre iniciação sexual, casamento, gravidez, contracepção e prevenção das DST/Aids, homossexualidade, aborto e direitos humanos. Observou-se como jovens e autoridades religiosas convivem com a tensão entre tradição e modernidade e os distintos discursos sobre a sexualidade. Como sujeitos religiosos (do discurso religioso) e sujeitos sexuais (de discursos sobre sexualidade), devem ser incorporados pelos programas como sujeitos de direito nos termos de sua religiosidade.

[Evaluation of the status of patients with severe infection, criteria for intensive care unit admittance. Spanish Society for Infectious Diseases and Clinical Microbiology. Spanish Society of Intensive and Critical Medicine and Coronary Units].

PubMed

Olaechea, Pedro M; Alvarez-Lerma, Francisco; Sánchez, Miguel; Torres, Antonio; Palomar, Mercedes; Fernández, Pedro; Miró, José M; Cisneros, José Miguel; Torres, Manuel

2009-06-01

Recent studies have shown that early attention in patients with serious infections is associated with a better outcome. Assistance in intensive care units (ICU) can effectively provide this attention; hence patients should be admitted to the ICU as soon as possible, before clinical deterioration becomes irreversible. The objective of this article is to compile the recommendations for evaluating disease severity in patients with infections and describe the criteria for ICU admission, updating the criteria published 10 years ago. A literature review was carried out, compiling the opinions of experts from the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC, Spanish Society for Infectious Diseases and Clinical Microbiology) and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC, Spanish Society for Intensive Medicine, Critical Care and Coronary Units) as well as the working groups for infections in critically ill patients (GEIPC-SEIMC and GTEI-SEMICYUC). We describe the specific recommendations for ICU admission related to the most common infections affecting patients, who will potentially benefit from critical care. Assessment of the severity of the patient's condition to enable early intensive care is stressed.

HCV core-antigen assay as an alternative to HCV RNA quantification: A correlation study for the assessment of HCV viremia.

PubMed

Alonso, Roberto; Pérez-García, Felipe; López-Roa, Paula; Alcalá, Luis; Rodeño, Pilar; Bouza, Emilio

2018-03-01

Detection of hepatitis C virus (HCV) RNA and the HCV core antigen assay (HCV-Ag) are reliable techniques for the diagnosis of active and chronic HCV infection. Our aim was to evaluate the HCV-Ag assay as an alternative to quantification of HVC RNA. A comparison was made of the sensitivity and specificity of an HCV-Ag assay (204 serum samples) with those of a PCR assay, and the correlation between the two techniques was determined. The sensitivity and specificity of HCV-Ag was 76.6% and 100%, respectively. Both assays were extremely well correlated (Pearson coefficient=0.951). The formula (LogCV=1.15*LogAg+2.26) was obtained to calculate the viral load by PCR from HCV-Ag values. HCV-Ag was unable to detect viral loads below 5000IU/mL. Although the HCV-Ag assay was less sensitive than the PCR assay, the correlation between both assays was excellent. HCV-Ag can be useful as a first step in the diagnosis of acute or chronic HCV infection and in emergency situations. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Principles of antisepsis, disinfection and sterilization].

PubMed

Hernández-Navarrete, María-Jesús; Celorrio-Pascual, José-Miguel; Lapresta Moros, Carlos; Solano Bernad, Victor-Manuel

2014-12-01

This article aims to provide a brief review of the main concepts on which the prevention and control of infection are based. Antisepsis comprises a set of techniques aimed at the total sterilization, or at most, disinfection, removing germs that contaminate an environment. Both procedures must be preceded by an environmental cleanup in the location in which they intend to be applied. The disinfection is carried out using biocides or germicides. Antimicrobial chemicals, that have mechanisms of action and resistances very similar to antibiotics, are generating concern due to the possibility of crossing genetic information that aggravates the problem of bacterial resistance. Most biocides can act as antiseptics, and applied to skin tissue, or disinfectants on inanimate materials. The spectrum of action of germicides depends on the product itself and external controllable factors: temperature, concentration, exposure time, etc. Sterilization techniques are primarily physical, by exposing the material to steam, or sterilizing gas, using autoclaves. Major advances are the use of low temperatures with shorter exposure times, in parallel with technological advances in instrumentation in order to avoid high temperatures and high use rotations due to workload. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Preventive measures for avoiding transmission of microorganisms between hospitalised patients. Hand hygiene].

PubMed

Lupión, Carmen; López-Cortés, Luis Eduardo; Rodríguez-Baño, Jesús

2014-11-01

Health-care associated infections are an important public health problem worldwide. The rates of health-care associated infections are indicators of the quality of health care. The infection control activities related to prevention of transmission of hospital microorganisms can be grouped in 4 mayor areas: standard precautions, specific precautions (including isolation if appropriate), environmental cleaning and disinfection, and surveillance activities (including providing infection rates and monitoring procedures). Hand hygiene and the correct use of gloves are the most important measures to prevent health-care associated infections and to avoid the dissemination of multidrug-resistant microorganisms. Continuous educational activities aimed at improving adherence to hand hygiene are needed. Periodical assessment of adherence to hand hygiene recommendations with feed-back have been shown to provide sustained improvement. Several complementary activities are being evaluated, including skin decolonization prior to certain surgeries, a package of measures in patients with central venous catheters or mechanical ventilation, and universal body hygiene with chlorhexidine. The present area of discussion concerns in which situations and in which groups would such measures be effective and efficient. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Linkage to care among new human immunodeficiency virus diagnoses in Spain].

PubMed

Oliva, Jesús; Malo, Carmen; Fernández, Ana; Izquierdo, Ana; Marcos, Henar; Cevallos, Carlos; Castilla, Jesús; García, Rocio; Díez, Mercedes

2014-03-01

To describe linkage to care among new HIV diagnoses in Spain; and to estimate factors associated to linkage to care within three months after diagnosis. The distribution of the time elapsing between the date of HIV diagnosis and the date of first determination of CD4 (considered to be the date of linkage to care) was calculated among new HIV diagnoses in 2010 in the seven Autonomous Regions participating, where data on date of CD4 count was available. Linkage to care was considered «correct» if done within three months after diagnosis. Factors associated to correct linkage to care were estimated using logistic regression. A total of 1769 new HIV diagnoses were included. Of them, 83.1% had evidence of linkage to care within a year, and 75.7% were linked within three months after diagnosis. Being an injectable drug user (IDU) was the only factor inversely associated with linkage to care within 3 months (OR = 0.3; 95% CI: 0.2-0.6). In Spain linkage to care after HIV diagnosis is good, but there is still room for improvement, especially among IDUs. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Cost/efficacy analysis of preferred Spanish AIDS study group regimens and the dual therapy with lopinavir/ritonavir plus lamivudine for initial ART in HIV infected adults.

PubMed

Gatell Artigas, Josep María; Arribas López, José Ramón; Lázaro Y de Mercado, Pablo; Blasco Bravo, Antonio Javier

2016-01-01

The National AIDS Plan and the Spanish AIDS study group (GESIDA) proposes "preferred regimens" (PR) of antiretroviral treatment (ART) as initial therapy in HIV-infected patients. In 2013, the recommended regimens were all triple therapy regimens. The Gardel Study assessed the efficacy of a dual therapy (DT) combination of lopinavir/ritonavir (LPV/r) plus lamivudine (3TC). Our objective is to evaluate the GESIDA PR and the DT regimen LPV/r+3TC cost/efficacy ratios. Decision tree models were built. probability of having viral load <50 copies/mL at week 48. ART regime cost: costs of ART, adverse effects, and drug resistance tests during the first 48 weeks. Cost/efficacy ratios varied between 5,817 and 13,930 euros per responder at 48 weeks, for the DT of LPV/r+3TC and tenofovir DF/emtricitabine+raltegravir, respectively. Taking into account the official Spanish prices of ART, the most efficient regimen was DT of LPV/r+3TC, followed by the triple therapy with non-nucleoside containing regimens. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Consensus Document on post-exposure prophylaxis against HIV, HBV and HCV in adults and children].

PubMed

2016-02-01

This consensus document is an update of occupational and non-occupational prophylaxis guidelines in HIV-patients, promoting appropriate use of them, from the standpoint of care. This document has been approved by expert panel of SPNS, GESIDA, SEMST and different scientific societies related, after reviewing the results of efficacy and safety clinical trials, cohort and pharmacokinetic studies published in biomedical journals (PubMed and Embase) or presented at conferences and different guidelines. The strength of the recommendation and gradation of their evidence are based on the GRADE system. We have developed recommendations for assessing the risk of transmission in different types of exposure situations in which post-exposure prophylaxis should be recommended, special circumstances to consider, patterns of antiretroviral with the start and duration of early monitoring of tolerance and adherence to treatment, the subsequent monitoring of exposed persons regardless of whether they received post-exposure prophylaxis or not, and the need of psychological support. These new guidelines updated previous recommendations regarding occupational post-exposure prophylaxis and non-occupational, in adults and children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[GEIPC-SEIMC (Study Group for Infections in the Critically Ill Patient of the Spanish Society for Infectious Diseases and Clinical Microbiology) and GTEI-SEMICYUC ( Working Group on Infectious Diseases of the Spanish Society of Intensive Medicine, Critical Care, and Coronary Units) recommendations for antibiotic treatment of gram-positive cocci infections in the critical patient].

PubMed

Astigarraga, P M Olaechea; Montero, J Garnacho; Cerrato, S Grau; Colomo, O Rodríguez; Martínez, M Palomar; Crespo, R Zaragoza; García-Paredes, P Muñoz; Cerdá, E Cerdá; Lerma, F Alvarez

2007-01-01

In recent years, an increment of infections caused by gram-positive cocci has been documented in nosocomial and hospital-acquired-infections. In diverse countries, a rapid development of resistance to common antibiotics against gram-positive cocci has been observed. This situation is exceptional in Spain but our country might be affected in the near future. New antimicrobials active against these multi-drug resistant pathogens are nowadays available. It is essential to improve our current knowledge about pharmacokinetic properties of traditional and new antimicrobials to maximize its effectiveness and to minimize toxicity. These issues are even more important in critically ill patients because inadequate empirical therapy is associated with therapeutic failure and a poor outcome. Experts representing two scientific societies (Grupo de estudio de Infecciones en el Paciente Crítico de la SEIMC and Grupo de trabajo de Enfermedades Infecciosas de la SEMICYUC) have elaborated a consensus document based on the current scientific evidence to summarize recommendations for the treatment of serious infections caused by gram-positive cocci in critically ill patients.

Drawbacks of the use of cotrimoxazole in foreign-body infections.

PubMed

El Haj, Cristina; Ribera, Alba; Lloberas, Nuria; Tubau, Fe; Ariza, Javier; Murillo, Oscar

The anti-staphylococcal efficacy of cotrimoxazole in the setting of difficult-to-treat infections seems to be compromised by large amounts of pus and devitalized tissue, and, therefore, high levels of thymidine. Our objective was to evaluate the activity of cotrimoxazole against a staphylococcal foreign-body infection experimental model, which also yields significant quantities of thymidine. We used a rat tissue-cage model of infection (with high inherent thymidine levels) caused by a strain of methicillin-susceptible Staphylococcus aureus (MSSA; ATCC 29213). MIC values were determined (microdilution method) and compared in the presence or absence of tissue-cage fluid samples. The inefficacy of cotrimoxazole was found to be similar to that of the control group. The MIC of cotrimoxazole was 4-8 fold higher in the presence of rat tissue-cage fluid. The inefficacy of cotrimoxazole in our foreign-body infection model by MSSA, and the probable negative impact of the presence of thymidine on its efficacy, challenge the use of this drug in acute phases of foreign-body infections. It should be reserved as an alternative treatment when the infection is more controlled. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC).

PubMed

de Cueto, Marina; Aliaga, Luis; Alós, Juan-Ignacio; Canut, Andres; Los-Arcos, Ibai; Martínez, Jose Antonio; Mensa, Jose; Pintado, Vicente; Rodriguez-Pardo, Dolors; Yuste, Jose Ramon; Pigrau, Carles

2017-05-01

Most urinary tract infections (UTI) are uncomplicated infections occurring in young women. An extensive evaluation is not required in the majority of cases, and they can be safely managed as outpatients with oral antibiotics. Escherichia coli is by far the most common uropathogen, accounting for >80% of all cases. Other major clinical problems associated with UTI include asymptomatic bacteriuria, and patients with complicated UTI. Complicated UTIs are a heterogeneous group associated with conditions that increase the risk of acquiring infection or treatment failure. Distinguishing between complicated and uncomplicated UTI is important, as it influences the initial evaluation, choice, and duration of antimicrobial therapy. Diagnosis is especially challenging in the elderly and in patients with in-dwelling catheters. The increasing prevalence of resistant uropathogens, including extended-spectrum β-lactamases and carbapenemase-producing Enterobacteriaceae, and other multidrug-resistant Gram-negative organisms further compromises treatment of both complicated and uncomplicated UTIs. The aim of these Clinical Guidelines is to provide a set of recommendations for improving the diagnosis and treatment of UTI. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Consensus document on psychiatric and psychological aspect in adults and children with HIV infection].

PubMed

2016-01-01

This consensus document is an update of psychiatric and psychological disorders guidelines in HIV-patientes, from the standpoint of care. This document has been approved by expert panel of SPNS, SEP, GESIDA and SEIP, after reviewing the results of efficacy and safety of clinical trials, cohort and pharmacokinetic studies published in biomedical journals (PubMed and Embase) or presented at conferences. The strength of recommendation and gradation of their evidence are based onthe GRADE system. HIV Patient care should include psychological and psychiatric care which is necessary for early detection thereof. Should suicidal ideation, refer the patient to a psychiatric unit. Pharmacological treatment is recommended when there is comorbidity with moderate or severe depression. You should look for the etiology of neuropsychiatric disorder before using psychoactive drugs in HIV patients. The overall management of the health of HIV adolescents should include an assessment of mental health, environmental stressors and support systems. Training in the management of the patient both own emotions is critical to getting provide optimal care. These new guidelines updated previous recommendations regarding psychiatric and psychological disorders, including the most common pathologies in adults and children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prevalence and re-infection rate of C. trachomatis genital infections in young people under 25 years in Catalonia.

PubMed

López-Corbeto, Evelin; González, Victoria; Casabona, Jordi

Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease. Re-infections are a major problem in its control as they increase the probability of developing sequellae. To estimate the prevalence of C.trachomatis and re-infection rate after 6 months of treatment by determining the possible causes. Cross-sectional study in which a urine sample was analysed by PCR in a convenience sample of 506 sexually active youths aged 16-25years. An epidemiological survey and re-test was performed at 3months. The prevalence of C.trachomatis was 8.5%. The age (OR=2.34; 95%CI: 1.21-4.55) and concurrency (OR=3.64; 95% CI: 3.58-26.39) were determining factors for acquiring C.trachomatis. The re-infection rate was 10.34%. The high prevalence of C.trachomatis, as well as the rate of reinfection, suggest the need to assess the effectiveness of the opportunistic screening program and ensure high levels of reporting of sexual partners. Ensuring these approaches facilitate the control of C.trachomatis among young people. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease.

PubMed

Merchante, Nicolás; Parra-Sánchez, Manuel; Rivero-Juárez, Antonio; Cifuentes, Celia; Camacho, Ángela; Macías, Juan; Martínez-Dueñas, Loreto; Pérez-Navarro, Elisabet; Rivero, Antonio; Pineda, Juan A

2015-10-01

To look for evidence of hepatitis E virus (HEV) exposure in HIV-infected patients with unexplained elevations of liver stiffness (LS). Case-control study conducted in 31 HIV-infected patients with unexplained elevations of LS and in 31 HIV-controls with normal LS, matched by age, sex and CD4 cell-counts. Serum HEV antibodies were tested by two ELISA procedures and by Immunoblot. We defined exposure to HEV as the detection of serum HEV antibodies by at least one of the two ELISA assays, provided that it was confirmed by Immunoblot. A real-time PCR RNA assay was conducted in all plasma samples to identify subjects with active HEV infection. Exposure to HEV was demonstrated, according to the criteria used in this study, in 9 (29%) of the cases, whereas it was shown in 5 (16%) of the controls (p=.3). Serum HEV RNA was detected in none of the controls and in only in one case. This patient had a documented chronic hepatitis E with progression to cirrhosis. HEV antibodies are frequently found in HIV-infected patients with unexplained liver disease. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Unusual presence of the immune evasion gene cluster in livestock-associated MRSA of lineage CC398 causing peridural and psoas abscesses in a poultry farmer.

PubMed

Pérez-Moreno, Mar Olga; Centelles-Serrano, María José; Nogales-López, Julio; Domenech-Spanedda, Marie France; Lozano, Carmen; Torres, Carmen

2017-12-01

To characterize a methicillin-resistant Staphylococcus aureus (MRSA) isolate responsible for an aggressive infection (peridural and psoas abscess secondary to haematogenous septic arthritis) in a poultry farmer. Molecular characterization was performed, including spa- and multilocus sequence typing of the isolate, assessment of its resistance phenotype and detection of tetracycline resistance and of virulence and immune evasion cluster (IEC) genes were performed. The MRSA isolate was tetracycline- and fluorquinolone-resistant, and was ascribed to CC398, spa-t1451. The isolate harboured tet(M) (distinctive of livestock-associated (LA) MRSA-CC398 clade) and IEC-type B system (characteristic of the methicillin-susceptible human lineage, but typically absent in LA-MRSA-CC398 strains), and lacked toxin-coding genes lukF/lukS-PV, tsst-1, eta and etb. IEC re-acquisition by LA-MRSA-CC398-LA strains is an unusual finding, but could constitute an emerging public health problem. It would represent an evolutionary step towards LA-MRSA-CC398's adaptation to human hosts, and might enhance its invasiveness and ability to be transmitted to humans. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prospective evaluation of fever of unknown origin in patients infected with the human immunodeficiency virus. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas.

PubMed

Lozano, F; Torre-Cisneros, J; Bascuñana, A; Polo, J; Viciana, P; García-Ordóñez, M A; Hernández-Quero, J; Márquez, M; Vergara, A; Díez, F; Pujol, E; Torres-Tortosa, M; Pasquau, J; Hernández-Burruezo, J J; Suárez, I

1996-09-01

The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequently. One hundred twenty-eight (3.5%) of 3603 hospitalised HIV-positive patients evaluated from October 1992 to December 1993 had FUO, defined by established criteria. Eighty-six percent of patients with FUO had previously progressed to AIDS. The median CD4+ cell count was 46/mm3. A definite diagnosis was made in 96 (75%) of the 128 patients and a possible diagnosis in 24 (18.7%). whilst no diagnosis was made in eight cases (6.2%). Tuberculosis (48.3%), visceral leishmaniasis (16%), and infection by Mycobacterium avium complex (6.9%) were the diseases found most frequently. The most useful diagnostic tests were liver biopsy (68.9%) and bone marrow aspirate/biopsy (39.7%). It is not possible to predict clinically the cases of FUO due to tuberculosis, whilst thrombocytopaenia < 100,000 cells/mm3 alone is useful for differentiating the cases of visceral leishmaniasis, with a negative predictive value of 95.2%.

[Consensus statement: recommendations for the management of metabolic bone disease in human immunodeficiency virus patients].

PubMed

Martínez, Esteban; Jódar Gimeno, Esteban; Reyes García, Rebeca; Carpintero, Pedro; Casado, José Luis; Del Pino Montes, Javier; Domingo Pedrol, Pere; Estrada, Vicente; Maalouf, Jorge; Negredo, Eugenia; Ocampo, Antonio; Muñoz-Torres, Manuel

2014-04-01

To provide practical recommendations for the evaluation and treatment of metabolic bone disease in human immunodeficiency virus (HIV) patients. Members of scientific societies related to bone metabolism and HIV: Grupo de Estudio de Sida (GeSIDA), Sociedad Española de Endocrinología y Nutrición (SEEN), Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM), and Sociedad Española de Fractura Osteoporótica (SEFRAOS). A systematic search was carried out in PubMed, and papers in English and Spanish with a publication date before 28 May 2013 were included. Recommendations were formulated according to GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) setting both their strength and the quality of supporting evidence. Working groups were established for each major part, and the final resulting document was later discussed in a face-to-face meeting. All the authors reviewed the final written document and agreed with its content. The document provides evidence-based practical recommendations on the detection and treatment of bone disease in HIV-infected patients. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Influenza vaccination. Effectiveness of current vaccines and future challenges].

PubMed

Ortiz de Lejarazu, Raúl; Tamames, Sonia

2015-01-01

Seasonal influenza is an annual challenge for health-care systems, due to factors such as co-circulation of 2 influenza A subtypes jointly with 2 influenza B lineages; the antigenic drift of these virus, which eludes natural immunity, as well as immunity conferred by vaccination; together with influenza impact in terms of morbidity and mortality. Influenza vaccines have been available for more than 70 years and they have progressed in formulation, production and delivery route. Recommendations on vaccination are focused on those with a higher probability of severe disease, and have a progressively wider coverage, and classically based on inactivated vaccines, but with an increasing importance of attenuated live vaccines. More inactivated vaccines are becoming available, from adyuvanted and virosomal vaccines to intradermal delivery, cell-culture or quadrivalent. Overall vaccine effectiveness is about 65%, but varies depending on characteristics of vaccines, virus, population and the outcomes to be prevented, and ranges from less than 10% to almost 90%. Future challenges are formulations that confer more extensive and lasting protection, as well as increased vaccination coverage, especially in groups such as pregnant women and health-care professionals, as well as being extended to paediatrics. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Management of urinary tract infection in solid organ transplant recipients: Consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI).

PubMed

Vidal, Elisa; Cervera, Carlos; Cordero, Elisa; Armiñanzas, Carlos; Carratalá, Jordi; Cisneros, José Miguel; Fariñas, M Carmen; López-Medrano, Francisco; Moreno, Asunción; Muñoz, Patricia; Origüen, Julia; Sabé, Núria; Valerio, Maricela; Torre-Cisneros, Julián

2015-12-01

Urinary tract infections (UTIs) are one of the most common infections in solid organ transplant (SOT) recipients. Experienced SOT researchers and clinicians have developed and implemented this consensus document in support of the optimal management of these patients. A systematic review was conducted, and evidence levels based on the available literature are given for each recommendation. This article was written in accordance with international recommendations on consensus statements and the recommendations of the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Recommendations are provided on the management of asymptomatic bacteriuria, and prophylaxis and treatment of UTI in SOT recipients. The diagnostic-therapeutic management of recurrent UTI and the role of infection in kidney graft rejection or dysfunction are reviewed. Finally, recommendations on antimicrobials and immunosuppressant interactions are also included. The latest scientific information on UTI in SOT is incorporated in this consensus document. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Como Podar Arboles (Spanish Version), How to Prune Trees

Treesearch

Maureen McDonough; Russell; Lisa Burban; Lee Nancarrow; United States Department of Agriculture, Forest Service, Northeastern Area, State and Private Forestry

2004-01-01

Introduccion, El proposito de la poda es tener plantas fuertes, sanas y atractivas. Esta meta se puede alcanzar sabiendo como, cuando y por que podar, y siguiendo unos cuantos principios muy sencillos.

Religiosidade, juventude e sexualidade: entre a autonomia e a rigidez1

PubMed Central

Silva, Cristiane Gonçalves da; Santos, Alessandro Oliveira; Licciardi, Daniele Carli; Paiva, Vera; Parker, Richard

2009-01-01

Esse artigo descreve como jovens religiosos e autoridades religiosas de sua comunidade compreendem a sexualidade, considerando suas experiências pessoais e como membros de comunidades religiosas. A análise pretende contribuir para que políticas públicas dedicadas à promoção da saúde sexual da juventude considerem a religiosidade, no contexto de um estado laico e da promoção do direito à prevenção. Foram realizadas 26 entrevistas abertas e semidirigidas em diferentes comunidades da região metropolitana da cidade de São Paulo (comunidades católicas, da umbanda, do candomblé e de diferentes denominações evangélicas) sobre iniciação sexual, casamento, gravidez, contracepção e prevenção das DST/Aids, homossexualidade, aborto e direitos humanos. Observou-se como jovens e autoridades religiosas convivem com a tensão entre tradição e modernidade e os distintos discursos sobre a sexualidade. Como sujeitos religiosos (do discurso religioso) e sujeitos sexuais (de discursos sobre sexualidade), devem ser incorporados pelos programas como sujeitos de direito nos termos de sua religiosidade. PMID:21886456

Microwave effects on NiMoS and CoMoS single-sheet catalysts.

PubMed

Borges, I; Silva, Alexander M; Modesto-Costa, Lucas

2018-05-04

Single-sheet nanoclusters of MoS 2 , NiMoS or CoMoS are widely used in hydrodesulfurization (HDS) catalysis in the petroleum industry. In HDS reactions under microwave irradiation, experiments indirectly pointed out that for pristine MoS 2 reaction rates are accelerated because hot spots are generated on the catalyst bed. In this work, we investigated NiMoS and CoMoS isolated single-sheet substituted catalysts before and after thiophene adsorption focusing on quantifying the effect of microwave irradiation. For that purpose, density functional theory (DFT) molecular charge densities of each system were decomposed according to the distributed multipole analysis (DMA) of Stone. Site dipole values of each system were directly associated with a larger or smaller interaction with the microwave field according to a proposed general approach. We showed that microwave enhancement of HDS reaction rates can occur more efficiently in the CoMoS and NiMoS promoted clusters compared to pristine MoS 2 in the following order: CoMoS > NiMoS > MoS 2 . The atomic origin of the catalyst hot spots induced by microwaves was clearly established in the promoted clusters.

Dicloruro de paraquat

EPA Pesticide Factsheets

El dicloruro de paraquat, comúnmente conocido como “paraquat,” es uno de los herbicidas registrados de mayor uso en los Estados Unidos. El paraquat también se conoce como Gramaxone (un producto popular de uso final

Evolution of the Active Phase of CoMo/Al2O3 Catalysts under Industrial Conditions: a High-Pressure MES Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dugulan, A.I.; Overweg, A.R.; Craje, M.W.J.

2005-04-26

The behavior of CoMo/Al2O3 catalysts sulfided in H2S/H2 gas mixture, under industrial conditions, was investigated using Moessbauer emission spectroscopy (MES). An intermediate Co-Mo phase is formed after increasing the sulfidation pressure to 4 MPa, favoring the Co-Mo-S phase formation. An increase in the quadrupole splitting value of the Co-sulfide species after treatment at 573 K is proposed as a prerequisite for the formation of ideal Co-Mo-S structures.

Catalytic functionalities of supported sulfides. I. Effect of support and additives on the CoMo catalyst

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muralidhar, G.; Massoth, F.E.; Shabtai, J.

1984-01-01

C-S hydrogenolysis (HDS) of thiophene, hydrogenation (HYD) of 1-hexene, and hydrocracking (HCG) of 2,4,4-trimethyl-1-pentene, were used as separate model test reactions to differentiate and assess the catalytic functionalities of sulfided CoMo catalysts, and their dependence on the nature of the support and incorporation of additives. Rate constants and relative catalyst activities for these three reaction types were determined. HDS and HYD activities of CoMo supported on different types of Al/sub 2/O/sub 3/ were higher, while the HCG activity was lower compared with CoMo supported on SiO/sub 2/-Al/sub 2/O/sub 3/, SiO/sub 2/-MgO, or TiO/sub 2/. For SiO/sub 2/-Al/sub 2/O/sub 3/ supportsmore » both HDS and HYD activities decreased with increase in SiO/sub 2/ content from 10 to 75%, while HCG activity showed the opposite trend. Additives to a finished CoMo catalyst at 0.5% level caused variations in HDS and HCG activities, while HYD was essentially unaffected. HDS was promoted by NH/sub 4/HF/sub 2/ and NH/sub 4/Cl, but depressed by NaNO/sub 3/, Ca(NO/sub 3/)/sub 2/, and H/sub 3/BO/sub 3/. HCG was promoted by NH/sub 4/HF/sub 2/, NH/sub 4/Cl, and H/sub 3/BO/sub 3/. Additives at 5% level, prior to or after CoMo impregnation, showed a strong depressing effect on HDS and a lesser effect on HYD, while HCG was strongly promoted by NH/sub 4/HF/sub 2/, Ti isopropoxide, and H/sub 3/BO/sub 3/. The changes in catalytic functionalities are rationalized in terms of different interactions between CoMo phase, support, and additives. 3 tables, 1 figure.« less

Sistema Solar: de la observación de La Tierra a los planetas gigantes y sus lunas

NASA Astrophysics Data System (ADS)

Rodrigo, R.

La fotoquímica tiene un papel principal en la composición de las atmósferas planetarias. Se examinan diferentes procesos fotoquímicos tanto para atmósferas oxidadas como reductoras, poniendo un especial énfasis en los ciclos químicos más importantes. En este sentido, se presentan diferentes ciclos químicos capaces de producir hidrocarbonos y nitrilos en atmósferas reductoras, así como aquellos capaces de mantener las proporciones de mezcla de las moléculas que contienen oxígeno, tales como CO2, O2 y H2O. También se analizan otros procesos importantes tales como la condensación y procesos de sputtering y de sublimación que han de tenerse en cuenta cuando se realizan modelos sobre la composición atmosférica.

78 FR 38287 - Bitterroot National Forest, Darby Ranger District, Como Forest Health Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF AGRICULTURE Forest Service Bitterroot National Forest, Darby Ranger District, Como Forest Health Project AGENCY: Forest Service. ACTION: Notice; Correction. SUMMARY: The Department of Agriculture (USDA), Forest Service, Bitterroot National Forest, Darby Ranger District published a document in...

[Is it ethically acceptable to invite a pregnant woman to enroll in a clinical trial with Tdap if it could entail not being vaccinated with Tdap before delivery?

PubMed

Dal-Ré, Rafael

2017-02-01

Pertussis incidence has increased in recent years, especially among infants aged <2months. A number of Spanish regions have started a vaccination program with Tdap vaccine to all pregnant women in the third trimester of pregnancy. An observational study has shown that this strategy reduces the number of cases of pertussis by 90% in infants aged <2months. Mathematical models showed that a cocooning strategy (i.e. vaccination of the mother at immediate postpartum, and other adults and adolescents who have close contact with the newborn and caregivers) will reduce the incidence of pertussis by 70% in infants aged <2months. It is intended to conduct a clinical trial in which 340 pregnant women will receive Tdap vaccine, whereas another 340 pregnant woman will be vaccinated soon after delivery. Vaccination with Tdap will be offered to all partners and caregivers of the newborn. After assessing both the ethical and scientific reasons supporting the trial, it is concluded that it is ethically and legally acceptable to invite pregnant women living in communities where Tdap vaccination has been implemented to participate in the trial. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Epidemiology of hepatitis E virus infection in Spain].

PubMed

Echevarría, José Manuel; Fogeda, Marta; Avellón, Ana

2015-04-01

The general features of the epidemiology and ecology of hepatitis E virus in Spain are already known after 20 years of investigations. Genotype 3 strains, mainly from sub-genotype 3f, circulated among swine livestock and certain wild mammals, and would be sporadically transmitted to humans through direct contact with the reservoirs or by consumption of foods derived from them. Bivalve shellfish contaminated by hepatitis E virus from sewage could also play a role in transmission. Although the interpretation of results from seroprevalence studies in low endemic settings is still controversial, antibody to hepatitis E virus displays an overall prevalence less than 10% among the population of Spain, increasing significantly with age. From the, approximately, 150 cases of acute hepatitis E recorded in the international literature, males older than 40 years, suffering a mild, locally acquired disease predominate. In addition, hepatitis E might be more frequent in the North of the country than in other regions. Although the disease does not usually have a great clinical relevance, the occasional finding of cases of fulminant hepatitis, and of ribavirin-resistant, chronic hepatitis E virus infections among the immunocompromised would recommend the surveillance of the infection by the public health authority and a better implementation of specific diagnostic procedures in clinical laboratories. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Study of human immunodeficiency virus transmission chains in Andalusia: analysis from baseline antiretroviral resistance sequences].

PubMed

Pérez-Parra, Santiago; Chueca-Porcuna, Natalia; Álvarez-Estevez, Marta; Pasquau, Juan; Omar, Mohamed; Collado, Antonio; Vinuesa, David; Lozano, Ana Belen; García-García, Federico

2015-11-01

Protease and reverse transcriptase HIV-1 sequences provide useful information for patient clinical management, as well as information on resistance to antiretrovirals. The aim of this study is to evaluate transmission events, transmitted drug resistance, and to georeference subtypes among newly diagnosed patients referred to our center. A study was conducted on 693 patients diagnosed between 2005 and 2012 in Southern Spain. Protease and reverse transcriptase sequences were obtained for resistance to cART analysis with Trugene(®) HIV Genotyping Kit (Siemens, NAD). MEGA 5.2, Neighbor-Joining, ArcGIS and REGA were used for subsequent analysis. The results showed 298 patients clustered into 77 different transmission events. Most of the clusters were formed by pairs (n=49), of men having sex with men (n=26), Spanish (n=37), and below 45 years of age (73.5%). Urban areas from Granada, and the coastal areas of Almeria and Granada showed the greatest subtype heterogeneity. Five clusters were formed by more than 10 patients, and 15 clusters had transmitted drug resistance. The study data demonstrate how the phylogenetic characterization of transmission clusters is a powerful tool to monitor the spread of HIV, and may contribute to design correct preventive measures to minimize it. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of the GESIDA/National AIDS Plan Consensus Document on Antiretroviral Therapy in Adults Infected by the Human Immunodeficiency Virus (Updated January 2016).

PubMed

2016-01-01

In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The objective of ART is to achieve an undetectable plasma viral load (PVL). Initial ART should comprise 3 drugs, namely, 2 nucleoside reverse transcriptase inhibitors (NRTI), and 1 drug from another family. Four of the recommended regimens, all of which have an integrase strand transfer inhibitor (INSTI) as the third drug, are considered a preferred regimen; a further 6 regimens, which are based on an INSTI, a non-nucleoside reverse transcriptase inhibitor (NNRTI), or a protease inhibitor boosted with cobicistat or ritonavir (PI/COBI, PI/r), are considered alternatives. The reasons and criteria for switching ART are presented both for patients with an undetectable PVL and for patients who experience virological failure, in which case the rescue regimen should include 3 (or at least 2) drugs that are fully active against HIV. The specific criteria for ART in special situations (acute infection, HIV-2 infection, pregnancy) and comorbid conditions (tuberculosis and other opportunistic infections, kidney disease, liver disease, and cancer) are updated. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Analysis of the epidemiological pattern of Shigellosis in Barcelona between 1988 and 2012: Is it an emerging sexually transmitted infection?].

PubMed

Culqui, Dante R; García-de-Olalla-Rizo, Patricia; Alva-Chavez, Kenedy Pedro; Lafuente, Sarah; Rius, Cristina; de Simón, Mercè; Sabater, Sarah; Caylá, Joan A

2015-01-01

The aim of this study was to describe the evolution and epidemiologic characteristics of shigellosis patients over a 25 year period in a large city. Shigellosis is a notifiable disease in Spain since 1988. Cases are analyzed in Barcelona residents included in the registry between 1988-2012. A descriptive analysis by sex, age, mode of transmission and Shigella species is presented. Trend analysis and time series were performed. Of the 559 cases analyzed, 60.15% were males. A sustained increase was observed in the trend since 2008 in males (p<0,05), especially at the expense of males who had no history of food poisoning or travel to endemic areas. The increasing tendency was greater in males from 21 to 60 years, both for S. flexneri (since 2009), and for S. sonnei (since 2004). In 2012 it was noted that in the men with S. flexneri, the 63% were men who have sex with men. An increased trend was detected in men who had no history of food poisoning or travel to endemic areas. This increase points to a change in the pattern of shigellosis, becoming predominantly male and its main mechanism probably by sexual transmission. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Acute outbreak of hepatitis C in human immunodeficiency virus-infected patients].

PubMed

Martínez-Rebollar, Maria; Mallolas, Josep; Pérez, Iñaki; González-Cordón, Ana; Loncà, Montserrat; Torres, Berta; Rojas, Jhon-Fredy; Monteiro, Polyana; Blanco, José-Luis; Martínez, Esteban; Gatell, José-María; Laguno, Montserrat

2015-01-01

Recent studies suggest an increased incidence of acute infection with hepatitisC virus (AHC) in men who have sex with men (MSM) co-infected with HIV. Early treatment with interferon-alpha, alone or in combination with ribavirin, significantly reduces the risk of chronic evolution. This retrospective study includes all HIV patients with AHC in our centre from 2003 to March 2013. AHC was defined by seroconversion of HCV antibodies and detection of serum HCV RNA. 93 episodes of AHC were diagnosed in 89 patients. All but three were MSM with a history of unprotected sex. Thirty-seven (40%) patients had other associated sexually transmitted disease. The 29% (27) had any symptoms suggestive of AHC. HCV genotype 4 was the most common (41%), followed by genotype1. Seventy patients started treatment with interferon-alfa and weight-adjusted ribavirin. Currently 46 have completed treatment and follow-up, reaching 26 of them (56.5%) sustained viral response. The incidence of AHC in HIV MSM patients from our centre has increased exponentially in recent years; sexual transmission remains the main route of infection. Early treatment with interferon-alpha and ribavirin achieved a moderate response in these patients. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Prevalence study of the genetic markers associated with slow progression of human inmunodefiency virus type 1 in the Galician population (Northwest of Spain)].

PubMed

Rodríguez-Da Silva, Alfredo; Miralles, Celia; Ocampo, Antonio; Valverde, Diana

2017-02-01

The deletion in the CCR5 gene (CCR5Δ32), the HLA-B*27:05, and polymorphisms rs2395029 and rs9264942 have been associated with slower progression of HIV-1. An analysis was performed on 408 patients on follow-up. The analysis of viral load, CD4+ Tlymphocytes and other clinical variables since the diagnosis of the infection were collected. The prevalence of the genetic markers rs9264942, CCR5wt/Δ32, rs2395029, HLA-B*27:05 was 17.9%, 11.5%, 7.6%, and 6.4%, respectively. Of all the patients, 354 were classified as progressors and 46 as long-term non-progressors (LTNPs). Except for the HLA-B*27:05 allele, other genetic markers were associated with slower progression: CCR5wt/Δ32 (P=.011) and SNPs rs2395029 and rs9264942 (P<.0001), as well as their association (P<.0001). The prevalence of the HLA-B*57:01 allele was higher than described nationally. No association could be found between the HLA-B*27:05 allele and the presence of slower disease progression. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[The antibiotic policy. The Infection Committee and antimicrobial use].

PubMed

Cisneros, José Miguel; Pérez-Moreno, M Antonia; Gil-Navarro, M Victoria

2014-10-01

The antibiotic policy is the set of strategies and activities undertaken to organize the antimicrobial treatment in the hospital, and achieve health outcomes for patients. The basic principles are to be direct evidence-based medicine, local epidemiology and freedom for prescribing physicians. An antibiotic policy is now more necessary than ever for clinical, epidemiological and economic reasons. The Infection Committee is responsible for the antibiotics policy in hospitals. Its functions as an advisory body to the medical directorate are the analysis of the epidemiology of the infections in the center, measures for its prevention and control, improving the appropriate use of antimicrobials, training, and knowledge production. To achieve clinical, environmental and economic policy objectives of antibiotics is not easy. The agreement of hundreds of professionals for recommendations on indications, dosage and duration of antibiotic treatment, based on the best scientific evidence and local guides is complex, but it can be done. The key to this is that the Infection Committee develops antimicrobial stewardship through a multidisciplinary team and professional leadership, and has the institutional support to ensure that the proper use of antimicrobials is a priority for the center, and therefore of each of the services involved, and that the team has the resources for antimicrobial stewardship. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Comparative study of bacteremias caused by Enterococcus spp. with and without high-level resistance to gentamicin. The Grupo Andaluz para el estudio de las Enfermedades Infecciosas.

PubMed

Caballero-Granado, F J; Cisneros, J M; Luque, R; Torres-Tortosa, M; Gamboa, F; Díez, F; Villanueva, J L; Pérez-Cano, R; Pasquau, J; Merino, D; Menchero, A; Mora, D; López-Ruz, M A; Vergara, A

1998-02-01

A prospective, multicenter study was carried out over a period of 10 months. All patients with clinically significant bacteremia caused by Enterococcus spp. were included. The epidemiological, microbiological, clinical, and prognostic features and the relationship of these features to the presence of high-level resistance to gentamicin (HLRG) were studied. Ninety-three patients with enterococcal bacteremia were included, and 31 of these cases were caused by HLRG (33%). The multivariate analysis selected chronic renal failure, intensive care unit stay, previous use of antimicrobial agents, and Enterococcus faecalis species as the independent risk factors that influenced the development of HLRG. The strains with HLRG showed lower levels of susceptibility to penicillin and ciprofloxacin. Clinical features (except for chronic renal failure) were similar in both groups of patients. HLRG did not influence the prognosis for patients with enterococcal bacteremia in terms of either the crude mortality rate (29% for patients with bacteremia caused by enterococci with HLRG and 28% for patients not infected with strains with HLRG) or the hospital stay after the acquisition of enterococcal bacteremia. Hemodynamic compromise, inappropriate antimicrobial therapy, and mechanical ventilation were revealed in the multivariate analysis to be the independent risk factors for mortality. Prolonged hospitalization was associated with the nosocomial acquisition of bacteremia and polymicrobial infections.

[Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures].

PubMed

San Juan Sanz, Isabel; Díaz-Agero-Pérez, Cristina; Robustillo-Rodela, Ana; Pita López, María José; Oliva Iñiguez, Lourdes; Monge-Jodrá, Vicente

2014-10-01

Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system. All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey. A total of 409patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI). Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Eradication of Staphylococcus aureus in carrier patients undergoing joint arthroplasty].

PubMed

Barbero Allende, José M; Romanyk Cabrera, Juan; Montero Ruiz, Eduardo; Vallés Purroy, Alfonso; Melgar Molero, Virginia; Agudo López, Rosa; Gete García, Luis; López Álvarez, Joaquín

2015-02-01

Prosthetic joint infection (PJI) is a complication with serious repercussions and its main cause is Staphylococcus aureus. The purpose of this study is to determine whether decolonization of S.aureus carriers helps to reduce the incidence of PJI by S.aureus. An S.aureus screening test was performed on nasal carriers in patients undergoing knee or hip arthroplasty between January and December 2011. Patients with a positive test were treated with intranasal mupirocin and chlorhexidine soap 5 days. The incidence of PJI was compared with patients undergoing the same surgery between January and December 2010. A total of 393 joint replacements were performed in 391 patients from the control group, with 416 joint replacements being performed in the intervention group. Colonization study was performed in 382 patients (91.8%), of which 102 were positive (26.7%) and treated. There was 2 PJI due S.aureus compared with 9 in the control group (0.5% vs 2.3%, odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.4 to 2.3, P=.04). In our study, the detection of colonization and eradication of S.aureus carriers achieved a significant decrease in PJI due to S.aureus compared to a historical group. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Characterization of phenotypic and genotypic drug resistance patterns of Mycobacterium tuberculosis isolates from a city in Mexico.

PubMed

Flores-Treviño, Samantha; Morfín-Otero, Rayo; Rodríguez-Noriega, Eduardo; González-Díaz, Esteban; Pérez-Gómez, Héctor Raúl; Mendoza-Olazarán, Soraya; Balderas-Rentería, Isaías; González, Gloria María; Garza-González, Elvira

2015-03-01

The emergence of multidrug-resistant (MDR) Mycobacterium tuberculosis strains has become a worldwide health care problem, making treatment of tuberculosis difficult. The aim of this study was to determine phenotypic resistance and gene mutations associated with MDR of clinical isolates of Mycobacterium tuberculosis from Guadalajara, Mexico. One hundred and five isolates were subjected to drug susceptibility testing to first line drugs using the proportion and Mycobacteria Growth Indicator Tube (MGIT) methods. Genes associated with isoniazid (inhA, katG, ahpC) and rifampicin (rpoB) resistance were analyzed by either pyrosequencing or PCR-RFLP. Resistance to any drug was detected in 48.6% of isolates, of which 40% were isoniazid-resistant, 20% were rifampicin-resistant and 19% were MDR. Drug-resistant isolates had the following frequency of mutations in rpoB (48%), katG (14%), inhA (26%), ahpC (26%). Susceptible isolates also had a mutation in ahpC (29%). This is the first analysis of mutations associated with MDR of M. tuberculosis in Guadalajara. Commonly reported mutations worldwide were found in rpoB, katG and inhA genes. Substitution C to T in position -15 of the ahpC gene may possibly be a polymorphism. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

A six-month Serratia marcescens outbreak in a Neonatal Intensive Care Unit.

PubMed

Morillo, Áurea; González, Verónica; Aguayo, Josefa; Carreño, Concepción; Torres, María José; Jarana, Daniel; Artacho, María José; Jiménez, Francisco; Conde, Manuel; Aznar, Javier

2016-12-01

To investigate a Serratia marcescens (S. marcescens) outbreak in a Neonatal Unit in a tertiary university hospital. Descriptive study of children admitted to the Unit with S. marcescens infection from November 2012 to March 2013. Conventional microbiological methods for clinical and environmental samples were used. The clonal relationship between all available isolates was established by molecular methods. A multidisciplinary team was formed, and preventive measures were taken. S. marcescens was isolated from 18 children. The overall attack rate was 12%, and the case fatality rate in the Intensive Care Unit was 23.5%. The most prevalent types of infections were pneumonia (6), conjunctivitis (6), and bloodstream infection (5). Clinical isolates and environmental isolates obtained from an incubator belonged to a unique clone. The clonal relationship between all S. marcescens strains helped us to identify the possible source of the outbreak. Isolation of S. marcescens from stored water in a container, and from the surface of an incubator after cleaning, suggests a possible environmental source as the outbreak origin, which has been perpetuated due to a failure of cleaning methods in the Unit. The strict hygiene and cleaning measures were the main factors that contributed to the end of the outbreak. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Molecular (ticks) and serological (humans) study of Crimean-Congo hemorrhagic fever virus in the Iberian Peninsula, 2013-2015.

PubMed

Palomar, Ana M; Portillo, Aránzazu; Santibáñez, Sonia; García-Álvarez, Lara; Muñoz-Sanz, Agustín; Márquez, Francisco J; Romero, Lourdes; Eiros, José M; Oteo, José A

Crimean-Congo hemorrhagic fever (CCHF) is a viral disease, mainly transmitted through tick bite, of great importance in Public Health. In Spain, Crimean-Congo hemorrhagic fever virus (CCHFV) was detected for the first time in 2010 in Hyalomma lusitanicum ticks collected from deer in Cáceres. The aim of this study was to investigate the presence of CCHFV in ticks from Cáceres, and from other Spanish areas, and to evaluate the presence of antibodies against the virus in individuals exposed to tick bites. A total of 2053 ticks (1333 Hyalomma marginatum, 680 H. lusitanicum and 40 Rhipicephalus bursa) were analyzed using molecular biology techniques (PCR) for CCHFV detection. The determination of specific IgG antibodies against CCHFV in 228 serum samples from humans with regular contact with ticks (at risk of acquiring the infection) was performed by indirect immunofluorescence assay. The CCHFV was not amplified in ticks, nor were antibodies against the virus found in the serum samples analyzed. The absence of the CCHFV in the ticks studied and the lack of antibodies against the virus in individuals exposed to tick bites would seem to suggest a low risk of acquisition of human infection by CCHFV in Spain. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

78 FR 36163 - Bitterroot National Forest, Darby Ranger District, Como Forest Health Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... Lake Como and Lost Horse Roads, about XX miles northwest of Darby in Ravalli County, Montana. The... Lost Horse Road, about three miles northwest of Darby, Montana (R22W,T4N, Sec. 13, 24, 25, 36; R21W,T4N...

Recent DDT and PCB contamination in the sediment and biota of the Como Bay (Lake Como, Italy).

PubMed

Bettinetti, R; Quadroni, S; Boggio, E; Galassi, S

2016-01-15

Due to its peculiar geographical and morphological characteristics, Lake Como (Northern Italy) represents an interesting study-case for investigating the sub-basin scale circulation of persistent organic pollutants (POPs) that, despite being banned since the 1970s, have reached surprisingly high concentrations in some southern alpine lakes as a consequence of their release from melting glaciers in recent years. In particular, the Como Bay, which is located in the city of Como, seems noteworthy because its waters have a longer residence time than the other areas of the lake. The analyses of the historical concentration of PCBs, pp′DDT and its metabolites in a sediment core sampled from the Como Bay covering a time-period from their ban to recent times, showed that the DDTs have never experienced a significant (p < 0.05) decrease over time, with concentrations of the most abundant homologue, pp′DDE, ranging from 27 to 75 ng g(-1) d.w. Conversely PCBs significantly (p < 0.05) decreased towards recent times, reaching concentrations around 80 ng g(-1) d.w. The contribution of high altitude and local sources was recorded also in the food web: both zooplankton and the zooplanktivorous fish agone were mainly contaminated by pp′DDE (81.4 ng g(-1) w.w. and 534.6 ng g(-1) w.w. respectively) and by the PCB metabolite hexa-CB (449.7 ng g(-1) w.w. and 1672.1 ng g(-1) w.w. respectively). The DDT concentrations in the agone (sampled during the years 2006–2009) never exceeded the limits for human consumption in Italy, while concentrations of six selected PCBs exceeded human health advisory recommendations in one of the fish samples analysed, when it was approximately two times higher than the recommended value of 125 ng g(-1) w.w.

Helenistic Encomium: A Reflection on Comics and Rhetoric

ERIC Educational Resources Information Center

Helms, Jason

2009-01-01

This video reflection starts in a presentation on comics at the Thomas R. Watson Conference last October, which prompted the author to explore the etymology of cosmos and comos through an alternate reading of Gorgias' "Encomium of Helen". The author then works with comos, as revelry, to offer thoughts on comics as a form of multimodal composition…

DESAFÍOS ÉTICOS DE LA INVESTIGACIÓN CON ANIMALES, MANIPULACIÓN GENÉTICA

PubMed Central

Yunta, Eduardo Rodríguez

2012-01-01

En la investigación con animales existen cuestionamientos éticos tanto en el uso como modelos de enfermedades humanas y requisito previo para ensayos en humanos como en la introducción de modificaciones genéticas. Algunos de estos cuestionamientos son: no representar exactamente la condición humana como modelos, realizar pruebas de toxicidad con grave daño para los animales, alterar su naturaleza mediante modificaciones genéticas, riesgos de la introducción de organismos genéticamente modificados. El uso de animales en investigación para beneficio humano, impone al ser humano la responsabilidad moral de respetarlo, no haciéndoles sufrir innecesariamente, al estar trabajando con seres vivientes y sentientes. PMID:23338641

Cúmulos globulares como trazadores de bimodalidad estelar en galaxias cD

NASA Astrophysics Data System (ADS)

Forte, J. C.

Se muestra que tanto la forma de los perfiles de brillo como de color observados en dos galaxias arquetípicas de tipo cD (NGC 1399 y NGC 4486) son compatibles con la presencia de poblaciones estelares bi-modales que comparten la misma distribución espacial y composición química de las familias dominantes de cúmulos globulares asociadas con ellas. El modelo resultante también predice una variación de la frecuencia específica de los cúmulos como función del radio galactocéntrico. Se discute este resultado en el contexto de una variedad de escenarios astrofísicos que intentan describir la formación de galaxias cD.

Estudio multifrecuencia del medio interestelar cercano a HD 192281

NASA Astrophysics Data System (ADS)

Arnal, E. M.; Cappa, C.; Cichowolski, S.; Pineault, S.; St-Louis, N.

Una de las causas que modifica la estructura y dinámica del medio interestelar es la acción que los vientos de las estrellas de gran masa ejercen sobre el mismo. En este trabajo, mediante el uso de datos interferométricos obtenidos en la banda de radio en la transición de 21-cm del Hidrógeno neutro y de imágenes de la emisión de continuo en las bandas de 408 y 1420 MHz, de imágenes HIRES del satélite IRAS en 60 y 100 micrones, y de observaciones de continuo obtenidas con radiotelescopios de disco simple en 2695, 4850 y 8350 MHz se ha realizado un estudio multifrecuencia de los efectos que los vientos estelares de HD 192281, una estrella de tipo espectral O5 Vn((f))p, han tenido sobre el medio interestelar que rodea a la misma.

Estudio multifrecuencia del medio interestelar cercano a HD 192281

NASA Astrophysics Data System (ADS)

Arnal, E. M.; Cappa, C. E.; Cichowolski, S.; Pineault, S.; St-Louis, N.

Una de las causas que modifica la estructura y dinámica del medio interestelar es la acción que los vientos de las estrellas de gran masa ejercen sobre el mismo. En este trabajo, mediante el uso de datos interferométricos obtenidos en la banda de radio en la transición de λ˜21-cm del hidrógeno neutro y de imágenes de la emisión de continuo en las bandas de 408 y 1420 MHz, de imágenes HIRES del satélite IRAS en 60 y 100μm, y de observaciones de continuo obtenidas con radiotelescopios de disco simple en 2695, 4850 y 8350 MHz se ha realizado un estudio multifrecuencia de los efectos que los vientos estelares de HD 192281, una estrella de tipo espectral O5,Vn((f))p, han tenido sobre el medio interestelar que rodea a la misma.

Uso de terreno urbano y rural en Puerto Rico

Treesearch

Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez; Maya Quinones; Michael E. Jimenez

2008-01-01

El Proyecto de Analisis de Gap de Puerto Rico (PRGAP) (Gould et al. 2008) desarrollo tres usos de terrenos para Puerto Rico: Urbano, Suburbano, y Rural (Martinuzzi et al. 2007). Estas regiones tambien pueden ser consideradas como urbano, densamente-poblado rural, y escasamente-poblado rural, o como urbano y area silvestre con una interfase de area silvestre-urbana. La...

M S MOLECULARES Rumo aos limites da miniaturiza o - (Molecular Magnets - towards the limits of miniaturization)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reis, Mario S; Moreira Dos Santos, Antonio F

Por s culos, acreditou-se que o magnetismo s se manifestava em metais, como aqueles contendo ferro; hoje, a imagem mais comum de um m talvez seja a daquelas plaquinhas flex veis coladas geladeira com propagandas dos mais diversos tipos. O leitor conseguiria imaginar um material puramente org nico daqueles que formam os seres vivos como magn tico? E m s do tamanho de mol culas? fato: ambos existem. Esses novos materiais, conhecidos como magnetos moleculares, descobertos e desenvolvidos em v rios laborat rios do mundo, j re nem longa lista de aplica es, do tratamento do c ncer a refrigeradoresmore » ecol gicos, passando pela transmiss o de eletricidade sem perda de calor e a fabrica o de computadores extremamente velozes.« less

[Diabetic foot osteomyelitis: is conservative treatment possible?].

PubMed

Jordano-Montañez, Queralt; Muñiz-Tatay, Montse; Viadé-Julià, Jordi; Jaen-Manzanera, Angeles; Royo-Serrando, Josep; Cuchí-Burgos, Eva; Anglada-Barceló, Jordi; de la Sierra-Iserte, Alejandro

2014-11-01

The aim of the present study is to determine the proportion of foot ulcers, complicated by osteomyelitis in diabetic patients, that heal without amputation. Furthermore, an attempt is made to analyze the main clinical and microbiological characteristics of episodes, and to identify potential predictive factors leading to the failure of conservative treatment. A prospective observational study was carried out between 2007 and 2009 on diabetic patients with a foot lesion and attending a diabetic foot clinic. A percutaneous bone biopsy was required to be included in the study. A total of 81 episodes of diabetic foot osteomyelitis in 64 patients were evaluated. Staphylococcus aureus (28/81) and coagulase negative Staphylococcus (22/81) were the most frequent organisms isolated. Among the gramnegative group (34/81), non-fermenting gram negative bacteria were the most prevalent organisms isolated (14/81). Conservative treatment was successful in 73% of episodes. After a logistic regression analysis using the most significant prognostic variables, only lesion size greater than 2cm independently predicted failure of conservative treatment. Culture guided antibiotic treatment was associated with a better prognosis. Conservative treatment, including culture-guided antibiotics, is successful without amputation in a large proportion of diabetic patients with diabetic foot osteomyelitis. Considering empiric therapy directed at non-fermenting gramnegative bacteria could be advisable in some cases, because they are frequently isolated in our setting. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

First Enterovirus D68 (EV-D68) cases detected in hospitalised patients in a tertiary care university hospital in Spain, October 2014.

PubMed

Gimferrer, Laura; Campins, Magda; Codina, Maria Gema; Esperalba, Juliana; Martin, Maria Del Carmen; Fuentes, Francisco; Pumarola, Tomas; Anton, Andres

2015-11-01

Several outbreaks of Enterovirus 68 (EV-D68) have recently been reported in the USA and Canada, causing substantial hospitalisation of children with severe respiratory disease. The acute flaccid paralysis detected in the USA and Canada among children with EV-D68 infection has raised concerns about the aetiological role of this EV serotype in severe neurological disease. The circulation of EV-D68 in the general European population seems to be low, but European Centre for Disease Prevention and Control (ECDC) recommends being vigilant to new cases, particularly in severely ill hospitalised patients. In October 2014, enteroviruses were detected in respiratory samples collected from five hospitalised patients, children and adults. Phylogenetic analysis of partial VP1 sequences confirmed that the detected enteroviruses belonged to the D68 serotype, which were also similar to strains reported in USA (2014). However, all five patients developed respiratory symptoms, but only one required ICU admission. None of the patients described had symptoms of neurological disease. Other considerations related to the detection methods used for the diagnosis of respiratory enteroviruses are also discussed. In conclusion, additional evidence has been provided that supports the role of EV-D68 in respiratory infections in hospitalised patients. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Evaluation of a new rapid diagnostic test for the detection of influenza and RSV.

PubMed

Gómez, Sara; Prieto, Columbiana; Vera, Carmen; R Otero, Joaquín; Folgueira, Lola

2016-05-01

Influenza viruses and respiratory syncytial virus (RSV) can cause an acute respiratory disease that occurs seasonally in epidemic waves. This retrospective study was conducted to evaluate the Sofia(®) Influenza A+B and the Sofia(®) RSV fluorescence immunoassays (FIAs), two novel rapid detection tests (RDTs) for influenza A and B and RSV. Two hundred and nine breath samples were selected from patients with respiratory symptoms determined to be positive/negative for influenza A, influenza B or RSV using one of the reference diagnostic techniques, cell culture and/or RT-PCR (Simplexa™Flu A/B & RSV). The Sofia Influenza A+B FIA was tested on 123 samples (63 from children and 60 from adults) and the Sofia RSV FIA was tested on 86 pediatric samples. Sensitivity and specificity values of both assays were calculated assuming the reference techniques as the gold standard. Sensitivity and specificity values for the Sofia Influenza A+B FIA were 73.1% and 97.8%, respectively. Sensitivity and specificity values for the Sofia RSV FIA were 87.5% and 86.7%, respectively. The sensitivity results obtained for the two assays were considerably higher than those reported for other RDTs. In conclusion, the Sofia Influenza A+B and the Sofia RSV FIAs are appropriate tools for the rapid diagnosis of these viruses. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Population study of seroprevalence of antibodies against hepatitis A virus in the Community of Madrid, 2008-2009].

PubMed

García-Comas, Luis; Ordobás, María; Sanz, Juan Carlos; Ramos, Belén; Arce, Araceli; Barranco, Dolores

2016-01-01

Seroprevalence surveys enable the level of endemicity of hepatitis A (HAV) to be assessed. The aim of this study was to estimate the seroprevalence (SP) antibody against HAV by age group, and compare it with those obtained in previous surveys. Observational cross-sectional study. The target population consists of residents from 2 to 60 years old in the Community of Madrid. Two-stage cluster sampling was performed with stratification of first stage units. After signing the informed consent, a serum sample was extracted from each participant and sociodemographic data were collected by a questionnaire. SP antibodies to hepatitis A is 46.8% (95% CI 44.6 to 49.0). The SP increases with age. It is higher in the population from more endemic countries and people with less education and lower social class. In relation to the previous survey, SP increased in the population under 30 years old, and a decline after that age is observed. If only the autochthonous population and from countries with very low endemicity is observed, the increase is statistically significant in the 2-5 years age group. Our region has a very low level of endemicity thus, following the recommendations of WHO, vaccination should be targeted at specific risk groups. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Immune reconstitution inflammatory syndrome in HIV-infected patients with Pneumocystis jirovecii pneumonia.

PubMed

Roade Tato, Luisa; Burgos Cibrian, Joaquín; Curran Fábregas, Adrià; Navarro Mercadé, Jordi; Willekens, Rein; Martín Gómez, María Teresa; Ribera Pascuet, Esteban; Falcó Ferrer, Vicenç

2017-11-26

The incidence of immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients after an episode of Pneumocystis jirovecii pneumonia (PJP) seems to be lower than with other opportunistic infections. We conducted an observational study in order to determine the incidence, clinical characteristics and outcome of patients diagnosed with PJP-related IRIS. We conducted an observational study of HIV patients diagnosed with PJP-related IRIS from January 2000 to November 2015. We analyzed epidemiological and clinical characteristics as well as laboratory findings. We also carried out a systematic review of published cases. Six cases of IRIS out of 123 (4.9%) HIV-infected patients with PJP who started ART were diagnosed. All six cases were men with a median age of 34 (IQR: 8) years. The six patients developed paradoxical IRIS. Subjects younger than 40 years old (p=0.084) and with an HIV-RNA viral load >100000 copies/ml (p=0.081) at diagnosis showed a tendency to develop IRIS. Thirty-seven published cases of PJP-related IRIS were identified. Although 51% of cases involved respiratory failure, no deaths were reported. PJP-related IRIS is rare condition compared to other opportunistic infections. It can lead to a severe respiratory failure in a significant proportion of cases, although no deaths have been reported. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Consensus statement on metabolic disorders and cardiovascular risks in patients with human immunodeficiency virus].

PubMed

Polo Rodríguez, Rosa; Galindo Puerto, María José; Dueñas, Carlos; Gómez Candela, Carmen; Estrada, Vicente; Villar, Noemí G P; Locutura, Jaime; Mariño, Ana; Pascua, Javier; Palacios, Rosario; von Wichmman, Miguel Ángel; Álvarez, Julia; Asensi, Victor; Lopez Aldeguer, José; Lozano, Fernando; Negredo, Eugenia; Ortega, Enrique; Pedrol, Enric; Gutiérrez, Félix; Sanz Sanz, Jesús; Martínez Chamorro, Esteban

2015-01-01

This consensus document is an update of metabolic disorders and cardiovascular risk (CVR) guidelines for HIV-infected patients. This document has been approved by an expert panel of GEAM, SPNS and GESIDA after reviewing the results of efficacy and safety of clinical trials, cohort and pharmacokinetic studies published in biomedical journals (PubMed and Embase) or presented in medical scientific meetings. Recommendation strength and the evidence in which they are supported are based on the GRADE system. A healthy lifestyle is recommended, no smoking and at least 30min of aerobic exercise daily. In diabetic patients the same treatment as non-HIV infected patients is recommended. HIV patients with dyslipidemia should be considered as high CVR, thus its therapeutic objective is an LDL less than 100mg/dL. The antihypertensive of ACE inhibitors and ARAII families are better tolerated and have a lower risk of interactions. In HIV-patients with diabetes or metabolic syndrome and elevated transaminases with no defined etiology, the recommended is to rule out a hepatic steatosis Recommendations for action in hormone alterations are also updated. These new guidelines update previous recommendations regarding all those metabolic disorders involved in CVR. Hormone changes and their management and the impact of metabolic disorders on the liver are also included. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Imported malaria in children in Madrid, Spain, 2007-2013.

PubMed

Sánchez, Beatriz Soto; Tato, L M Prieto; Martín, S Guillén; Pérez, E; Grasa, C; Valderrama, S; Augusto, I de; Sierra, M; Ros, M García; Aguado, I; Hortelano, M García López

The majority of malaria cases diagnosed in Europe in the last few years have occurred in people living in non-endemic areas travelling back to their home country to visit friends and relatives (VFRs). Children account for 15-20% of imported malaria, with known higher risk of severe disease. A retrospective multicentre study was conducted in 24 hospitals in Madrid (Spain) including patients under 16 years diagnosed with malaria (2007-2013). A total of 149 episodes in 147 children were reported. Plasmodium falciparum was the species most commonly isolated. Twenty-five patients developed severe malaria and there was one death related to malaria. VFR accounted for 45.8% of our children. Only 17 VFRs had received prophylaxis, and 4 of them taken appropriately. They presented more frequently with fever (98% vs. 69%), a longer time with fever (55 vs. 26%), delay in diagnosis of more than three days (62 vs. 37%), and more thrombocytopenia (65 vs. 33%) than non-VFRs, and with significant differences (p<0.05). VFRs represent a large proportion of imported malaria cases in our study. They seldom took adequate prophylaxis, and delayed the visit to the physician, increasing the length of fever and subsequent delaying in diagnosis. Appropriate preventive measures, such as education and pre-travel advices should be taken in this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Genetic profiling of Giardia intestinalis by polimerase chain in human and dogs samples of Colombian Caribean Coast].

PubMed

Arroyo-Salgado, Bárbara; Buelvas-Montes, Yaleyvis; Villalba-Vizcaíno, Vivian; Salomón-Arzuza, Octavio

2014-01-01

Giardia intestinalis (G. Intestinalis) is a protozoan that causes diarrheal disease and malabsorption syndrome in humans and other mammals. It presents a high genetic diversity evidenced in the recognition of 7 genotypes (A-G). Genotypes A and B are commonly associated to humans and domestic animals such as dogs. The aim of this study was to conduct a preliminary genetic characterization of G. intestinalis in humans and dogs from two cities on the Caribbean coast of Colombia. Sampling areas were selected according to the highest numbers of acute diarrheal disease. Stool samples were collected from children under 7 years old, with positive medical tests for G. intestinalis. Cysts were purified by sucrose gradient and DNA samples were isolated by extraction with organic solvents. Molecular characterization was performed by amplifying the gene triose phosphate isomerase (tpi) by using a semi-nested PCR. A total of 202 samples of DNA were obtained; of these, 111 were positive in coproparasitological analysis (13 dogs and 98 children). Genotype distribution in positive samples was: 5.1% belonged to genotype A and 92.3% to genotype B. Genotype B was present in humans and animals. The most common genotype in both human and animal samples was genotype B, suggesting a zoonotic transmission cycle. Copyright © 2012 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Hospitalization due to whooping cough in Spain (1997-2011)].

PubMed

Fernández-Cano, María Isabel; Armadans-Gil, Lluís; Alvarez-Bartolomé, Mercedes; Rodrigo-Pendás, José Ángel; Campins-Martí, Magda

2014-12-01

Pertussis incidence has increased in recent years in countries with high vaccination coverage. The aim of this study was to determine the health impact of pertussis in Spain in the period 1997-2011 in relation to hospitalizations, mortality, and associated costs. We retrospectively analyzed hospital discharges included in the Minimum Data Set (MDS) in Spain for the period 1997-2011, with a primary or secondary diagnosis related to pertussis. We calculated incidence rates of hospitalization for pertussis (per 100,000) per year, by age group and by Autonomous Region, along with the mortality and lethality rates. A total of 8,331 hospital discharges with a diagnosis of pertussis were recorded in Spain between 1997 and 2011. The overall incidence of pertussis hospitalizations was 1.3 cases per 100,000 inhabitants. The large majority (92%) of hospitalizations occurred in children under one year of age, with an incidence of 115.2 hospitalizations per 100,000. There were 47 deaths, 37 (79%) in the group of children under 1 year and 6 (13%) in the group older than 65 years. The estimated cost of hospitalization for pertussis was 1,841 euros. The epidemiology of severe cases of pertussis, and its clinical and economic impact, confirms the need to modify the vaccination strategies for Spain to achieve more effective control in the most vulnerable groups. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[An outbreak of mumps in a high school: Estimation of vaccine effectiveness. Zaragoza 2011].

PubMed

Compés-Dea, Cecilia; Guimbao-Bescós, Joaquín; Gaspar-Escayola, José Ignacio; Lázaro-Belanche, María Ángeles; Aznar-Brieba, Amaya

2015-01-01

Mumps outbreaks continue to occur, even after the consolidation of vaccination programs. An outbreak of mumps occurred in a high school in Zaragoza during December 2011. To describe the outbreak and estimate vaccine effectiveness. unilateral or bilateral swelling of the parotid or other salivary glands for three or more days without any other apparent cause. People attending the 'Parque Goya' High School or with transmission chain origin in the High School. From two days before the onset of symptoms of the first case to five days after the last case. Samples were collected for virus confirmation (IgM, urine culture and oropharyngeal exudate), and isolates were processed for genotyping. A retrospective cohort study was performed in two high school classrooms to estimate vaccine efficacy. Public health authorities conducted active surveillance, isolation of cases, and vaccination of susceptible contacts. There were 27 cases. Twenty-one (77.8%) were vaccinated with two doses of Measles-Mumps-Rubella vaccine. Twelve (44%) were confirmed microbiologically. G1 genotype was determined in six cases. According to the cohort study, vaccine efficacy for one dose was 34% (95%CI: -44 to 70), and was 67% (95%CI: 28 to 83) for two doses. Vaccine effectiveness was lower than expected. Early detection and isolation of cases have been instrumental in preventing new cases in schools. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Does the prescribing of antibiotics in paediatrics improve after a multidisciplinary intervention?].

PubMed

Lalana-Josa, Pilar; Laclaustra-Mendizábal, Blanca; Aza-Pascual-Salcedo, M Mercedes; Carcas-de-Benavides, Cristina; Lallana-Álvarez, M Jesús; Pina-Gadea, M Belén

2015-02-01

Antibiotics overuse is linked to elevated antimicrobial resistance. In Aragon, Spain, the highest antibiotic prescription rates occur among children from 1 to 4 years old. The rate of use in this age group is over 60%. To evaluate the effect of multi-faceted intervention on Primary Care paediatricians to reduce antibiotic use and to improve antibiotic prescribing for paediatric outpatients. Outpatient antimicrobial prescribing was analysed before and after an intervention in paediatricians. The intervention included a clinical education session about diagnosis and treatment in the most prevalent paediatric infectious diseases, a clinical interview and communication skills, a workshop on rapid Streptococcus antigen detection test and patient information leaflets and useful internet websites for parents. The control group included paediatricians without this educational intervention on antibiotics. Antibiotic prescribing decreased from 19.17 defined daily doses per 1000 inhabitants/day (DID) to 14.36 DID among intervention paediatricians vs 19.84 DID to 16.02 DID in controls. The decreasing was higher in the intervention group, but the effect was not statistically significant. Macrolides and broad-spectrum penicillins prescribing decreased in both groups. Antibiotic prescribing decreased, but there were no statistically significant differences between the two groups. The high satisfaction of paediatricians in the intervention group makes it necessary to continue with these kinds of strategies to improve antibiotic use in outpatients. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Usefulness of a novel multiplex real-time PCR assay for the diagnosis of sexually-transmitted infections.

PubMed

Fernández, Gema; Martró, Elisa; González, Victoria; Saludes, Verónica; Bascuñana, Elisabet; Marcó, Clara; Rivaya, Belén; López, Evelin; Coll, Pep; Matas, Lurdes; Ausina, Vicente

2016-10-01

Sexually transmitted infections (STI) are currently on the increase worldwide. New molecular tools have been developed in the past few years in order to improve their diagnosis. An evaluation was carried out using a new commercially available real-time PCR assay, Anyplex™ II STI-7 (Seegene, Seoul, Korea), which detects seven major pathogens in a single reaction - Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, and Ureaplasma parvum - and compared with conventional methods performed in our laboratory. Two different populations were included, and 267 specimens from different sites of infection (urines, endocervical swabs, rectal swabs, vaginal swabs, urethral swabs and one inguinal adenopathy) were processed for both methods. The parameters of clinical performance were calculated for C. trachomatis, N. gonorrhoeae, and T. vaginalis, and the assay achieved sensitivities (SE) from 93.94% to 100%, and specificities (SP) from 96.55% to 100%, with negative predictive values (NPV) from 93.33% to 98.85%, and positive predictive values (PPV) from 96.88% to 100%, with a very good agreement (kappa index from 0.88 to 1). Anyplex™ II STI-7 is a good tool for the reliable diagnosis of STI. Its ease of use and processing allows it to be incorporated into the day to day laboratory work. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population].

PubMed

Padilla-España, Laura; Repiso-Jiménez, Bosco; Fernández-Sánchez, Fernando; Frieyro-Elicegui, Marta; Fernández-Morano, Teresa; Pereda, Teresa; Rivas-Ruiz, Francisco; Redondo, Maximino; de-Troya Martín, Magdalena

2014-11-01

The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology. Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[An outbreak of Burkholderia cepacia bacteremia in a hemodialysis unit, Cadiz, 2014].

PubMed

Montaño-Remacha, Carmen; Márquez-Cruz, María Dolores; Hidalgo-Guzmán, Pilar; Sánchez-Porto, Antonio; Téllez-Pérez, Francisco de Paula

2015-12-01

In January 2014 a possible outbreak of Burkholderia cepacia bacteremia occurred in a hemodialysis center situated in La Linea de la Concepción (Cadiz). An investigation was begun to confirm the outbreak, identify the source, and implement control measures. A descriptive analysis was performed to describe the characteristics of the patients affected with Burkholderia cepacia bacteremia from November 2013 to February 2014. Environmental samples were taken. A molecular typing study was performed using pulsed field gel electrophoresis (SpeI PFGE) and MLST analysis in order to determine the genetic similarity between the isolates. The bacterium was isolated from blood cultures of 7 patients during the study period. Three of the samples (2 of which were also cases) were endoluminal fluid from catheter locks, and 4 chlorhexidine bottle samples. The patients were coincident in 2 of the 6 work shifts. The mean age of the cases was 67 years of whom 57% were women. Human samples and an environmental sample was analyzed and found to be genetically identical (ST653 clone). The analysis confirmed the outbreak of Burkholderia cepacia, with 7 cases among the patients of the hemodialysis center. The outbreak was due to the same strain, probably a common source and secondary transmission from person to person. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Tendencia de los egresos hospitalarios por enfermedades infecciosas intestinales en niños en Argentina, 2005-2013.

PubMed

Degiuseppe, Juan I

2017-08-01

Acute diarrhea is one of the most serious public health problems in developing countries because it is generally associated with unfavorable living conditions. The objective of this study was to analyze trends in hospital discharges for intestinal infectious disease in children under age 5 recorded in official public hospitals from Argentina in the 2005-2013 period. This was an ecological, time-series study based on data provided by the Health Statistics and Information Department, at a national and regional level. Specific hospital discharge rates were estimated, and seasonal behavior and trends were analyzed in relation to this event. In Argentina, 2 521 729 patients under age 5 were discharged in this period; of these, 9.0% were diagnosed with intestinal infectious disease. Children under age 1 accounted for a third of hospitalizations; two annual peaks (summer and winter) were observed in the seasonality analysis. Overall, a downward trend was observed, with a mild increase in the 2007-2009 period. Rates were up to 3 or 4 times higher in Northwest and Northeast Argentina than in the Pampa region. Hospital discharges for intestinal infectious disease in the public subsector account for approximately 10% of all discharges of children under age 5. This event shows a seasonal pattern, with a slightly downward trend over the past years in spite of its heterogeneous distribution across the different Argentine regions. Sociedad Argentina de Pediatría

[Human papillomavirus vaccine. Efficacy and safety].

PubMed

Bruni, Laia; Serrano, Beatriz; Bosch, Xavier; Castellsagué, Xavier

2015-05-01

Human papillomavirus (HPV) related disease remains a major cause of morbidity and mortality worldwide. Prophylactic vaccines have been recognized as the most effective intervention to control for HPV-related diseases. This article reviews the major phaseii/iii trials of the bivalent (HPVs16/18), quadrivalent (HPVs6/11/16/18), and the recently approved 9-valent vaccine (HPVs6/11/16/18/31/33/45/52/58). Large trials have been conducted showing the safety, immunogenicity and high efficacy of the bivalent and quadrivalent vaccines in the prevention of pre-invasive lesions and infection, especially when administered at young ages before exposure to HPV. Trials of the 9-valent vaccine have also demonstrated the safety, immunogenicity and efficacy of the vaccine in the prevention of infection and disease associated with the vaccine types, and its potential to substantially increase the overall prevention of HPV-related diseases. Post-licensure country reports have shown the recent and early impact of these vaccines at population level after the implementation of established HPV vaccination programs, including decreases in the prevalence of vaccine HPV types, the incidence of genital warts, and the incidence of high-grade cervical abnormalities. If widely implemented, current HPV vaccines may drastically reduce the incidence of cervical cancer and other HPV-related cancers and diseases. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Acellular vaccines (DTPa/dTpa) against whooping cough, protection duration].

PubMed

Rigo-Medrano, M Vicenta; Mendoza-García, José L; Gimeno-Gascón, Adelina; Roda-Ramón, Jorge; Cremades-Bernabeú, Israel; Antequera-Rodríguez, Pedro; Alcalá-Minagorre, Pedro J; Ortiz-de la Tabla, Victoria; Rodríguez-Díaz, Juan Carlos

2016-01-01

An increase in whooping cough in most of the developed countries has been detected in the last decade. To determine whether the administration of dTpa vaccine instead of DTPa fifth dose is contributing to the appearance of these cases. A descriptive study based on cases of whooping cough reported during an epidemic period in the city of Alicante in the first 5 months of 2014. Only pertussis cases confirmed by PCR were included in the study, and only those vaccinated with 5 doses were included in the analysis of the period of protection. A total of 104 cases of pertussis confirmed by PCR were reported, with 85 cases (82%) having had 5 doses of vaccine. The mean time and standard deviation (SD) of protection was 2.1±1.1 years with dTpa, and 5.1±1.5 years with DTPa (p<.001). In the protection, adjusted for age, it was observed that, after 3 years, only 47.6% of people vaccinated with dTpa were still protected, while people vaccinated with DTPa were 100% protected (P<.001). This study found that people who were properly vaccinated against pertussis and received their last re-vaccination dose with dTpa had a shorter period of protection than those who were vaccinated with DTPa. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Clinical and epidemiological differences between Bordetella pertussis and respiratory syncytial virus infections in infants: a matched case control study].

PubMed

Giménez-Sánchez, Francisco; Cobos-Carrascosa, Elena; Sánchez-Forte, Miguel; López-Sánchez, María Ángeles; González-Jiménez, Yolanda; Azor-Martínez, Ernestina

2014-01-01

An increase in cases of pertussis, mainly in young infants, has been reported in the last few years. The clinical presentation of this disease is very similar to that produced by respiratory syncytial virus (RSV), which makes the diagnosis difficult. To compare the clinical and epidemiological characteristics between Bordetella pertussis and RSV infections in infants admitted to hospital. An analytical matched case-control study was conducted during the period 2008-2011. Cases were defined as infants admitted with pertussis confirmed by PCR in nasopharyngeal aspirate. Each case was matched by age, sex and date of admission to two controls defined as patients with RSV infection detected by immunochromatography in nasal aspirate. Demographic, clinical, laboratory data were compared. Seventy eight patients (26 cases of pertussis and 52 controls RSV+) were included. Sociodemographic characteristics were similar in both groups. Cases had more days of symptoms prior to admission, longer hospital stays, and increased frequency of epidemic family environment. Apnoea and cyanosis were more frequent. Cases of pertussis were more likely to have apnoea, cyanosis, and lymphocytosis while RSV infections had more frequent fever, vomiting and respiratory distress. The clinical presentations of pertussis and RSV infection are similar, but there are some characteristics that can help to distinguish between them. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Validation and adhesion to GESIDA quality indicators in patients with HIV infection].

PubMed

Riera, Melchor; Esteban, Herminia; Suarez, Ignacio; Palacios, Rosario; Lozano, Fernando; Blanco, Jose R; Valencia, Eulalia; Ocampo, Antonio; Amador, Concha; Frontera, Guillem; vonWichmann-de Miguel, Miguel Angel

2016-01-01

The objective of the study is to validate the relevant GESIDA quality indicators for HIV infection, assessing the reliability, feasibility and adherence to them. The reliability was evaluated using the reproducibility of 6 indicators in peer review, with the second observer being an outsider. The feasibility and measurement of the level of adherence to the 22 indicators was conducted with annual fragmented retrospective collection of information from specific databases or the clinical charts of the nine participating hospitals. Reliability was very high, with interobserver agreement levels higher than 95% in 5 of the 6 indicators. The median time to achieve the indicators ranged between 5 and 600minutes, but could be achieved progressively from specific databases, enabling obtaining them automatically. As regards adherence to the indicators related with the initial evaluation of the patients, instructions and suitability of the guidelines for ART, adherence to ART, follow-up in clinics, and achieve an undetectable HIV by PCR at week 48 of the ART. Indicators of quality related to the prevention of opportunistic infections and control of comorbidities, the standards set were not achieved, and significant heterogeneity was observed between hospitals. The GESIDA quality indicators of HIV infection enabled the relevant indicators to be feasibly and reliably measured, and should be collected in all the units that care for patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Populações estelares do bojo galáctico

NASA Astrophysics Data System (ADS)

Escudero, A. V.; Costa, R. D. D.; Maciel, W. J.

2003-08-01

Os estudos mais recentes do bojo galáctico têm enfocado essencialmente as abundâncias químicas de elementos pesados, como o ferro, obtidos a partir das estrelas nas regiões centrais da galáxia. Elementos leves, como hélio, nitrogênio, oxigênio e argônio ainda são pouco estudados nestas regiões, devido à difícil determinação de suas abundâncias a partir de estrelas. Nestas condições as nebulosas planetárias desempenham um importante papel, pois permitem a determinação de abundâncias destes elementos usando técnicas de espectroscopia nebular. Neste trabalho, reportamos a análise das abundâncias químicas de uma nova amostra de nebulosas planetárias do bojo, bem como os resultados preliminares de um código numérico destinado a modelar a evolução química desta região. Usamos como vínculos observacionais os resultados obtidos das nebulosas planetárias, bem como de abundâncias estelares da região do bojo, obtidas da literatura. A partir deste modelo da evolução química e dos vínculos observacionais foi possível fazer um diagnóstico mais preciso das populações que constituem o bojo galáctico. O estudo destas populações que compõem a região central de nossa galáxia é de extrema importância para o maior entendimento da evolução química e dinâmica da galáxia como um todo. Por isto, verificamos a importância dos modelos de formação simples e mista utilizados para explicar características da população da região central da galáxia. Algumas destas características são: uma grande dispersão nos valores das abundâncias químicas e um grande espalhamento nas correlações entre as abundâcias de nitrogênio e oxigênio. Estas peculiaridades são dificilmente reproduzidas por modelos de formação simples, e portanto são importantes indícios da validade dos modelos de formação mista, tais como um rápido colapso do bojo seguido de uma evolução secular. (FAPESP, CNPq)

Proceedings of the Fourth Symposium on Conference on Dynamics of Cosmic Gases, Varenna Italy (Lake of Como), August 18-30, 1960; ATTI DEL IV SYMPOSIUM SULLA DINAMICA DEL GAS COSMICO, VARENNA SUL LAGO DI COMO 18-30 AGOSTO 1960

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1961-01-01

Fifteen papers are included: separate abstracts have been prepared for l0. A single abstract has been prepared to cover the remaining 5 papers, which consist of observational studies. Extensive discussions are included. (T.F.H.)

Cardiac Magnetic Resonance-Verified Myocardial Fibrosis in Chagas Disease: Clinical Correlates and Risk Stratification.

PubMed

Uellendahl, Marly; Siqueira, Maria Eduarda Menezes de; Calado, Eveline Barros; Kalil-Filho, Roberto; Sobral, Dário; Ribeiro, Clébia; Oliveira, Wilson; Martins, Silvia; Narula, Jagat; Rochitte, Carlos Eduardo

2016-11-01

Chagas disease (CD) is an important cause of heart failure and mortality, mainly in Latin America. This study evaluated the morphological and functional characteristics of the heart as well the extent of myocardial fibrosis (MF) in patients with CD by cardiac magnetic resonance (CMR). The prognostic value of MF evaluated by myocardial-delayed enhancement (MDE) was compared with that via Rassi score. This study assessed 39 patients divided into 2 groups: 28 asymptomatic patients as indeterminate form group (IND); and symptomatic patients as Chagas Heart Disease (CHD) group. All patients underwent CMR using the techniques of cine-MRI and MDE, and the amount of MF was compared with the Rassi score. Regarding the morphological and functional analysis, significant differences were observed between both groups (p < 0.001). Furthermore, there was a strong correlation between the extent of MF and the Rassi score (r = 0.76). CMR is an important technique for evaluating patients with CD, stressing morphological and functional differences in all clinical presentations. The strong correlation with the Rassi score and the extent of MF detected by CMR emphasizes its role in the prognostic stratification of patients with CD. A doença de Chagas (DC) é importante causa de insuficiência cardíaca e mortalidade, principalmente na América Latina. Este estudo avaliou as características morfológicas e funcionais do coração, assim como a extensão da fibrose miocárdica (FM) em pacientes com DC através de ressonância magnética cardíaca (RMC). O valor prognóstico da FM avaliada por realce tardio miocárdico (RTM) foi comparado àquele do escore de Rassi. Avaliação de 39 pacientes divididos em 2 grupos: grupo 'forma indeterminada' (IND), 28 pacientes assintomáticos; e grupo 'cardiopatia chagásica' (CC), pacientes sintomáticos. Todos os pacientes foram submetidos a RMC com as técnicas de cine-RM e RTM, sendo a quantidade de FM evidenciada ao exame comparada ao escore de Rassi. As análises morfológica e funcional mostraram significativas diferenças entre os 2 grupos (p < 0,001). Houve ainda uma forte correlação entre a extensão da FM e o escore de Rassi (r = 0,76). A RMC é uma importante técnica para avaliar pacientes com DC, ressaltando as diferenças morfológicas e funcionais em todas as apresentações clínicas. A forte correlação entre o escore de Rassi e a extensão da FM detectada por RMC enfatiza seu papel na estratificação prognóstica de pacientes com DC.

On Ensino de Astronomia: Desafios para Implantação

NASA Astrophysics Data System (ADS)

Faria, R. Z.; Voelzke, M. R.

2008-09-01

Em 2002 o ensino de Astronomia foi proposto como um dos temas estruturadores pelos Parâmetros Curriculares Nacionais e sugerido como facilitador para que o aluno compreendesse a Física como construção humana e parte do seu mundo vivencial, mas raramente seus conceitos foram ensinados. A presente pesquisa discute dois aspectos relacionados à abordagem de Astronomia. O primeiro aspecto é se ela está sendo abordada pelos professores do Ensino Médio e o segundo, aborda a maneira como ela está sendo ensinada. Optou-se pela aplicação de um questionário a partir do 2° semestre de 2006 e durante o ano de 2007 com professores que ministram a disciplina de Física, os quais trabalham em escolas estaduais em Rio Grande da Serra, Ribeirão Pires e Mauá no estado São Paulo. Dos 66,2% dos professores que responderam ao questionário nos municípios de Rio Grande da Serra, Ribeirão Pires e Mauá, 57,4% não aplicaram nenhum tópico de astronomia, 70,2% não utilizaram laboratório, 89,4% não utilizaram qualquer tipo de programa computacional, 83,0% nunca fizeram visitas com alunos a museus e planetários e 38,3% não indicaram qualquer tipo de livro ou revista referente à astronomia aos seus alunos. Mesmo considerando a Astronomia um conteúdo potencialmente significativo, esta não fez parte dos planejamentos escolares. Portanto são necessárias propostas que visem estratégias para a educação continuada dos professores como, por exemplo, cursos específicos sobre o ensino em Astronomia.

LA BIOÉTICA COMO QUEHACER FILOSÓFICO

PubMed Central

Ferrer, Jorge José

2009-01-01

El artículo examina el estatuto epistemológico de la bioética como disciplina académica. El autor sostiene que el estatuto epistemológico de un discurso lo determina la pregunta fundamental que se plantea y la respuesta que se busca, focos integradores del discurso. En el caso de la bioética, la pregunta fundamental es de índole moral. La bioética es pues una disciplina ética que tiene su hogar epistemológico en la filosofía. El autor también defiende el concepto de “éticas aplicadas”. Sugiere finalmente que el método de la bioética, sobre todo la que se hace desde nuestras latitudes, debería adoptar el círculo hermenéutico como metodología para su filosofar. PMID:20463860

Como preparar un programa de informacion sobre la asistencia economica (Planning a Financial Aid Awareness Program).

ERIC Educational Resources Information Center

Department of Education, Washington, DC.

This booklet, written in Spanish, is intended to be used with a set of slides as part of a presentation to students on "How To Apply for Federal Student Aid" ("Como Solicitar la Asistencia Economica Federal para Estudiantes"). The first part of the book is a script based on the slides. After the script is a guide to hosting a financial aid…

Estimaciones de cambio climatico para Michoacan: Implicaciones para el sector agropecuario y forestal y para la conservacion de la Mariposa Monarca [In Spanish

Treesearch

Cuauhtemoc Saenz-Romero; Gerald E. Rehfeldt; Nicholas L. Crookston; Pierre Duval; Jean Beaulieu

2009-01-01

El cambio climatico, conocido comunmente como calentamiento global, es el incremento de la temperatura a nivel mundial y los cambios que de ello derivan, causados por el "efecto invernadero" del bioxido de carbono (CO2) y otros gases emitidos a la atmosfera. El uso de combustibles fosiles (carbon y derivados del petroleo, como gasolina, diesel, combustoleo y...

Percepção Astronômica de Alunos do Ensino Médio da Rede Estadual de São Paulo

NASA Astrophysics Data System (ADS)

de Oliveira, E. F.; Voelzke, M. R.; Amaral, L. H.

2005-08-01

Embora a astronomia seja uma das ciências mais antigas da humanidade e muitos dos conceitos astronômicos serem populares, principalmente nesta época de alta globalização do conhecimento por intermédio de eficientes meios de comunicação e de obtenção da informação, notadamente através da internet, observa-se que uma parcela significativa dos estudantes encontra-se à margem dessas informações. O presente trabalho visa analisar o nível de conhecimento básico dos alunos de Ensino Médio da rede estadual da cidade de Suzano quanto aos fenômenos astronômicos que os rodeiam, tais como a sucessão dos dias e das estações do ano, além de questioná-los sobre fatos genéricos tais como: quais são os astros que se encontram mais próximos do planeta Terra, o que vem a ser o Sol, o Big Bang, um ano-luz, uma estrela cadente, a estrela de Bélem e o que ocasionou a extinção dos dinossauros. Para tanto foi elaborado um formulário constando de questões de múltipla escolha, o qual foi aplicado no primeiro colegial noturno da Escola Estadual Batista Renzi. Num espaço amostral de 34 alunos constatou-se que apenas 29,4% compreendiam a sucessão dos dias da semana, que apenas 20,6% explicaram corretamente as estações do ano, que apenas 20,6% tinham idéia de quais são os objetos celestes mais próximos da Terra, em contraposição 67,6% sabiam classificar corretamente o Sol como estrela, 55,9% relacionavam o Big Bang à origem do universo, apenas 20,6% identificavam um ano-luz como unidade de distância, 32,4% reconheciam uma estrela cadente como meteoro, 41,2% consideravam a estrela de Belém como um cometa e 50,0% explicaram corretamente a extinção dos dinossauros. A presente análise será expandida para as demais classes de primeiro colegial, não somente do período noturno, mas também do diurno da Escola Estadual Batista Renzi, bem como o formulário será devidamente ampliado. Já nesta primeira fase nota-se claramente o pequeno discernimento de eventos astronômicos dos alunos e principalmente a grande confusão sobre o significado correto de termos astronômicos populares.

Conhecimento Científico e Cotidiano em Astronomia: Uma Investigação com Alunos da Educação Básica

NASA Astrophysics Data System (ADS)

Vieira, J. B.; Longhini, M. D.

2011-12-01

Este texto apresenta resultados de uma investigação que teve como objetivo, investigar como os conhecimentos científicos e do cotidiano relacionados a essa área de conhecimento apresentam na escola de Educação Básica, especialmente, em alunos do Ensino Médio prestes a deixar Educação Básica. Para realização da pesquisa, utilizamos como recurso metodológico a aplicação de um questionário estruturado contendo 47 questões, organizadas em duas categorias: Conhecimento Cotidiano e Conhecimento Científico. As questões da categoria “Conhecimento Cotidiano” possuíam afirmações relacionadas a crendices, contos populares, especulações e temáticas do gênero, as quais, geralmente, estão fora do círculo de discussão da comunidade científica, talvez por não serem consideradas como objeto de estudo da ciência. As questões da categoria “Conhecimento Científico” são relacionadas a conteúdos específicos de Astronomia, as quais são compartilhadas pela comunidade científica e aceitas, pelo menos provisoriamente, como possuindo fundamentação científica. Concluímos que, possuem ainda concepções de temas Astronômicos persistentes à mudança, por exemplo, fases da Lua relacionadas à melhor período para corte de cabelo e também para plantio; estrela cadente e ocasião perfeita para se fazer um pedido. Entretanto, podemos observar no que diz respeito a mitos e superstições, que quase não existe influência destes entre os alunos. Portanto, ao trabalharmos com os alunos determinados conceitos científicos, é importante lembrarmos que o professor não opera no vazio; os alunos são sujeitos de saberes, práticas e, dessa forma constroem e reconstroem saberes. Cabe ao professor ouvir os estudantes reconstruindo junto deles conceitos científicos. Acreditamos que o ensino de Ciências na Educação Básica deve lidar criticamente com o conhecimento cotidiano e científico e, assim, efetivar a Ciência como disciplina educativa, formativa e libertadora.

Gabapentina a dosis de 300 vs. 450 mg como premedicación anestésica para hipertensión reactiva, ansiedad y analgesia.

PubMed

Rascón-Martínez, Dulce María; Guzmán-Sánchez, Joaquín Antonio; Corral-Urdapilleta, Nora Paulina; Arguelles-Uribe, Gema Damaris; Velázquez-Loeza, Jazmín; Soto-Palma, Gustavo; Carrillo-Torres, Orlando

Observar el comportamiento de la gabapentina para aminorar la hipertensión reactiva secundaria a ansiedad y dolor en pacientes sometidos a cirugía oftálmica, así como el consumo de opiáceos entre los grupos. Ensayo clínico controlado aleatorizado y doble ciego que analizó a 125 pacientes divididos en tres grupos: grupo A, gabapentina 300 mg; grupo B, gabapentina 450 mg; grupo C, amaranto en grageas como control 2 horas antes del procedimiento quirúrgico. Se utilizó la prueba de ji al cuadrado para variables sociodemográficas y ANOVA de un factor para variables numéricas continuas. Se consideró como significativo un valor de p < 0.05 para un estudio de dos colas con un poder beta del 80%. La ansiedad y la analgesia transoperatoria y posoperatoria tuvieron diferencias significativas entre los grupos. Se encontró menor consumo de opiáceos en los grupos que usaron gabapentina. La gabapentina por vía oral, 300 o 450 mg, 2 horas antes de la cirugía, reduce el dolor, la ansiedad y el consumo de opiáceos durante el posoperatorio en pacientes sometidos a cirugía oftalmológica. Copyright: © 2018 SecretarÍa de Salud

[Women's complaint leadership in the Causa Kleinwächter. A contribution to patient history of the Innsbruck maternity hospital].

PubMed

Hilber, Marina

On the basis of the Innsbruck Maternity Clinic this paper deals with the individual and collective worlds of experience of obstetric patients. However, not only the patient's view on the proceedings in this specific medical space is being reconstructed, also the prevailing conventions surrounding the treatment of pregnant, parturient and puerperal patients serving as clinical material in obstetric research and education are critically scrutinised. At the centre of this paper stands Dr. Ludwig Kleinwächter's period of duty, who acted as professor for obstetrics and gynaecology in Innsbruck between 1877 and 1881. During this period numerous conflicts regarding the treatment of patients are documented. Concerned about the good reputation of the Maternity Clinic, the Tyrolean State Committee, as the Clinic's provider, tried to solve the crisis. The existing letters of complaint and protocols do not only give a voice to the women concerned, but also to the medical professions as well as the local political representatives involved.

[An information system for injuries from external causes (SILEX): a successful project in El Salvador].

PubMed

Salinas, Oscar; de Cosío, Gerardo; Clavel-Arcas, Carme; Montoya, Jeannette; Serpas, Mario; Morán de García, Silvia; Concha-Eastman, Alberto

2008-12-01

This article examines the stages in developing an information system for injuries from external causes (Sistema de Información de Lesiones de Causa Externa-SILEX), as well as its limitations and achievements. SILEX is a Web-based application for collection, quality control, presentation, and analysis of data available from the hospital system for surveillance of injuries from external causes created by Ministry of Health of El Salvador with data from the hospital emergency services. This system maintains comprehensive information on the injured person-type of injury, intention, injury site, activity being performed at the time of injury, risk factors, etc.-in the form of tables, graphs, and maps, which streamlines the development of intervention plans and prevention initiatives for these types of injuries in El Salvador. This experience is an example of what can be done to close the information gap on injuries by external causes in the Region of the Americas.

Profilaxia de tromboembolismo venoso na gestação

PubMed Central

de Oliveira, André Luiz Malavasi Longo; Marques, Marcos Arêas

2016-01-01

Resumo O tromboembolismo venoso é importante causa de morbidade e mortalidade obstétrica. Durante a gestação, o risco de sua ocorrência aumenta entre cinco e dez vezes quando comparado ao de mulheres não gestantes de mesma idade. Associado a esse fato, a gestante apresenta algumas limitações para o diagnóstico clínico (alta frequência de dor e edema nos membros inferiores), ecográfico (menor sensibilidade e especificidade no diagnóstico de trombose venosa de ilíaca com a evolução da gestação) e laboratorial (o D-dímero apresenta aumento progressivo no decorrer da gravidez). Uma estratificação criteriosa de risco de tromboembolismo venoso de cada mulher antes da gestação pode diminuir a incidência dessa doença, frequente e de difícil diagnóstico na gravidez, e suas complicações. PMID:29930607

Sobrevivendo a un tsunami: lecciones de Chile, Hawai y Japon

USGS Publications Warehouse

Compilado por Atwater, Brian F.; Cisternas V., Marco; Bourgeois, Joanne; Dudley, Walter C.; Hendley, James W.; Stauffer, Peter H.

1999-01-01

Este folleto contiene historias veridicas que ilustran como sobrevivir, y como no sobrevivir, a un tsunami. Esta publicacion esta dirigida a las personas que viven, trabajan o, simplemente, se divierten a lo largo de las costas que pueden ser afectadas por un tsunami. Tales costas rodean la mayor parte del Oceano Pacifico pero tambien incluyen algunas areas costeras de los Oceanos Atlantico e Indico. Aunque mucha gente llama a los tsunamis 'olas de marea', estos no estan relacionados a las mareas, sino son una serie de olas, o 'tren de olas', generalmente causadas por cambios en el nivel del fondo marino durante los terremotos. Los tsunamis tambien pueden ser generados por la erupcion de volcanes costeros, islas volconicas, deslizamientos submarinos e impactos de grandes meteoritos en el mar. Como sucedio en Sumatra en el 2004, los tsunamis pueden alcanzar alturas de 15 metros, no tan solo en la costa sino tambien kilometros tierra adentro. Los relatos presentados en este folleto fueron seleccionados de entrevistas realizadas a personas que sobrevivieron al tsunami del Oceano Pacifico de 1960. Muchas de estas personas, incluyendo a la enfermera de la foto, se enfrento a las olas generadas a poca distancia, en la costa chilena. En cambio, otros debieron hacer frente al tsunami muchas horas despues, en Hawai y Japon. La mayoria de las entrevistas fueron realizadas a fines de los anos ochenta y en los noventa. Las historias ofrecen una mezcla de lecciones de supervivencia a un tsunami. En algunos casos se presentan las acciones que confiablemente salvaron vidas: poner atencion a los avisos de la naturaleza, abandonar los bienes, dirigirse rapidamente a un sector alto y permanecer alli hasta que el tsunami realmente haya terminado. Otras historias describen como se encontro refugio al subir a construcciones y arboles o flotar sobre desechos, tacticas que tuvieron diferentes resultados y que pueden ser recomendadas solo como actos desesperados de personas atrapadas en sectores bajos.

Astronomia Motivadora no Ensino Fundamental

NASA Astrophysics Data System (ADS)

Melo, J.; Voelzke, M. R.

2008-09-01

O objetivo principal deste trabalho é procurar desenvolver o interesse dos alunos pelas ciências através da Astronomia. Uma pesquisa com perguntas sobre Astronomia foi realizada junto a 161 alunos do Ensino Fundamental, com o intuito de descobrir conhecimentos prévios dos alunos sobre o assunto. Constatou-se, por exemplo, que 29,3% da 6ª série responderam corretamente o que é eclipse, 30,0% da 8ª série acertaram o que a Astronomia estuda, enquanto 42,3% dos alunos da 5ª série souberam definir o Sol. Pretende-se ampliar as turmas participantes e trabalhar, principalmente de forma prática com: dimensões e escalas no Sistema Solar, construção de luneta, questões como dia e noite, estações do ano e eclipses. Busca-se abordar, também, outros conteúdos de Física tais como a óptica na construção da luneta, e a mecânica no trabalho com escalas e medidas, e ao utilizar uma luminária para representar o Sol na questão do eclipse, e de outras disciplinas como a Matemática na transformação de unidades, regras de três; Artes na modelagem ou desenho dos planetas; a própria História com relação à busca pela origem do universo, e a Informática que possibilita a busca mais rápida por informações, além de permitir simulações e visualizações de imagens importantes. Acredita-se que a Astronomia é importante no processo ensino aprendizagem, pois permite a discussão de temas curiosos como, por exemplo, a origem do universo, viagens espaciais a existência ou não de vida em outros planetas, além de temas atuais como as novas tecnologias.

Health-care management of an unexpected case of Ebola virus disease at the Alcorcón Foundation University Teaching Hospital.

PubMed

Rodríguez-Caravaca, Gil; Timermans, Rafael; Parra-Ramírez, Juan Manuel; Domínguez-Hernández, Francisco Javier; Algora-Weber, Alejandro; Delgado-Iribarren, Alberto; Hermida-Gutiérrez, Guillermo

2015-04-01

The first Ebola virus infected patient outside Africa was diagnosed and treated at Alcorcón Foundation University Teaching Hospital (AFUTH). We describe the integrated management strategy (medical, occupational health, preventive and public health) applied to the case. Descriptive study of health-care management of an unexpected case of Ebola virus disease (EVD) at AFUTH treated on 6 October 2014. We describe the clinical evolution of the patient while he was attended at the Emergency Department, the drawing-up process of the action protocol, the process of training of hospital staff, the administrative management for transferring the patient to the referral centre, and the measures implemented for cleaning, disinfection and management of waste. Qualitative variables are expressed as percentages. Our centre designed and updated, from May to October, five versions of the acting and care protocol for patients with EVD. The protocol was in force at the AFUTH when a nursing assistant was attended on 6 October 2014. All preventive, diagnostic and therapeutic measures outlined in the protocol were applied and 206 professionals had received training and information about care procedures with a suspect case. Health-care management of an unexpected case of EVD was adequate and there was no secondary cases in our staff as a result. All resources available should be used to fight EVD. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Polio, the long walk to the endgame].

PubMed

García-Sánchez, José Elías; García-Sánchez, Enrique; García-Merino, Enrique; Fresnadillo-Martínez, María José

2015-12-01

Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 -thanks to vaccination and institutional, public and private, resources for that purpose-, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling "from" and "to" endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the "non-vaccination" against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Quality of care indicators for the care of human immunodeficiency virus-infected individuals, adapted to the pediatric age].

PubMed

Soler-Palacín, Pere; Provens, Ana Clara; Martín-Nalda, Andrea; Espiau, María; Fernández-Polo, Aurora; Figueras, Concepció

2014-03-01

Since infection with human immunodeficiency virus (HIV) was first described, there have been many advances in its diagnosis, monitoring and treatment. However, few contributions are related to the area of health care quality. In this sense, the Spanish Study Group on AIDS (GESIDA) has developed a set of quality care indicators for adult patients living with HIV infection that includes a total of 66 indicators, 22 of which are considered to be relevant. Standards were calculated for each of them in order to reflect the level of the quality of care offered to these patients. Similar documents for pediatric patients are currently lacking. Preparation of a set of quality care indicators applicable to pediatric patients based on the GESIDA document and the Spanish Guidelines for monitoring of pediatric patients infected with HIV. Each indicator was analysed with respect to the required standards in all patients under 18 years of age followed-up in our Unit, with the aim of evaluating the quality of care provided. A total of 61 indicators were collected (51 from the GESIDA document and 10 from currently available pediatric guidelines), 30 of which were considered to be relevant. An overall compliance of 81%-83% was obtained when assessing the relevant indicators. The availability of health care quality standards is essential for the care of pediatric HIV-infected patients. The assessment of these indicators in our Unit yielded satisfactory results. Copyright © 2012 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Executive summary of the GESIDA/National AIDS Plan Consensus Document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2015).

PubMed

Berenguer, Juan; Polo, Rosa; Aldeguer, José López; Lozano, Fernando; Aguirrebengoa, Koldo; Arribas, José Ramón; Blanco, José Ramón; Boix, Vicente; Casado, José Luis; Clotet, Bonaventura; Crespo, Manuel; Domingo, Pere; Estrada, Vicente; García, Federico; Gatell, José María; González-García, Juan; Gutiérrez, Félix; Iribarren, José Antonio; Knobel, Hernando; Llibre, Josep María; Locutura, Jaime; López, Juan Carlos; Miró, José M; Moreno, Santiago; Podzamczer, Daniel; Portilla, Joaquín; Pulido, Federico; Ribera, Esteban; Riera, Melchor; Rubio, Rafael; Santos, Jesús; Sanz-Moreno, José; Sanz, Jesús; Téllez, María Jesús; Tuset, Montserrat; Rivero, Antonio

2015-10-01

In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The strength and grade of the recommendation vary depending on the CD4+ T-lymphocyte count, the presence of opportunistic infections or comorbid conditions, age, and the efforts to prevent the transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load (PVL). Initial ART should comprise three drugs, namely, two nucleoside reverse transcriptase inhibitors (NRTI) and one drug from another family. Three of the recommended regimens, all of which have an integrase strand transfer inhibitor (INSTI) as the third drug, are considered a preferred regimen; a further seven regimens, which are based on an INSTI, an non-nucleoside reverse transcriptase inhibitor (NNRTI), or a protease inhibitor boosted with ritonavir (PI/r), are considered alternatives. The reasons and criteria for switching ART are presented both for patients with an undetectable PVL and for patients who experience virological failure, in which case the rescue regimen should include three (or at least two) drugs that are fully active against HIV. The specific criteria for ART in special situations (acute infection, HIV-2 infection, pregnancy) and comorbid conditions (tuberculosis and other opportunistic infections, kidney disease, liver disease, and cancer) are updated. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Spread of genetically related methicillin-susceptible Staphylococcus aureus belonging to CC45, in healthy nasal carriers in Child Day Care Centers of Medellin, Colombia].

PubMed

Rodríguez-Tamayo, Erika Andrea; Ruiz-Cadavid, Alejandra; Sánchez-González, Leidy Maritza; García-Valencia, Natalia; Jiménez-Quiceno, Judy Natalia

2016-03-01

Colonization plays a major role in the epidemiology and pathogenesis of Staphylococcus aureus infections. The child population is one of the most susceptible to colonization; however, community and children studies are limited in Colombia. To assess the clonal relationship of S.aureus strains isolated from colonized children in eight day care centers (DCCs) from Medellin and to determine the presence of epidemiological characteristics in these populations. An observational cross-sectional study was conducted on a sample of 200 children aged from 6 months to 5 years attending eight DCCs in Medellin, Colombia, during 2011. Nasal samples were collected from each nostril. The isolates species and methicillin resistance were molecularly confirmed using nuc and mec genes. Genotypic analysis included SCCmec typing, spa typing, PFGE and MLST. Epidemiological information was obtained from the parents and analyzed using the statistics program SPSS 21.0 RESULTS: The colonization frequency in DCCs ranged from 16.7% (n=3) to 53.6% (n=15). Genetically related isolates were identified inside four DCCs. Half (50%) of the isolates were grouped in 3 clusters, which belonged to the clonal complexes CC45, CC30, and CC121. Molecular typing of isolates from colonized children and comparison among DCCs showed the spread of colonizing strains inside DCCs in Medellin; predominantly the CC45 clone, a successful child colonizer. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Direct bacterial identification from positive blood cultures using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry: A systematic review and meta-analysis.

PubMed

Ruiz-Aragón, Jesús; Ballestero-Téllez, Mónica; Gutiérrez-Gutiérrez, Belén; de Cueto, Marina; Rodríguez-Baño, Jesús; Pascual, Álvaro

2017-10-27

The rapid identification of bacteraemia-causing pathogens could assist clinicians in the timely prescription of targeted therapy, thereby reducing the morbidity and mortality of this infection. In recent years, numerous techniques that rapidly and directly identify positive blood cultures have been marketed, with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) being one of the most commonly used. The aim of this systematic review and meta-analysis was to evaluate the accuracy of MALDI-TOF (Bruker ® ) for the direct identification of positive blood culture bottles. A meta-analysis was performed to summarize the results of the 32 studies evaluated. The overall quality of the studies was moderate. For Gram-positive bacteria, overall rates of correct identification of the species ranged from 0.17 to 0.98, with a cumulative rate (random-effects model) of 0.72 (95% CI: 0.64-0.80). For Gram-negative bacteria, correct identification rates ranged from 0.66 to 1.00, with a cumulative effect of 0.92 (95% CI: 0.88-0.95). For Enterobacteriaceae, the rate was 0.96 (95% CI: 0.94-0.97). MALDI-TOF mass spectrometry shows high accuracy for the correct identification of Gram-negative bacteria, particularly Enterobacteriaceae, directly from positive blood culture bottles, and moderate accuracy for the identification of Gram-positive bacteria (low for some species). Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Evaluation of mass spectrometry for the identification of clinically interesting yeasts].

PubMed

Galán, Fátima; García-Agudo, Lidia; Guerrero, Inmaculada; Marín, Pilar; García-Tapia, Ana; García-Martos, Pedro; Rodríguez-Iglesias, Manuel

2015-01-01

Identification of yeasts is based on morphological, biochemical and nutritional characteristics, and using molecular methods. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, a new method for the identification of microorganisms, has demonstrated to be very useful. The aim of this study is to evaluate this new method in the identification of yeasts. A total of 600 strains of yeasts isolated from clinical specimens belonging to 9 genera and 43 species were tested. Identification was made by sequencing of the ITS regions of ribosomal DNA, assimilation of carbon compounds (ID 32C), and mass spectrometry on a Microflex spectrometer (Bruker Daltonics GmbH, Germany). A total of 569 strains (94.8%) were identified to species level by ID 32C, and 580 (96.7%) by MALDI-TOF. Concordance between both methods was observed for 553 strains (92.2%), with 100% in clinically relevant species: C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and almost 100% in C. krusei. MALDI-TOF identified species requiring molecular methods: Candida dubliniensis, C. nivariensis, C. metapsilosis and C. orthopsilosis. Some irregularities were observed in the identification of arthroconidia yeast and basidiomycetes. MALDI-TOF is a rapid, effective and economic method, which enables the identification of most clinically important yeasts and the differentiation of closely related species. It would be desirable to include more species in its database to expand its performance. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Hepatotoxicity in healthy infants exposed to nevirapine during pregnancy].

PubMed

Iveli, Pablo; Noguera-Julian, Antoni; Soler-Palacín, Pere; Martín-Nalda, Andrea; Rovira-Girabal, Núria; Fortuny-Guasch, Clàudia; Figueras-Nadal, Concepció

2016-01-01

The use of nevirapine in HIV-infected pregnant women is discouraged due to its potential to cause hepatotoxicity. There is limited information available on the toxicity in non-HIV infected newborn exposed to this drug during pregnancy. The aim of the study is to determine the extent of hepatotoxicity in the newborn exposed to nevirapine and HIV during pregnancy. A cross-sectional, observational, multicenter study was conducted on a cohort of healthy infants born to HIV-infected mothers, in whom the first determination of alanine aminotransferase (ALT), before 6weeks of age, was collected. Patients were allocated to 2groups according to exposure to nevirapine during pregnancy. Hepatotoxicity was rated according to the AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS). This study included 160newborns from 159pregnancies (88exposed to nevirapine-based regimens and 71 exposed to protease inhibitors-based therapies). No cases of hepatotoxicity were observed according to the DAIDS Table for Grading. Two cases of ALT above normal values (2.8%; 95%CI: 0.3-9.8%) were observed in patients not exposed to nevirapine, and one case (1.1%; 95%CI: 0.0-6.1%) in the group exposed to nevirapine (P=.585). The lack of differences between groups suggests that highly active antiretroviral treatment regimens including nevirapine administered during pregnancy do not involve a higher risk of liver disease compared to other treatment combinations. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Psychosocial aspects in a cohort of vertically transmitted human immunodeficiency virus-infected adolescents].

PubMed

García-Navarro, Cristina; García, Isabel; Medín, Gabriela; Ramos-Amador, José Tomás; Navarro-Gómez, Marisa; Mellado-Peña, M José; Gómez, M I de José; Cortés, Marisol; Zamora Crespo, Berta; Muñoz-Fernandez, M Angeles; Gamero, Daniel Blázquez; González-Tomé, M Isabel

2014-12-01

Thanks to advances in antiretroviral treatment, children with HIV infections through vertical transmission have improved their life expectancy. However, new challenges have emerged. We propose this study in order to determine the psychosocial aspects and knowledge of infections in a cohort of adolescents with vertically transmitted HIV infections. Patients with vertically-acquired HIV infection between 12 and 19 years old were included. Data were obtained through semi-structured interviews and a Strengths and Difficulties Questionnaire for emotional and behavioral disorders screening. We evaluated 96 patients (58% females) with a median age of 15 years (11-19.1) and a median age at diagnosis of 1.70 years (0-12.2). The median CD4 count was 626cells/mm(3) (132-998), and the viral load was<50cp/ml in 72% of patients. Among them, 90% attended school and 60% repeated at least one course. Although 81% of them knew of their diagnosis, only 30% understood their disease, with 18.2% having discussed it with friends. Six unwanted pregnancies occurred during the study period. Strengths and Difficulties Questionnaire showed hyperactivity risk in 33%. A high percentage of adolescents show difficulties in several areas (disease knowledge, peer relationship, school failure...) that can have an impact on their adult lives. Further studies are needed to evaluate their origin and development in depth, as well as interventions to modify this situation. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Tropheryma whipplei endocarditis in Spain

PubMed Central

García-Álvarez, Lara; Sanz, María Mercedes; Marín, Mercedes; Fariñas, MªCarmen; Montejo, Miguel; Goikoetxea, Josune; Rodríguez García, Raquel; de Alarcón, Arístides; Almela, Manuel; Fernández-Hidalgo, Núria; Alonso Socas, María del Mar; Goenaga, Miguel Ángel; Navas, Enrique; Vicioso, Luis; Oteo, José Antonio

2016-01-01

Abstract Tropheryma whipplei endocarditis is an uncommon condition with very few series and <90 cases reported in the literature. The aim of the study was to analyze the epidemiological, clinical, and outcome characteristics of 17 cases of T. whipplei endocarditis recruited in our country from a multicentric cohort from 25 Spanish hospitals from the Spanish Collaboration on Endocarditis—Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España. From a total of 3165 cases included in the cohort, 14.2% were diagnosed of blood culture negative endocarditis (BCNE) and 3.5% of these had T. whipplei endocarditis. This condition was more frequent in men. The average age was 60.3 years. Previous cardiac condition was present in 35.3% of the cases. The main clinical manifestation was cardiac failure (76.5%) while fever was only present in the 35.3%. Ecocardiography showed vegetations in 64.7% of patients. Surgery was performed in all but 1 cases and it allowed the diagnosis when molecular assays were performed. A broad range rRNA 16S polymerase chain reaction was used for first instance in all laboratories and different specific targets for T. whipplei were employed for confirmation. A concomitant Whipple disease was diagnosed in 11.9% of patients. All patients received specific antimicrobial treatment for at least 1 year, with no relapse and complete recovery. T. whipplei endocarditis is an uncommon condition with an atypical presentation that must be considered in the diagnosis of BCNE. The prognosis is very good when an appropriate surgical management and antimicrobial-specific treatment is given. PMID:27368042

[Chlamydia trachomaatis DNA in leukocytes of peripheral blood from neonates].

PubMed

López-Hurtado, Marcela; Cuevas-Recillas, Karla N; Flores-Salazar, Verónica R; Guerra-Infante, Fernando M

2015-01-01

Diagnosis of Chlamydia trachomatis infection in newborns is difficult; however, this diagnosis is performed by cell culture or by detection of IgM antibodies against C. trachomatis. Detection of C. trachomatis DNA in peripheral blood leukocytes using polymer chain reaction (PCR) may be a better tool for the diagnosis of infection by this pathogen. A total of 44 premature newborns, all weighing less than 2500g, were included in the study. A blood sample and nasopharyngeal lavages were obtained from each newborn. Leukocyte DNA was obtained by phenol-chloroform extraction technique. Detection of C. trachomatis was performed by amplifying the ompA gene using the PCR endpoint. Cell culture tests and the detection of IgM antibodies against C. trachomatis by microimmunofluorescence assay were also performed. Twenty newborns were PCR-positive (45.5%), with this test being significantly associated with the presence of pneumonia (RR=2.28; 95%CI: 1.01 to 5.17; P=.035). The cell culture of nasopharyngeal lavage was positive in only 7 samples and no significant association was observed with any clinical or laboratory data. The titer of IgM antibodies against C. trachomatis associated with PCR-positive was 1:32 (RR=2.74; 95%CI: 1.21 to 6.23; P=.008), however this titer was not associated with the presence of pneumonia. DNA detection in peripheral blood leukocytes could be useful for diagnosis of C. trachomatis infection. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Evaluation of the usefulness of a quantitative blood culture in the diagnosis of catheter-related bloodstream infection: Comparative analysis of two periods (2002 and 2012).

PubMed

Planes, Anna Maria; Calleja, Raquel; Bernet, Albert; Campins-Martí, Magda; Almirante, Benito; Pumarola, Tomàs; Fernández-Hidalgo, Núria

2016-10-01

A retrospective study was conducted to investigate the usefulness of systematic quantitative blood culture (QBC) in the diagnosis of catheter-related bloodstream infection (CRBSI) during two 1-year periods (2002 and 2012). The study included all QBC requests sent to the microbiology laboratory for suspected CRBSI in adults (≥18 years) with any type of intravascular catheter (IVC). Based on a ratio of ≥4:1CFU/mL of the same microorganism between IVC blood culture from any lumen and peripheral blood culture, 5 diagnostic groups were defined: confirmed or probable CRBSI, primary BSI, other focus of infection, and colonization. In total, 4521 QBCs were evaluated; 24% positive in 2002 and 16% in 2012 (P<0.0001). There were 243 episodes of suspected CRBSI (101 in 2002 and 142 in 2012). Confirmed CRBSI episodes were higher in 2002 than 2012 (56% vs 34%) (P<0.0001), whereas colonization episodes were lower (18% vs 38%) (P=0.0006). Gram-positive cocci decrease in 2012 relative to 2002 (56% vs 79.7%) (P=0.022). Almost one-third (32%) of confirmed CRBSI would have been missed if blood from all catheter lumens had not been cultured. QBC is a useful method for diagnosing CRBSI. Blood samples from all catheter lumens must be cultured to avoid missing around one-third of CRBSI diagnoses. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Combat Identification Systems COMO Integrated Air Defense Model Evaluation (CISE) Study

DTIC Science & Technology

1989-02-01

use K or IR , whichever one applies) E-6 CAA-SR-89- 3 Subroutine PDECLR 1/21/88 Before label 1000 Insert: IF (IR.GT.10) IR a 10 These changes were made...Internal Distribution: Unclassified Library 2 F-2 CAA-SR-89- 3 GLOSSARY 1. ABBREVIATIONS, ACRONYMS, AND SHORT TERMS ADM2 Air Defense Models Modification...STUDY REPORT ’ , CAA-Sn-89- 3 i , .- CD o COMBAT IDENTIFICATION SYSTEMS N COMO INTEGRATED AIR DEFENSE MODEL EVALUATION (CISE) STUDY FEBRUARY 1989

Influence of H 2O and H 2S on the composition, activity, and stability of sulfided Mo, CoMo, and NiMo supported on MgAl 2O 4 for hydrodeoxygenation of ethylene glycol

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dabros, Trine Marie Hartmann; Gaur, Abhijeet; Pintos, Delfina Garcia

Here in this work, density functional theory (DFT), catalytic activity tests, and in-situ X-ray absorption spectroscopy (XAS) was performed to gain detailed insights into the activity and stability of MoS 2, Ni-MoS 2, and Co-MoS 2 catalysts used for hydrodeoxygenation (HDO) of ethylene glycol upon variation of the partial pressures of H 2O and H 2S. The results show high water tolerance of the catalysts and highlight the importance of promotion and H 2S level during HDO. DFT calculations unraveled that the active edge of MoS 2 could be stabilized against SO exchanges by increasing the partial pressure of Hmore » 2S or by promotion with either Ni or Co. The Mo, NiMo, and CoMo catalysts of the present study were all active and fairly selective for ethylene glycol HDO at 400 °C, 27 bar H 2, and 550–2200 ppm H 2S, and conversions of ≈50–100%. The unpromoted Mo/MgAl 2O 4 catalyst had a lower stability and activity per gram catalyst than the promoted analogues. The NiMo and CoMo catalysts produced ethane, ethylene, and C1 cracking products with a C 2/C 1 ratio of 1.5–2.0 at 550 ppm H 2S. This ratio of HDO to cracking could be increased to ≈2 at 2200 ppm H 2S which also stabilized the activity. Removing H 2S from the feed caused severe catalyst deactivation. Both DFT and catalytic activity tests indicated that increasing the H 2S concentration increased the concentration of SH groups on the catalyst, which correspondingly activated and stabilized the catalytic HDO performance. In-situ XAS further supported that the catalysts were tolerant towards water when exposed to increasing water concentration with H2O/H2S ratios up to 300 at 400–450 °C. Raman spectroscopy and XAS showed that MoS2 was present in the prepared catalysts as small and highly dispersed particles, probably owing to a strong interaction with the support. Linear combination fitting (LCF) analysis of the X-ray absorption near edge structure (XANES) spectra obtained during in-situ sulfidation showed that Ni was sulfided faster than Mo and CoMo, and that Mo was sulfided faster when promoted with Ni. Extended X-ray absorption fine structure (EXAFS) results showed the presence of MoS 2 in all sulfided catalysts. Lastly, sulfided CoMo was present as a mixture of CoMoS and Co 9S 8, whereas sulfided NiMo was present as NiMoS.« less

Influence of H 2O and H 2S on the composition, activity, and stability of sulfided Mo, CoMo, and NiMo supported on MgAl 2O 4 for hydrodeoxygenation of ethylene glycol

DOE PAGES

Dabros, Trine Marie Hartmann; Gaur, Abhijeet; Pintos, Delfina Garcia; ...

2017-12-10

Here in this work, density functional theory (DFT), catalytic activity tests, and in-situ X-ray absorption spectroscopy (XAS) was performed to gain detailed insights into the activity and stability of MoS 2, Ni-MoS 2, and Co-MoS 2 catalysts used for hydrodeoxygenation (HDO) of ethylene glycol upon variation of the partial pressures of H 2O and H 2S. The results show high water tolerance of the catalysts and highlight the importance of promotion and H 2S level during HDO. DFT calculations unraveled that the active edge of MoS 2 could be stabilized against SO exchanges by increasing the partial pressure of Hmore » 2S or by promotion with either Ni or Co. The Mo, NiMo, and CoMo catalysts of the present study were all active and fairly selective for ethylene glycol HDO at 400 °C, 27 bar H 2, and 550–2200 ppm H 2S, and conversions of ≈50–100%. The unpromoted Mo/MgAl 2O 4 catalyst had a lower stability and activity per gram catalyst than the promoted analogues. The NiMo and CoMo catalysts produced ethane, ethylene, and C1 cracking products with a C 2/C 1 ratio of 1.5–2.0 at 550 ppm H 2S. This ratio of HDO to cracking could be increased to ≈2 at 2200 ppm H 2S which also stabilized the activity. Removing H 2S from the feed caused severe catalyst deactivation. Both DFT and catalytic activity tests indicated that increasing the H 2S concentration increased the concentration of SH groups on the catalyst, which correspondingly activated and stabilized the catalytic HDO performance. In-situ XAS further supported that the catalysts were tolerant towards water when exposed to increasing water concentration with H2O/H2S ratios up to 300 at 400–450 °C. Raman spectroscopy and XAS showed that MoS2 was present in the prepared catalysts as small and highly dispersed particles, probably owing to a strong interaction with the support. Linear combination fitting (LCF) analysis of the X-ray absorption near edge structure (XANES) spectra obtained during in-situ sulfidation showed that Ni was sulfided faster than Mo and CoMo, and that Mo was sulfided faster when promoted with Ni. Extended X-ray absorption fine structure (EXAFS) results showed the presence of MoS 2 in all sulfided catalysts. Lastly, sulfided CoMo was present as a mixture of CoMoS and Co 9S 8, whereas sulfided NiMo was present as NiMoS.« less

Identification of duck plague virus by polymerase chain reaction

USGS Publications Warehouse

Hansen, W.R.; Brown, Sean E.; Nashold, S.W.; Knudson, D.L.

1999-01-01

A polymerase chain reaction (PCR) assay was developed for detecting duck plague virus. A 765-bp EcoRI fragment cloned from the genome of the duck plague vaccine (DP-VAC) virus was sequenced for PCR primer development. The fragment sequence was found by GenBank alignment searches to be similar to the 3a?? ends of an undefined open reading frame and the gene for DNA polymerase protein in other herpesviruses. Three of four primer sets were found to be specific for the DP-VAC virus and 100% (7/7) of field isolates but did not amplify DNA from inclusion body disease of cranes virus. The specificity of one primer set was tested with genome templates from other avian herpesviruses, including those from a golden eagle, bald eagle, great horned owl, snowy owl, peregrine falcon, prairie falcon, pigeon, psittacine, and chicken (infectious laryngotracheitis), but amplicons were not produced. Hence, this PCR test is highly specific for duck plague virus DNA. Two primer sets were able to detect 1 fg of DNA from the duck plague vaccine strain, equivalent to five genome copies. In addition, the ratio of tissue culture infectious doses to genome copies of duck plague vaccine virus from infected duck embryo cells was determined to be 1:100, making the PCR assay 20 times more sensitive than tissue culture for detecting duck plague virus. The speed, sensitivity, and specificity of this PCR provide a greatly improved diagnostic and research tool for studying the epizootiology of duck plague. /// Se desarroll?? una prueba de reacci??n en cadena por la polimerasa para detectar el virus de la peste del pato. Un fragmento EcoRI de 765 pares de bases clonado del genoma del virus vacunal de la peste del pato fue secuenciado para la obtenci??n de los iniciadores de la prueba de la reacci??n en cadena por la polimerasa. En investigaciones de alineaci??n en el banco de genes ('GenBank') se encontr?? que la secuencia del fragmento era similar a los extremos 3a?? de un marco de lectura abierto indefinido y al gen para la proteina de la DNA polimerasa en otros virus herpes. Se encontraron tres o cuatro grupos de iniciadores especificos para el virus vacunal y para el 100% (7/7) de los a??slamientos de campo, pero no amplificaron el DNA del virus de hepatitis por cuerpos de inclusi??n de grullas. Se analiz?? la especificidad de un primer juego de iniciadores con moldes del genoma de otros virus herpes aviares, incluyendo el ?!guila dorada, ?!guila de cabeza blanca, lechuza de cuernos grandes, lechuza blanca, halc??n peregrino, palomas, aves psit?!cidas y pollos (virus de laringotraqueitis infecciosa), pero no se produjeron los productos finales. Por lo tanto, esta prueba de reacci??n en cadena por la polimerasa es altamente especifica para el DNA del virus. Dos grupos de iniciadores fueron capaces de detectar un fragmento de DNA de la cepa vacunal equivalente a cinco copias del genoma. Adem?!s, se determin?? que la proporci??n de la dosis infecciosa en cultivo celular y copias del genoma del virus vacunal de c??lulas de embri??n de pato infectadas era de 10 a 100 respectivamente, haciendo la prueba de la reacci??n en cadena por la polimerasa 20 veces m?!s sensible que el cultivo celular para detectar el virus. La velocidad, sensibilidad y especificidad de la prueba de la reacci??n en cadena por la polimerasa suministra una herramienta de investigaci??n y de diagn??stico altamente mejorada para el estudio de la epizootiolog?-a del virus.

Neurobiología del autismo y TDAH mediante técnicas de neuroimagen: divergencias y convergencias

PubMed Central

Proal, Erika; Olvera, Jorge González; Blancas, Aurea S.; Chalita, Pablo J.; Castellanos, F. Xavier

2013-01-01

En el área clínica algunos síntomas del trastorno por déficit de atención e hiperactividad (TDAH), se presentan en los pacientes con trastorno del espectro autista (TEA). Se ha demostrado que existen alteraciones en circuitos cerebrales que impactan en fallas cognitivas y de comportamiento específicas de cada uno de estos trastornos. Sin embargo, han sido poco estudiados los correlatos cerebrales que hay detrás tanto de las similitudes como de las diferencias sintomatológicas. En la presente revisión se analizaron los estudios meta-analíticos existentes estructurales y funcionales en TDAH y TEA. Por un lado, se observaron convergencias en circuitos como el dorsal atencional, de funciones ejecutivas, visual, somatomotor y circuito de activación por defecto. Estas similitudes posiblemente explican las manifestaciones comórbidas entre los trastornos como la falla en la integración de información, motricidad fina y procesos atencionales específicos. Por otro lado, específicamente en el TDAH se observan déficits en el circuito de recompensa y ventral atencional, sistemas involucrados en la medición de efectos de reforzamiento y monitoreo atencional. En TEA los circuitos más afectados fueron los implicados en procesos de cognición social y lenguaje. En conclusión, existen correlatos neuronales en TEA que explican las manifestaciones clínicas tanto convergentes como divergentes presentes en TDAH. PMID:23897144

[Not Available].

PubMed

Zubiaga, Lorea; Ruiz-Tovar, Jaime; Giner, Lorena; González, Juan; Aguilar, María Del Mar; García, Alejandro; Calpena, Rafael; Durán, Manuel

2016-07-19

Introducción y objetivo: el IMC puede resultar engañoso para ciertas complexiones corporales, por lo que se han propuesto otros parámetros como la adiposidad (calculada a través de fórmula CUN-BAE,) el índice de Framingham de riesgo cardiovascular (IF) y el índice aterogénico (IA) (rCT/HDL-c) como predictores de riesgo cardiovascular. Se propone comparar estos factores como marcadores de éxito terapéutico tras cirugía en pacientes obesos sometidos a gastrectomía vertical laparoscópica (GVL) como procedimiento de cirugía bariátrica.Material y métodos: realizamos un estudio observacional prospectivo de pacientes sometidos a GVL y con un periodo de seguimiento mínimo de 1 año. Analizamos la evolución de IMC, adiposidad, IF e IA.Resultados: analizamos 140 pacientes. El IMC preoperatorio fue de 49,1 kg/m2, con una adiposidad del 54,8%, un IF 7,54% y un IA de 4,2. A los 12 meses el IMC era de 28,4 kg/m2, con una adiposidad del 39,4%, un IF del 3,7% y un IA de 1,64. En función de estos resultados, a los 12 meses el IMC medio está en rango de sobrepeso, la adiposidad en niveles de obesidad (obesidad: > 25% en hombres y > 35% en mujeres), el IF en rango de riesgo cardiovascular bajo (< 5%) y el IA dentro del rango de normalidad (< 3). Correlacionando estos parámetros observamos que el IMC se correlaciona con la adiposidad tanto en valores preoperatorios (Pearson 0,486; p = 0,004), posoperatorios (Pearson 0,957; p < 0,001), como en la diferencia entre ambos (Pearson 0,606; p = 0,017), lo cual es lógico, porque el IMC se incluye en la fórmula CUN-BAE para el cálculo de la adiposidad. En los valores posoperatorios se objetiva una correlación de la adiposidad con el IF (Pearson 0,814, p = 0,036) y con el IA (Pearson 0,517; p = 0,049). En los valores preoperatorios no se objetivan dichas correlaciones. El IMC no se correlacionó con la adiposidad.Conclusión: la adiposidad se correlaciona con índices de riesgo cardiovascular, como el índice de Framingham o el índice aterogénico, pero solo en las determinaciones posoperatorias. Estos elementos suponen herramientas útiles para valorar la disminución del riesgo de enfermedad cardiovascular después de cirugía bariátrica.

Determinacion del error sistematico del momentum de muones producidos por interacciones neutrino-nucleon en el detector MINER$$\

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diaz Bautista, Gonzalo A.

El Modelo Estandar describe todas las partculas observadas en el naturaleza hasta el momento as como las caractersticas que gobiernan a las interacciones fundamentales entre ellas. En especial es posible identicar a las interacciones electromagnetica y debil, las cuales bajo determinadas condiciones de temperatura y energa pueden ser descritas a traves de una sola teora que engloba a ambas. A esta teora se le denomina electrodebil y tiene como nalidad caracterizar las propiedades de la interaccion maniesta a partir de la mezcla de las interacciones electromagnetica y debil, la que tambien lleva como nombre interaccion electrodebil. Particularmente, los neutrinos sonmore » de especial interes ya que, por un lado, interactuan por medio de la interaccion debil muy raramente en comparacion con otras partculas y, por el otro, no son acertadamente descritos por el Modelo Estandar. Por medio de observaciones experimentales que demostraban que los neutrinos cambian de sabor al propagarse, fenomeno llamado oscilaciones de neutrinos, se pudo llegar a la conclusion de que la implicancia de este fenomeno da como consecuencia que los neutrinos efectivamente s tienen masa, algo que entra en contradiccion con la descripcion inicial del Modelo Estandar, el cual los describe como partculas sin masa. Es de esta manera que las oscilaciones de neutrinos han sido y siguen siendo en la actualidad objeto de interes en la Fsica de Altas Energas tanto teorica como experimental. A n de poder realizar mediciones precisas de oscilaciones de neutrinos, los experimentos encargados de estas mediciones deben tratar de reducir sus incertidumbres en lo posible. Una de estas proviene de la caracterizacion de las secciones de choque de los neutrinos cuando interactuan con la materia, particularmente los nucleones al interior de los nucleos atomicos. El experimento MINERA esta orientado, entre otras cosas, a hacer una correcta caracterizacion de secciones de choque neutrino-nucleon por medio del estudio de un tipo especco de interaccion denominado corriente cargada, cuyas partculas de estado nal incluye hadrones y, principalmente, muones. La precision en los resultados de secciones de choque esta sujeta a que la energa y el momentum estos muones sean, a su vez, correctamente caracterizados, incluyendo sus incertidumbres sistematicas. El objetivo de este trabajo de tesis es precisamente presentar la metodologa usada para medir las energas de los muones producidos por interacciones de neutrinos y sus correspondientes incertidumbres asociadas a dicha medicion.« less

Communicacion Expresiva: Como los ninos nos envian mensajes [and] Comunicacion Receptiva: Como los ninos entienden nuestros mensajes [and] Interacciones de Comunicacion: Hacen falta dos. Hojas informativa de DB-LINK (Communication Interactions: It Takes Two [and] Receptive Communication: How Children Understand Your Messages to Them [and] Expressive Communication: How Children Send Their Messages to You. DB-LINK Fact Sheets).

ERIC Educational Resources Information Center

Stremel, Kathleen

This document consists of three separately published fact sheets combined here because of the close relationship of their subject matter. The first fact sheet, "Communication Interactions: It Takes Two" (Kathleen Stremel), defines communication; suggests ways to find opportunities for interactive communication; offers specific suggestions for…

Intra-aortic balloon pump in cardiogenic shock: state of the art.

PubMed

Thomaz, Petronio Generoso; Moura, Leonel Adelino; Muramoto, Giovana; Assad, Renato Samy

2017-01-01

The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP. Its clinical indication has been based on non-randomized studies and registry data. Recent studies have shown that the use of IABP did not reduce 30-day mortality in patients with AMI and cardiogenic shock treated with the strategy of early myocardial revascularization as the planned primary objective. The guidelines of the American Heart Association and of the European Society of Cardiology have reassessed their recommendations based on the results of meta-analyzes, including the IABP-SCHOCK II Trial study, which did not evidence an increase in survival of patients who received mechanical support with IABP. This review article addresses the clinical impact of IABP use in the cardiogenic shock caused by AMI. RESUMO A definição clínica de choque cardiogênico é a de um quadro de baixo débito cardíaco e evidência de hipóxia tecidual, na presença de volemia adequada. O choque cardiogênico representa a principal causa de óbito relacionada ao infarto agudo do miocárdio (IAM), com índice de mortalidade em torno de 45% a 70%, na ausência de cuidados técnicos agressivos e altamente especializados. O balão intra-aórtico (BIA) é um dos dispositivos de assistência mecânica mais utilizados no mundo. Nas duas últimas décadas, cerca de 42% dos pacientes com IAM, que evoluíram com choque cardiogênico, receberam assistência circulatória mecânica com BIA. Sua indicação clínica tem sido baseada em estudos não randomizados e dados de registro. Estudos recentes têm demonstrado que o uso do BIA não reduziu a mortalidade hospitalar (30 dias) em pacientes com IAM e choque cardiogênico, tratados com a estratégia de revascularização precoce do miocárdio como objetivo primário planejado. As diretrizes da Associação Americana de Cardiologia e da Sociedade Europeia de Cardiologia reavaliaram suas recomendações, baseadas nos resultados de metanálises, incluindo o estudo IABP-SCHOCK II Trial, que não evidenciou aumento na sobrevida de pacientes que receberam suporte mecânico com BIA. Este artigo de revisão aborda o impacto clínico do uso do BIA no choque cardiogênico ocasionado pelo IAM.

Estrategia de Aprendizaje Basado en Problemas (ABP) para explorar las concepciones alternativas relacionadas al tema estados de agregacion de la materia en estudiantes de nivel elemental =

NASA Astrophysics Data System (ADS)

Rosado Olivieri, Wilda Y.

Gran parte de la investigacion acerca de la ensenanza de las ciencias se dedica a estudiar la forma o manera en que los estudiantes visualizan los conceptos cientificos. Para Driver (1983) esas ideas o concepciones se conocen como concepciones alternativas; las cuales pueden ocasionar dificultad para comprender los conceptos de las diferentes areas del conocimiento. El proposito de este estudio fue: (a) indagar como las distintas etapas del ABP permiten explorar las concepciones alternativas que poseen los estudiantes de nivel elemental acerca de los estados de agregacion de la materia y, (b) explorar en que medida el ABP permite identificar e incorporar las concepciones alternativas que poseen los estudiantes de nivel elemental con relacion al concepto de estados de agregacion de la materia para facilitar su aprendizaje. Con el fin de explorar las concepciones alternativas en el tema de los estados agregados de la materia se implanto la estrategia de Aprendizaje Basado en Problemas (ABP) con estudiantes de quinto grado de nivel elemental. Se utilizo la metodologia mixta con varias estrategias de recopilacion de datos, como una pre y pos prueba para elucidar el conocimiento previo y al mismo tiempo las concepciones alternativas sobre el tema bajo estudio y luego verificar el aprendizaje en los estudiantes. Asimismo, el uso de mapas conceptuales para determinar la profundidad del tema estudiado y el entrelazamiento de los conceptos Una tercera estrategia fue el grupo focal para tomar en cuenta la impresion de los estudiantes acerca del proyecto ABP. El aspecto colaborativo y cooperativo fue un factor fundamental, ya que el aprendizaje ocurrio en ese contexto educativo. Para los hallazgos de esta investigacion fue tan importante el conocimiento previo como los procesos que se generaban para que la adquisicion del mismo fuera de forma significativa y funcional (Escribano & Del Valle, 2010). La estrategia de ABP constituyo en este estudio una forma para indagar las concepciones alternativas que poseian los estudiantes y a su vez, determinar como el estudiante manejaba dichas concepciones a situaciones que requeririan aplicar su conocimiento para luego modificar las estructuras conceptuales hacia el conocimiento cientifico.

Resultados do desenvolvimento de um propulsor à plasma no Brasil

NASA Astrophysics Data System (ADS)

Ferreira, I. S.; Ferreira, J. L.

2003-08-01

Uma das partes mais importantes de um satélite é o controle de atitude do mesmo. E se tratando de um satélite científico, a atenção para este sistema deve ser redobrada. Uma possibilidade atraente para executar esta tarefa é a propulsão elétrica. Aqui, mostraremos resultados obtidos pelo propulsor à plasma PHALL-01, desenvolvido na Universidade de Brasília entre 2000 e 2003. Este é derivado do propulsor russo SPT-100 (Stationary Plasma Thruster), mas com o emprego inovador de um arranjo de imãs permanentes como fonte do campo magnético, este último o agente da aceleração do plasma. Esta alteração foi motivada pelo objetivo de que o mesmo operasse com o mínimo de potência elétrica. A partir da formulação teórica do mecanismo de aceleração, tendo como base as equações da magnetohidrodinâmica, pode-se obter vínculos sob os quais o propulsor pudesse ser construído. O mais forte destes é o que dita a topologia do campo magnético. Sendo assim, foram realizadas simulações computacionais, que definiram a geometria do propulsor. Após construído, este foi diagnosticado usando-se sondas de Langmuir e analisadores de energia. Como resultados, obtivemos a distribuição espacial da temperatura, densidade e potencial do plasma, bem como a distribuição angular do feixe produzido pelo mesmo em vários regimes de operação. O espectro de energia do feixe de plasma também foi medido, indicando íons de até 560eV. Combinando estes resultados, calculou-se o empuxo do propulsor: 84mN; e o impulso específico: 1083s. Estes demonstram que o mesmo estará qualificado, num futuro próximo, para o emprego no controle de atitude de satélites científicos, ou até mesmo como parte do conjunto propulsor primário, responsáveis pela transferência de órbitas.

Investigaccion-accion en la sala de clases sobre las creencias de la cultura de la ciencia de un grupo de estudiantes universitarios y su relacion reciproca con el aprendizaje de las ciencias biologicas

NASA Astrophysics Data System (ADS)

Cordova-Santiago, Lizzette Astrid

La investigacion---accion que se llevo a cabo en la sala de clases tenia como punto de partida las creencias de la cultura de la ciencia de un grupo de estudiantes universitarios para luego examinar sus implicaciones en el proceso de aprendizaje de las Ciencias Biologicas. ¿Que se supone que hagan las creencias en relacion con el aprendizaje? ¿En que consiste incorporar este aspecto a la practica educativa universitaria? Utilizando el modelo de Kemmis y McTaggart (1987) la investigacion-accion se planteo como un proceso dinamico en cuatro momentos en espiral constituidos por la planificacion, la accion, la observacion y la reflexion. Cada una de las fases tuvo una intencion retrospectiva y prospectiva formando una espiral de autorreflexion del conocimiento y la accion. Se llevaron a cabo audio grabaciones en clases y analisis de documentos. Ademas, la profesora-investigadora hizo un portafolio para reflexionar sobre las creencias de la cultura de la ciencia que tienen los estudiantes y las creencias del aprendizaje que tiene la profesora y sobre como la comprension de estos elementos ayudo a mejorar su practica educativa a traves del tiempo. Los resultados obtenidos apuntan a que las creencias de la cultura de la ciencia que tiene el grupo de estudiantes son diversas. Ellos si creen que la ciencia tiene una cultura la cual describieron como: complicada y desconocida que evoluciona constantemente, que es un conjunto de metodos, que es altamente tecnologica, que resuelve problemas de salud, ayuda a interpretar la realidad del mundo que los rodea y su origen y que existen unas intersecciones entre la ciencia y el poder. Sobre las creencias del proceso de aprendizaje de la profesora-investigadora, estas senalan que el modelaje de actores, la vision de la academia que tiene ella asi como la participacion y negociacion entre todos los involucrados en el proceso educativo, son factores que inciden en el proceso de aprendizaje.

Comprension de los conceptos de los enlaces ionico y covalente en estudiantes universitarios del primer curso de quimica general

NASA Astrophysics Data System (ADS)

Ballesteros Benavides, Maria Elvira

Para este trabajo utilizamos el estudio de casos cualitativo que se llevo a cabo en una universidad privada de Puerto Rico. Empleamos como unidad de analisis el concepto de enlace quimico, ionico y covalente. Los participantes fueron los estudiantes de la seccion nocturna del curso de Quimica General I. La investigacion se desarrollo por medio de dos entrevistas de persona a persona, observaciones de las expresiones no verbales y la hoja de identificacion de conceptos. Para la triangulacion tomamos en consideracion las preconcepciones erroneas, las concepciones alternativas y el mapa de conceptos de cada participante. Preparamos un mapa de conceptos para el enlace quimico validado por un comite de expertos. Tambien, elaboramos los mapas de conceptos de los participantes que sirvieron para varios propositos: conocer la estructura conceptual, expresar los logros, hacer comparaciones e identificar la presencia de concepciones alternativas. Entre los hallazgos encontramos que todos los participantes poseen conocimiento previo de los enlaces quimicos ionico y covalente y dentro de ese conocimiento existen preconcepciones erroneas mas numerosas para el enlace ionico. Al principio del semestre el 50% de los participantes demostraron tener "carencia fuerte de conceptos" tanto para el enlace ionico como para el covalente. Al finalizar el semestre encontramos en el 40% de los participantes concepciones alternativas tanto para el enlace ionico como para el covalente y el 90% no lograron distinguir un enlace del otro. Nuestras conclusiones fueron que los participantes sin distincion del aprovechamiento academico demostraron tener la tendencia de "carencia fuerte de conceptos" tanto para el enlace ionico como para el covalente, presentaron dificultad al integrar los conceptos de los enlaces quimicos ionico y covalente que se pusieron de manifiesto al dar los ejemplos. Las preconcepciones erroneas contribuyen en el desarrollo de las concepciones alternativas. Ademas, los participantes no lograron diferenciar los dos enlaces quimicos. Esto implica que reflexionemos sobre la necesidad de revisar tanto las competencias cognoscitivas como la forma de ensenar quimica en el salon de clase. Recomendamos indagar y dar importancia al conocimiento previo de los estudiantes, enfatizar la ensenanza de los conceptos y propiciar el aprendizaje con significado.

Prevalence of Diphyllobothrium latum (Cestoda: Diphyllobothriidae) plerocercoids in fish species from four Italian lakes and risk for the consumers.

PubMed

Gustinelli, Andrea; Menconi, Vasco; Prearo, Marino; Caffara, Monica; Righetti, Marzia; Scanzio, Tommaso; Raglio, Annibale; Fioravanti, Maria Letizia

2016-10-17

In recent years there has been a re-emergence of diphyllobothriasis by Diphyllobothrium latum (Cestoda: Diphyllobothriidae) in Italy, France and Switzerland, where in the past this fish-borne zoonosis was widespread and then virtually disappeared. A change in eating habits such as the consumption of raw/undercooked freshwater fish, has led to an increased risk for consumers of ingesting infective larvae of D. latum. A survey on the factors responsible for the re-emergence of human diphyllobothriasis in Italy was carried out from March 2013 to December 2014. The aim of this study was to assess the diffusion of D. latum plerocercoids in the fish populations of the sub-alpine lakes of Maggiore, Como, Iseo and Garda, updating the scarce historical data and assessing a preliminary "risk level" of the lacustrine environments and fish species under investigation. A total of 2228 fish belonging to 5 species, 690 from Lake Maggiore, 500 from Lake Como, 655 from Lake Iseo and 383 from Lake Garda were submitted to parasitological examination. The presence of D. latum plerocercoid larvae was detected in 6.6%, 25.4% and 7.6% of perch (Perca fluviatilis) from Lakes Maggiore, Como and Iseo respectively. The parasite was also present in pike (Esox lucius) with prevalence values ranging from 71.4 to 84.2% and in 3.6-3.8% of burbot (Lota lota) from Lakes Iseo and Como. Fish from Lake Garda were negative as well as sampled whitefish (Coregonus lavaretus) and shad (Alosa fallax lacustris). The results of this survey showed a widespread presence of D. latum plerocercoid larvae in Maggiore, Como and Iseo fish populations. Urban fecal contamination of water is still a key issue to be resolved, together with the improvement of communication with consumers regarding the best dietary habits and the most effective processes of parasite inactivation, required for the consumption of raw/undercooked fish caught in high-risk areas. Copyright © 2016 Elsevier B.V. All rights reserved.

Análise sobre o Conhecimento de um Grupo de Alunos do Ensino Médio da Rede Estadual de São Paulo sobre Termos e Fenômenos Astronômicos do Cotidiano

NASA Astrophysics Data System (ADS)

de Oliveira, E. F.; Voelzke, M. R.; Amaral, L. H.

2007-08-01

Embora os Parâmetros Curriculares Nacionais do Ensino Médio (PCN-EM) e as orientações complementares a esses Parâmetros (PCN+) apontem a importância de uma abordagem significativa de conceitos relacionados à astronomia nas aulas de Física, muitos estudantes terminam o Ensino Médio (EM) sem compreender a razão de certos acontecimentos de origem celeste, ainda que estes façam parte de seu cotidiano. Este trabalho tem por objetivo analisar os conhecimentos básicos em astronomia dos alunos de EM da escola estadual Batista Renzi, bem como investigar os meios através dos quais estes conhecimentos foram adquiridos. Para tanto foi elaborado um questionário de múltipla escolha aplicado a 310 alunos distribuídos entre as três séries do EM dos períodos matutino e noturno. Dessa forma, observou-se que apenas 34,5% relacionaram as estações do ano à inclinação do eixo de rotação da Terra, 21,3% indicaram a influência gravitacional da Lua e do Sol como responsáveis pelo fenômeno das marés, 24,5% indicaram corretamente quais são os objetos celestes mais próximos da Terra, 36,1% identificaram ano-luz como uma medida de distância e 34,2% reconheceram uma estrela cadente como meteoro. Em contrapartida, 67,1% compreendiam a sucessão entre dia e noite, 73,9% identificaram o Sol como estrela e 52,3% relacionaram o Big Bang à origem do Universo. Além disso, foram comparadas as respostas de alunos de diferentes séries e períodos, observando-se, dentre outras coisas, que os estudantes do terceiro ano apresentam um percentual de acertos semelhante ao dos alunos do primeiro, caracterizando que a abordagem de tópicos relacionados à astronomia no EM não tem contribuído para uma maior compreensão dos fenômenos e conceitos.

Determinação de regiões de órbitas diretas estáveis ao redor da Lua

NASA Astrophysics Data System (ADS)

de Melo, C. F.; Winter, O. C.; Vieira Neto, E.

2003-08-01

Neste Trabalho estamos investigando regiões do sistema Terra-Lua que contêm órbitas diretas estáveis ao redor da Lua visando a utilização destas órbitas em futuras missões de veículos espaciais como alternativas de trajetórias com baixo custo de manutenção. Adotando-se o problema restrito de três corpos, Terra-Lua-partícula, a localização e a extensão destas regiões de estabilidade foram investigadas numericamente considerando como estável toda órbita que permanece ao redor a Lua por, no mínimo, 1000 dias com energia de dois corpos da partícula em relação à Lua negativa. A estabilidade de tais regiões está associada a duas famílias de órbitas periódicas simples H1 e H2 e a órbitas quase-periódicas associadas a elas. Uma vez identificadas as regiões de estabilidade passamos a analisá-las introduzindo, paulatinamente, outras interações relevantes ao sistema como as perturbações do Sol (via problema restrito de quatro corpos), das marés, da pressão de radiação e do achatamento terrestre. Os resultados encontrados até o momento mostram que a perturbação do Sol é a única que reduz significativamente o tamanho das regiões de estabilidade. Também estamos investigando o comportamento de tais regiões quando características intrínsecas do sistema como as excentricidades das órbitas da Terra e da Lua e a inclinação da órbita Lua são consideradas. Com este estudo estamos reunindo informações que nos permitirão compreender a evolução das regiões de estabilidade no sistema Terra-Lua, bem como estabelecer parâmetros adequados para a utilização das trajetórias estáveis em futuras missões espaciais. Agradecimentos: Este projeto conta com o apoio do CNPq, da Capes e da Fapesp.

Life Course Experiences, Pain and Suffering: A Case Study of an Older Mexican American Woman with Mobility Impairment

PubMed Central

Walker, Janiece L.; Harrison, Tracie C.; Hendrickson, Sherry G.

2012-01-01

There is a dearth of literature examining how adversity shapes the experiences of pain and/or suffering in a middle aged Mexican American women. The purpose of this qualitative descriptive study was to understand pain and suffering from a life course perspective as described by a Mexican American woman aging with early onset mobility impairment. This Hispanic woman experienced episodes of abuse and rejection over the life course, which may have significantly influenced her pain and suffering experience in adulthood. This adds to the literature on how adversity influences later life pain experience and provides insight on why pharmacological treatment alone may not be as successful as a holistic intervention. Hay escasez de literatura que examine cómo la adversidad da forma a las experiencias de dolor y / o sufrimiento en mujeres mexicana-americana mayores de edad. El propósito de este estudio descriptivo cualitativo fue comprender el dolor y el sufrimiento desde una perspectiva de ciclo de vida como descrito por una mujer mexicana-americana envejeciendo con inicio temprano de deterioro de movilidad. Esta Latina experimentó episodios de maltrato y rechazo, que se percibió haber afectado su experiencia de dolor y sufrimiento luego como adulta. Este estudio aumenta la literatura sobre cómo la adversidad influya la experiencia de dolor más tarde en la vida, y nos permite comprender mejor como el tratamiento farmacológico por sí solo no es tan exitoso como pueda ser una intervención integral. PMID:24830728

[Not Available].

PubMed

Domínguez, Raúl; Garnacho-Castaño, Manuel Vicente; Maté-Muñoz, José Luis

2016-06-30

La fuerza influye directamente en el estado de salud y en la capacidad de fitness, motivo por el que el entrenamiento contra resistencias o resistance training (RT) se incluye dentro de aquellos programas de ejercicio encaminados a mejorar la salud y calidad de vida. Debido a que muchasenfermedades cursan con alteración de la masa y funcionalidad muscular y a que el RT es la principal modalidad de ejercicio encaminada a mejorar la función muscular, el objetivo de la presente revisión bibliográfica ha sido exponer las evidencias actuales sobre las adaptaciones delRT, así como su posible aplicación en patologías como la obesidad, diabetes, dislipemia, hipertensión, cáncer, Parkinson, esclerosis múltiple o fibromialgia. El RT en estas enfermedades puede aumentar los niveles de masa muscular, disminuyendo los niveles de masa grasa, los nivelesde ácidos grasos en sangre y la glucemia, incrementando la sensibilidad a la insulina, y disminuyendo los niveles de citokinas inflamatorias. El RT, además, mejora el gasto cardiaco y la funcionalidad endotelial, regulando la tensión arterial e incrementando el consumo de oxígeno. Las ganancias de fuerza muscular mejoran la funcionalidad y la calidad de vida, especialmente en población con una afectación neuromuscular grave, como pudieran ser los enfermos de esclerosis múltiple, fibromialgia o Parkinson. Por ello, el RT debe ser incorporado como parte del tratamiento en las personas que presentan determinado tipo de patologías.

Valorisation of Como Historical Cadastral Maps Through Modern Web Geoservices

NASA Astrophysics Data System (ADS)

Brovelli, M. A.; Minghini, M.; Zamboni, G.

2012-07-01

Cartographic cultural heritage preserved in worldwide archives is often stored in the original paper version only, thus restricting both the chances of utilization and the range of possible users. The Web C.A.R.T.E. system addressed this issue with regard to the precious cadastral maps preserved at the State Archive of Como. Aim of the project was to improve the visibility and accessibility of this heritage using the latest free and open source tools for processing, cataloguing and web publishing the maps. The resulting architecture should therefore assist the State Archive of Como in managing its cartographic contents. After a pre-processing consisting of digitization and georeferencing steps, maps were provided with metadata, compiled according to the current Italian standards and managed through an ad hoc version of the GeoNetwork Opensource geocatalog software. A dedicated MapFish-based webGIS client, with an optimized version also for mobile platforms, was built for maps publication and 2D navigation. A module for 3D visualization of cadastral maps was finally developed using the NASA World Wind Virtual Globe. Thanks to a temporal slidebar, time was also included in the system producing a 4D Graphical User Interface. The overall architecture was totally built with free and open source software and allows a direct and intuitive consultation of historical maps. Besides the notable advantage of keeping original paper maps intact, the system greatly simplifies the work of the State Archive of Como common users and together widens the same range of users thanks to the modernization of map consultation tools.

Percepción de competencia y adiestramiento profesional especializado relativos al VIH/SIDA en estudiantes y profesionales de la salud: el estigma como un indicador de necesidad

PubMed Central

RODRÍGUEZ, Yarimar ROSA; DÍAZ, Nelson VARAS

2009-01-01

El proceso de estigmatización asume una devaluación de la persona debido a una característica o marca que haya sido identificada socialmente y que permita que se le describa como diferente. Desde que se desató la epidemia del VIH/SIDA, vivir con la enfermedad ha sido señalado de manera social como una marca estigmatizante. Las manifestaciones de dicha estigmatización se han documentado entre profesionales de la salud. Este estigma puede afectar los servicios de salud que las personas que viven con VIH/SIDA reciben de estos profesionales. Los objetivos de esta investigación fueron explorar: 1) la percepción que tienen estudiantes y profesionales de la salud sobre su nivel de competencia para ofrecer servicios a personas que viven con VIH/SIDA, 2) las opiniones de éstos sobre el tipo de adiestramiento profesional recibido y la necesidad del mismo, y 3) la manifestación de actitudes estigmatizantes como indicadores de necesidad de adiestramiento profesional. La muestra total del estudio estuvo compuesta por 80 de diversas profesiones de la salud. Los resultados reflejan que algunos/as de los/as participantes han recibido formación en VIH pero ésta no ha sido suficiente para contrarrestar las nociones estigmatizantes. Discutimos las implicaciones de los resultados para investigaciones futuras y el desarrollo de intervenciones con vías de minimizar las nociones estigmatizantes en los escenarios de salud. PMID:20011236

Alejarse como proceso social: niños y ancianos «abandonados» en Ayacucho1

PubMed Central

Leinaweaver, Jessaca

2013-01-01

En investigaciones previas sobre el acogimiento familiar y la adopción en Ayacucho, se ha podido descubrir cómo los ayacuchanos adquieren y producen relaciones sociales. Mientras negocian creativamente los discursos y espacios construidos simultáneamente por instituciones, comunidades, y estructuras sociales, van adquiriendo nuevas formas de relacionarse. Este artículo discute el proceso opuesto: el deshacerse de relaciones de parentesco, y el proceso social del abandono o alejamiento. Cuando se aleja a una persona de su familia o su comunidad, los que se quedan en ella llegan a entenderse como ciertos tipos de personas. En los estudios de caso discutidos aquí, recopilados a través de una detallada y cuidadosa observación participante y de entrevistas etnográficas grabadas entre 2001 y 2007, se puede ver cómo, después de un alejamiento social, los individuos que alejan se reinterpretan como sujetos que se encuentran superándose o volviéndose modernos, o bien sacrificándose. PMID:25177044

Cálculos ab initio con correlación electrónica

NASA Astrophysics Data System (ADS)

Merchán Bonete, M.

Estamos entrando en una era donde la ortogonalidad entre las investigaciones de carácter experimental y de naturaleza teórica se irá difuminando progresivamente y la problemática a resolver quedará en escena como el único actor principal de la obra. Como premisa para una cooperación teórico-experimental de igual a igual, la metodología químico-cuántica utilizada debe ser capaz de ofrecer resultados de carácter predictivo. Sin duda, esta madurez en la metodología químico-cuántica ya la hemos alcanzado hace algunos años, tal y como muestra entre otras muchas, la labor que nuestro grupo ha realizado en el transcurso de la última década, dentro del campo de la Espectroscopía Teórica. Los estudios realizados comprenden una amplia gama de sistemas, variando tanto en tamaño como en complejidad, abordando problemáticas espectroscópicas consideradas tradicionalmente como especialmente controvertidas. Nuestra contribución científica más relevante reside en el carácter cuantitativo de las asignaciones espectroscópicas que hemos propuesto en base a resultados ab initio. Recordemos que en los años noventa los resultados ab initio solían presentar para las energías de excitación de sistemas de tamaño molecular moderado, como el benceno, errores de más de 1 eV. En comparación con el éxito relativo de los métodos semiempíricos, la frustración de la metodología ab initio quedaba todavía más patente. Los estudios que hemos presentado representan una comprensión profunda de los espectros electrónicos en sistemas orgánicos claves, mostrando el camino a seguir para obtener asignaciones espectroscópicas precisas (entre 0.1-0.2 eV). La naturaleza del método CASPT2 junto al diseño de estrategias computacionales nos ha permitido alcanzar el carácter cuantitativo con el que se caracterizan nuestras contribuciones[1,2]. Por todo ello, algunos de los trabajos publicados se consideran clásicos dentro del campo, pues en cierto modo definen el campo, y se reflejan en libros publicados recientemente. En la conferencia se analizarán ciertos pormenores de las investigaciones realizadas. El tipo de aplicaciones llevadas a cabo hasta la fecha se ilustrará mediante el estudio teórico del espectro electrónico de ciclooctatetraeno. Dando un paso más en la evolución de nuestra investigación, pretendemos en la actualidad describir, desde un formalismo teórico y al mismo nivel de exigencia, los mecanismos subyacentes que tienen lugar en las reacciones biológicas fototoinducidas, es decir, reacciones que se inician mediante la absorción de luz[3]. Como muestra de la caracterización de los procesos fotofísicos y fotoquímicos en fotobiología teórica, hemos elegido la descripción de la conversión interna ultrarrápida que tiene lugar en los cromóforos del ADN. Los estados excitados de las moléculas de los ácidos nucleicos presentan tiempos de vida media que se encuentran en el rango de sub-picosegundos, sugiriendo la presencia de un canal ultrarrápido de conversión interna, lo que normalmente se asocia en la fotoquímica contemporánea a una intersección cónica entre el estado excitado y el fundamental[4]. De esta forma nuestro ADN previene de forma eficaz posibles reacciones en el estado excitado y se revela como un excelente protector solar.

Astronomy in High School: Using a Mini-Planetarium to Understand Details of the Apparent Movement of Stars. (Spanish Title: Astronomía en la Escuela Secundaria: Comprendiendo los Detalles del Movimiento Aparente de Las Estrellas con un Miniplanetario.) Astronomia no Ensino Médio: Compreendendo Detalhes do Movimento Aparente das Estrelas com um Miniplanetário

NASA Astrophysics Data System (ADS)

dos Santos Leão, Demetrius

2013-07-01

The aim of this article is to present part of the results obtained by the intervention made from the author's Master degree project, which consisted in the development of a set of Astronomy classes for first year of High School students from a private school in the "Distrito Federal", Brasilia, Brazil, making use of a didactical material called mini-planetarium (MP) as the main resource. Using Paulo Freire's contextualization and dialogicity ideas as a theoretical framework guided by these lessons, it was proposed to the students the assembly and application of that resource in a planetarium session. During the project, some subjects such as the apparent trajectory of stars through Brasilia's sky, the location of the cardinal points beginning from the Southern Cross constellation, the color of stars and the stars being seen from a particular place were emphasized. It was found that the students showed an improvement of their understanding about these subjects, as well as a significant excitement with the developed methodology. El objetivo de este trabajo es presentar algunos de los resultados obtenidos en el proyecto de la tesis de maestría del autor, que incluyó el desarrollo de algunas clases de Astronomía, con estudiantes del primer año del bachillerato de una escuela privada del Distrito Federal (Brasilia, Brasil), utilizando como materia prima didáctica el recurso llamado miniplanetario (MP). Utilizando como base teórica orientadora de esas clases las ideas de contextualización y dialógica de Paulo Freire, fue propuesto a los estudiantes el montaje y la utilización de este recurso en una función de planetario. Durante el proyecto, se enfatizaron asuntos tales como la trayectoria aparente de las estrellas del cielo de Brasilia, la ubicación de los puntos cardinales a partir de la constelación de la Cruz del Sur, los colores de las estrellas y las estrellas vistas desde una localidad determinada. Se constató que los estudiantes mostraron una mejora en la comprensión de estas cuestiones y demostraron un gran interés por esta metodología. O objetivo deste artigo é apresentar parte dos resultados obtidos com a intervenção feita como projeto da dissertação de mestrado do autor, que consistiu no desenvolvimento de um conjunto de aulas de Astronomia, com alunos do 1º Ano do Ensino Médio de uma escola da rede privada do Distrito Federal (Brasília, Brasil), empregando como recurso principal um material didático chamado miniplanetário (MP). Utilizando como pressuposto teórico norteador dessas aulas as ideias de contextualização e dialogicidade de Paulo Freire, foi proposta aos estudantes a montagem e utilização desse recurso em uma sessão de planetário. Durante o projeto, enfatizaram-se assuntos como a trajetória aparente das estrelas para o céu de Brasília, a localização dos pontos cardeais a partir da constelação do Cruzeiro do Sul, as cores das estrelas e as estrelas vistas de uma determinada localidade. Apurou-se que os alunos apresentaram melhoria na compreensão desses assuntos, bem como demonstraram expressiva empolgação com essa metodologia desenvolvida.

['Third day intervention': an analysis of the factors associated with following the recommendations on the prescribing of antibiotics].

PubMed

García-San Miguel, Lucía; Cobo, Javier; Martínez, José Antonio; Arnau, Josep Maria; Murillas, Javier; Peña, Carmen; Segura, Ferran; Gurguí, Montserrat; Gálvez, Juan; Giménez, Montserrat; Gudiol, Francesc

2014-12-01

Stewardship programs on the use of antibiotics usually include interventions based on non-compulsory recommendations for the prescribers. Factors related to the adherence to expert recommendations, and the implementation of these programmes in daily practice, are of interest. A randomized, controlled, multicentre intervention study was performed in 32 hospitalization units. Antibiotic prescriptions were evaluated by an infectious disease specialist on the third day. We describe the implementation of the intervention, the factors associated with adherence to recommendations, and the impact of the intervention. A total of 3,192 interventions were carried out. Information sources used to prepare the recommendations varied significantly between centres. A modification was recommended in 65% of cases: withdrawal (47%), change in administration route (26%), change of drugs or number of antibiotics (27%), and change in dose (5%). Simplification of treatment accounted for 75% of all recommendations. Adherence was 68%, with significant differences between hospitals, and higher when the recommendations consisted of a dose adjustment or change of route, during the first intervention period, and also when recommendations were personally commented on, in addition to writing a note in the clinical chart. We did not find any reduction in antibiotic consumption or variation in the incidence of resistant pathogens. An important proportion of antibiotic prescriptions may be susceptible to improvement, most of them towards simplification. The adherence to the intervention was high, but significant variations at different centres were observed, depending on the type of recommendation, and the study period. Those recommendations that were personally commented on were more followed more than those only written. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Prevalence and genotype distribution changes in hepatitis C virus co-infection among human immunodeficiency virus-infected patients].

PubMed

Cifuentes, Celia; Mancebo-Hernández, María; Pérez-Navarro, Elisabet; Recio, Eva; Monje-Agudo, Patricia; Valiente, Adoración; Pineda, Juan A

2015-02-01

The prevalence of hepatitisC is decreasing among new diagnoses of HIV/HCV coinfection in Spain. The increasing use of the HCV treatment could have changed the HCV genotype distribution. The aim of this study is to analyze changes in the prevalence of HCV coinfection and in HCV genotype distribution among HIV-infected patients. A serial cross-sectional study was conducted that included all HIV-infected patients who attended the Outpatient Clinic of a hospital in Andalusia, between September 2008 and February 2009 (first period), and between January 2013 and June 2013 (second period). A total of 520 and 651 patients were included in the first and second period, respectively. The risk factors of HCV infection in the first vs. second period were: IDU, 319 (61%) vs. 348 (53%); heterosexual contact, 111 (21%) vs. 135 (21%); homosexual men, 76 (15%) vs. 114 (22%) (P=.006). The prevalence of HCV antibody per period was: 358 (69%) vs. 380 (58%) (P=<.001), and for the HCV-RNA was 255 (49%) vs. 240 (37%) (P=<.001). In both periods, the HCV genotype distribution was: 1, 137 (60%) vs. 138 (59%); 3, 45 (20%) vs. 42 (18%); 4, 42 (18%) vs. 47 (20%) (P=.881). The prevalence of HCV infection in HIV-infected patients has decreased in our area, including overall exposure to HCV virus and active infection during the last 5 years. However, the HCV genotype distribution has not changed. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Phenotypic and genetic characteristics of fluoroquinolone- and methicillin-resistant Staphylococcus aureus.

PubMed

Moreno-Flores, Antonio; Potel-Alvarellos, Carmen; Otero-Fernández, Susana; Álvarez-Fernández, Maximiliano

2017-07-20

Fluoroquinolone resistance in methicillin-resistant Staphylococcus aureus (MRSA) has increased in recent years. The objective of this study was to characterise two MRSA populations, one susceptible to fluoroquinolones and other resistant identifying the clonal types and the differential characteristics of both MRSA populations. Molecular typing using PFGE, MLST, spa and SSCmec was performed on 192 MRSA strains isolated from 2009 to 2011, 49 only oxacillin-resistant (OX-R) and 143 oxacillin and levofloxacin-resistant (OX-R-LEV-R). Mutations that conferred resistance to fluoroquinolones, hypermutable phenotypes and the presence of eight microbial surface components recognising adhesive matrix molecules (MSCRAMMs) were also studied. A statistically significant increase in the OX-R-LEV-R phenotype was observed (p<0.05). The most common clone of the OX-R isolates was sequence type (ST) 8 (32.6%), followed by ST72 (26.5%) and ST5 (26.5%). In the OX-R-LEV-R phenotype, the ST5 clone was the most common (65.7%), followed by ST72 (15.4%), and ST125 (12.6%). All isolates except the ST398 clone carried the SCCmecIVc. Clones ST5, ST72, ST125, and ST30 had hypermutable phenotypes. The ST72 clone and the ST30 clone in the OX-R phenotype harboured the highest number of MSCRAMMs. ST5 and ST72 clones were the most frequent clones identified in OX-R-LEV-R phenotype. Both clones showed a hypermutable phenotype that favours their selection as the fluoroquinolone resistant clones. The genetic relationships identified indicate that OX-R-LEV-R clones have evolved from OX-R MRSA clones. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Anaerobic bacteria 150 years after their discovery by Pasteur].

PubMed

García-Sánchez, José Elías; García-Sánchez, Enrique; Martín-Del-Rey, Ángel; García-Merino, Enrique

2015-02-01

In 2011 we celebrated the 150th anniversary of the discovery of anaerobic bacteria by Louis Pasteur. The interest of the biomedical community on such bacteria is still maintained, and is particularly focused on Clostridium difficile. In the past few years important advances in taxonomy have been made due to the genetic, technological and computing developments. Thus, a significant number of new species related to human infections have been characterised, and some already known have been reclassified. At pathogenic level some specimens of anaerobic microflora, that had not been isolated from human infections, have been now isolated in some clinical conditions. There was emergence (or re-emergence) of some species and clinical conditions. Certain anaerobic bacteria have been associated with established infectious syndromes. The virulence of certain strains has increased, and some hypotheses on their participation in certain diseases have been given. In terms of diagnosis, the routine use of MALDI-TOF has led to a shortening of time and a cost reduction in the identification, with an improvement directly related to the improvement of data bases. The application of real-time PCR has been another major progress, and the sequencing of 16srRNA gene and others is currently a reality for several laboratories. Anaerobes have increased their resistance to antimicrobial agents, and the emergence of resistance to carbapenems and metronidazole, and multi-resistance is a current reality. In this situation, linezolid could be an effective alternative for Bacteroides. Fidaxomicin is the only anti-anaerobic agent introduced in the recent years, specifically for the diarrhoea caused by C.difficile. Moreover, some mathematical models have also been proposed in relation with this species. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Characteristics of tuberculosis in the immigrant population in South Granada Health Area].

PubMed

Morales-García, Concepción; Parra-Ruiz, Jorge; Valero-Aguilera, Beatriz; Sanbonmatsu-Gámez, Sara; Sánchez-Martínez, José Antonio; Hernández-Quero, José

2015-03-01

The incidence of tuberculosis (TB) among the native population in Spain continues to decrease, resulting in a higher proportion of foreign-born cases. The aim of this study was to identify the differential TB characteristics within the immigrant population with respect to the native population in the South Granada Health Area, Spain. This was a descriptive study, including all cases of TB diagnosed during the period 2003-2010. Cases were identified through a prospective database. A logistic regression analysis was performed to determine differential characteristics. From 319 TB cases diagnosed, 247 were natives and 72 (22.6%) immigrants, and 272 were pulmonary tuberculosis. The following variables were significantly associated with immigrant TB cases: age<35 years (OR=4.75, CI: 2.72-8.31), higher percentage of cavitated chest X-ray (OR=2.26, CI: 1.20-4.20), higher percentage of smear-positive cases (OR=1.80, CI: 1.02-3.16), longer diagnostic delay in smear-positive pulmonary TB (median 32 days vs. 21 days P=.043), and lower total lethality (OR=0.12; CI: 0.01-0.89). The incidence of TB has remained constant in the South Granada Health Area due to the increase in cases among immigrants. Compared with native TB patients, immigrant patients were younger and had more advanced disease (higher percentage of smear-positive cases and higher percentage of cavitated chest X-ray) and longer diagnostic delay in smear-positive pulmonary TB, indicating poorer TB control. Strategies for earlier diagnosis of TB in immigrants are essential. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

High prevalence of asymptomatic carriers of Tropheryma whipplei in different populations from the North of Spain.

PubMed

García-Álvarez, Lara; Pérez-Matute, Patricia; Blanco, José Ramón; Ibarra, Valvanera; Oteo, José Antonio

2016-01-01

Tropheryma whipplei is the causative agent of Whipple disease. T. whipplei has also been detected in asymptomatic carriers with a very different prevalence. To date, in Spain, there are no data regarding the prevalence of T. whipplei in a healthy population or in HIV-positive patients, or in chronic fatigue syndrome (CFS). Therefore, the aim of this work was to assess the prevalence of T. whipplei in stools in those populations. Stools from 21 HIV-negative subjects, 65 HIV-infected, and 12 CFS patients were analysed using real time-PCR. HIV-negative and positive subjects were divided into two groups, depending on the presence/absence of metabolic syndrome (MS). Positive samples were sequenced. The prevalence of T. whipplei was 25.51% in 98 stool samples analysed. Prevalence in HIV-positive patients was significantly higher than in HIV-negative (33.8% vs. 9.09%, p=0.008). Prevalence in the control group with no associated diseases was 20%, whereas no positive samples were observed in HIV-negative patients with MS, or in those diagnosed with CFS. The prevalence observed in HIV-positive patients without MS was 30.35%, and with MS it was 55.5%. The number of positive samples varies depending on the primers used, although no statistically significant differences were observed. There is a high prevalence of asymptomatic carriers of T. whipplei among healthy and in HIV-infected people from Spain. The role of T. whipplei in HIV patients with MS is unclear, but the prevalence is higher than in other populations. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].

PubMed

Padilla-España, Laura; Repiso-Jiménez, Juan Bosco; Fernández-Sánchez, Fernando; Pereda, Teresa; Rivas-Ruiz, Francisco; Fernández-Morano, Teresa; de la Torre-Lima, Javier; Palma, Fermín; Redondo, Maximino; de Troya-Martín, Magdalena

2016-01-01

The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Re-emergence of measles in the province of Guadalajara, Spain. Is it time to establish new strategies for its elimination?].

PubMed

Martínez-Ramírez, Mariela; González-Praetorius, Alejandro; Ory-Manchón, Fernando de; Martínez-Benito, Yolanda; García-Rivera, M Victoria; Hübschen, Judith; Echevarría-Mayo, Juan Emilio

2014-10-01

Measles is a viral infection that was almost eradicated, but it is re-emerging in Spain and Europe in recent years. The aim of this study was to describe the microbiological, clinical and epidemiological characteristics of a measles outbreak that occurred in Guadalajara (Spain) from June to August 2012. A descriptive and retrospective study was conducted. A total of 117 samples (including serum, urine and pharyngeal swabs) from 52 patients were analyzed for measles. Measles was diagnosed in 50 patients, 41 of them by microbiological diagnosis, and 9 by epidemiological link. The patients were grouped in four community outbreaks. No imported cases were observed. Positive IgM and positive CRP were detected in 25 patients, positive CRP only in 11 and positive IgM only in 5. The genotype D4 was identified in 13 patients and the genotype A in a post-vaccine case. The age groups most affected were adults between 20-34 years of age (38%) and younger than 15 months (26%). The large majority (86%) of patients were unvaccinated (44% Roma population, 27% younger than 15 months, 11% ideological reasons), 6% had one vaccine dose. The signs/symptoms were: rash and fever, 100%, cough, 82%, and conjunctivitis 50%. Almost one-third (32%) of patients were hospitalized, and 28% had complications. It is very important to intensify the epidemiological surveillance of infections in the elimination phase. The increased incidence of measles was associated to unvaccinated pockets, presenting a challenge for Public Health Centers. These agencies should prepare strategies to obtain a higher vaccine coverage for the eradication of measles. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Pregnancy as an opportunity to diagnose human-immunodeficiency virus immigrant women in Catalonia.

PubMed

Soriano-Arandes, Antoni; Noguera-Julian, Antoni; López-Lacort, Mónica; Soler-Palacín, Pere; Mur, Antonio; Méndez, María; Mayol, Lluís; Vallmanya, Teresa; Almeda, Jesús; Carnicer-Pont, Dolors; Casabona, Jordi; Fortuny, Claudia

2018-01-01

Mother-to-child transmission (MTCT) is relevant in the global epidemiology of human-immunodeficiency virus (HIV), as it represents the main route of infection in children. The study objectives were to determine the rate of HIV-MTCT and its epidemiological trend between the Spanish-born and immigrant population in Catalonia in the period 2000-2014. A prospective observational study of mother-child pairs exposed to HIV, treated in 12 hospitals in Catalonia in the period 2000-2014. HIV-MTCT rate was estimated using a Bayesian logistic regression model. R and WinBUGS statistical software were used. The analysis included 909 pregnant women, 1,009 pregnancies, and 1,032 children. Data on maternal origin was obtained in 79.4% of women, of whom 32.7% were immigrants, with 53.0% of these from sub-Saharan Africa. The overall HIV-MTCT rate was 1.4% (14/1,023; 95% CI; 0.8-2.3). The risk of MTCT-HIV was 10-fold lower in women with good virological control (P=.01), which was achieved by two-thirds of them. The proportion of immigrants was significantly higher in the period 2008-2014 (P<.0001), for the HIV-diagnosis (P<.0001), and antiretroviral administration (P=.02) during pregnancy, and for undetectable viral load next to delivery (P<.001). There were no differences in the rate of MTCT-HIV among Spanish-born and immigrant women (P=.6). There is a gradual increase in HIV pregnant immigrants in Catalonia. Although most immigrant women were diagnosed during pregnancy, the rate of MTCT-HIV was no different from the Spanish-born women. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Changes in clinic-epidemiological characteristics of new cases of HIV-1 infection in Castellón (Spain), and its impact on delayed presentation (1987-2011)].

PubMed

Mínguez-Gallego, Carlos; Vera-Remartinez, Enrique J; Albert-Coll, Monica; Roldán-Puchalt, M Concepción; Aguilar-Climent, Manuel; Rovira-Ferrando, Rosa E; Andrés-Soler, Jorge; Roig-Espert, Belén; Penadés-Vidal, María; Usó-Blasco, Jorge

2015-03-01

To describe the trend of the clinical and epidemiological characteristics of a cohort of HIV-1 infected patients in Castellón (Spain), and its impact on the delayed presentation. Data from HIV-1 infected outpatients presenting for care for the first time between 1987 and 2011 were retrospectively analyzed. There have been significant changes in the characteristics of the 1001 newly presented patients during the period studied. An increase in the mean age was observed (increasing from about 30 years before 1996, to approximately 35 after the 2000-2002 period), as well as an increase in the percentage of immigrants (<2% before 1997, to 50% in the 2009-2011 period), and a decline in the proportion of intravenous drug use as the main transmission route (changing from being 92.3% before 1988 to below 20% after the 2003-2005 period), together with a decrease in the proportion of hepatitis-C coinfection. The rate of late presentation has not significantly changed, being 47.1% in the period studied. Factors associated with this late presentation were: older age, hospital diagnosis, an increased delay between estimated infection time and diagnosis, and between diagnosis and initial presentation. The epidemiology of HIV-1 infection in our area has dramatically changed since the beginning of the disease. The increasing delay between estimated infection time and diagnosis is an important cause of the lack of variation in the late presentation rate, and highlights the low impact of early diagnosis strategies. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Early diagnosis of human immunodeficiency virus-1 in infants: The prevention of mother-to-child transmission program in Equatorial Guinea].

PubMed

Prieto-Tato, Luis Manuel; Vargas, Antonio; Álvarez, Patrícia; Avedillo, Pedro; Nzi, Eugenia; Abad, Carlota; Guillén, Sara; Fernández-McPhee, Carolina; Ramos, José Tomás; Holguín, África; Rojo, Pablo; Obiang, Jacinta

2016-11-01

Great efforts have been made in the last few years in order to implement the prevention of mother-to-child transmission (PMTCT) program in Equatorial Guinea (GQ). The aim of this study was to evaluate the rates of mother-to-child HIV transmission based on an HIV early infant diagnosis (EID) program. A prospective observational study was performed in the Regional Hospital of Bata and Primary Health Care Centre Maria Rafols, Bata, GQ. Epidemiological, clinical, and microbiological characteristics of HIV-1-infected mothers and their exposed infants were recorded. Dried blood spots (DBS) for HIV-1 EID were collected from November 2012 to December 2013. HIV-1 genome was detected using Siemens VERSANT HIV-1 RNA 1.0 kPCR assay. Sixty nine pairs of women and infants were included. Sixty women (88.2%) had WHO clinical stage 1. Forty seven women (69.2%) were on antiretroviral treatment during pregnancy. Forty five infants (66.1%) received postnatal antiretroviral prophylaxis. Age at first DBS analysis was 2.4 months (IQR 1.2-4.9). One infant died before a HIV-1 diagnosis could be ruled out. Two infants were HIV-1 infected and started HAART before any symptoms were observed. The rate of HIV-1 transmission observed was 2.9% (95%CI 0.2-10.5). The PMTCT rate was evaluated for the first time in GQ based on EID. EID is the key for early initiation of antiretroviral therapy and to reduce the mortality associated with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Economic impact of nosocomial bacteraemia. A comparison of three calculation methods].

PubMed

Riu, Marta; Chiarello, Pietro; Terradas, Roser; Sala, Maria; Castells, Xavier; Knobel, Hernando; Cots, Francesc

2016-12-01

The excess cost associated with nosocomial bacteraemia (NB) is used as a measurement of the impact of these infections. However, some authors have suggested that traditional methods overestimate the incremental cost due to the presence of various types of bias. The aim of this study was to compare three assessment methods of NB incremental cost to correct biases in previous analyses. Patients who experienced an episode of NB between 2005 and 2007 were compared with patients grouped within the same All Patient Refined-Diagnosis-Related Group (APR-DRG) without NB. The causative organisms were grouped according to the Gram stain, and whether bacteraemia was caused by a single or multiple microorganisms, or by a fungus. Three assessment methods are compared: stratification by disease; econometric multivariate adjustment using a generalised linear model (GLM); and propensity score matching (PSM) was performed to control for biases in the econometric model. The analysis included 640 admissions with NB and 28,459 without NB. The observed mean cost was €24,515 for admissions with NB and €4,851.6 for controls (without NB). Mean incremental cost was estimated at €14,735 in stratified analysis. Gram positive microorganism had the lowest mean incremental cost, €10,051. In the GLM, mean incremental cost was estimated as €20,922, and adjusting with PSM, the mean incremental cost was €11,916. The three estimates showed important differences between groups of microorganisms. Using enhanced methodologies improves the adjustment in this type of study and increases the value of the results. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Phenotypic and genotypic characterization of vancomycin-resistant Enterococcus faecium clinical isolates from two hospitals in Mexico: First detection of VanB phenotype-vanA genotype.

PubMed

Bocanegra-Ibarias, Paola; Flores-Treviño, Samantha; Camacho-Ortiz, Adrián; Morfin-Otero, Rayo; Villarreal-Treviño, Licet; Llaca-Díaz, Jorge; Martínez-Landeros, Erik Alan; Rodríguez-Noriega, Eduardo; Calzada-Güereca, Andrés; Maldonado-Garza, Héctor Jesús; Garza-González, Elvira

2016-01-01

Enterococcus faecium has emerged as a multidrug-resistant nosocomial pathogen involved in outbreaks worldwide. Our aim was to determine the antimicrobial susceptibility, biofilm production, and clonal relatedness of vancomycin-resistant E. faecium (VREF) clinical isolates from two hospitals in Mexico. Consecutive clinical isolates (n=56) were collected in two tertiary care hospitals in Mexico from 2011 to 2014. VREF isolates were characterized by phenotypic and molecular methods including pulsed-field gel electrophoresis (PFGE). VREF isolates were highly resistant to vancomycin, erythromycin, norfloxacin, high-level streptomycin, and teicoplanin, and showed lower resistance to tetracycline, nitrofurantoin and quinupristin-dalfopristin. None of the isolates were resistant to linezolid. The vanA gene was detected in all isolates. Two VanB phenotype-vanA genotype isolates, highly resistant to vancomycin and susceptible to teicoplanin, were detected. Furthermore, 17.9% of the isolates were classified as biofilm producers, and the espfm gene was found in 98.2% of the isolates. A total of 37 distinct PFGE patterns and 6 clones (25% of the isolates as clone A, 5.4% as clone B, and 3.6% each as clone C, D, E, and F) were detected. Clone A was detected in 5 different wards of the same hospital during 14 months of surveillance. The high resistance to most antimicrobial agents and the moderate cross-transmission of VREF detected accentuates the need for continuous surveillance of E. faecium in the hospital setting. This is also the first reported incidence of the E. faecium VanB phenotype-vanA genotype in the Americas. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Time to positivity of blood cultures in patients with bloodstream infections: A useful prognostic tool.

PubMed

Martín-Gutiérrez, Guillermo; Martín-Pérez, Carlos; Gutiérrez-Pizarraya, Antonio; Lepe, José A; Cisneros, José M; Aznar, Javier

2017-12-01

The time to positivity (TTP) of blood cultures in patients with bloodstream infections (BSIs) has been considered to be a possible prognostic tool for some bacterial species. However, notable differences have been found between sampling designs and statistical methods in published studies to date, which makes it difficult to compare results or to derive reliable conclusions. Our objective was to evaluate the clinical and microbiological implications of TTP among patients with BSI caused by the most common pathogens. A total of 361 episodes of BSI were reported for 332 patients. The survival of the entire cohort was measured from the time of blood culture sampling. In order to compare our results with those of previous studies, TTP was divided in three different groups based on log rank (short TTP <12h; medium TTP ≥12h to ≤27h, and long TTP >27h). Cox proportional hazard models were used to calculate crude and adjusted hazard ratios (HR). The Cox proportional hazard model revealed that TTP is an independent predictor of mortality (HR=1.00, p=0.031) in patients with BSIs. A higher mortality was found in the group of patients with the shortest TTP (<12h) (HR=2.100, p=0.047), as well as those with longest TTP (>27h) (HR=3.277, p=0.031). It seems that TTP may provide a useful prognostic tool associated with a higher risk of mortality, not only in patients with shorter TTP, but also in those with longer TTP. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Infective endocarditis in adult patients with congenital heart disease. Experience from a reference centre].

PubMed

Loureiro-Amigo, Jose; Fernández-Hidalgo, Nuria; Pijuan-Domènech, Antonia; Dos-Subirà, Laura; Subirana-Domènech, Teresa; Gonzàlez-Alujas, Teresa; González-López, Juan José; Tornos-Mas, Pilar; García-Dorado, David; Almirante, Benito

2016-12-01

A growing number of patients with congenital heart disease (CHD) will reach adulthood. Infective endocarditis (IE) is a major complication in this population. The aim of this study was to describe the features of IE in adults with CHD treated in a reference centre. A retrospective review was performed on a cohort of patients over 16 years of age with CHD who presented with IE (defined by the modified Duke criteria) between 1996 and 2014. Only the first episode from each patient was considered for the descriptive analysis. IE was observed in 27 patients. The median age at diagnosis of IE was 27.7 years, and 63% were male. Comorbidity was low (median Charlson index was 0). IE was mostly community-acquired (78%). The most frequent CHD were ventricular septal defect (33%). A repair was performed in 48% of patients, and 19% received palliative treatment. Forty-one percent of patients had some type of prosthesis. A residual defect was observed in 81%. The IE was detected in the right side of 44% of the patients. The most frequent aetiological agents were viridans group streptococci (41%) and Staphylococcus epidermidis (30%). Surgery was required to treat IE in 37% of patients. There were five re-infections and three relapses. Two patients died, both as a result of recurrence. IE in adults with CHD occurred in young patients, and almost all of them carried some prosthetic material or a residual defect. The IE is frequently right-sided. Although surgical treatment was required in many cases, mortality was low, except in the case of relapses. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Influenza infection in the intensive care unit: Four years after the 2009 pandemic.

PubMed

Pérez-Carrasco, Marcos; Lagunes, Leonel; Antón, Andrés; Gattarello, Simone; Laborda, César; Pumarola, Tomás; Rello, Jordi

2016-03-01

The role of influenza viruses in severe acute respiratory infection (SARI) in Intensive Care Units (ICU) remains unknown. The post-pandemic influenza A(H1N1)pdm09 period, in particular, has been poorly studied. To identify influenza SARI patients in ICU, to assess the usefulness of the symptoms of influenza-like illness (ILI), and to compare the features of pandemic vs. post-pandemic influenza A(H1N1) pdm09 infection. A prospective observational study with SARI patients admitted to ICU during the first three post-pandemic seasons. Patient demographics, characteristics and outcomes were recorded. An influenza epidemic period (IEP) was defined as >100 cases/100,000 inhabitants per week. One hundred sixty-three patients were diagnosed with SARI. ILI was present in 65 (39.9%) patients. Influenza infection was documented in 41 patients, 27 (41.5%) ILI patients, and 14 (14.3%) non-ILI patients, 27 of them during an IEP. Influenza A viruses were mainly responsible. Only five patients had influenza B virus infection, which were non-ILI during an IEP. SARI overall mortality was 22.1%, and 15% in influenza infection patients. Pandemic and post-pandemic influenza infection patients shared similar clinical features. During influenza epidemic periods, influenza infection screening should be considered in all SARI patients. Influenza SARI was mainly caused by subtype A(H1N1)pdm09 and A(H3N2) in post-pandemic seasons, and no differences were observed in ILI and mortality rate compared with a pandemic season. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Seroprevalence of varicella-zoster virus antibodies after the recent introduction of the universal childhood immunisation schedule in the Community of Madrid].

PubMed

García-Comas, Luis; Ordobás Gavín, María; Sanz Moreno, Juan Carlos; Ramos Blázquez, Belén; Gutiérrez Rodríguez, M Angeles; Barranco Ordóñez, Dolores

2016-12-01

In November 2006, the Community of Madrid included the chickenpox vaccine into the immunisation schedule for children from 15 months of age. This was withdrawn in January 2014. Seroprevalence of antibodies to the virus is estimated after the first 2-3 years from the inclusion of the vaccine, and as well as its evolution since 1999. A cross-sectional study was conducted on the target population consisting of residents in the Community of Madrid between 2 and 60 years of age. Measurement of IgG antibodies was performed using an ELISA technique. Seroprevalence was estimated according to sociodemographic characteristics using multiple logistic regressions. The results are compared with previous surveys. Also, the seroprevalence and geometric mean of the antibody according immunisation status and history of the disease are presented. The confidence level used is 95%. A total of 4,378 subjects were included, with a response rate of 69%. The estimated seroprevalence was 95.3% (95% CI: 94.6% - 95.9%). Over 90% of children from the age of 10 have antibodies. The seroprevalence was higher in people with less education. The seroprevalence of immunity vaccine exceeds 90% in the first year after vaccination, but in the second year decreased to 82.6% (95% CI 56.0 - 94.7). Significant differences, attributable to universal vaccination, were found compared to previous surveys. Continued surveillance is needed in order to assess the impact of the withdrawal of the recommendation to vaccinate at 15 months. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Cryptosporidiosis outbreak in a child day-care center caused by an unusual Cryptosporidium hominis subtype.

PubMed

Goñi, Pilar; Almagro-Nievas, Diego; Cieloszyk, Joanna; Lóbez, Silvia; Navarro-Marí, José María; Gutiérrez-Fernández, José

2015-12-01

This work describes the genetic characterization of Cryptosporidium and Giardia involved in an outbreak in a nursery school in Granada, Spain, that affected seven children under the age of 4. Nucleic acids were extracted from the seven stool samples positive to Cryptosporidium or Giardia by microscopy and/or immunochromatography. The species and subtypes of Cryptosporidium were identified by PCR-RFLP and PCR of the SSUrRNA and gp60 genes, respectively. The assemblages of Giardia duodenalis isolates were characterized by PCR of the tpi gene. PCR products were sequenced and analyzed. All of the isolates were positive for Cryptosporidium hominis. Five of them belonged to subtype IaA11R2, one to subtype IbA10G2R2, and the other could not be identified. Three of these samples were positive for G. duodenalis by PCR, two belonging to the assemblage A, and the other one to assemblage B. This is the first report of Cryptosporidium hominis subtype IaA11R2 as a cause of an outbreak in Europe where subtype IbA10G2R2 is the most frequently identified. In the case of Giardia, an outbreak could not be confirmed because of the low number of positive samples and the low genetic variability of the amplified fragments for assemblage A of tpi gene. A new subtype, of Cryptosporidium hominis named IaA11R2, has been described as a cause of an outbreak in a nursery school in Granada, Spain. However an outbreak of giardiasis could not be confirmed. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Clinical usefulness of therapeutic drug monitoring of voriconazole in a university hospital.

PubMed

Cabral-Galeano, Evelyn; Ruiz-Camps, Isabel; Len-Abad, Oscar; Pou-Clavé, Leonor; Sordé-Masip, Roger; Meije-Castillo, Yolanda; Blanco-Grau, Albert; Barba-Suñol, Pere; Monforte-Torres, Victor; Román-Broto, Antonio; Pahissa-Berga, Albert; Gavaldà-Santapau, Joan

2015-05-01

The aim of this study was to assess the clinical usefulness of therapeutic drug monitoring (TDM) of voriconazole (VOR) in a university hospital. A retrospective review was conducted on the clinical records of 52 patients treated with VOR and on whom TDM was performed. Steady-state trough plasma VOR concentration was measured at least 5 days after starting treatment. The therapeutic range of plasma VOR concentration was defined as 1-5.5μg/mL. The most frequent underlying conditions in the study population were lung transplant (48.1%) and hematological malignancies (26.9%). At the first TDM in each patient, VOR levels were outside the therapeutic range in 16 (30.7%) cases: <1μg/mL in 10 (19.2%) and >5.5μg/mL in 6 (11.5%). Eleven patients (21.2%) experienced severe muscle weakness and had considerable difficulty walking. All these patients were receiving concomitant treatment with corticosteroids. Age younger than 30 years (p=.005) and cystic fibrosis as the underlying disease (p=.04) were factors associated with low VOR levels. Almost all patients who had VOR concentrations >1μg/mL at the first TDM had a successful outcome (96%). Plasma VOR concentrations were outside the therapeutic range at the first TDM in 30% (16/52) of patients. Age younger than 30 years and cystic fibrosis were factors associated with low VOR levels. The potential interactions between corticosteroids and VOR should be highlighted, as they could be responsible for a high rate of muscle weakness observed in our patients. Prospective trials are needed to investigate VOR TDM and corticosteroid pharmacokinetics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Training should be the first step toward an antifungal stewardship program.

PubMed

Valerio, Maricela; Muñoz, Patricia; Rodríguez-González, Carmen; Sanjurjo, María; Guinea, Jesús; Bouza, Emilio

2015-04-01

The frequency of use of systemic antifungal agents has increased significantly in most tertiary centers. However, antifungal stewardship has received very little attention. The objective of this article was to assess the knowledge of prescribing physicians in our institution as a first step in the development of an antifungal stewardship program. Attending physicians from the departments that prescribe most antifungals were invited to complete a questionnaire based on current guidelines on diagnosis and therapy of invasive candidiasis and invasive aspergillosis (IA). The survey was completed by 60.8% (200/329) of the physicians who were invited to participate. The physicians belonged to the following departments: medical (60%), pediatric (19%), intensive care (15.5%), and surgical (5.5%). The mean (±SD) score of correct responses was 5.16±1.73. In the case of candidiasis, only 55% of the physicians clearly distinguished between colonization and infection, and 17.5% knew the local rate of fluconazole resistance. Thirty-three percent knew the accepted indications for antifungal prophylaxis, and 23% the indications for empirical therapy. However, most physicians knew which antifungals to choose when starting empirical therapy (73.5%). As for aspergillosis, most physicians (67%) could differentiate between colonization and infection, and 34.5% knew the diagnostic value of galactomannan. The radiological features of IA were well recognized by 64%, but only 31.5% were aware of the first line of treatment for IA, and 36% of the recommended duration of therapy. The usefulness of antifungal levels was known by 67%. This simple, easily completed questionnaire enabled us to identify which areas of our training strategy could be improved. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Cost-effectiveness study of the microbiological diagnosis of tuberculosis using geneXpert MTB/RIF®.

PubMed

Herráez, Óscar; Asencio-Egea, María Ángeles; Huertas-Vaquero, María; Carranza-González, Rafael; Castellanos-Monedero, Jesús; Franco-Huerta, María; Barberá-Farré, José Ramón; Tenías-Burillo, José María

To perform a cost-effectiveness analysis of a molecular biology technique for the diagnosis of tuberculosis compared to the classical diagnostic alternative. A cost-effectiveness analysis was performed to evaluate the theoretical implementation of a molecular biology method including two alternative techniques for early detection of Mycobacterium tuberculosis Complex, and resistance to rifampicin (alternative1: one determination in selected patients; alternative2: two determinations in all the patients). Both alternatives were compared with the usual procedure for microbiological diagnosis of tuberculosis (staining and microbiological culture), and was accomplished on 1,972 patients in the period in 2008-2012. The effectiveness was measured in QALYs, and the uncertainty was assessed by univariate, multivariate and probabilistic analysis of sensitivity. A value of €8,588/QALYs was obtained by the usual method. Total expenditure with the alternative1 was €8,487/QALYs, whereas with alternative2, the cost-effectiveness ratio amounted to €2,960/QALYs. Greater diagnostic efficiency was observed by applying the alternative2, reaching a 75% reduction in the number of days that a patient with tuberculosis remains without an adequate treatment, and a 70% reduction in the number of days that a patient without tuberculosis remains in hospital. The implementation of a molecular microbiological technique in the diagnosis of tuberculosis is extremely cost-effective compared to the usual method. Its introduction into the routine diagnostic procedure could lead to an improvement in quality care for patients, given that it would avoid both unnecessary hospitalisations and treatments, and reflected in economic savings to the hospital. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Bibliometric analysis of the Spanish scientific production in Infectious Diseases and Microbiology].

PubMed

Ramos, José Manuel; González-Alcaide, Gregorio; Gutiérrez, Félix

2016-03-01

The bibliometric analysis of production and impact of documents by knowledge area is a quantitative and qualitative indicator of research activity in this field. The aim of this article is to determine the contribution of Spanish research institutions in Infectious Diseases and Microbiology in recent years. Documents published in the journals included in the categories "Infectious Diseases" and "Microbiology" of the Web of Science (Science Citation Index Expanded) of the ISI Web of Knowledge from the year 2000-2013 were analysed. In Infectious Diseases, Spain ranked fourth worldwide, and contributed 5.7% of the 233,771 documents published in this specialty. In Microbiology, Spain was in sixth place with a production rate of 5.8% of the 149,269 documents of this category. The Spanish production increased over the study period, both in Infectious Diseases and Microbiology, from 325 and 619 documents in 2000 to 756 and 1245 documents in 2013, with a growth rate of 131% and 45.8%, respectively. The journal with the largest number of documents published was Enfermedades Infecciosas y Microbiología Clínica, with 8.6% and 8.2% of papers published in the categories of Infectious Diseases and Microbiology, respectively, and was the result of international collaborations, especially with institutions in the United States. The "index h" was 116 and 139 in Infectious Diseases and Microbiology, placing Spain in fifth place in both categories within countries of the European Union. In recent years, Spanish research in Infectious Diseases and Microbiology has reached a good level of production and international visibility, reaching a global leadership position. Copyright © 2015. Published by Elsevier España, S.L.U.

Comparison of phenotypic tests for the detection of metallo-beta-lactamases in clinical isolates of Pseudomonas aeruginosa.

PubMed

Lucena, Andréa; Dalla Costa, Libera M; Nogueira, Keite da Silva; Matos, Adriana P; Gales, Ana C; Raboni, Sonia M

2014-12-01

Metallo-β-lactamase (MBL)-producing gram-negative bacteria are an increasing public health concern worldwide. Screening tests for the rapid and specific identification of these pathogens are essential, and should be included among routine diagnostics in laboratories. This study aimed to determine the MBL frequency among carbapenem-resistant Pseudomonas aeruginosa isolates, and to evaluate the accuracy of different tests in screening for MBL production. From January 2001 to December 2008, a total of 142 imipenem-non-susceptible P. aeruginosa strains were isolated from distinct clinical samples from hospitalized patients. These isolates were examined by PCR, MBL E-test, double-disk synergy test (DDST), and combined disk (CD) test. The minimal inhibitory concentration (MIC; μg/mL) was determined by agar dilution, and pulsed field gel electrophoresis (PFGE) was performed on all samples. Sequencing was performed to confirm and define the MBL variant and subtype. Using PCR and DNA sequence analysis, 93 strains were confirmed positive for MBLs, 91 strains for the blaSPM-1 gene, 1 strain for the blaIMP-1 gene, and 1 strain for the blaIMP-16 gene. PFGE displayed a clonal pattern. The sensitivities, specificities, positive and negative predictive values were evaluated for all tests. The DDST assay (CAZ-MPA) was the optimal method for screening MBL production in P. aeruginosa strains. However, the results of the CD assay (IMP/EDTA) showed close agreement with those of the DDST. In addition, the CD assay allowed a more objective interpretation and did not require the use of a toxic substance. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Vaccination coverage against pertussis in pregnant women of Catalonia in the first year of implementation of the immunisation program.

PubMed

Fernández-Cano, María Isabel; Espada-Trespalacios, Xavier; Reyes-Lacalle, Azahara; Manresa Domínguez, Josep Maria; Armadans-Gil, Lluís; Campins-Martí, Magda; Falguera-Puig, Gemma; Toran Monserrat, Pere

2017-11-01

The re-emergence of pertussis and the severity of its complications in infants younger than 3 months, were determining factors for starting a vaccination program for pregnant women in the third trimester of gestation in Catalonia in February 2014. This was the first autonomous community to introduce it in Spain. The aim of the study was to estimate the coverage of the program in its first year of implementation. A retrospective analysis was performed on the data from the Primary Care Centre computerised medical records of pregnant women attending Sexual and Reproductive Health Care centres of the Metropolitan Nord area of the province of Barcelona, part of the Catalan Institute of Health. The overall coverage was estimated, as well as the sociodemographic variables of Tdap vaccination of women who had registered a delivery of a live birth between August 2014 and August 2015. A total of 6,697 deliveries of live births were recorded, and 1,713 pregnant women were vaccinated, which represented an overall coverage of 25.6% (95% CI; 24.1-26.1). Vaccination coverage was higher in pregnant women under 18 years and Spanish women (P=.018 and P=.036, respectively). The estimation of vaccine coverage against pertussis in pregnant women in the third trimester of pregnancy, after the first year of implementation of the program in a health area of Catalonia was lower than the objective set. Strategies need to be designed in order to improve program coverage. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Hepatitis C prevalence among the immigrant population in Spain: A systematic review and meta-analysis.

PubMed

Lazarus, Jeffrey V; Bromberg, Daniel J; Del Amo, Julia; Norgaard, Ole; García-Samaniego, Javier; Casellas, Aina; Calleja, José Luis; Requena-Méndez, Ana

2018-05-11

Spain, which has one of the largest immigrant populations in Europe, has committed to eliminating the hepatitis C virus (HCV). The aim of this study was to estimate the prevalence of HCV among migrant groups in Spain, a country of 46 million people, with an estimated HCV-antibody prevalence of 1.7%. Studies on HCV and migration in Spain were identified by systematically searching three databases from the first records to 30 November 2017, and consulting experts at the Ministry of Health and in the 17 Spanish autonomous communities. A meta-analysis was conducted to determine pooled HCV prevalence for the general migrant population. Prevalences were also calculated for high-risk migrant populations and populations who had undergone hospital screening, stratified by region of origin. Out of 243 studies identified, 26 met the eligibility criteria. The meta-analysis of the general migrant population found HCV antibody prevalence to be 1.6%. Migrants originating from European countries, including those at high or moderate risk for HCV, had the highest pooled prevalence (7.1%). In the general migrant population, prevalence was highest among sub-Saharan African migrants (3.1%) and lowest among Latin American migrants (0.2%). Based on the limited available data, the prevalence among the general migrant population was found to be the same as the general Spanish population. Further research is needed to more accurately determine HCV prevalence for the overall migrant population and specific migrant subpopulations with a higher risk in the country as a whole and in each of Spain's 17 autonomous communities. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Computerised sepsis protocol management. Description of an early warning system.

PubMed

de Dios, Begoña; Borges, Marcio; Smith, Timothy D; Del Castillo, Alberto; Socias, Antonia; Gutiérrez, Leticia; Nicolás, Jordi; Lladó, Bartolomé; Roche, Jose A; Díaz, Maria P; Lladó, Yolanda

2018-02-01

New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST. An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this. Of the 1,581 first consultations, 65.1% were solicited consultations (84.1% activation of PIMIS and 15.9% by telephone). The majority of unsolicited consultations were generated by the microbiology laboratory (95.2%), and 4.8% from the SIDCV. Referral from solicited consultations were generated sooner (5.63days vs 8.47days; P<.001) and came from clinical specialties rather than from the surgical ward (73.0% vs 39.1%; P<.001). A recommendation was made for antimicrobial prescription change in 32% of first consultations. The treating physician accepted 78.1% of recommendations. The high rate of solicited consultations and acceptance of recommended prescription changes suggest that a MST is seen as a helpful resource, and that PIMIS software is perceived to be useful and convenient to use, as it is the main source of referral. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Can we rely on the antiretroviral treatment as the only means for human immunodeficiency virusprevention? A Public Health perspective.

PubMed

Mozalevskis, Antons; Manzanares-Laya, Sandra; García de Olalla, Patricia; Moreno, Antonio; Jacques-Aviñó, Constanza; Caylà, Joan A

2015-11-01

The evidence that supports the preventive effect of combination antiretroviral treatment (cART) in HIV sexual transmission suggested the so-called 'treatment as prevention' (TAP) strategy as a promising tool for slowing down HIV transmission. As the messages and attitudes towards condom use in the context of TAP appear to be somehow confusing, the aim here is to assess whether relying on cART alone to prevent HIV transmission can currently be recommended from the Public Health perspective. A review is made of the literature on the effects of TAP strategy on HIV transmission and the epidemiology of other sexual transmitted infections (STIs) in the cART era, and recommendations from Public Health institutions on the TAP as of February 2014. The evolution of HIV and other STIs in Barcelona from 2007 to 2012 has also been analysed. Given that the widespread use of cART has coincided with an increasing incidence of HIV and other STIs, mainly amongst men who have sex with men, a combination and diversified prevention methods should always be considered and recommended in counselling. An informed decision on whether to stop using condoms should only be made by partners within stable couples, and after receiving all the up-to-date information regarding TAP. From the public health perspective, primary prevention should be a priority; therefore relying on cART alone is not a sufficient strategy to prevent new HIV and other STIs. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Trends and determinants factors of Chlamydia trachomatis genital infection in young people under 25 years. Catalonia 2007-2014].

PubMed

López-Corbeto, Evelin; González, Victoria; Bascunyana, Elisabeth; Humet, Victoria; Casabona, Jordi

2016-10-01

Chlamydia trachomatis (chlamydia) infection is the most common bacterial sexually transmitted diseases (STD). However, the prevalence among young people is unknown in our country. In 2007, the monitoring of the prevalence and behaviours related to acquiring it began in Catalonia in young people ≤25years. To determine and monitor the prevalence and determining factors of chlamydia among a young sexually active population ≤25years, treated in sexual and reproductive health care centras (CT/NG-ASSIR) and in prisons (CT/NG-Prisons). An analysis was performed on 6 cross-sectional data studies in two sentinel populations of young people from the period 2007-2014. Behavioural indicators were recorded and urine specimens were collected for analysis by PCR. The prevalence and trends are described, and the variables associated with infection were evaluated using multivariate logistic regression analysis. The mean prevalence for CT/NG-ASSIR was 7.4%, with an upward trend (P=.174), and an increase of 46.5%. CT/NG-Prisons had a mean 8.0%, with an upward trend (P=.282), and an increase of 31.6%. Age and foreign origin are presented as risk factors in both populations. The concurrent sexual partners added to CT/NG-ASSIR and the time spent in prison to CT/NG-Prisons. The results underscore the need for a more efficient approach to control activities related to chlamydia infection in Catalonia. Policies need to be strengthened to promote safer sexual behaviours and active case finding by opportunistic screening in less than 25year-old. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[How is the implementation of the new legal framework for health care affecting HIV-infected immigrants in an irregular situation in Spain?].

PubMed

Pérez-Molina, José A; Pulido, Federico

2015-01-01

The entry into force of Royal Decree (RD) 16/2012 in Spain in September 2012 led to the exclusion of the group of irregular immigrants from the National Healthcare System. With this work, GESIDA attempts to measure the impact of the entry into force of the RD in relation to its application by the Autonomous Communities (CCAA), and how it has affected the health care of irregular immigrants infected with HIV. Information was requested from the 17 CCAA of the existence of measures to ensure the care and treatment of people with HIV infection that were left unprotected because of the implementation of the RD. Likewise, a survey was conducted on health professionals and NGOs involved in the care of these people, to find out how it has affected the implementation of the RD to their daily healthcare work and the availability of information on regulations to implement it. The response of the CCAA was variable, hardly contributing, in some cases, to mitigate the negative effect of the RD. To this is added a complex bureaucracy to access the benefits offered by some regions, often inaccessible to the most vulnerable subjects. Lack of information for health-care professionals and NGOs involved in the care of immigrants, hinders access of this population to health care and the establishment of control measures for diseases with an impact on the public health. The RD 16/2012 has had a negative impact on daily healthcare working, generating the appearance of deep inequities throughout the country. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Factors determining irregular attendance to follow-up visits among human immunodeficiency virus patients: results of the hospital survey of patients infected with human immunodeficiency virus].

PubMed

Diaz, Asuncion; Ten, Alicia; Marcos, Henar; Gutiérrez, Gonzalo; González-García, Juan; Moreno, Santiago; Barrios, Ana María; Arponen, Sari; Portillo, Álvaro; Serrano, Regino; García, Maria Teresa; Pérez, José Luis; Toledo, Javier; Royo, Maria Carmen; González, Gustavo; Izquierdo, Ana; Viloria, Luis Javier; López, Irene; Elizalde, Lázaro; Martínez, Eva; Castrillejo, Daniel; Aranguren, Rosa; Redondo, Caridad; Diez, Mercedes

2015-05-01

To describe the occurrence of non-regular attendance to follow-up visits among HIV patients and to analyze the determining factors. One-day survey carried out annually (2002-2012) in public hospitals. Epidemiological, clinical and behavioral data are collected in all HIV-infected inpatients and outpatients receiving HIV-related care on the day of the survey. "Non-regular attendance to a follow-up visit" was defined as sporadic attendance to the medical appointments, according to the judgment of the attending physician. Descriptive and bivariate analyses were performed, and factors associated to non-regular attendance to follow-up visits were estimated using logistic regression. A total of 7,304 subjects were included, of whom 13.7% did not attend medical appointments regularly. Factors directly associated with non-regular attendance were: age between 25-49 years; birth in Sub-Saharan Africa or Latin-America; low educational level; being homeless or in prison; living alone or in closed institutions; being unemployed or retired; being an intravenous drug user; not using a condom at last sexual encounter, and injecting drugs in the last 30 days. Conversely, HIV diagnosis within the last year and being men who have sex with men were factors inversely associated with non-regular attendance to follow-up visits. In spite of health care beings free of charge for everyone in Spain, social factors can act as barriers to regular attendance to medical appointments, which, in turn, can endanger treatment effectiveness in some population groups. This should be taken into account when planning HIV policies in Spain. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Changes in the etiology, incidence and prognosis of acute lower respiratory track infections in human immunodeficiency virus patients.

PubMed

Perelló, Rafael; Escoda, Ona; Camón, Silvia; Miró, Òscar; Castañeda, Marta; Moreno, Asunción; Marcos, Maria Ángeles; Perea, Verónica; Alcolea, Natalia; Sánchez, Miquel; Gatell, Josep Maria; Martínez, Esteban

2015-04-01

To describe the incidence, the changes in the etiology and the prognosis of lower respiratory tract infection (LRTI) in HIV infected patients, presenting by the first time to the Emergency Department (ED), during years 2000-2010. Prospective collection of data. Data were collected on the first visit of HIV-infected patients at our ED due to a LRTI, (defined according to the criteria of the European Respiratory Society), between 1/1/2000 and 31/12/2010. A series of epidemiological and laboratory variables as well as the need for admission to the intensive care unit (ICU). LRTI etiology were also collected. The influence ofthe mentioned variables on 30-day mortality were analyzed. One hundred thirty one patients were included. LRTI represented 27% of visits to the ED by HIV-infected patients. Mean age was 39±9 years. 72% of patients were males. 18% required admission to the ICU. The most frequent LRTI was pneumonia by P. jiroveci in 35 cases, bacterial penumonia in 27 and pulmonary tuberculosis in 20. LRTI incidence gradually reduced significantly over time from 6.13 × 1000 patients/year in year 2000 to 0.23 × 1000 patients/year in 2010 (p<0.05). Overall mortality was 14%. Logistic regression analysis showed that admission to ICU (p<0.004) and viral load (p<0.029) were independent variables predicting mortality. LRTI is a pathology with a decreasing incidence, probably related to the widespread utilization increased of HAART regimens. lts etiology has also been changing, but with a non negligible mortality, mostly when ICU admission was required. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Correlation of inflammatory and cardiovascular biomarkers with pneumonia severity scores.

PubMed

Lacoma, Alicia; Bas, Albert; Tudela, Pere; Giménez, Montse; Mòdol, Josep Maria; Pérez, Miguel; Ausina, Vicente; Dominguez, Jose; Prat-Aymerich, Cristina

2014-03-01

To assess the correlation of procalcitonin (PCT), C-reactive protein (CRP), neopterin, mid-regional pro-atrial natriuretic peptide (MR-proANP), and mid-regional pro-adrenomedullin (MR-proADM) with severity risk scores: severe CAP (SCAP) and SMART-COP in patients with community-acquired pneumonia (CAP), as well as short term prognosis and to determine the correlation with mortality risk scores. Eighty-five patients with a final diagnosis of pneumonia were consecutively included during a two month period. Epidemiological, clinical, microbiological, and radiological data were recorded. Patients were stratified according to the PSI, CURB-65, SCAP and SMART-COP. Complications were defined as respiratory failure/shock, need of ICU, and death. Plasma samples were collected at admission. MR-proANP and MR-proADM showed significantly higher levels in high risk SCAP group in comparison to low risk. When considering SMART-COP none of the biomarkers showed statistical differences. MR-proADM levels were high in patients with high risk of needing intensive respiratory or vasopressor support according to SMRT-CO. Neopterin and MR-proADM were significantly higher in patients that developed complications. PCT and MR-proADM showed significantly higher levels in cases of a definite bacterial diagnosis in comparison to probable bacterial, and unknown origin. MR-proANP and MR-proADM levels increased statistically according to PSI and CURB-65. Biomarker levels are higher in pneumonia patients with a poorer prognosis according to SCAP and SMART-COP indexes, and to the development of complications. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Dermatological manifestations in onchocerciasis: A retrospective study of 400 imported cases.

PubMed

Puente, Sabino; Ramirez-Olivencia, German; Lago, Mar; Subirats, Mercedes; Perez-Blazquez, Eugenio; Bru, Fernando; Garate, Teresa; Vicente, Belén; Belhassen-Garcia, Moncef; Muro, Antonio

2017-12-20

Onchocerciasis is caused by Onchocerca volvulus and mainly leads to pruritus and skin and visual disorders, including blindness. Seventeen million people are infected in 38 countries; 31 of these are in sub-Saharan Africa, six in Latin America and one on the Arabian Peninsula. More than 99% of cases occur in sub-Saharan Africa where 120 million people are at risk of infection. Eye disorders have been well-documented; however, skin disorders have not been described accurately. The objective of our study was to describe the epidemiology, main skin manifestations and treatment of imported onchocerciasis. A retrospective study was thus conducted by analysing the main demographic, clinical and treatment data regarding a cohort of 400 patients attending a reference clinical unit over a 17-year period. Most patients were female (55%) with mean age 37.5±16.7 years. All the migrants came from sub-Saharan countries. The most frequently occurring dermatological symptom was pruritus. Ivermectin had been used as first-line therapy and adverse reactions had been described in 11 patients (3.2%). The results indicate the fact that there should be a clinical suspicion of onchocerciasis regarding immigrants from endemic areas having skin lesions compatible with the disease's profile or asymptomatic patients having eosinophilia or unexplained high IgE. Moreover, skin snips from the buttocks region were very fruitful and treatment with ivermectin was seen to be safe. This is the largest case series regarding imported onchocerciasis described up to the present time. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Assessment of anaerobic blood cultures in pediatric oncology patients.

PubMed

Monsonís Cabedo, Manuel; Rives Solá, Susana; Noguera-Julian, Antoni; Urrea Ayala, Mireia; Cruz Martinez, Ofelia; Gené Giralt, Amadeu

2017-01-01

The routine use of a single aerobic bottle for blood culture in pediatric patients has become commonplace, as anaerobic bacteria are not frequently involved in clinically significant infections. The aim of this study was to assess the usefulness of routinely performing anaerobic blood cultures in pediatric oncology patients. Prospective study was conducted on pediatric (<18 years) patients affected with febrile syndrome after receiving chemotherapy for hematological or solid malignancies. Samples were inoculated into pediatric aerobic and standard anaerobic bottles (BacT/Alert automatic system). Strains were considered clinically significant, or deemed as contaminants, depending on isolation circumstances and clinical criteria. A total of 876 blood cultures from 228 patients were processed during the 21-month study period (January 2014 to September 2015). Baseline diagnosis included 143 solid tumors and 67/18 cases of leukemia/lymphoma. Bacterial growth was detected in 90 (10.2%) blood cultures for 95 different isolates, of which 62 (7.1%)/63 isolates were considered clinically significant. Among the latter, 38 (60.3%) microorganisms grew in both aerobic and anaerobic bottles, 18 (28.6%) only in aerobic bottles, and 7 (11.1%) only in anaerobic bottles. Gram-negative bacilli (33; 52.4%), mainly from the Enterobacteriaceae family, were the most frequently isolated microorganisms. Overall, only 3 out of 90 isolates (3.3%) were strict anaerobes (Propionibacterium acnes), and all of them were deemed contaminants. Strict anaerobes did not cause significant infections in febrile pediatric oncology patients, and anaerobic blood culture bottles offered no additional advantages over aerobic media. Our results suggest that routine blood cultures should be solely processed in aerobic media in this group of patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Community-acquired bacterial pneumonia in human immunodeficiency virus-infected patients: validation of severity criteria. The Grupo Andaluz para el Estudio de las Enfermedades Infecciosas.

PubMed

Cordero, E; Pachón, J; Rivero, A; Girón, J A; Gómez-Mateos, J; Merino, M D; Torres-Tortosa, M; González-Serrano, M; Aliaga, L; Collado, A; Hernández-Quero, J; Barrera, A; Nuño, E

2000-12-01

Severity criteria for community-acquired pneumonia (CAP) have always excluded patients with human immunodeficiency virus (HIV) infection. A 1-yr, multicenter, prospective observational study of HIV-infected patients with bacterial CAP was done to validate the criteria used in the American Thoracic Society (ATS) guidelines for CAP, and to determine the prognosis-associated factors in the HIV-infected population with bacterial CAP. Overall, 355 cases were included, with an attributable mortality of 9.3%. Patients who met the ATS criteria had a longer hospital stay (p = 0.01), longer duration of fever (p < 0.001), and higher attributable mortality (13.1% versus 3.5%, p = 0.02) than those who did not. Three factors were independently related to mortality: CD4(+) cell count < 100/microl, radiologic progression of disease, and shock. Pleural effusion, cavities, and/or multilobar infiltrates at admission were independently associated with radiologic progression. A prognostic rule based on the five criteria of shock, CD4(+) cell count < 100/microl, pleural effusion, cavities, and multilobar infiltrates had a high negative predictive value for mortality (97.1%). The attributable mortality for severe pneumonia was 11.3%, as compared with 1.3% for nonsevere disease (p = 0.008). The ATS severity criteria are valid in HIV-infected patients with bacterial CAP. Our study provides the basis for identification of patients who may require hospitalization determined by clinical judgment and the five clinical criteria of shock, a CD4(+) cell count < 100/microl, pleural effusion, cavities, and multilobar involvement. These prognostic factors should be validated in independent cohort studies.

Executive summary of imported infectious diseases after returning from foreign travel: Consensus document of the Spanish Society for Infectious Diseases and Clinical Microbiology (SEIMC).

PubMed

Pérez-Arellano, José Luis; Górgolas-Hernández-Mora, Miguel; Salvador, Fernando; Carranza-Rodríguez, Cristina; Ramírez-Olivencia, Germán; Martín-Echeverría, Esteban; Rodríguez-Guardado, Azucena; Norman, Francesca; Velasco-Tirado, Virginia; Zubero-Sulibarría, Zuriñe; Rojo-Marcos, Gerardo; Muñoz-Gutierrez, José; Ramos-Rincón, José Manuel; Sánchez-Seco-Fariñas, M Paz; Velasco-Arribas, María; Belhassen-García, Moncef; Lago-Nuñez, Mar; Cañas García-Otero, Elías; López-Vélez, Rogelio

2018-03-01

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)].

PubMed

López, Cristina; Masiá, Mar; Padilla, Sergio; Aquilino, Ana; Bas, Cristina; Gutiérrez, Félix

2016-04-01

The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; P<.001) and higher mortality from NAEs (68% vs 45%; P=.006). There was a very sharp increase in non-AIDS-defining cancers (18.5% vs 2.1%, p=001), and increased deaths from cardiovascular disease (9.2% vs 2.1%, P=.06). Patients who died in the second period were older, and had a better immunological and virological status at cohort entry and before death. They received antiretroviral therapy (ART) more often and were more often virologically suppressed before death (61.5% vs 24%; P=.001). Non-AIDS-defining cancers, unnatural deaths, and cardiovascular diseases are now major causes of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Perspective of Spanish medical students regarding undergraduate education in infectious diseases, bacterial resistance and antibiotic use.

PubMed

Sánchez-Fabra, David; Dyar, Oliver J; Del Pozo, José Luis; Amiguet, Juan Antonio; Colmenero, Juan de Dios; Fariñas, María Del Carmen; López-Medrano, Francisco; Portilla, Joaquín; Praena, Julia; Torre-Cisneros, Julián; Rodríguez-Baño, Jesús; Pulcini, Céline; Paño-Pardo, José Ramón

2018-02-08

One of the main tools to optimize antibiotics use is education of prescribers. The aim of this article is to study undergraduate education in the field of infectious diseases, antimicrobial resistance and antibiotic stewardship from the perspective of Spanish medical students. An anonymous online questionnaire was distributed among sixth grade students using different channels in Europe, within the ESGAP Student-Prepare survey. The questionnaire included 45 questions about knowledge, attitudes and perceptions about diagnosis, bacterial resistance, use of antibiotics and undergraduate training in infectious diseases. We present here the Spanish results. A total of 441 surveys were received from 21 medical schools. A total of 374 responses (84.8%) were obtained from the 8 most represented faculties, with a response rate of 28.9%. Most students felt adequately prepared to identify clinical signs of infection (418; 94.8%) and to accurately interpret laboratory tests (382; 86.6%). A total of 178 (40.4%) acknowledged being able to choose an antibiotic with confidence without consulting books or guidelines. Only 107 (24.3%) students considered that they had received sufficient training in judicious use of antibiotics. Regarding learning methods, the discussion of clinical cases, infectious diseases units rotatories and small group workshops were considered the most useful, being evaluated favorably in 76.9%, 76% and 68.8% of the cases. Medical students feel more confident in the diagnosis of infectious diseases than in antibiotic treatment. They also feel the need to receive more training in antibiotics and judicious antibiotic use. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Adapting immunisation schedules for children undergoing chemotherapy.

PubMed

Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen

2018-02-01

Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Identification of mycobacteria to the species level by molecular methods in the Public Health Laboratory of Bogotá, Colombia].

PubMed

Hernández-Toloza, Johana Esther; Rincón-Serrano, María de Pilar; Celis-Bustos, Yamile Adriana; Aguillón, Claudia Inés

2016-01-01

Global epidemiology of non-tuberculous mycobacteria (NTM) is unknown due to the fact that notification is not required in many countries, however the number of infection reports and outbreaks caused by NTM suggest a significant increase in the last years. Traditionally, mycobacteria identification is made through biochemical profiles which allow to differentiate M. tuberculosis from NTM, and in some cases the mycobacteria species. Nevertheless, these methods are technically cumbersome and time consuming. On the other hand, the introduction of methods based on molecular biology has improved the laboratory diagnosis of NTM. To establish the NTM frequency in positive cultures for acid-fast bacilli (AAFB) which were sent to Laboratorio de Salud Pública de Bogotá over a 12 month period. A total of 100 positive cultures for acid-fast bacilli from public and private hospitals from Bogotá were identified by both biochemical methods and the molecular methods PRA (PCR-restriction enzyme analysis) and multiplex-PCR. Furthermore, low prevalence mycobacteria species and non-interpretable results were confirmed by 16SrDNA sequentiation analysis. Identification using the PRA method showed NMT occurrence in 11% of cultures. In addition, this molecular methodology allowed to detect the occurrence of more than one mycobacteria in 4% of the cultures. Interestingly, a new M. kubicae pattern of PCR-restriction analysis is reported in our study. Using a mycobacteria identification algorithm, which includes the molecular method PRA, improves the diagnostic power of conventional methods and could help to advance both NTM epidemiology knowledge and mycobacteriosis control. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Group B streptococcal early-onset neonatal sepsis in the area of Barcelona (2004-2010). Analysis of missed opportunities for prevention].

PubMed

Giménez, Montserrat; Sanfeliu, Isabel; Sierra, Montserrat; Dopico, Eva; Juncosa, Teresa; Andreu, Antonia; Lite, Josep; Guardià, Cèlia; Sánchez, Ferran; Bosch, Jordi

2015-01-01

To study the evolution of the incidence of early-onset neonatal sepsis (EOS) by Streptococcus agalactiae in the area of Barcelona and to analyze failure of compliance with the prevention protocol. A retrospective review was carried out on EOS cases in 8 Health-Care Centers in the Barcelona area between 2004 and 2010. Forty-nine newborns from 48 mothers were diagnosed with EOS. The incidence was 0.29‰ living newborns (0.18-0.47‰), with no significant differences in the fluctuations along the 7 years. The mortality rate was 8.16%. In 68.5% cases the maternal colonization studies were negative, and in 21% these studies were not performed. No risk factors were detected in 58.3% of pregnant women, and 22.9% of births were premature. In 58% of cases intra-partum antibiotic prophylaxis was not administered because it was not indicated, and in 42% due to failure to follow the protocol (3 strains were resistant to erythromycin). Resistance to clindamycin was 33.3%. The Streptococcus agalactiae serotypes more frequently isolated were iii, v, and ia. No significant changes were detected in the incidence of Streptococcus agalactiae EOS in the 7 years of the study. The increased sensitivity of screening methods with the use of molecular techniques, the performance of susceptibility testing of strains isolated from pregnant women, and the improvement of communication between Health-Care Centers, can contribute to a better implementation of the protocol, as well as to reduce the incidence of EOS. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prevalence of anal infection due to high-risk human papillomavirus and analysis of E2 gene integrity among women with cervical abnormalities.

PubMed

Gonzalez-Losa, María Del Refugio; Puerto-Solís, Marylin; Ayora-Talavera, Guadalupe; Gómez-Carvallo, Jesús; Euán-López, Alejandra; Cisneros-Cutz, José I; Rosado-López, Ariel; Echeverría Salazar, Jesúa; Conde-Ferráez, Laura

2018-04-01

High-risk human papillomaviruses (HR-HPV) infection has been associated with 90% of anal cancer cases. Women with abnormal cytology are a high-risk group to develop anal neoplasia. The aim of this study is to describe the prevalence and epidemiology of HR-HPV 16, 18, 45, and 58 anal infections in women with cervical abnormalities, as well as to assess E2 gene integrity. A cross-sectional study was performed on 311 cervical and 311 anal samples from patients with abnormal cytology in two colposcopy clinics in Yucatan, Mexico. A specific PCR for oncogenes was performed in order to identify HVP 16, 18, 45 and 58. Real time PCR was used to amplify the whole HPV 16, 18, and 58 E2 gene to verify its integrity in anal samples. High risk HPV 16, 18, 58, and/or 45 were found in 41.47% (129/311) of cervical samples, and in 30.8% (96/331) of anal samples, with 18% (57/311) of the patients being positive in both samples. The same genotypes in both anatomical sites were observed in 11.25% (35/311). The E2 gene was disrupted in 82% of all tested samples. The frequency of genome disruption viral integration in anal samples by genotype was: HPV 58 (97.2%); HPV 16 (72.4%), and HPV 18 (0%). Women with cervical disease have HR-HPV anal infections, and most of them have the E2 gene disrupted, which represents a risk to develop anal cancer. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Community-acquired febrile urinary tract infection caused by extended-spectrum beta-lactamase-producing bacteria in hospitalised infants.

PubMed

Hernández Marco, Roberto; Guillén Olmos, Elena; Bretón-Martínez, José Rafael; Giner Pérez, Lourdes; Casado Sánchez, Benedicta; Fujkova, Julia; Salamanca Campos, Marina; Nogueira Coito, José Miguel

2017-05-01

Extended-spectrum beta-lactamase (ESBL) producing bacteria are infrequent pathogens of urinary tract infections in children. The objective of our study was to investigate the presence, clinically associated characteristics and risk factors for acquisition of urinary tract infection/acute pyelonephritis (UTI/APN) in hospitalised children <2years old caused by community-acquired ESBL. A case-control study in a second level community hospital in Spain, in which 537 episodes of UTI/APN were investigated in a retrospective study between November 2005 and August 2014. Cases were patients with ESBL strains. For each case, four ESBL-negative controls were selected. A questionnaire with the variables of interest was completed for every patient, and the groups were compared. ESBL-positive strains were found in 19 (3,5%) cultures. Of these 16 (84%) were Escherichia coli. Vesicoureteral reflux (VUR) of any grade was more frequent in the ESBL group (60 vs. 29%), although without statistical significance. Relapses were more frequent in the ESBL group (42% vs. 18%) (P=.029; OR=3.2; 95%CI: 1.09-9.5). The prevalence of UTI/APN due to ESBL-positive strains increased slightly from 2.7% in the period 2005-2009 to 4.4% in the period 2010-2014. ESBL UTI/APN were associated with more frequent relapses. VUR of any grade was twice more frequent in the ESBL group. Piperacillin/tazobactam, fosfomycin and meropenem showed an excellent activity. Aminoglycosides may be a therapeutic option, and in our patients gentamicin was the antibiotic most used. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Evaluation of a commercial multiplex PCR (Unyvero i60®) designed for the diagnosis of bone and joint infections using prosthetic-joint sonication.

PubMed

Prieto-Borja, Laura; Rodriguez-Sevilla, Graciela; Auñon, Alvaro; Pérez-Jorge, Concepción; Sandoval, Enrique; Garcia-Cañete, Joaquín; Gadea, Ignacio; Fernandez-Roblas, Ricardo; Blanco, Antonio; Esteban, Jaime

2017-04-01

The development of sonication protocols over the last few years has improved the sensitivity of conventional cultures for the diagnosis of prosthetic-joint infection (PJI). However, the development of a new, specifically designed kit for the molecular diagnosis of PJI could provide a major improvement in this field. Prostheses retrieved from patients who underwent implant removal from May 2014 to May 2015 were sent for culture, and processed according to a previously defined protocol that included sonication. Furthermore, 180 microlitres of sonication fluid were used to carry out the multiplex PCR test (Unyvero i60 system ® ). A comparison of the sensitivity, specificity, positive (PPV) and negative (NPV) predictive value, was performed. The study was approved by the Clinical Research Ethics Committee. The analysis included 88 prostheses from 68 patients (1.29 prostheses/patient). The type of prostheses studied were knee (n=55), total hip (n=26), partial hip (n=5), and shoulder (n=2). Twenty-nine patients were diagnosed with a PJI (15 delayed, 12 acute, and 2 haematogenous infections). In 24 cases, the result of the PCR was positive, all but 1 corresponding to patients with clinical criteria of PJI. Nine resistance mechanisms were detected from 5 samples. The Unyvero i60 system ® showed slightly better results than traditional culture in terms of specificity and PPV. The Unyvero i60 system ® may play a role in rapid diagnosis of PJI, due to its high specificity and PPV. However, despite these results, cultures have to be performed to detect organisms not detected by the system. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission].

PubMed

Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernández, Antonio; Péres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, María Carmen; González Tomé, María Isabel

2014-05-01

The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.). Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Predictive factors of bacterial meningitis in the patients seen in emergency departments.

PubMed

Morales-Casado, María Isabel; Julián-Jiménez, Agustín; Lobato-Casado, Paula; Cámara-Marín, Belén; Pérez-Matos, Julio Alberto; Martínez-Maroto, Tamara

2017-04-01

To analyse and compare predictive factors of bacterial meningitis in the patients seen in the Emergency Departments (ED) due to an episode of acute meningitis (AM). A prospective, observational study was carried out in patients aged 15 years and older seen in ED due to AM between August 2009 and November 2015. Thirty-two variables for predicting bacterial meningitis were assessed. They covered epidemiological, comorbidity, clinical and analytical factors. Multivariate logistic regression analysis was performed. The study included 154 patients. The diagnosis was bacterial meningitis in 53 (34.4%) patients. Four variables were significantly associated with bacterial aetiology: cerebrospinal fluid (CSF) lactate concentration ≥33mg/dl (odds ratio [OR] 50.84; 95% confidence interval [CI]: 21.63-119.47, P<.001), serum procalcitonin (PCT) ≥0.8ng/ml (OR 46.34; 95%CI: 19.71-108.89; P<.001), CSF glucose <60% of blood value (OR 20.82; 95%CI: 8.86-48.96; P=.001), CSF polymorphonuclears greater than 50% (OR 20.19; 95%CI: 8.31-49.09; P=.002]. The area under the curve for the model serum PCT≥0.8ng/ml plus CSF lactate ≥33mg/dl was 0.992 (95%CI: 0.979-1; P<.001), and achieved 99% sensitivity and 98% specificity for predicting bacterial meningitis. Serum PCT with CSF lactate, CSF glucose and CSF polymorphonuclears evaluated in an initial assessment in the ED for patients with AM, achieved an excellent diagnostic usefulness for predicting bacterial meningitis. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Screening for parasite infections in immigrant children from low-income countries.

PubMed

Belhassen-García, Moncef; Pardo-Lledías, Javier; Pérez Del Villar, Luis; Velasco-Tirado, Virginia; Siller Ruiz, María; Cordero-Sánchez, Miguel; Vicente, Belen; Hernández Egido, Sara; Muñoz Bellido, Juan Luis; Muro, Antonio

2017-01-01

In Spain, minors represent approximately 20% of the immigration flow. Many of these immigrants come from countries in the tropics and sub-tropics where intestinal parasitic infections caused by helminths and protozoa are one of the major causes of human disease. The main objective of the present work was to describe parasite infections in a group of immigrant children. A prospective evaluation was performed in 373 minors from Sub-Saharan Africa, North Africa, and Latin America. Details were collected from the medical records and physical examination. Urine, stool and peripheral blood samples were obtained for serological and routine laboratory tests. Direct and indirect parasitological tests were also performed. At least 1 parasitic disease was diagnosed in 176 (47.1%) immigrant children, while 77 (20.6%) minors were infected with two or more parasites. The number of parasites was highest in children from Sub-Saharan Africa compared with the rest of the areas of origin (p<.001), and in children from urban areas compared with those from rural areas (OR 1.27 [1.059-1.552], p=.011). The most frequent causes of multiple parasite infection were filariasis plus strongyloidiasis and filariasis plus schistosomiasis. Intestinal parasite infection was diagnosed in 38 cases (13.8%). Logistic regression analysis revealed that for each month of stay, the probability of a positive finding in the stool sample decreased by 0.02% [β=-0.020, (p=.07)]. The high infection rates of parasite diseases in immigrant children point to the need for screening protocols for certain infectious diseases in these children according to their country of origin and their length of residence in Spain. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Validation and verfication of microbiology methods].

PubMed

Camaró-Sala, María Luisa; Martínez-García, Rosana; Olmos-Martínez, Piedad; Catalá-Cuenca, Vicente; Ocete-Mochón, María Dolores; Gimeno-Cardona, Concepción

2015-01-01

Clinical microbiologists should ensure, to the maximum level allowed by the scientific and technical development, the reliability of the results. This implies that, in addition to meeting the technical criteria to ensure their validity, they must be performed with a number of conditions that allows comparable results to be obtained, regardless of the laboratory that performs the test. In this sense, the use of recognized and accepted reference methodsis the most effective tool for these guarantees. The activities related to verification and validation of analytical methods has become very important, as there is continuous development, as well as updating techniques and increasingly complex analytical equipment, and an interest of professionals to ensure quality processes and results. The definitions of validation and verification are described, along with the different types of validation/verification, and the types of methods, and the level of validation necessary depending on the degree of standardization. The situations in which validation/verification is mandatory and/or recommended is discussed, including those particularly related to validation in Microbiology. It stresses the importance of promoting the use of reference strains as controls in Microbiology and the use of standard controls, as well as the importance of participation in External Quality Assessment programs to demonstrate technical competence. The emphasis is on how to calculate some of the parameters required for validation/verification, such as the accuracy and precision. The development of these concepts can be found in the microbiological process SEIMC number 48: «Validation and verification of microbiological methods» www.seimc.org/protocols/microbiology. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Epidemiology of measles in vaccinated people, Spain 2003-2014.

PubMed

Risco-Risco, Carlos; Masa-Calles, Josefa; López-Perea, Noemí; Echevarría, Juan Emilio; Rodríguez-Caravaca, Gil

2017-11-01

During the final phase of measles elimination rigorous investigation of each individual case becomes fundamental to confirm or discard cases, particularly among vaccinated people, since they experience a milder disease, and laboratory diagnosis is more complex. Our study focused in the epidemiology of measles in vaccinated people. Longitudinal study on measles cases in two dose vaccinated people in Spain from 2003 to 2014. We confirmed 138 measles cases (90 of them, laboratory confirmed) in people with two doses of vaccine. The median of time from last vaccination to rash onset showed a lineal trend (P<.001), in parallel with the number of doses of vaccine received (0, 1, 2 doses). Among confirmed cases, the hospitalization risk decreased inversely proportional to the number of administered vaccine doses (linear trend, P<.001). Only in 23.9% of confirmed cases and 50% of discarded cases the guidelines about sample taking were fulfilled. 50% of samples in two dose vaccinated people were taken without fulfilling time delay criteria. 16.7% (36/215) of discarded cases with a negative IgM result did correspond to samples taken early (first 72h after rash) and could represent false negatives. Our results highlight the importance of fulfilling properly the guidelines for laboratory diagnosis in order to confirm or discard every measles case, especially in two dose vaccinated people. When a negative IgM result is obtained in early samples a new IgM test should be practiced, as well as a PCR test, in order to avoid infra-detection of cases. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Use of procalcitonin and C-reactive protein as infection markers in febrile neutropenic patients undergoing haematopoietic stem cell transplant].

PubMed

Sánchez-Yepes, Marina; Aznar-Oroval, Eduardo; Lorente-Alegre, Pablo; García-Lozano, Tomás; Picón-Roig, Isabel; Pérez-Ballestero, Pilar; Ortiz-Muñoz, Blanca

2014-01-01

Neutropenia is a frequent sign in patients who are going to have a haematopoietic stem cell transplant (HSCT). Infection is an important complication in these patients, which is favoured by immunosuppression and the degree of neutropenia. This study aims to evaluate the diagnostic usefulness of procalcitonin (PCT) and C-reactive protein (CRP) in onco-haematological patients undergoing chemotherapy and HSCT to determine the origin of the fever. PCT and CRP values were measured in 30 episodes of febrile neutropenia: before starting chemotherapy, appearance of neutropenia, onset of fever, days 1, 2, 3 and 6 after the onset of fever, and when the febrile episode ended. The episodes were classified as 5 bacteraemia, 3 microbiologically documented infections, 10 clinical infections, and 12 fevers of unknown origin. The highest PCT mean values corresponded to the group of patients with bacteraemia. Statistically significant differences (P=.04) were found on the second day after the onset of fever. The cut-off point of 0.5ng/ml showed a sensitivity of 66% and a specificity of 75%. PCR results showed statistically significant differences on days 1, 2 and 3 after the onset of fever (P=.01, P=.003, and P=.002, respectively). The cut-off point of 7.5mg/L had a sensitivity of 88% and a specificity of 58%. The combination of PCT and CRP is an insufficient method to detect bacterial infections and may not replace the proper clinical and microbiological diagnosis. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Evaluation of an antibody avidity index method for detecting recent human immunodeficiency virus type 1 infection using an automated chemiluminescence immunoassay.

PubMed

Fernández, Gema; Manzardo, Christian; Montoliu, Alexandra; Campbell, Colin; Fernández, Gregorio; Casabona, Jordi; Miró, José Maria; Matas, Lurdes; Rivaya, Belén; González, Victoria

2015-04-01

Recent infection testing algorithms (RITAs) are used in public health surveillance to estimate the incidence of recently acquired HIV-1 infection. Our aims were (i) to evaluate the precision of the VITROS® Anti-HIV 1+2 automated antibody avidity assay for qualitative detection of antibodies to HIV 1+2 virus; (ii) to validate the accuracy of an automated guanidine-based antibody avidity assay to discriminate between recent and long standing infections using the VITROS 3600 platform; (iii) to compare this method with BED-CEIA assay; and (iv) to evaluate the occurrence of false recent misclassifications by the VITROS antibody avidity assay in patients with a CD4 count <200 cells/μL and in patients on combination antiretroviral therapy (cART). The VITROS® antibody avidity assay is highly reproducible. The ROC curve analysis of the accuracy of this assay, optimized for sensitivity and specificity, had an AI cut off of ≤0.51, with sensitivity and specificity values of 86.67% (95% CI: 72.51-94.46) and 86.24% (95% CI: 78.00-91.84), respectively. The agreement between VITROS antibody avidity and BED-CEIA assays was good. Misclassifications of long standing infections as recent infection occurred in 8.2% of patients with CD4 <200 cell/μL and 8.7% in patients on combination antiretroviral therapy. The VITROS antibody avidity assay is a reliable serological method to detect recent HIV-1 infections and it could be incorporated into a RITA to estimate HIV incidence. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Paediatric invasive pneumococcal disease on the island of Gran Canaria: 16-year prospective study (2001-2016).

PubMed

Santana Hernández, Milagrosa; Aguiar-Santana, Ione Ahedey; Artiles Campelo, Fernando; Colino Gil, Elena

2017-11-24

To calculate the incidence of invasive pneumococcal disease (IPD) in the paediatric population of Gran Canaria (Spain), its clinical and epidemiological characteristics, serotype distribution, antibiotic resistance, and variations in these variables before and after the introduction of the PCV13 vaccine. Prospective hospital-based study including all patients (190) aged 0-14 years admitted with confirmed IPD between January 2001-May 2010 (152 cases) and June 2010-December 2016 (38 cases). Patients were divided into 3 age groups (<2 years; 2-5 years; and >5 years). Clinical symptoms were mutually-exclusively classified as meningitis, bacteraemic pneumonia, pleural effusion (PE), empyema or bacteraemia without a focus. Most cases occurred in boys (59.47%), during autumn-winter (65.79%), in children aged <2 years (55.79%) and with mean age increasing from the pre-PCV13 to the post-PCV13 period (2.5 vs 3.1 years). Incidence between periods reduced by 66.4% (p<0.001): from 13.1/100,000 to 4.4/100,000. PEs (3.9% vs 18.4%, p<0.005) and empyemas (1.5% vs 16.7%, p=NS) increased in the post-PCV13 period whereas all other symptoms decreased, although this was not statistically significant. Vaccine serotypes (77% vs 40.6%, p=0.000), particularly serotypes 19A (23.9% vs 12.5%) and 14 (14.2% vs 9.4%), as well as erythromycin resistance (57.2% vs 7.9%, p=0.000) decreased in the post-PCV13 period. IPD incidence, vaccine serotypes and erythromycin resistance decreased in the post-PCV13 period whereas PEs increased. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Lactancia Materna y VIH/SIDA

PubMed Central

Valeria Cortés, F.; Jaime Pérez, A.; Lilian Ferrer, L.; Rosina Cianelli, A.; Báltica Cabieses, V.

2009-01-01

Resumen VIH/SIDA es una pandemia que afecta a hombres, mujeres y niños, pero que presenta una tendencia hacia la feminización, afectando especialmente a mujeres jóvenes. Su consecuencia es el aumento de la transmisión vertical, durante el embarazo, parto o lactancia materna. Este estudio bibliográfico describe la relación entre VIH/SIDA y lactancia materna, explicitando factores que influyen en la elección de la modalidad de alimentación de madres viviendo con VIH/SIDA. Se describen causas de morbimortalidad infantil asociada y recomendaciones internacionales de lactancia en mujeres con VIH/SIDA. En un mundo globalizado con constantes migraciones poblacionales, estos resultados representan un llamado de atención para profesionales de salud quienes deben considerar factores sociales que influenciarán la toma de decisión de madres viviendo con VIH/SIDA al escoger la modalidad de lactancia. No sólo basta conocer el riesgo de transmisión vertical, sino que se debe tomar conciencia de aquellos factores dinámicos y específicos de cada comunidad. PMID:20046815

The Douro estuarine plume: Detection, processes and dynamics =

NASA Astrophysics Data System (ADS)

Mendes, Renato Paulo dos Santos

O Douro e um dos maiores rios da Peninsula Iberica, constituindo a maior descarga de agua doce para o Oceano Atlântico na costa noroeste portuguesa. A sua pluma estuarina tem particular relevância na dinâmica costeira e na modulacao de fenomenos biogeoquimicos. Sao objetivos desta dissertacao contribuir para a compreensao dos processos fisicos associados a geracao e propagacao da pluma estuarina do Rio Douro no oceano, assim como para o conhecimento dos seus padroes de dispersao e da forma como estes alteram a hidrologia e a circulacao costeira, considerando os agentes forcadores tipicos deste fenomeno (caudal fluvial, vento e mare) e indices climaticos relevantes. Para concretizacao destes objetivos foram desenvolvidas e aplicadas metodologias inovadoras de processamento de dados de detecao remota, assim como novas implementacoes estuarinas e costeiras de modelos numericos. Atraves de imagens MODIS, otimizadas para o estudo de fenomenos costeiros, efetuou-se uma detecao rigorosa da pluma. Identificou-se uma relacao entre o sinal turbido nLw555 e o caudal, demonstrando-se este produto como um bom proxy para a observacao da pluma no oceano. As escalas temporais e espaciais da pluma foram caraterizadas atraves destas imagens, combinadas com dados de caudal fluvial, mare, vento e precipitacao, e tambem com indices climaticos relevantes. Para compreender a propagacao da pluma e caracterizar a sua dinâmica e impacto na circulacao costeira, foi desenvolvida uma aplicacao 3D de modelos estuarinos e costeiros com malhas aninhadas de resolucao variavel. Definiramse e analisaram-se diferentes cenarios de vento e descarga fluvial. A interacao da pluma do Rio Douro e do Minho foi ainda analisada atraves dos resultados de simulacoes baseadas num evento de inverno. Os compositos turbidos mostraram que a pluma e facilmente detetada quando o caudal e maior que 500 m3 s??1. A descarga fluvial e o vento sao os principais forcadores da sua propagacao, enquanto a mare e apenas importante na regiao proxima a embocadura do estuario. Observaram-se relacoes a uma escala interanual entre a turbidez da pluma e os indices climaticos East Atlantic e NAO, com uma correlacao maxima identificada com 1 e 3 meses de desfasamento, respetivamente. Com base nos resultados das simulacoes efetuadas, a pluma e classificada como de larga escala e de advecao superficial, apresentando caracteristicas de uma pluma prototipica. Em condicoes de caudal moderado a elevado, a descarga estuarina e suficiente para gerar uma corrente costeira para norte sem acao do vento. Em eventos de ventos leste, a propagacao da pluma e similar ao caso sem vento, com um aumento da velocidade da corrente. Uma corrente costeira para sul e unicamente identificada sob condicoes de forte vento de oeste. Ventos de norte tendem a estender a pluma para o largo, com uma inclinacao na direcao sudoeste, enquanto ventos de sul intensificam a corrente para norte, sendo a mistura das plumas do Douro e do Minho uma consequencia possivel. A analise desta interacao apontou a contribuicao do Douro como importante na estabilizacao da WIBP e nas trocas de agua entre o oceano e as Rias Baixas. A interacao da pluma do Douro com estuarios localizados a sul da sua foz e a confirmacao in situ da recirculacao observada nos resultados numericos afiguram-se como temas relevantes para investigacoes futuras. None

Patient safety and nursing: interface with stress and Burnout Syndrome.

PubMed

Rodrigues, Cláudia Cristiane Filgueira Martins; Santos, Viviane Euzébia Pereira; Sousa, Paulo

2017-01-01

To analyze studies on stress, Burnout Syndrome, and patient safety in the scope of nursing care in the hospital environment. This was an integrative literature review. Data collection was performed in February 2016 in the following databases: Medical Literature Analysis and Retrieval System Online - PubMed/MEDLINE, Latin American and Caribbean Literature in Health Sciences - LILACS. Ten scientific productions were selected, which listed that factors contributing to stress and Burnout Syndrome of nursing professionals are the work environment as a source of stress, and excessive workload as a source of failures. The analysis found that the stress and Burnout Syndrome experienced by these professionals lead to greater vulnerability and development of unsafe care, and factors such as lack of organizational support can contribute to prevent these failures. Analisar estudos que versam sobre o estresse e Síndrome de Burnout, bem como a segurança do paciente no âmbito da assistência de enfermagem no ambiente hospitalar. Tratou-se de uma revisão integrativa de literatura. O levantamento dos dados foi efetuado nas bases de dados Medical Literature Analysis and Retrieval System Online - PubMed / MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde -LILACS em fevereiro de 2016. Foram selecionadas10 produções científicas que apontaram que os fatores que contribuem para o estresse e a Síndrome de Burnout dos profissionais de enfermagem são o ambiente de trabalho como fonte de estresse e a carga de trabalho excessiva como geradora de falhas. A análise apontou que o estresse e a Síndrome de Burnout vivenciada por esses profissionais acarretam maior vulnerabilidade ao desenvolvimento de uma assistência insegura e que fatores como a falta de apoio organizacional podem contribuir para dirimir essas falhas.

XAS Study at Mo and Co K-Edges of the Sulfidation of a CoMo / Al2O3 Hydrotreating Catalyst

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pichon, C.; Gandubert, A. D.; Legens, C.

2007-02-02

Because of its impact on environment, the removal of sulfur is an indispensable step, called hydrotreatment, in the refining of petroleum. One of the most commonly used hydrotreating catalysts is CoMo-type catalyst which is composed of molybdenum disulfide slabs promoted by cobalt atoms (CoMoS phase) and well dispersed on a high specific area alumina. As far as the highest sulfur content allowed in gasoline and diesel is continually decreasing, more and more efficient and active hydrotreating catalysts are required. In order to optimize the reactivity of the CoMo-type catalyst in hydrotreatment, a better understanding of the processes used to producemore » the active phase (CoMoS slabs) of the catalyst is necessary. The study reported here deals with the sulfiding mechanism of the slabs and the influence of temperature on the phenomenon. Ex situ X-ray absorption spectroscopy (XANES and EXAFS) was used to study the evolution of the structure of CoMo-type catalyst sulfided at various temperatures (from 293 to 873 K). XAS analysis was performed at both molybdenum and cobalt K-edges to obtain a cross-characterization of the sulfidation of the slabs. It evidenced the formation of various compounds, including two molybdenum oxides, MoS3 (or MoS3-like compound) and Co9S8, at specific steps of the sulfiding process. It showed the role of intermediate played by MoS3 (or MoS3-like compound) during the formation of the slabs and the competition between the appearance of promoted slabs (CoMoS phase) and Co9S8. At last, it leaded to the proposal of a mechanism for the sulfidation of the catalyst.« less

Contribution to the scintillation detection optimization in double phase detectors for direct detection of dark matter

NASA Astrophysics Data System (ADS)

Balan, Catalin

Na ultima decada, foram feitos grandes progressos no desenvolvimento dos detetores de detecao direta das particulas que constituem a materia negra. Com estrategias do aumento gradual do volume do alvo e, simultaneamente, de reducao dos niveis de fundo, a experiencia XENON obteve resultados muito bons e perspetivas promissoras para a detecao de materia negra. Tarefas relativas a analise de dados experimentais adquiridos com o detetor de dupla fase em uso, assim como as simulacoes do campo eletrico, desenvolvimento, montagem e testes para o proximo detetor XENON1T, assim como a participacao regular na manutencao geral e monitorizacao do prototipo atual XENON100 no LNGS, constituiram o plano de trabalhos para as atividades de investigacao do presente doutoramento e a minha contribuicao para a otimizacao da detecao de cintilacao nos detetores da experiencia XENON. A necessidade de alcancar niveis elevados de sensibilidade, requer inovacao em todos os aspetos fisicos do detetor, assim como a reducao de todas as fontes de radioatividade que contribuem para o fundo. O modo mais indicado de operacao para os detetores com enchimento a Xe no estado liquido e gasoso envolve a medicao da cintilacao primaria e da secundaria provenientes da interacao das particulas no Xe liquido. A razao entre estes dois sinais permite diferenciar claramente a maior parte dos eventos correspondentes as fundo dos eventos correspondentes a WIMPs. Deste modo, a leitura dos sinais correspondentes a cintilacao e de extrema importancia. A amplitude do sinal de cintilacao antes dos fotossensores e maximizada atraves da otimizacao de varios parametros, tais como a geometria do alvo do detetor, a transparencia das grelhas dos eletrodos, a uniformidade do ganho em cintilacao secundaria e a utilizacao de material reflectivo para cobrir as superficies que nao sao fotossensiveis.

Esquizofrenia y trastorno en el consumo de sustancias: prevalencia y characterísticas sociodemográficas en la población Latina

PubMed Central

Jiménez-Castro, Lorena; Raventós-Vorst, Henriette; Escamilla, Michael

2012-01-01

El interés por comprender la co-morbilidad de la esquizofrenia y el trastorno en el uso de sustancias, ha aumentado debido al incremento de este diagnóstico, a los efectos negativos observados en el sujeto y a los costos en los servicios de salud. Este trastorno dual puede tener efectos dramáticos en el curso clínico del trastorno psicótico tales como: mayores recaídas, re-hospitalizaciones, síntomas más severos, no adherencia al tratamiento antipsicótico, cambios marcados del humor, aumento en el grado de hostilidad e ideación suicida, así como alteraciones en otras áreas del funcionamiento incluyendo violencia, victimización, indigencia y problemas legales. La literatura proveniente en particular de Estados Unidos y Europa sugiere que el rango de prevalencia para este diagnóstico puede oscilar entre el 10% hasta el 70%. En este estudio, revisamos la prevalencia del diagnóstico dual de esquizofrenia y trastorno en el uso sustancias, así como sus características sociodemográficas, con base en la literatura disponible alrededor del mundo dando énfasis en la poblacion latina. A pesar de que este diagnóstico es ampliamente aceptado, se conoce poco sobre su prevalencia en la población latina, sobre los factores ambientales, demográficos, clínicos y otras características de estos individuos. Un mejor conocimiento sobre este diagnóstico permitiría mejorar los métodos para la detección y adecuada valoración del trastorno en el uso de sustancias en personas con trastornos metales severos como la esquizofrenia. PMID:21404151

Los padres como maestros de los ninos. Los padres como recursos para los maestros. Serie E: [E1] logro de la participacion de los padres. cuadernos 1 y 2. Edicion para el maestro. Cuadernos para el entrenamiento de maestros de educacion bilingue. (Parents as Their Children's Teachers. Parents as Resources for Teachers. Series E: Parent Participation, Book 1 and 2. Teacher Edition. Bilingual Education Teacher Training Packets).

ERIC Educational Resources Information Center

Lazos, Hector, Comp.

This guide on training bilingual education teachers focuses on parent participation in school activities. The guide addresses three groups of people: paraprofessionals and non-graduate students, bilingual teachers, and graduate students. Two units are presented, one dealing with the important influence parents have on their child's language…

A Visão do Universo Segundo a Concepção de um Grupo de Alunos do Ensino Médio de São Paulo

NASA Astrophysics Data System (ADS)

Araújo, M. A. A.; Elias, D. C. N.; Amaral, L. H.; Araújo, M. S. T.; Voelzke, M. R.

2005-12-01

Nesse trabalho foi identificada por meio de um questionário a visão de mundo sobre o Universo espaço e tempo entre 270 estudantes de Ensino Médio de três escolas de São Paulo. Constatou-se pouco conhecimento dos temas investigados sendo que apenas 20% dos alunos relacionaram as semanas com as fases da lua enquanto 28% associaram as estações do ano à inclinação do eixo de rotação da Terra e 23% tinham noções das distâncias entre objetos celestes próximos da Terra. Enquanto 56% conseguiram relacionar o Big Bang com a origem do Universo verificou-se que 37% reconheciam ano-luz como unidade de distância e 60% reconheciam o Sol como uma estrela. Apesar de 60% dos alunos indicarem a escola como principal fonte dos conhecimentos de astronomia seus conceitos ainda são inadequados havendo necessidade de aprimoramento da abordagem desses conteúdos pois apesar de popular a astronomia é veiculada de maneira pouco esclarecedora e com imprecissões.

Del sujeto que ha intentado suicidarse y el Otro: la Institución Psiquiátrica

PubMed Central

Liliana, Mondragón B.; Miguel Ángel, Caballero G.

2009-01-01

El hospital psiquiátrico se ha constituido como un lugar donde se posibilita legitimar la exclusión y la radicalidad de ese otro “que no es igual”, como es el caso del sujeto que atenta contra su propia vida. En consecuencia, el intento de suicidio desde el pensamiento foucaultiano, es una resistencia que desmantela la estructura de dominación a través de un acto de poder, el cual se ejerce sobre el propio cuerpo. Así, la intención de este texto es mostrar que la relación Otro-otro es un lugar en la estructura subjetiva, que se deposita en la institución psiquiátrica, la cual representa el poder, la ley, y es aquello a lo que se le quiere agredir, resistir, abatir con un intento de suicidio. Para demostrar como se materializan estos hechos, se exponen los testimonios de tres adolescentes atendidas en un hospital psiquiátrico por intentos suicidas, en los cuales se señalan los diferentes significados que le atribuyen a la institución psiquiátrica en tanto que representa un Otro en sus actos autoinfligidos. PMID:25400324

[Not Available].

PubMed

Torres Díaz, Cristina V; Martín Peña, Gonzalo; Ezquiaga, Elena; Navas García, Marta; García de Sola, Rafael

2016-07-19

Gracias a los avances técnicos en técnicas neuroquirúrgicas, y debido a que el diagnóstico y la clasificación de las enfermedades psiquiátricas han evolucionado significativamente a lo largo de las últimas décadas, se están desarrollando tratamientos a nivel experimental para aquellos pacientes resistentes al manejo conservador.La anorexia nerviosa es una enfermedad de prevalencia creciente, con la tasa de mortalidad más elevada dentro de los trastornos psiquiátricos, y con aproximadamente un 20% de pacientes que presentan una evolución tórpida. Para estos pacientes que no responden a manejo conservador, la estimulación cerebral profunda ha surgido como una alternativa terapéutica, si bien la literatura especializada al respecto es escasa.A continuación presentamos una revisión de la fisiopatología de la anorexia nerviosa, así como de los distintos tratamientos neuroquirúrgicos realizados a lo largo de la historia. Se detalla la perspectiva de tratamiento quirúrgico actual, así como los aspectos éticos que se han de considerar en relación con el surgimiento de estas nuevas terapias.

Desarrollo curricular, conciencia ambiental y tecnologia para estudiantes de intermedia: Una investigacion en accion

NASA Astrophysics Data System (ADS)

Rodriguez Ramos, Teresita

Se llevó a cabo una investigación en acción con los propósitos de 1) documentar las relaciones de las tecnologías de la información y la comunicación en las clases de ciencias de escuela intermedia como elemento de apoyo cuando se aborda el tema ambiental y sus conceptos pertinentes, a partir de las observaciones de la investigadora, así como las entrevistas y diarios reflexivos de los estudiantes de una escuela intermedia en la zona metropolitana, y luego 2) diseñar una unidad instruccional sobre el tema ambiental que integre actividades tecnologías para el curso de ciencias de la escuela intermedia según el modelo PROCIC y las observaciones que hayan iniciado los estudiantes participantes. Finalmente, se plantearon las implicaciones educativas para el currículo del Programa de Ciencias al instrumentar este modelo de unidad mediante PROCIC, e integrado la tecnología y el tema ambiental. Los hallazgos se analizaron y se categorizaron de acuerdo con las preguntas de investigación. El hallazgo principal de la investigación aborda las cuatro relaciones centrales en las que se articula la utilización de las tecnologías y sus aplicaciones en la clase de ciencias. Estas cuatro relaciones que recogen la posición de los estudiantes son: 1) Perspectiva de los estudiantes hacia la tecnología. 2) Participación de los estudiantes en los aspectos docentes. 3) Aprendizaje estudiantil sobre el ambiente, y 4) Conciencia ambiental en relación con la vida diaria. Estas relaciones ponen de manifiesto,cómo se plantea en las implicaciones, la necesidad de más investigación en acción en la sala de clases, la importancia—como tema transversal—de la conciencia ambiental mediante la tecnología al construir conocimientos significativos dentro y fuera de la escuela, asó como, valorar la investigación y la dialogicidad en la sala de clases como actividades que obligan al reexamen de la práctica didáctica en su formas curriculares de objetivos, recursos, actividades, evaluación, entre otros. Estos planteamientos definen la unidad curricular que se propone en el cuatro capítulo.

Myocardial Viability on Cardiac Magnetic Resonance.

PubMed

Souto, Ana Luiza Mansur; Souto, Rafael Mansur; Teixeira, Isabella Cristina Resende; Nacif, Marcelo Souto

2017-05-01

The study of myocardial viability is of great importance in the orientation and management of patients requiring myocardial revascularization or angioplasty. The technique of delayed enhancement (DE) is accurate and has transformed the study of viability into an easy test, not only for the detection of fibrosis but also as a binary test detecting what is viable or not. On DE, fibrosis equal to or greater than 50% of the segmental area is considered as non-viable, whereas that below 50% is considered viable. During the same evaluation, cardiac magnetic resonance (CMR) may also use other techniques for functional and perfusion studies to obtain a global evaluation of ischemic heart disease. This study aims to highlight the current concepts and broadly emphasize the use of CMR as a method that over the last 20 years has become a reference in the detection of infarction and assessment of myocardial viability. Resumo O estudo de viabilidade miocárdica é de grande importância para a orientação e manejo de pacientes que necessitam de cirurgia de revascularização miocárdica ou angioplastia. A técnica de realce tardio (RT) é precisa e transformou o estudo de viabilidade em um teste fácil, não só para a detecção de fibrose, mas também como um modelo binário para a detecção do que é ou não é viável. Uma fibrose identificada pelo RT é considerada como não viável quando igual ou maior do que 50% da área segmentar e como viável quando menor que 50%. A ressonância magnética cardíaca (RMC) também pode lançar mão de outras técnicas para estudo funcional e de perfusão para uma avaliação global da doença isquêmica do coração no mesmo exame. Este estudo tem como objetivo destacar os conceitos atuais e enfatizar amplamente o uso da RMC como um método que nos últimos 20 anos se tornou referência na detecção de infarto e avaliação de viabilidade miocárdica.

Spin-Transfer-Torque Nano-Oscillators: Fabrication, Characterization and Dynamics

NASA Astrophysics Data System (ADS)

Costa, Jose Diogo Teixeira Barbosa

Este trabalho aborda algumas propriedades magneticas e estruturais de nanoparticulas de oxidos e oxidos-hidroxidos de ferro crescidos em matrizes hibridas orgânicas-inorgânicas. As matrizes hibridas, denominadas di-ureasils e obtidas pelo processo sol-gel, sao compostas por uma rede siliciosa ligada covalentemente por pontes ureia a cadeias orgânicas de diferente peso molecular. A estrutura local dos di-ureasils nao dopados esta modelada como grupos de dominios siliciosos com dimensoes nanometricas, estruturalmente correlacionados no seio de uma matriz rica em polimero. Neste trabalho mostra-se que os di-ureasils permitem o crescimento controlado de oxidos e oxidos-hidroxidos de ferro, incluindo a magnetite, maguemite, oxihidroxinitrato de ferro e ferrihidrite. O crescimento das nanoparticulas de ferrihidrite da-se em condicoes acidas a superficie dos dominios siliciosos, junto aos grupos carbonilo, que funcionam como pontos de nucleacao. Desse modo da-se uma nucleacao heterogenea, onde o tamanho das nanoparticulas depende da concentracao de ferro (entre 1 e 6% em massa), sendo a concentracao de particulas constante. As propriedades magneticas das nanoparticulas de ferrihidrite revelam a existencia de interaccoes antiferromagneticas e de momentos descompensados. A contribuicao destas duas componentes nas curvas de magnetizacao em funcao do campo magnetico pode ser separada usando um metodo aqui proposto, o que permite um adequado estudo da evolucao do momento magnetico com a temperatura. O estudo das propriedades magneticas dinâmicas das particulas de ferrihidrite, atraves de susceptibilidade ac, medidas de relaxacao e medidas de efeito Mossbauer, permitiu estudar a evolucao das interaccoes dipolares em funcao da concentracao de ferro, bem como determinar a distribuicao de barreiras de energia de anisotropia no caso em que essas interaccoes sao desprezaveis. E apresentado um novo metodo para comparacao desta distribuicao com a distribuicao de tamanhos, que permitiu concluir que os momentos magneticos descompensados estao aleatoriamente distribuidos em volume. Usando baixas concentracoes de agua, foi possivel crescer fases de oxihidroxinitrato de ferro com diferentes graus de cristalinidade, sendo algumas precursoras da ferrihidrite (como observado noutros trabalhos) e sendo outras novas fases. O crescimento de nanoparticulas de maguemite e magnetite acontece apos incorporacao de ioes de Fe2+ e Fe3+ seguidos de tratamento basico e termico. Estes sistemas apresentam propriedades magneticas tipicas de nanoparticulas superparamagneticas sem interaccoes dipolares. As propriedades magneticas dependem criticamente da existencia de grupos isocianato livres, que actuarao como pontos de nucleacao. None

Structural and Magnetic Studies on Iron Oxide Nanoparticles in Hybrid Matrices =

NASA Astrophysics Data System (ADS)

Silva, Nuno Joao de Oliveira

Este trabalho aborda algumas propriedades magneticas e estruturais de nanoparticulas de oxidos e oxidos-hidroxidos de ferro crescidos em matrizes hibridas orgânicas-inorgânicas. As matrizes hibridas, denominadas di-ureasils e obtidas pelo processo sol-gel, sao compostas por uma rede siliciosa ligada covalentemente por pontes ureia a cadeias orgânicas de diferente peso molecular. A estrutura local dos di-ureasils nao dopados esta modelada como grupos de dominios siliciosos com dimensoes nanometricas, estruturalmente correlacionados no seio de uma matriz rica em polimero. Neste trabalho mostra-se que os di-ureasils permitem o crescimento controlado de oxidos e oxidos-hidroxidos de ferro, incluindo a magnetite, maguemite, oxihidroxinitrato de ferro e ferrihidrite. O crescimento das nanoparticulas de ferrihidrite da-se em condicoes acidas a superficie dos dominios siliciosos, junto aos grupos carbonilo, que funcionam como pontos de nucleacao. Desse modo da-se uma nucleacao heterogenea, onde o tamanho das nanoparticulas depende da concentracao de ferro (entre 1 e 6% em massa), sendo a concentracao de particulas constante. As propriedades magneticas das nanoparticulas de ferrihidrite revelam a existencia de interaccoes antiferromagneticas e de momentos descompensados. A contribuicao destas duas componentes nas curvas de magnetizacao em funcao do campo magnetico pode ser separada usando um metodo aqui proposto, o que permite um adequado estudo da evolucao do momento magnetico com a temperatura. O estudo das propriedades magneticas dinâmicas das particulas de ferrihidrite, atraves de susceptibilidade ac, medidas de relaxacao e medidas de efeito Mossbauer, permitiu estudar a evolucao das interaccoes dipolares em funcao da concentracao de ferro, bem como determinar a distribuicao de barreiras de energia de anisotropia no caso em que essas interaccoes sao desprezaveis. E apresentado um novo metodo para comparacao desta distribuicao com a distribuicao de tamanhos, que permitiu concluir que os momentos magneticos descompensados estao aleatoriamente distribuidos em volume. Usando baixas concentracoes de agua, foi possivel crescer fases de oxihidroxinitrato de ferro com diferentes graus de cristalinidade, sendo algumas precursoras da ferrihidrite (como observado noutros trabalhos) e sendo outras novas fases. O crescimento de nanoparticulas de maguemite e magnetite acontece apos incorporacao de ioes de Fe2+ e Fe3+ seguidos de tratamento basico e termico. Estes sistemas apresentam propriedades magneticas tipicas de nanoparticulas superparamagneticas sem interaccoes dipolares. As propriedades magneticas dependem criticamente da existencia de grupos isocianato livres, que actuarao como pontos de nucleacao. None

El rol de Ia colaboracion y el Modelo de Aprendizaje Basado en Proyectos (ABPr) mediante el lente de la Teoria de Actividad (CHAT): un estudio de caso con estudiantes de 9no grado

NASA Astrophysics Data System (ADS)

Delgado, Isabel C.

Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos (ABPr) se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion. Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos. Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion es de tipo cualitativo e incorpora como diseno el estudio de caso. Las diversas interacciones constituyen la unidad de analisis. En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes (Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos). Las tecnicas que se utilizaron para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos (cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto). Para el analisis de los datos se aplico la teoria de actividad (CHAT) que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje. Una mayor interaccion entre pares durante las etapas de planificar y desarrollar los productos finales de la unidad, promueve una mejor comprension de los conceptos de la unidad, segun evidencia los productos finales del ABPr. La interaccion con el docente es muy importante para mediar los conflictos y desacuerdos que surgen como parte de las interacciones entre pares. Por lo tanto, el uso de diversas estrategias de andamiaje por parte del docente durante las reuniones de los grupos colaborativos es esencial para el exito del modelo ABPr.

A proposed contents astronomy for basic education

NASA Astrophysics Data System (ADS)

Albrecht, E.; Voelzke, M. R.

2014-08-01

A Astronomia é um tema que sempre exerceu fascínio sobre as pessoas de um modo geral. Conhecer e estudar o que há nos “céus”, além de nossos olhos, continua sendo instigador e de grande interesse. Baseado nestas justificativas desenvolveu-se uma pesquisa de Doutorado, na qual, o objetivo principal foi investigar sobre a presença dos conteúdos de Astronomia nas Propostas Curriculares da região Sul do Brasil, a saber, os estados de Paraná, Rio Grande do Sul e Santa Catarina e, posterior comparação com os Parâmetros Curriculares Nacionais (PCN) que trazem propostas de conteúdos para toda a Educação Básica brasileira. Tal investigação pautou-se na abordagem de caráter qualitativo e utilizouse para tal da Análise de Conteúdos (Bardin, 2011), que possibilitou a construção de quatro categorias, nas quais os conteúdos astronômicos foram agrupados: Terra, Sistema Solar, Via Láctea e Universo. Após a leitura, coleta de dados, construção de categorias, observou-se a dicotomia na apresentação destes conteúdos. As propostas curriculares analisadas foram as de Geografia, Ciências e Física dos estados do Paraná (2008), Rio Grande do Sul (2009) e de Santa Catarina (1998), responsáveis pelo trabalho com Astronomia nestes estados. No Ensino Fundamental, a proposta curricular do estado do Paraná apresenta conteúdos ligados à Astronomia desde o sexto ano até o nono ano, como conteúdo do primeiro bimestre, o que também é apresentado na proposta curricular do estado do Rio Grande do Sul, porém, este, não divide os conteúdos por bimestre e nem por ano, mas por ciclos, sexto e sétimo anos como primeiro ciclo e oitavo e nono anos como segundo ciclo, deixando livre para o professor estruturar sua sequência de conteúdos. A proposta curricular de Santa Catarina não apresenta estes conteúdos de maneira explícita, não divide dos conteúdos nem por ano, nem por série, traz uma sequência de conteúdos para serem trabalhados ao longo dos quatro anos, nos quais, aparecem timidamente alguns conteúdos de Astronomia. Para o Ensino Médio, as propostas curriculares do Paraná e de Santa Catarina parecem que se repetem, apresentando apenas o conteúdo Gravitação Universal, na primeira série do Ensino Médio, já a proposta curricular do Rio Grande do Sul, traz uma sequência que é proposta nos PCN (Brasil, 1998; 1999; 2002), na qual aparece o tema em questão, porém, em todos os anos, em todas as propostas, não há um detalhamento do que, de como trabalhar os conteúdos. O detalhamento facilita a prática pedagógica, pois, conteúdos simples como as Estações do Ano, Fases da Lua, sequer são citados nas propostas curriculares pesquisadas. Outro aspecto observado é que os conteúdos de um modo geral não trazem uma sequência e não primam por partir do entorno do aluno, daquilo que ele conhece para estruturar novos conceitos. Tais aspectos dificultam o fazer pedagógico, pois, por ser uma região com características culturais semelhantes, era esperado que as propostas fossem mais próximas, o! que facilitaria em muito, por exemplo, transferências dentro de um mesmo estado ou interestaduais. Pautando-se no que foi observado, na falta de especificidade dos conteúdos, clareza, sequência dos conteúdos e propostas de trabalho é proposto uma sequência de conteúdos de Astronomia, com materiais e recursos, pois, como apontado por Langhi e Nardi (2009), é necessário fornecer além da informação, do conteúdo, o como fazer. Tal proposta não visa estabelecer-se como regra, mas como suporte ao professor para facilitar sua prática pedagógica e tornar o trabalho com Astronomia presente nas escolas brasileiras. Bardin, L. Análise de conteúdo. Tradução Luís Antero Reto, Augusto Pinheiro. São Paulo: Edições 70, 2011. 279 p. Langhi, R; Nardi, R. Ensino da astronomia no Brasil: educação formal, informal, não-formal e divulgação científica. Revista Brasileira de Ensino de Física, v. 31, n. 4, p. 4402-1 a 4402-11, 2009.

The Science Teachers and Their way of Thinking about Astronomy. (Spanish Title: Los Profesores de Ciencias y Sus Formas de Pensar la Astronomía.) Os Professores de Ciências e Suas Formas de Pensar a Astronomia

NASA Astrophysics Data System (ADS)

Leite, Cristina; Hosoume, Yassuko

2007-12-01

The research presented in this article is about the way science teachers from Elementary School think about astronomical elements. Its methodology is based on semi-structured interviews, which were video recorded. The research is centered in a three-dimensional perspective of astronomical Earth, the Sun, the Moon, the planets and the stars, and also the conceptions about sky and Universe. The esults indicate a Universe that contains: Sun, stars, planets and Moon; where the Solar System is a little part of the whole. Sometimes they think that the Solar System is the Universe. The objects are in the sky or in the Universe, which, for many of them, is only the space above the Earth. The flat shape of astronomical objects and the spatial structure of the Universe are striking features. Many of them think that Sun and stars are different: the Sun is a hot object and the stars are cold ones. These results worry us and they certainly indicate how urgent it is to plan Professional Development in Astronomy for teachers, after all the PCN's emphasize that this subject is important to be taught. El objeto de investigación de este artículo es la manera de pensar sobre los elementos de la Astronomía de los profesores de Ciencias en la enseñanza fundamental. La metodología consiste en entrevistas semi-estructuradas, filmadas en video y centradas en la tridimensionalidad de los elementos astronómicos, para posibilitar un mapeamiento de las concepciones sobre las formas y dimensiones de la Tierra, del Sol, de la Luna, de los planetas y de las estrellas, como también de la concepción de cielo y de Universo en su totalidad. Los resultados indican un Universo conteniendo: Sol, estrellas, planetas y Luna, donde el Sistema Solar se ubica como parte. Algunas veces, el Universo es concebido como el propio Sistema Solar. Los objetos están en el cielo o en el Universo, que, para muchos, se restringe al espacio que está arriba de la Tierra. La forma plana de los objetos astronómicos y la estructura espacial del montaje del Universo son características fundamentales. Muchos indican Sol y estrellas como cosas distintas: el Sol es un objeto caliente y las estrellas son frías. Esos resultados nos preocupan y ciertamente señalan una urgencia de programas de formación continuada para profesores en el contenido de astronomía, pues los PCN's (Parámetros Curriculares Nacionales) recomiendan con énfasis la enseñanza de este contenido. O modo de pensar dos professores de Ciências do ensino fundamental sobre os elementos da Astronomia é o objeto de pesquisa presente neste artigo, cuja metodologia consiste em entrevistas semiestruturadas, filmadas em vídeo e centradas numa perspectiva tridimensional dos elementos astronômicos, possibilitando um mapeamento das concepções das formas e das dimensões da Terra, do Sol, da Lua, dos planetas e das estrelas, bem como da concepção de céu e de Universo como um todo. Os resultados indicam um Universo contendo: Sol, estrelas, planetas e Lua, onde o Sistema Solar é parte do todo. Algumas vezes o Universo é concebido como o próprio Sistema Solar. Os objetos estão no céu ou no Universo o qual, para muitos, se restringe ao espaço que está acima da Terra. A forma plana dos objetos astronômicos e a estrutura espacial da montagem do Universo são características marcantes. Muitos indicam Sol e estrelas como coisas diferentes: Sol é um objeto quente e as estrelas são frias. Esses resultados nos preocupam e certamente sinalizam uma urgência de programas de formação continuada para professores no conteúdo de astronomia, uma vez que os PCN's indicam fortemente o ensino desse conteúdo.

Modelizacion, control e implementacion de un procesador energetico paralelo para aplicacion en sistemas multisalida

NASA Astrophysics Data System (ADS)

Ferreres Sabater, Agustin

Cualquier sistema electronico que incluya un procesado o tratamiento de la senal, y ademas, algun tipo de actuador mecanico generalmente necesita, como minimo, dos tensiones diferentes de alimentacion. Excluyendo los sistemas de alimentacion distribuida, la solucion tecnica mas utilizada para proporcionar dos o mas tensiones consiste en las fuentes de alimentacion multisalida. En una fuente de alimentacion multisalida los diferentes circuitos que conforman cada salida comparten un mismo transformador de potencia optimizando coste, masa, y volumen. Las ventajas obtenidas con este procedimiento tienen en su contra el efecto que sobre cada salida individual provocan las demas en su conjunto debido, principalmente, a los efectos de los elementos parasitos de los componentes. Un cambio de carga en una de las salidas produce un transitorio que es visto por todas las demas como un efecto de impedancia cruzada, y al final del transitorio, la tension de cada salida es diferente respecto a la que tenian antes del transitorio. Este ultimo resultado se conoce como regulacion cruzada. La disminucion de los efectos de la regulacion cruzada ha sido objeto de estudio durante los ultimos anos. El objetivo ha sido el desarrollo de distintas estrategias que permiten, desde disminuir los efectos de la regulacion cruzada hasta los niveles deseables, a eliminarla completamente. El resultado final suele suponer una penalizacion sobre el diseno del sistema directamente proporcional al grado de regulacion a conseguir en las distintas salidas. Entre las soluciones propuestas para eliminar la regulacion cruzada las tecnicas de post-regulacion se han consolidado como la opcion mas aceptada ya que, pueden aplicarse a cualquier convertidor y no suponen ninguna complejidad adicional a la hora de plantear el diseno. En esta Tesis Doctoral se abordara el estudio de la tecnica conocida como postregulacion mediante transformador controlado, que si bien se ha empleado en convertidores resonantes, su modelizacion, y aplicacion en convertidores PWM, esta aun por estudiar y valorar. El primer Capitulo consiste en una breve introduccion al problema de la regulacion cruzada y la impedancia cruzada para posteriormente describir las tecnicas de post-regulacion actualmente mas empleadas, con especial atencion al post-regulador con transformador controlado. El Capitulo segundo trata del estudio de las caracteristicas estaticas del postregulador con transformador controlado. Partiendo de los estudios disponibles sobre el postregulador se plantean mejoras en su modo de actuacion y se discuten tres alternativas diferentes para controlar el transformador. Las dos primeras consisten en emplear un convertidor auxiliar Boost en sus dos modos de funcionamiento, continuo y discontinuo. La tercera consiste en controlar el transformador con una tension PWM directamente, sin filtrado. Finalmente se comprueba experimentalmente, para el estado estacionario, el funcionamiento del post-regulador para cada uno de los tres metodos de control. El Capitulo tercero trata de la dinamica de la salida controlada con el post-regulador cuando este emplea un convertidor auxiliar tipo Boost. Mediante la tecnica de promediado de variables de estado se propone el modelo de pequena senal, tanto para el modo continuo como para el modo discontinuo de funcionamiento del convertidor auxiliar. Los resultados mas significativos de esta seccion son las expresiones analiticas de las impedancias cruzadas y de la impedancia de la salida post-regulada. Como complemento al modelo de pequena senal se plantea un modelo de gran senal implementado sobre el simulador Pspice. Con este nuevo modelo se reproducen los resultados obtenidos con el modelo de pequena senal y ademas es posible simular los transitorios en las tensiones de salida ante cambios de carga. La modelizacion del convertidor cuando el transformador se controla con una tension PWM sin filtrar es el objetivo del Capitulo 4. En las secciones siguientes del Capitulo se plantea el correspondiente modelo de gran senal aplicado a un nuevo prototipo experimental, de mayor tension de entrada y mayores corrientes de salida. El final del Capitulo contrasta los resultados experimentales con los teoricos confirmando la utilidad del modelo de gran senal como una herramienta basica de diseno. Finalmente, en el Capitulo 5, se presentan las conclusiones y la valoracion de los diferentes estudios plateados a lo largo de la Tesis Doctoral.

[Leadership and CETREMI].

PubMed

Sandoval-Gutiérrez, José Luis

2017-01-01

Según la Real Academia Española, el término «líder» significa «persona que dirige u orienta a un grupo, que reconoce su autoridad». Es importante este término ya que es muy ambiguo, porque no reconoce el nivel moral o la empatía que puede ejercer una persona en determinado grupo al reconocerlo como líder, y no solo con la autoridad que este puede ejercer en el mismo, siendo este último concepto algo muy común en el mundo anglosajón, denominándose líder a alguien que tiene un puesto de autoridad, lo cual se puede confundir con lo que conocemos como «jefe».

Distribución del continuo ultravioleta e infrarrojo en estrellas Be

NASA Astrophysics Data System (ADS)

Cruzado, A.; Ringuelet, A.; di Rocco, H.

Estamos interesados en interpretar los excesos de flujo infrarrojo y/o ultravioleta observados en estrellas Be con respecto al de estrellas B normales, así como su posible correlación. Una envoltura rodeando la estrella distingue una estrella Be de una B normal; para explicar las observaciones es necesario entonces tener en cuenta todos los posibles procesos físicos que en ella tienen lugar. Adoptando un modelo atmosférico específico, hemos estudiado el proceso de recombinación dielectrónica de metales como MgII y FeII, teniendo en cuenta la posible influencia de la opacidad del medio en el flujo emitido.

Perspectivas Futuras para o Observatório do Pico dos Dias

NASA Astrophysics Data System (ADS)

Bruch, Albert

2004-02-01

Com o Observatório Gemini plenamente operacional e o telescópio SOAR iniciando suas operações em breve, a astronomia observacional brasileira encontra-se no auge de uma transformação profunda que terá um impacto grave no Observatório do Pico dos Dias - OPD. Refletimos aqui sobre a natureza desse impacto e estratégias para manter a competitividade do OPD. Não queremos apresentar receitas prontas, mas idéias que poderão servir como base de discussão sobre o uso inteligente dos telescópios do OPD como parte do conjunto de instrumentos disponíveis à comunidade astronômica brasileira.

Conceptos Basicos Sobre el Gas Natural (in Spanish)

DOE Office of Scientific and Technical Information (OSTI.GOV)

El gas natural abastece cerca de 150.000 vehiculos en los Estados Unidos y aproximadamente 22 millones de vehiculos en todo el mundo. Los vehiculos de gas natural (NGV, por sus siglas en ingles) son una buena opcion para las flotas de vehiculos de alto kilometraje, tales como autobuses, taxis, vehiculos de recoleccion de basura, los cuales son alimentados centralmente u operan dentro de un area limitada o a lo largo de una ruta con estaciones de servicio de gas natural. Las ventajas del gas natural como combustible alternativo incluyen su disponibilidad interna, la red de distribucion establecida, un costo relativamentemore » bajo, y los beneficios de las emisiones.« less

[80 years of soial service in medicine].

PubMed

Hace 80 años, la Escuela de Medicina de la Universidad Nacional, en voz de su director, Gustavo Baz Prada, hizo una propuesta que pronto se convirtió en realidad y finalmente en norma, la que desde entonces se conoce como SS. Esta iniciativa se vio como una manera para que los estudiantes de medicina del último año retribuyeran a la sociedad una parte de lo que esta invirtió en su educación, consolidaran su formación mediante la exposición a las realidades de todos los días en los medios más necesitados, se pusieran a prueba sobre sus verdaderas capacidades para atender pacientes y participaran en la solución de un problema de atención sanitaria que en ese entonces era mucho más apremiante que ahora. Unos años después, los recién egresados de otras licenciaturas (pasantes) también fueron incorporados a esta estrategia y, al fin, se reconoció formalmente como una responsabilidad de las instituciones educativas. Las aportaciones del SS a la salud de las personas y a la formación de los médicos han sido incuestionables, y la experiencia humana que ha representado para quienes lo han vivido ha dejado marcas indelebles.

Neurobiología de la impulsividad y los trastornos de la conducta alimentaria*

PubMed Central

Orozco-Cabal, Luis Felipe; Herin, David

2009-01-01

Resumen Introducción La impulsividad es un rasgo de personalidad multidimensional relacionado con el control del comportamiento y las emociones. Está presente de manera diversa en los trastornos de la conducta alimentaria, particularmente, en la bulimia nerviosa (BN). Aunque la relación entre la impulsividad y BN ha sido objeto de numerosas investigaciones, en la actualidad se desconocen los sustratos neurobiológicos de esta relación. Objetivos Discutir críticamente la evidencia que sugiere que las alteraciones en los sistemas neuronales relacio-nados con las funciones ejecutivas, con la formación de preferencias y con la regulación de los estados emocionales sirven como base para el rasgo de personalidad impulsiva, así como su estado en subgrupos de pacientes con BN. Métodos Búsqueda selectiva de la literatura relevante. Resultados y conclusiones Esta discusión ilustra la complejidad de la relación entre la impulsividad y BN, donde la impulsividad actúa como un factor de vulnerabilidad que puede sensibilizar al sujeto con BN a estados emocionales negativos, durante los cuales modifica el impacto de estímulos internos y externos sobre el comportamiento y su regulación, favoreciendo así patrones de comportamiento maladaptativos e inflexibles. PMID:19838321

Como os Alunos do Ensino Médio da Rede Estadual de São Paulo obtém Conhecimentos Astronômicos?

NASA Astrophysics Data System (ADS)

da Cunha, W. S.; Voelzke, M. R.; Amaral, L. H.

2005-08-01

Atualmente vivencia-se um mundo globalizado onde os computadores e a internet permitiram um acesso rápido e seguro a todo tipo de informação e conhecimento. O presente trabalho visa analisar a maneira pela qual alunos de segundo grau da rede estadual da cidade de São Paulo obtiveram, caso tenham, conhecimentos básicos de astronomia quanto aos fenômenos celestes que os rodeiam, tais como a sucessão dos dias e das estações do ano, além de questioná~los sobre fatos genéricos tais como: o que vem a ser o Sol, o Big Bang, o que ocasionou a extinção dos dinossauros. Para tanto foi elaborado um formulário constando de questões de múltipla escolha, o qual foi aplicado no primeiro colegial diurno da Escola Estadual Guilherme de Almeida. Num espaço amostral de 44 alunos constatou-se que 41% dos alunos adquiriram seus conhecimentos astronômicos na escola e 59% através da mídia em geral. Neste mesmo espaço amostral apenas 11% dos alunos usaram computadores na escola, 41% na residência, 5% no trabalho e 43% não utilizaram. O presente estudo revelou também que para 50% dos alunos o professor jamais utilizou um programa de computador a respeito de astronomia ou fez alguma apresentação sobre o tema. Embora em sua fase inicial este estudo revela claramente que a maioria dos alunos não obtém na escola seus conhecimentos astronômicos, estes provém de fontes não especificamente didático-pedagógicas tais como filmes e revistas populares que não raramente geram conhecimentos incompletos e em muitos casos inclusive falhos.

Encefalitis por anticuerpos contra el receptor de NMDA: experiencia con seis pacientes pediátricos. Potencial eficacia del metotrexato

PubMed Central

Bravo-Oro, Antonio; Abud-Mendoza, Carlos; Quezada-Corona, Arturo; Dalmau, Josep; Campos-Guevara, Verónica

2016-01-01

Introducción La encefalitis por anticuerpos contra el receptor de N-metil-D-aspartato (NMDA) es una entidad cada vez más diagnosticada en edad pediátrica. A diferencia de los adultos, en muchos casos no se asocia a tumores y las manifestaciones iniciales en niños más frecuentes son crisis convulsivas y trastornos del movimiento, mientras que en los adultos predominan las alteraciones psiquiátricas. Casos clínicos Presentamos seis casos pediátricos confirmados con anticuerpos contra la subunidad NR1 del receptor de NMDA en suero y líquido cefalorraquídeo. Cinco de los casos comenzaron con crisis convulsivas como manifestación clínica inicial antes de desarrollar el cuadro clásico de esta entidad. En todos los casos se utilizaron esteroides como primera línea de tratamiento, con los que sólo se observó control de las manifestaciones en uno, por lo que el resto de los pacientes requirió inmunomoduladores de segunda línea. Todos los pacientes recibieron metotrexato como tratamiento inmunomodulador para evitar recaídas y la evolución fue a la mejoría en todos ellos. Conclusiones En nuestra serie de pacientes con encefalitis por anticuerpos contra el receptor de NMDA, ninguno se asoció a tumores. Todos los casos recibieron metotrexato por lo menos durante un año, no observamos eventos adversos clínicos ni por laboratorio, ni hubo secuelas neurológicas ni recaídas durante el tratamiento. Aunque es una serie pequeña y es deseable incrementar el número y tiempo de evolución, consideramos el metotrexato una excelente alternativa como tratamiento inmunomodulador para esta patología. PMID:24150952

PubMed

Oyarce Merino, Karina; Valladares Vega, Macarena; Elizondo-Vega, Roberto; Obregón, Ana María

2016-11-29

Introducción: cambios socioculturales como el incremento en el sedentarismo y el consumo de alimentos ricos en grasas y azúcares, sumado a características genéticas, han producido un aumento en las cifras de obesidad a nivel mundial. La evaluación temprana en niños, mediante el establecimiento de perfi les genéticos asociados a obesidad y a la regulación metabólica y hedónica de la alimentación, complementado con estudios de la conducta alimentaria, nos permitiría predecir la predisposición a la obesidad en etapas adultas.Objetivo: revisar los conceptos asociados a la conducta alimenticia, enfocándose en la regulación hedónica, que puede convertirse en un parámetro predictivo de obesidad en niños.Material y métodos: se revisó la bibliografía asociada a obesidad infantil y a la regulación homeostática y hedónica de la obesidad, como también parámetros génicos asociados a la obesidad. En la búsqueda de artículos se incluyó el trabajo en animales y humanos (adultos y niños, pero con énfasis en niños).Resultados: se analizaron los mecanismos celulares de la regulación de la ingesta, así como los estudios de conducta alimentaria en niños, entregando antecedentes y carencias en el desarrollo investigativo para la predicción de la obesidad infantil.Conclusión: la regulación hedónica de la ingesta alimenticia en niños, como perfi les genéticos asociados a receptores de dopamina, puede convertirse en un importante predictor de la obesidad. Es necesario incrementar el número de estudios que permitan defi nir de mejor forma, cuáles son los mejores parámetros para predecir el desarrollo de la obesidad adulta.

Obstáculos a la adherencia y retención en los sistemas de salud público y privado según pacientes y personal de salud

PubMed Central

Arístegui, Inés; Dorigo, Analía; Bofill, Lina; Bordatto, Alejandra; Lucas, Mar; Cabanillas, Graciela Fernández; Sued, Omar; Cahn, Pedro; Cassetti, Isabel; Weiss, Stephen; Jones., Deborah

2016-01-01

Resumen Introducción el Programa Nacional de Sida garantiza el acceso universal a los antirretrovirales, aun así las personas que reciben medicamentos a través del sistema público no logran obtener una carga viral indetectable en la misma proporción que los pacientes del sistema privado. Este estudio cualitativo tiene como objeto identificar los factores asociados a la adherencia y retención en la cascada de atención de VIH de los sistemas de salud público y privado de Buenos Aires, según las percepciones de pacientes y del personal de salud. Métodos se registraron datos cualitativos de 12 entrevistas semi-estructuradas a informantes clave y 4 grupos focales de pacientes y personal de salud tanto del sistema público como privado. Se codificaron y analizaron temas predeterminados sobre adherencia, utilizando el software QRS Nvivo9® de análisis de datos cualitativos. Resultados pacientes y personal de salud de ambos sistemas coinciden en la importancia del estigma asociado al VIH, la relación médicopaciente, la comunicación entre ambos y la división de responsabilidades en relación al tratamiento como aspectos fundamentales para la adherencia y retención en la cascada de atención. Se observan diferencias entre los sistemas en la forma en que algunos de estos aspectos actúan. Las barreras estructurales se presentan como principales obstáculos del sistema público. Discusión se resalta la necesidad de intervenciones focalizadas en la díada médico-paciente que considere las particularidades de cada sistema de atención para facilitar el compromiso del paciente en la adherencia. PMID:26878024

PubMed

Domínguez, Vanihamín; Aguiñiga, Itzen; Moreno, Leticia; Torres, Beatriz; Santiago-Osorio, Edelmiro

2017-12-01

Introducción. El caseinato de sodio, una sal de la caseína utilizada como agente proinflamatorio en ratones, es capaz de inducir granulopoyesis en vivo e incrementar la producción de citocinas esenciales en dicho evento.Objetivo. Evaluar si el caseinato de sodio es capaz de inducir un efecto biológico en células de origen linfoide y la producción de citocinas involucradas con este linaje.Materiales y métodos: Se utilizaron ratones hembra BALB/c de 8 a 12 semanas de edad. Los animales se inyectaron cuatro veces, con intervalos de 48 horas, por vía intraperitoneal con 1 ml de caseinato de sodio (10 % de SFB p/v). La población de linfocitos B y la incorporación de bromodesoxiuridina (BrdU) se analizaron mediante citometría de flujo. La detección de la interleucina 7 se evaluó mediante la técnica de ELISA.Resultados. Tras la inyección por vía intraperitoneal, el número de linfocitos B 220+ provenientes del bazo de ratones tratados con caseinato de sodio aumentó comparados con los que solo recibieron el vehículo como tratamiento (89,01±1,03 Vs. 75,66±2,08), así como la incorporación de BrdU en células B220+ (38,59±4,48 Vs. 11,82±1,04). Se evidenció, asimismo, el incremento en la concentración de la interleucina 7 (IL-7) en el suero de los ratones tratados con caseinato de sodio, comparados con los que solo recibieron el vehículo (62,1±17,5 Vs. 26,9±4,4 pg/ml).Conclusión. El caseinato de sodio fue capaz de aumentar el número de linfocitos B en bazo de ratones, así como inducir la producción de IL-7, citocina clave para la linfopoyesis B.

Prevalence of previously undiagnosed abdominal aortic aneurysms in the area of Como: the ComoCuore "looking for AAA" ultrasonography screening.

PubMed

Corrado, Giovanni; Durante, Alessandro; Genchi, Vincenzo; Trabattoni, Loris; Beretta, Sandro; Rovelli, Enza; Foglia-Manzillo, Giovanni; Ferrari, Giovanni

2016-08-01

The prognosis for abdominal aortic aneurysm (AAA) rupture is poor. Long-term follow-up of population-based randomized trials has demonstrated that ultrasound (US) screening for abdominal aortic aneurysms (AAAs) measuring 3 cm or greater decreases AAA-related mortality rates and is cost-effective. We though to prospectively perform during a 26-month period a limited US examination of the infrarenal aorta in volunteers of both gender aged 60-85 years without history of AAA living in the area of Como, Italy. From September 2010 to November 2013 ComoCuore, a no-profit nongovernmental association, enrolled 1555 people (aged 68.8 ± 6.8 years; 48.6 % males). Clinical data and a US imaging of the aorta were collected for each participant. AAA was found in 22 volunteers (1.4 %) mainly males (2.5 % in males vs. 0.4 % in females p = 0.005). Overall, the prevalence of cardiovascular risk factors was higher in patients with vs. without AAA (mean 2.9 ± 3.0 vs. 1.4 ± 1.0 respectively, p < 0.0001). Independent predictors of AAA on multivariate analysis were age (OR 1.14, 1.06-1.22; p < 0.0001), male gender (OR 8.23, 1.79-37.91; p = 0.007), and both current (OR 4.98, 1.57-15.79; p = 0.007) and previous smoking (OR 2.76, 1.12-8.94; p = 0.03). Our study confirms the feasibility of one time US screening for AAA in a large cohort of asymptomatic people. Independent predictors of AAA were male sex, older age and a history of smoking. Accordingly to recent data the prevalence of AAA seems to be declining, maybe due to a reduction of smoking in Italy.

Abundâncias químicas de estrelas T Tauri fracas

NASA Astrophysics Data System (ADS)

Rojas, G. A.; Gregorio-Hetem, J.

2003-08-01

Apresentamos resultados do estudo de 44 estrelas pré-seqüência principal, para as quais buscamos realizar uma classificação espectroscópica e determinar parâmetros estelares e abundâncias químicas. A amostra foi escolhida da seguinte maneira : 21 objetos selecionados a partir de catálogos de objetos jovens, como o Pico dos Dias Survey e o Herbig Bell Catalogue, e 23 objetos selecionados a partir de contrapartidas ópticas de fontes de raios X detectadas pelo satélite ROSAT. Dentre 24 objetos previamente classificados como estrelas T Tauri Fracas, apenas 7 revelaram ser realmente pertencentes à essa classe, sendo os demais objetos T Tauri Clássicas ou estrelas evoluídas da pré-seqüência principal. Esse resultado demonstra que o critério mais utilizado para distinguir as T Tauri Clássicas das T Tauri Fracas, baseado na largura equivelente da emissão Ha, não é suficiente para determinar o estágio evolutivo desses objetos. Para o cálculo de parâmetros estelares e abundâncias, foram escolhidas as estrelas que apresentam características ideais para esse tipo de estudo, como ausência de velamento, baixa velocidade de rotação e espectros com razão sinal-ruído adequada. Os parâmetros estelares como temperatura efetiva e gravidade foram determinados através do equilíbrio de excitação e ionização das linhas de Ferro, e as abundâncias químicas foram calculadas utilizando o método de síntese espectral. Serão apresentados os parâmetros estelares e as abundâncias de Lítio para toda a amostra, e abundâncias de vários elementos quimicos para 7 estrelas estudadas em maior detalhe

Organization of professional practices against intrafamily violence against children and adolescents in the institutional context.

PubMed

Schek, Gabriele; Silva, Mara Regina Santos da; Lacharité, Carl; Bueno, Maria Emília Nunes

2017-06-05

to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents. analisar, com base no discurso dos profissionais, como ocorre a organização de suas práticas frente às situações de violência intrafamiliar contra crianças e adolescentes. pesquisa qualitativa, realizada com 15 profissionais que atuam em serviços sociais e de saúde localizados no extremo sul do Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas, realizadas no próprio local de trabalho dos participantes. Para a análise dos dados foi construída uma matriz teórica com base na Etnografia Institucional e utilizada a técnica de análise textual discursiva. as práticas profissionais desenvolvidas nas situações de violência intrafamiliar contra crianças e adolescentes se organizam a partir de: relações de poder que se desenrolam nos serviços que atendem às situações de violência; rotinas instituídas para suprir as demandas de atendimento nos serviços e o inter-jogo entre a concepção de violência como um problema de saúde pública e a de violência como um problema social. a maneira como essas práticas estão organizadas se reflete em ações pouco protetivas frente às situações de violência intrafamiliar contra crianças e adolescentes. analizar, basado en el discurso profesional, como ocurre la organización de sus prácticas frente a las situaciones de violencia doméstica intrafamiliar contra niños y adolescentes. investigación cualitativa realizada con 15 profesionales que trabajan en salud y servicios sociales en el sur de Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas realizadas en el lugar de trabajo de los participantes. Para el análisis de los datos se construyó una matriz teórica basada en la Etnografia Institucional y utilizada la técnica de análisis textual del discurso. las prácticas profesionales desarrolladas en situaciones de violencia intrafamiliar contra los niños y adolescentes se organizan a partir de: las relaciones de poder que tienen lugar en los servicios que responden a las situaciones de violencia; las rutinas puestas en practica para satisfacer las demandas de servicios de atención y el inter-juego entre la concepción de la violencia como un problema de salud pública y la violencia como un problema social. la forma en que estas prácticas se organizan se refleja en acciones de poca protección en el enfrentamiento de las situaciones de violencia intrafamiliar contra niños y adolescentes.

PFI-ZEKE (Pulsed Field Ionization-Zero Electron Kinetic Energy) para el estudio de iones

NASA Astrophysics Data System (ADS)

Castaño, F.; Fernández, J. A.; Basterretxea, A. Longarte. F.; Sánchez Rayo, M. N.; Martínez, R.

Entre las áreas hacia donde ha evolucionado la Química en los últimos años están los estudios de sistemas con especies reactivas de alta energía y los dominados por fuerzas intermoleculares débiles, con energías de unas pocas kcal/mol. En efecto, el estudio de las propiedades de los iones, comenzando por su relación con la molécula neutra de la que procede, la energía de ionización, los estados vibracionales y rotacionales, energías de enlace de Van der Waals entre el ión y una amplia variedad de otras moléculas, sus confórmeros o isómeros y sus reacciones o semi-reacciones químicas están en la raíz de la necesidad de la espectroscopía conocida como PFI-ZEKE, Pulsed Field Ionization-Zero Electron Kinetic Energy. Entre las aplicaciones que requieren estos conocimientos se encuentran la generación de plasmas para la fabricación de semiconductores, memorias magnéticas, etc, así como los sistemas astrofísicos, la ionosfera terrestre, etc. La espectroscopía ZEKE es una evolución de las de fluorescencia inducida por láser, LIF, ionización multifotónica acrecentada por resonancia, REMPI, con uno y dos colores y acoplada a un sistema de tiempo de vuelo, REMPI-TOF-MS, y las espectroscopías de doble resonancia IR-UV y UV-UV. Sus espectros y la ayuda de cálculos ab inicio permite determinar las energías de enlace de complejos de van der Waals en estados fundamental y excitados, identificar confórmeros e isómeros, obtener energías de ionización experimentales aproximadas (100 cm-1) y otras variables de interés. Al igual que con LIF, REMPI y dobles resonancias, es posible utilizar muestras gaseosas, pero los espectros están muy saturados de bandas y su interpretación es difícil o imposible. Se evitan estas dificultades estudiando las moléculas o complejos en expansiones supersónicas, donde la T de los grados de libertad solo alcanzan unos pocos K. Para realizar experimentos de ZEKE hay que utilizar una propiedad recientemente descubierta, que va en contra de lo esperado en otros sistemas físicos y que consiste en que los altos estados Rydberg de átomos, moléculas y sus complejos de van der Waals (o de los iones) tienen tiempos de vida de centenas de μ s. En resumen, el experimento y la espectroscopía ZEKE consiste en excitar un átomo, molécula o cluster sucesivamente a dos estados excitados selectivos de manera que el final sea un estado Rydberg. A continuación se aplica un campo eléctrico variable que lo ioniza y después de un cierto retraso se aplica un campo eléctrico de extracción, tanto para el electrón como para el ión. El espectro de los iones, es un espectro ZEKE. Hay varias alternativas para hacer este último proceso. El estudio de la espectroscopía y propiedades de iones y sus clusters requiere el conocimiento detallado de la espectroscopía de la molécula neutra, los estados Rydberg, de los confórmeros y sus complejos. Todo ello implica el haber estudiado los sistemas por LIF, REMPI y doble resonancia (hole burning IR-UV, UV-UV). Además solo es posible interpretar los resultados y obtener la información contenida en los espectros con ayuda de cálculos cuánticos ab initio. Hasta el momento hemos aplicado tanto el ZEKE como el conjunto de técnicas mencionadas anteriormente, a varias molécula de interés químico general como anilina y sus derivados, así como sus complejos con agua y amoniaco. Sin embargo, el método es muy versátil y puede aplicarse a iones de átomos, iones múltiples, moléculas sencillas y sus clusters así como a sus semi-reacciones. Como ejemplo de uno de estos espectros PFI-ZEKE se presenta aquí el caso del amonibenzonitrilo, ABN y solamente en su estado fundamental. En la conferencia se presentarán espectros ZEKE del ABN y moléculas similares en estados vibracionales intermedios (islas de estabilidad), así como la determinación de potenciales de ionización precisos, energías de enlace de compuestos del ión con varios disolventes y otras propiedades de interés, discutiendo sus resultados.

[Not Available].

PubMed

Fort Casamartina, Eduard; Arribas Hortiguela, Lorena; Bleda Pérez, Carmen; Muñoz Sánchez, Carme; Peiro Martínez, Imma; Perayre Badía, María; Clopés Estela, Ana

2016-06-03

Durante la última década, el conocimiento de nuevos mecanismos implicados en el desarrollo del cáncer ha permitido el diseño de nuevos fármacos para su tratamiento y la mayor parte de ellos son fármacos que se administran por vía oral. Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales (de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados). Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional.

[Scabies and the significance of "suriones" in the handwritten manuscripts of Hildegard von Bingen].

PubMed

Riethe, Peter

2006-01-01

In her studies on nature and medicine, the "Liber simplicis medicinae" (LSM or "Physica") and the "Liber compositae medicinae" (LCM or "Causae et Curae"), Hildegard von Bingen mentions Scabies (mange) in several passages. She characterizes "suren aut (= or) sneuelzen" as the cause of the disease, which she calls also "gracillimi vermiculi", that is, tiny worms that burrow into the human skin ("ubi suren aut sneuelzen hominem comedendo ledunt"). In this context the meanings of the German-ancestor terms "suren aut sneuelzen", which are found in the Latin text concerning the "Alia Mynza", are still disputed. The question whether Hildegard knew the cause of scabies the author discusses on the basis of ancient and medieval sources as well as modem medical historical and philological/linguistic research approaches. He concludes that Hildegard was able not only to describe the symptoms exactly, but also to define the cause of the disease as a special parasite. Consequently, she differentiates other diseases of the skin, such as "grint", from scabies. The proposed interpretation of "sneuelzen" as the tick is untenable. The assumption that both terms are synonyms for sarcoptes scabiei can be confirmed by philological and medical historical research.

Ganglioneuroblastoma: Case report and review of the literature.

PubMed

Alessi, S; Grignani, M; Carone, L

2011-06-01

Neuroblastoma are among the most important tumors of extracranial origin in pediatric patients. They arise from embryonal cells involved in the development of the sympathetic nervous system, whose differentiation has been arrested [1,2]. They are the tumors most frequently diagnosed during the first decade of life. Their evolution is unpredictable, ranging from progression to spontaneous regression or maturation, and their location and metastatic potential vary. Little is known about the cause of these tumors and the risk factors associated with their development. This article describes a typical case of ganglioneuroblastoma and provides a review of the literature on this type of tumor.Sommario Il neuroblastoma è uno dei più importanti tumori pediatrici di derivazione extracranica; esso origina dalle cellule embrionali coinvolte nello sviluppo del sistema nervoso simpatico a causa di un blocco nel loro processo di differenziamento [1,2]. È la più frequente neoplasia della prima decade di vita; la sua progressione biologica è imprevedibile, regressione spontanea, maturazione a ganglioneuroma, localizzazione e metastatizzazione variabili. Poco è noto a riguardo dei fattori di rischio e della sua eziopatogenesi. Viene presentato un caso tipico di ganglioneuroblastoma e riesaminata la letteratura su questa neoplasia.

Tal Como Somos/Just As We Are: An Educational Film to Reduce Stigma towards Gay and Bisexual Men, Transgender Individuals & Persons Living with HIV/AIDS

PubMed Central

Ramirez-Valles, Jesus; Kuhns, Lisa M.; Manjarrez, Dianna

2013-01-01

In this paper we describe the development and dissemination of a film-based educational intervention to reduce negative attitudes towards gay and bisexual men and transgender women (GBT) and people living with HIV/AIDS (PLWHA) in Latino communities, with a focus on youth. The intervention, Tal Como Somos/Just as We Are, is based on stigma and attribution theories, extensive formative research, and community input. Evaluation findings among educators and school youth suggest the film has the potential to effectively impact attitudes towards GBT and PLWHA. The film and intervention are being disseminated using diffusion of innovations theory through community-based organizations, schools, television broadcasting and film festivals. PMID:24377496

Estructura orbital en el Problema Restringido Rectilíneo Isósceles

NASA Astrophysics Data System (ADS)

Orellana, R. B.

Para definir problemas en Mecánica Celeste se utilizan diferentes parámetros. El conocimiento de la dinámica del problema para valores particulares de estos parámetros nos permite entender el comportamiento en casos más generales. El Problema Restringido Rectilíneo Isósceles puede ser considerado como el caso límite del Problema de Sitnikov cuando la excentricidad tiende a uno o como el Problema Isósceles cuando la masa central tiende a cero. Se ha compactificado el espacio de fases y analizado la dinámica en el límite. Esto ha permitido separar el espacio de fases en diferentes regiones dependiendo de las clases de órbitas.

Como Lo Hago Yo: Myelomeningocele

PubMed Central

Lazareff, Jorge

2014-01-01

Fortificación con ádico fólico es efectiva, pero aún falta conciencia en los jóvenes. La legalidad del aborto aumenta la importancia de la consulta prenatal. Realizo la cirugía bajo microcoscopio por razones didácticas. Irrigación continua para reducir la temperatura del tejido. Trato a la plaqueta como tejido viable. No suturo la plaqueta. No cierro músculo. ATB por una semana después de cirugía. Hidrocefalia: Válvula en todos los casos de ventriculomegalia. Médula anclada: Desanclar una sola vez. Chiari II: Revisar la válvula. Incluir en el seguimiento rendimiento escolar, puede indicar obstrucción de la válvula o médula anclada. PMID:24791217

From Rome to Como: 20 years of active research on carbon-based electrodes for lithium batteries at INP-Grenoble

NASA Astrophysics Data System (ADS)

Yazami, Rachid

This paper reviews the main areas of research performed at different Laboratories of the Institut National Polytechnique de Grenoble (INPG) over the past 20 years, specifically on cabonaceous materials for electrode applications in lithium batteries. The most significant event was the discovery in the early 1980s of reversible lithium intercalation into graphite in polymer electrolytes, which led to the use of this material in today's lithium-ion batteries. Important work was also carried out on positive electrode for primary and secondary batteries, especially graphite oxide and graphite fluoride. Most of these results were presented at the 10 IMLB series Symposia, which started in Rome in 1982 and were back to Como, Italy, in 2000.

Low temperature growth of ultra-high mass density carbon nanotube forests on conductive supports

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sugime, Hisashi; Esconjauregui, Santiago; Yang, Junwei

2013-08-12

We grow ultra-high mass density carbon nanotube forests at 450 °C on Ti-coated Cu supports using Co-Mo co-catalyst. X-ray photoelectron spectroscopy shows Mo strongly interacts with Ti and Co, suppressing both aggregation and lifting off of Co particles and, thus, promoting the root growth mechanism. The forests average a height of 0.38 μm and a mass density of 1.6 g cm{sup −3}. This mass density is the highest reported so far, even at higher temperatures or on insulators. The forests and Cu supports show ohmic conductivity (lowest resistance ∼22 kΩ), suggesting Co-Mo is useful for applications requiring forest growth onmore » conductors.« less

PubMed

Rodríguez, Yarimar Rosa; Díaz, Nelson Varas

2008-01-01

El proceso de estigmatización asume una devaluación de la persona debido a una característica o marca que haya sido identificada socialmente y que permita que se le describa como diferente. Desde que se desató la epidemia del VIH/SIDA, vivir con la enfermedad ha sido señalado de manera social como una marca estigmatizante. Las manifestaciones de dicha estigmatización se han documentado entre profesionales de la salud. Este estigma puede afectar los servicios de salud que las personas que viven con VIH/SIDA reciben de estos profesionales. Los objetivos de esta investigación fueron explorar: 1) la percepción que tienen estudiantes y profesionales de la salud sobre su nivel de competencia para ofrecer servicios a personas que viven con VIH/SIDA, 2) las opiniones de éstos sobre el tipo de adiestramiento profesional recibido y la necesidad del mismo, y 3) la manifestación de actitudes estigmatizantes como indicadores de necesidad de adiestramiento profesional. La muestra total del estudio estuvo compuesta por 80 de diversas profesiones de la salud. Los resultados reflejan que algunos/as de los/as participantes han recibido formación en VIH pero ésta no ha sido suficiente para contrarrestar las nociones estigmatizantes. Discutimos las implicaciones de los resultados para investigaciones futuras y el desarrollo de intervenciones con vías de minimizar las nociones estigmatizantes en los escenarios de salud.

Estudio teórico de moléculas de interés en Astrofísica: compuestos binarios policarbonados

NASA Astrophysics Data System (ADS)

Largo-Cabrerizo, A.

Se han detectado en el espacio distintos compuestos binarios policarbonados (que se pueden formular como CnX), algunos de ellos con elementos de la primera fila del sistema periódico, pero también existen otros que contienen elementos de la segunda fila, como azufre o silicio. La información experimental sobre estos últimos compuestos es escasa, por lo que los estudios teóricos son especialmente valiosos en este campo. En esta comunicación presentaremos los avances mas recientes que sobre el tema ha realizado nuestro grupo. Incidiremos particularmente en dos aspectos. En primer lugar resumiremos los estudios en los que hemos intentado proporcionar información estructural sobre carburos metálicos formados por sodio, magnesio, aluminio o calcio, que pueda ser de ayuda a la hora de caracterizar estas moléculas en laboratorio como paso previo a su eventual detección en el espacio. Un aspecto importante dentro de este primer apartado es el análisis de las propiedades moleculares en función del tamaño del sistema (cuantificado en el numero de átomos de carbono) con el objeto de intentar sistematizar su estudio. En segundo lugar comentaremos brevemente algunos de los estudios realizados sobre posibles reacciones que pueden ser vías de síntesis de este tipo de compuestos en el medio interestelar.

Resposta do detector de ondas gravitacionais Mario Schenberg ao "ringdown" de buraco negros

NASA Astrophysics Data System (ADS)

Costa, C. A.; Aguiar, O. D.; Magalhães, N. S.

2003-08-01

Acredita-se que quando duas estrelas de nêutrons coalescem, elas, eventualmente, formam um buraco negro com massa igual a soma das massas dos objetos originais. Durante a formação do buraco negro, o espaço-tempo em torno do sistema sofre perturbações que se propagam na forma de radiação gravitacional. A forma de onda associada a radiação gravitacional, durante este estágio, aproxima-se a uma senóide exponencialmente amortecida. Este tipo de sinal é conhecido como "ringdown", e seu comportamento e parametrização são muito bem conhecidos. Neste trabalho, simulamos computacionalmente sinais provenientes do "ringdown" de buracos negros, com a finalidade de testar o desempenho do detector de ondas gravitacionais Mario Schenberg em observá-los, quando entrar em funcionamento. Este primeiro teste teórico ajudou-nos a criar estratégias de detecção de sinais imersos no ruído instrumental. Calculamos a relação sinal-ruído como uma função da frequência, bem como sua integral dentro da faixa de sensibilidade do detector. Os resultados obtidos mostraram que o detector Schenberg terá sensibilidade suficiente para detectar este tipo de sinal, proveniente de fontes astrofísicas localizadas dentro de um raio de ~100kpc.

Biblioteca Virtual de Salud Enfermería Regional: Trayectoria de Construcción, Fuentes de Información, Estrategias y Próximos Pasos.

PubMed Central

Lana, Francisco C. F.; Malvárez, Silvina

2012-01-01

Resumen La BVS Enfermeria constituye un nuevo paradigma en enfermería una vez que o modelo representa una expansión de la cooperación técnica y ha como objetivos centrales promover la ampliación del acceso la información sobre enfermería la través del acceso universal equitativo y construir un patrimonio informacional en enfermería, ayudando la mejorar la formación y práctica de enfermería a actuar con compromiso ético-social en el área de educación, investigación y atención a la salud. Como resultado del proceso de sensibilización, verifica-se la construcción de Bibliotecas Virtuales de Enfermería en varios países (Brasil, Argentina, Bolívia y Uruguay). La expectativa es que las BVS’s nacionais convergen a un gran portal que se está construyendo en una colaboración con BIREME/OPS/OMS, de la Asesoría Regional de Enfermería de la OPS-Washington y de Ministerio de Salud del Brasil, así como instituciones líderes en la producción del conocimiento en enfermería Iberoamérica. PMID:24199093

Perda de massa em ventos empoeirados de estrelas supergigantes

NASA Astrophysics Data System (ADS)

Vidotto, A. A.; Jatenco-Pereira, V.

2003-08-01

Em praticamente todas as regiões do diagrama HR, as estrelas apresentam evidências observacionais de perda de massa. Na literatura, pode-se encontrar trabalhos que tratam tanto do diagnóstico da perda de massa como da construção de modelos que visam explicá-la. O amortecimento de ondas Alfvén tem sido utilizado como mecanismo de aceleração de ventos homogêneos. Entretanto, sabe-se que os envelopes de estrelas frias contêm grãos sólidos e moléculas. Com o intuito de estudar a interação entre as ondas Alfvén e a poeira e a sua conseqüência na aceleração do vento estelar, Falceta-Gonçalves & Jatenco-Pereira (2002) desenvolveram um modelo de perda de massa para estrelas supergigantes. Neste trabalho, apresentamos um estudo do modelo acima proposto para avaliar a dependência da taxa de perda de massa com alguns parâmetros iniciais como, por exemplo, a densidade r0, o campo magnético B0, o comprimento de amortecimento da onda L0, seu fluxo f0, entre outros. Sendo assim, aumentando f0 de 10% a partir de valores de referência, vimos que aumenta consideravelmente, enquanto que um aumento de mesmo valor em r0, B0 e L0 acarreta uma diminuição em .

Estudio del comportamiento tribologico y de las interacciones de superficie de nuevos nanofluidos ionicos

NASA Astrophysics Data System (ADS)

Espinosa Rodriguez, Tulia

Ionic liquids are molten salts which are liquid at room temperature or at low temperatures and present a unique combination of properties. In the present work, we focus on their use as lubricants in complex tribological problems such as the lubrication of metals that slide against themselves, the development of water based lubricants and new self-lubricated surfaces. When it is difficult to reduce friction and wear by lubrication, as in the case of magnesium alloys, ionic liquids are studied as protective coatings precursors. Surface interactions and corrosion processes with protic and aprotic ionic liquids on copper and steel have been determined in order to develop new lubricants and lubricant additives. In the copper/copper contact, all ionic liquids present better tribological performance than the polyalphaolefin synthetic oil, except for the oleate derivative. New protic ionic liquids are not only exceptional lubricants of the steel/sapphire contact as neat lubricants, but when they are used as additives in water, the formation of a boundary layer after water evaporation occurs, thus reducing friction and wear. The formation of this boundary layer on steel under static conditions is described in order to prevent the running-in period with respect to the solution of ionic liquid in water. The best lubricating behaviour for the copper/copper contact and also for the steel/sapphire contact is obtained for the diprotic ammonium dianionic adipate, that has two carboxylate groups in its anion. A higher polarity and a higher number of ammonium protons, carboxylate and hydroxyl groups would give rise to stronger surface interaction with the metal surfaces and more stable boundary films. The tribological performance of new aprotic thiazolium ionic liquids and commercial aprotic imidazolium ionic liquids has been compared as lubricants of the steel/sapphire contact, obtaining the best results for the bis(trifluoromethanesulfonyl)imide derivatives, and also preventing tribocorrosion processes. The formation of a coating layer on magnesium alloys from phosphonate imidazolium ionic liquids by immersion and by chronoamperometry has been described. The new coatings reduce the abrasive wear in the magnesium-aluminium alloy but they are not effective in the magnesium-zinc alloy, which prevent the formation of continuous coatings. Los liquidos ionicos son sales liquidas a temperatura ambiente o bajas temperaturas que presentan excelentes propiedades fisico-quimicas. En el presente trabajo se estudian como lubricantes en problemas tribologicos complejos como la lubricacion de metales contra si mismos, el desarrollo de lubricantes base agua y de nuevas superficies autolubricadas. Cuando no es posible reducir la friccion y desgaste mediante lubricacion, como en las aleaciones de magnesio, los liquidos ionicos se han estudiado como precursores de recubrimientos protectores. Se han determinado las interacciones superficiales y los procesos de corrosion sobre cobre y sobre acero con diferentes liquidos ionicos proticos y aproticos para desarrollar nuevos lubricantes y aditivos. En el contacto cobre/cobre, excepto el liquido ionico protico derivado del oleato, todos los liquidos ionicos estudiados presentan mejor comportamiento tribologico que el lubricante comercial Polialfaolefina 6. En el contacto acero/zafiro, los nuevos liquidos ionicos proticos son buenos lubricantes cuando se utilizan en estado puro, y, como aditivos en agua, generan peliculas adsorbidas sobre la superficie del metal reduciendo la friccion y el desgaste tras la evaporacion del agua. Para evitar el periodo de alta friccion inicial en presencia de agua, se han generado peliculas superficiales de liquido ionico sobre el acero en condiciones estaticas. El mejor comportamiento lubricante tanto en el contacto cobre/cobre como en el contacto acero/zafiro se obtiene para el liquido ionico protico derivado del anion adipato, con dos grupos carboxilicos. Las interacciones de los grupos hidroxilo y carboxilato con la superficie metalica y los puentes de hidrogeno entre cation y anion podrian ser los responsables del buen comportamiento tribologico. Se ha comparado el comportamiento tribologico de los liquidos ionicos aproticos derivados de imidazolio y tiazolio como lubricantes del contacto acero/zafiro, obteniendose los mejores resultados para los derivados del anion bis(trifluorometanosulfonil)imida, que evita a su vez los procesos de tribocorrosion. Se han generado recubrimientos sobre aleaciones de magnesio con tres liquidos ionicos derivados del anion fosfonato, tanto por inmersion como mediante cronoamperometria. Los nuevos recubrimientos reducen el dano superficial por deslizamiento o abrasion de la aleacion magnesio-aluminio pero no de la aleacion magnesio-cinc, que impide la formacion de recubrimientos continuos.

Monóxido de carbono

EPA Pesticide Factsheets

La mayoria de los accidentes causados por envenenamiento por monoxido de carbono (CO) se producen en los hogares y estan relacionados a nuestras actividades diarias como cocinar y usar la calefaccion.

If Your Child Learns in Two Languages: A Parent's Guide for Improving Educational Opportunities for Children Acquiring English as a Second Language = Si su nino aprende en dos idiomes: Una guia para que las familias sepan como mejorar las oportunidades educativas de los ninos que adquieren el ingles como segunda lengua = Neu lon Ban Hoc Bang Hai Thu Tieng: Chi-nam cua phu-huynh de cai tien co hoi hoc van cua con em dang hoc Anh van nhu sinh ngu thu hai.

ERIC Educational Resources Information Center

Zelasko, Nancy; Antunez, Beth

This guide, in English, Spanish, and Vietnamese, aims to inform parents of students who have learned or are learning English as a Second Language about appropriate approaches for educating children so that they can work with schools to ensure a high quality education for their children. The emphasis is on explaining the laws, schools, and research…

Enhanced hydrogen evolution reaction on hybrids of cobalt phosphide and molybdenum phosphide

NASA Astrophysics Data System (ADS)

Fang, Si-Ling; Chou, Tsu-Chin; Samireddi, Satyanarayana; Chen, Kuei-Hsien; Chen, Li-Chyong; Chen, Wei-Fu

2017-03-01

Production of hydrogen from water electrolysis has stimulated the search of sustainable electrocatalysts as possible alternatives. Recently, cobalt phosphide (CoP) and molybdenum phosphide (MoP) received great attention owing to their superior catalytic activity and stability towards the hydrogen evolution reaction (HER) which rivals platinum catalysts. In this study, we synthesize and study a series of catalysts based on hybrids of CoP and MoP with different Co/Mo ratio. The HER activity shows a volcano shape and reaches a maximum for Co/Mo = 1. Tafel analysis indicates a change in the dominating step of Volmer-Hyrovský mechanism. Interestingly, X-ray diffraction patterns confirmed a major ternary interstitial hexagonal CoMoP2 crystal phase is formed which enhances the electrochemical activity.

Conceptos Basicos Sobre el Propano (in Spanish)

DOE Office of Scientific and Technical Information (OSTI.GOV)

El propano provee energia a mas de 143.000 vehiculos en los Estados Unidos y 23 millones en todo el mundo. Flotas de todos los Estados Unidos han implementado con exito el uso de vehiculos que funcionan con gas propano, y en la actualidad varios funcionan gracias a este gas, incluyendo autobuses escolares, lanzaderas y autobuses publicos, asi como tambien furgonetas, taxis, vehiculos utilizados por las fuerzas del orden, barredoras de calles y camiones para uso profesional. El propano tambien se utiliza con frecuencia en aplicaciones fuera de la carretera, tales como montacargas, podadoras y equipos de uso profesional y otrosmore » equipos agricolas. Las ventajas del propano incluyen la disponibilidad interna, su rendimiento y el hecho de que genera menos emisiones de gases contaminantes que otras alternativas energeticas.« less

Spanish Summary (Nuevos meteoritos encountrados en lmilac)

NASA Astrophysics Data System (ADS)

1987-03-01

Desde tiempos prehistoricos han sido coleccionadas piedras que caen dei cielo. Hasta hace poco eran la unica fuente para hacer estudios de laboratorio de la materia extragal, ktica, e incluso en nuestra era espacial, siguen siendo una valiosa fuente de investigacion de la temprana historia dei sistema solar. Se estima que como termine medio cada kilometro cuadrado de la superficie terrestre es golpeada cada millon de aiios por un meteorito con un pese superior a 500 gramos. La mayoria se pierden en los oceanos 0 caen en regiones con escasa poblacion. Como resultado, los museos en el munda reciben anualmente tan solo alrededor de 6 meteoritos cuya caida fuera atestiguada. Otros llegan por hallazgos casuales que en la mayoria de los casos son meteoritos que han cardo en tiempos prehistoricos.

[Competence in biocentric ethics.

PubMed

Stepke, Fernando Lolas

2012-07-01

ResumenEste artículo explora el origen y la conceptualización de la bioética en tanto ética biocéntrica, definida por el pionero Fritz Jahr como un imperativo hipotético que llama a respetar la vida en todas sus formas. Tras describirla como proceso social, procedimiento técnico y producto académico, se enumeran y comentan algunas competencias que debieran presidir el empleo del discurso bioético en cualquier punto del complejo social "investigación médica": miembros de comités de ética de investigación, investigadores, empresarios, administradores. Cada uno de estos grupos, en su "cultura epistémica" propia, define y explicita los principios básicos en tanto expresión de valores y leyes generales.

Les déformations eburnéennes de l'unité birrimienne de la comoé (côte d'ivoire)

NASA Astrophysics Data System (ADS)

Vidal, M.

The analysis of Eburnean strain fields in the Upper (?) Birrimian Comoé Unit shows four great stages of tectogenesis: an early cleavage subparallel to stratification which results from synkinematic granitoïd intrusions; a folding (N40°E to N60°E); a transcurrent faulting period, essentially ductile N-S sinistral; N120°E schistosity, and a N110°E transcurrent ductile sinistral (?) faulting phase. The importance of the sinistral N-S faulting system and, to a lesser extent, the N120°E schistosity direction, is shown. The probable rôle of these directions (particularly N-S) from Liberian to Upper Cretaceous is shown by the within-plate tectonic occurrences in the West-African craton.

Tal Como Somos/just as we are: an educational film to reduce stigma toward gay and bisexual men, transgender individuals, and persons living with HIV/AIDS.

PubMed

Ramirez-Valles, Jesus; Kuhns, Lisa M; Manjarrez, Dianna

2014-04-01

In this article, the authors describe the development and dissemination of a film-based educational intervention to reduce negative attitudes toward gay and bisexual men, transgender women, and people living with HIV/AIDS in Latino communities, with a focus on youth. The intervention, Tal Como Somos/Just as We Are, is based on stigma and attribution theories, extensive formative research, and community input. Evaluation findings among educators and school youth suggest the film has the potential to effectively influence attitudes toward gay and bisexual men, transgender women, and people living with HIV/AIDS. The film and intervention are being disseminated using diffusion of innovations theory through community-based organizations, schools, television broadcasting, and film festivals.

Investigación del USGS sobre el ecosistema de arrecifes de coral en el Atlántico

USGS Publications Warehouse

Kuffner, Ilsa B.; Yates, Kimberly K.; Zawada, David G.; Richey, Julie N.; Kellogg, Christina A.; Toth, Lauren T.; Torres-Garcia, Legna M.

2015-10-23

Los arrecifes de coral son estructuras sólidas, biomineralizadas que protegen comunidades costeras actuando como barreras protectoras de peligros tales como los huracanes y los tsunamis. Estos proveen arena a las playas a través de procesos naturales de erosión, fomentan la industria del turismo, las actividades recreacionales y proveen hábitats pesqueros esenciales. La conti-nua degradación mundial de ecosistemas de arrecifes de coral está bien documentada. Existe la necesidad de enfoque y organización de la ciencia para entender los procesos complejos físicos y biológicos e interacciones que están afectando el estado de los arrecifes coralinos y su capacidad para responder a un entorno cambiante.

Astronomy in the Classroom: Why? (Spanish Title: Astronomía en la Clase: ¿Por Qué?) Astronomia na Sala de Aula: Por Quê?

NASA Astrophysics Data System (ADS)

Daros Gama, Leandro; Bagdonas Henrique, Alexandre

2010-07-01

There are many discussions about the relevance of the topics covered in classes. One subject in particular is the focus of this essay: astronomy. In what sense and to what extent it would be worth to teach it in science or other kind of classes? In this paper we discuss some aspects of the advantages of dealing with this area of knowledge in schools, taking into account the epistemological and axiological dimensions of astronomy, in light of the vision of science as an intelligent dialogue with the world (Bachelard), in addition to the "problematization" knowledge of Paulo Freire. We propose that in fact the Astronomy does not need to be seen as just a new set of contents to be taught, but appears as a set of motivational contents for historical-philosophical discussions, and permit the discussion of concepts of other disciplines. Numerosas discusiones se están llevando a cabo acerca de la pertinencia de los temas tradicionalmente tratados en las clases. Uno de los temas, en particular, es el foco de este ensayo: la astronomía. ¿En qué sentido y en qué medida sería conveniente tratarla en clase, ya sea en clases de ciencias naturales, específicamente en las de astronomía o asignaturas afines? Elaboramos en este artículo algunos aspectos de las ventajas de tratar esta área del conocimiento en las escuelas, teniendo en cuenta las dimensiones epistemológica y axiológica de la astronomía, a la luz de la visión de la ciencia como un diálogo inteligente con el mundo (Bachelard), además de la propuesta del conocimiento "problematizador" de Paulo Freire. Proponemos que en realidad la astronomía no tiene por qué ser vista sólo como un nuevo conjunto de contenidos que se enseñan, sino que aparece como un conjunto de temas de motivación para el debate histórico-filosófico y para permitir la discusión de los conceptos típicos de otras disciplinas. Muitas discussões vêm acontecendo sobre a relevância dos temas abordados em sala de aula. Um tema, em particular, é foco deste ensaio: a astronomia. Em que sentido e em que medida valeria a pena abordá-la em aulas, seja de ciências, seja de astronomia especificamente, ou em disciplinas afins? Discutimos neste texto alguns aspectos das vantagens de se tratar essa área do conhecimento nas escolas, levando em conta as dimensões epistemológica e axiológica da astronomia, à luz da visão da ciência como um diálogo inteligente com o mundo, de Bachelard, além da proposta de problematização do conhecimento, de Paulo Freire. Proporemos que de fato a astronomia não precisa ser vista como apenas um novo conjunto de conteúdos a serem ensinados, mas figura como conjunto de temas motivadores para discussões histórico-filosóficas, além de permitir a abordagem de conceitos típicos de outras disciplinas.

Health and innovation: economic dynamics and Welfare State in Brazil.

PubMed

Gadelha, Carlos Augusto Grabois; Braga, Patrícia Seixas da Costa

2016-11-03

The effective enforcement of the access to healthcare as fundamental right requires an important theoretical and political effort at linking the often contradictory economic and social dimensions of development. This study suggests the need for a systemic view of policies related to the industrial base and innovation in health and the construction of the Brazilian Unified National Health System (SUS). The authors investigate the relations between health, innovation, and development, seeking to show and update the political, economic, and social determinants of the recent Brazilian experience with the Health Economic-Industrial Complex (HEIC). They discuss how the agenda for innovation and domestic industrial production in health gained a central place in the project for construction of the SUS. The article thus seeks to link inherent issues from the agenda for development, production, and innovation to social policy in healthcare, as observed in recent years, and based on this analysis, points to political and conceptual challenges for implementing the SUS, especially as regards strengthening its technological and industrial base. As a byproduct, the article develops an analytical and factual focus on the consolidation of the HEIC in Brazil, both as a dynamic vector of industrial development, generating investment, income, employment, and innovations, and as a decisive element for reducing vulnerability and structural dependence in health. The authors aim to show that strengthening the SUS and orienting it to social needs is an essential part of building a social Welfare State in Brazil. Resumo: A efetivação da saúde como um direito fundamental exige importante esforço, teórico e político, de articulação das dimensões econômicas e sociais, por vezes contraditórias, do desenvolvimento. Este trabalho indica a necessidade de um olhar sistêmico das políticas relacionadas à base produtiva e de inovação em saúde e à construção do Sistema Único de Saúde (SUS). Investiga as relações entre saúde, inovação e desenvolvimento, buscando mostrar e atualizar os determinantes políticos, econômicos e sociais da experiência brasileira recente relacionada ao Complexo Econômico-Industrial da Saúde (CEIS). Mostra como a agenda da inovação e da produção nacional em saúde ganhou centralidade no projeto de construção do SUS. O artigo procura, assim, articular questões inerentes à agenda do desenvolvimento, da produção e da inovação com a política social em saúde, tal como observado nos últimos anos e, valendo-se de sua análise, aponta desafios políticos e conceituais para a efetivação do SUS, em especial no que se refere ao fortalecimento de sua base tecnológica e produtiva. Como desdobramento, desenvolve um enfoque analítico e factual que relaciona a consolidação do CEIS no Brasil tanto como um vetor dinâmico do desenvolvimento industrial, gerando investimento, renda, emprego e inovações, quanto como elemento decisivo para a redução da vulnerabilidade e da dependência estrutural em saúde. Procura mostrar que seu fortalecimento e direcionamento para as necessidades sociais é parte essencial da construção de um Estado de Bem-Estar Social no Brasi.

Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study.

PubMed

Lombardi, Natália Fracaro; Mendes, Antonio Eduardo Matoso; Lucchetta, Rosa Camila; Reis, Wálleri Christini Torelli; Fávero, Maria Luiza Drechsel; Correr, Cassyano Januário

2016-08-15

this observational study aimed to describe the discrepancies identified during medication reconciliation on patient admission to cardiology units in a large hospital. the medication history of patients was collected within 48 hours after admission, and intentional and unintentional discrepancies were classified as omission, duplication, dose, frequency, timing, and route of drug administration. most of the patients evaluated were women (58.0%) with a mean age of 59 years, and 75.5% of the patients had a Charlson comorbidity index score between 1 and 3. Of the 117 discrepancies found, 50.4% were unintentional. Of these, 61.0% involved omission, 18.6% involved dosage, 18.6% involved timing, and 1.7% involved the route of drug administration. this study revealed a high prevalence of discrepancies, most of which were related to omissions, and 50% were unintentional. These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences. este estudo observacional teve como objetivo descrever discrepâncias encontradas na realização de conciliação medicamentosa de pacientes admitidos em unidades de cardiologia de um hospital de grande porte. a história de medicação dos pacientes foi coletada dentro de 48h após a admissão, e as discrepâncias, identificadas como intencionais ou não intencionais, foram classificadas como de: omissão, duplicidade, dose, frequência, intervalo e via. a maioria dos pacientes incluídos pertençia ao sexo feminino (58,0%), com idade média de 59 anos, e com índice de comorbidades de Charlson entre 1 e 3 (75,5% dos casos). Das 117 discrepâncias encontradas, 50,4% foram não intencionais. Dessas, 61,0% foram de omissão, 18,6% de dose, 18,6% de intervalo e 1,7% de via de administração. o estudo mostra a alta prevalência de discrepâncias, principalmente de omissão, sendo quase metade não intencionais. Esse dado remete ao número de medicamentos que não são reincorporados ao tratamento dos pacientes, podendo repercutir em consequências clínicas importantes. este estudio observacional tuvo como objetivo describir discrepancias encontradas en la realización de la conciliación medicamentosa de pacientes admitidos en unidades de cardiología de un hospital de gran porte. la historia de medicación de los pacientes fue recolectada dentro de 48h después de la admisión, y las discrepancias, identificadas como intencionales o no intencionales, fueron clasificadas como: omisión, duplicidad, dosis, frecuencia, intervalo y vía. la mayoría de los pacientes incluidos pertenecía al sexo femenino (58,0%), con edad promedio de 59 años, y con índice de comorbilidad de Charlson entre 1 y 3 (75,5% de los casos). De las 117 discrepancias encontradas, 50,4% fueron no intencionales. De estas, 61,0% fueron de omisión, 18,6% de dosis, 18,6% de intervalo y 1,7% de vía de administración. el estudio muestra la alta prevalencia de discrepancias, principalmente de omisión, siendo casi mitad de ellas no intencionales. Ese dato nos indica el número de medicamentos que no son reincorporados al tratamiento de los pacientes, lo que puede repercutir en consecuencias clínicas importantes.

Late Glacial to Holocene environmental variabilities: A new multi-proxy paleolimnological study of sedimentary sequences from Como (northern Italy)

NASA Astrophysics Data System (ADS)

Höbig, N.; Martinelli, E.; Motella, S.; Michetti, A. M.; Livio, F.; Tinner, W.; Reicherter, K.; Castelletti, L.

2012-04-01

Lake Como (northern Italy) is the deepest Italian lake, reaching a depth of about 425 m. The lambda-shaped lake expands about 45 km in NE-SW direction. Southwards of the hydrologically closed western branch, two sediment cores of 70 m (S1) and 65 m length (S2) were taken in the year 2005 close to the cathedral of Como (Piazza Verdi). The drilling sites are located in the middle of the Southern Alps, some 300 m from the present-day lakeshore. The cores provide the first detailed Late Glacial to Holocene multi-proxy record for the Lake Como basin. Our research is aimed at investigating the environmental and geological evolution of the Insubria Region. The multi-proxy study of the stratigraphic sequences contain geophysical, geotechnical, sedimentological, paleobotanical, and radiocarbon analyses. They have been performed for core S1 and are still in progress on core S2. With this data the working group focuses on two main issues. The first topic is the reconstruction of the natural and anthropogenic processes controlling the ground subsidence in the Como urban area (e.g., Comerci et al., 2007) and another aim is to reconstruct vegetation and land-use dynamics. In particular, 150 samples of vegetal macroremains have been collected in the palustrine deposits along S1 core, down to 31,00 m. Below this depth (dated 14C 12,496 ± 55 yr BP - 15,050 - 14,250 cal yr BP), the amount of plant macroremains in the sediment drops dramatically. The taxonomic determination was carried out on more than 800 macroremains. They are represented by fragments of wood, leaves, needles, seeds, fruits, mosses and tiny charcoals (Motella, 2009, unpublished PhD Thesis). Picea/Larix, Pinus sp., Juniperus with Betula, found in the deeper levels (30.80 - 30.00 m), are the first arboreal taxa that colonized the shores of Lake Como, and show that the reforestation began in this area about 16,000 years ago. During the early Holocene (25.10 m) Abies alba expanded and further upwards the sequence mixed deciduous forests became important. Preliminary results of palynological analyses for a section of the core S2 (35.04 - 18.12 m), show Late Glacial sediments in the depth of 35.04 - 31.16 m, due to vegetation changes related to natural climatic variability, with an alternation of communities typical of cold (Poaceae, Artemisia, Juniperus, Pinus and Betula) and temperate climates (e.g. Quercus). Later, during the Holocene, forests composed by mostly deciduous broadleaves and Abies alba expanded. During the mid and late Holocene human impact increased and modified vegetation. This is shown by the increase of herbs and heliofilous shrubs (26.51 m), typical of deforested spaces for fields and pastures. Human exploitation of wood is represented for example by the dramatic decline of Abies alba (24.97 m). Finally, the increase of Cerealia (19.39 m) is clearly related to intensified agricultural activities. The results of further paleobotanical and geophysical analyses which are in progress will be presented during the conference. Moreover, geochemical measurements (e.g., XRF) will be performed in future for core S2. Researches realized within the project of Italy-Switzerland Cooperation SITINET "Censimento, valorizzazione e messa in rete di siti geologici e archeologici" (Census, increase of value and computerization of geological and archaeological sites). Interreg IV A "Geo-Archeositi dell'Insubria" (Geo-Archaeosites of Insubria).

Mortality trends for tuberculosis in European Union countries, 2000-2010.

PubMed

Al-Rahamneh, Moad J; Al-Rahamneh, Anas; Guillén-Grima, Francisco; Arnedo-Pena, Alberto; Aguinaga-Ontoso, Inés

The objective of this study was to update and analyze tuberculosis (TB) mortality data in the European Union between 2000 and 2010 separately for men and women and try to detect if there have been any changes in trends in each country and the association with the economic situation and inequalities. Data were extracted for tuberculosis deaths in 2000-2010 for 29 European Union countries and for Switzerland, via the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTL1) codes for men and women separately for one age group (20-85+). We estimated age-standardised mortality rates, and analyzed data using the Joinpoint Regression Program for men and women separately in the European Union overall and by individual country for each year. Between 2000 and 2010, there were 68,771 recorded tuberculosis deaths in the European Union and the mortality rates were higher for men than women in the entire study zone. Overall, TB mortality rates declined linearly for both genders, but more in women than in men (from 5.43/100,000 in 2000 to 2.59/100,000 in 2010 in men and from 1.37/100,000 in 2000 to 0.51/100,000 in 2010 in women). There was decline in both genders for the entire study period, with a significant Estimated Annual Percentage Change (EAPC) of -8.1 for women and -7 for men when alpha<0.05 and with a 95% confidence interval (CI). A higher tuberculosis mortality was associated with lower economic resources and greater inequalities. TB mortality rates in the European Union decreased overall in 2000-2010 for both genders. Men have higher TB mortality rates than women in all countries. Our findings were consistent with the downward TB mortality trend in many other countries worldwide. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

In vitro activity of a polyhexanide-betaine solution against high-risk clones of multidrug-resistant nosocomial pathogens.

PubMed

López-Rojas, Rafael; Fernández-Cuenca, Felipe; Serrano-Rocha, Lara; Pascual, Álvaro

2017-01-01

To determine the in vitro activity of a polyhexanide-betaine solution against collection strains and multidrug-resistant (MDR) nosocomial isolates, including high-risk clones. We studied of 8 ATCC and 21 MDR clinical strains of Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, including the multiresistant high-risk clones. The MICs and MBCs of a 0.1% polyhexanide-0.1% betaine solution were determined by microdilution. For each species, strains with the highest MICs were selected for further experiments. The dilution-neutralization test (PrEN 12054) was performed by incubating bacterial inocula of 10 6 CFU/mL for 1min with undiluted 0.1% polyhexanide-betaine solution. The CFUs were counted after neutralization. Growth curves and time-kill curves at concentrations of 0.25, 1, 4, and 8×MIC, were performed. MICs of recovered strains were determined when regrowth was observed in time-kill studies after 24h of incubation. Strains with reduced susceptibility were selected by serial passage on plates with increasing concentrations of polyhexanide-betaine, and MICs were determined. Polyhexanide-betaine MIC range was 0.5-8mg/L. MBCs equalled or were 1 dilution higher than MICs. The dilution-neutralization method showed total inoculum clearance of all strains. In time-kill curves, no regrowth was observed at 4×MIC, except for S. aureus (8×MIC). Increased MICs were not observed in time-kill curves, or after serial passages after exposure to polyhexanide-betaine. Polyhexanide-betaine presented bactericidal activity against all MDR clinical isolates tested, including high-risk clones, at significantly lower concentrations and time of activity than those commercially used. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Influence of baseline MELD score in the efficacy of treatment of hepatitis C with simeprevir and sofosbuvir.

PubMed

Moreno-Planas, José María; Larrubia-Marfil, Juan Ramón; Sánchez-Ruano, Juan José; Morillas-Ariño, Julia; Patón-Arenas, Roberto; Sáiz-Chumillas, Rosa María; Tébar-Romero, Emilia; Lucendo-Villarín, Alfredo; Gancedo-Bringas, Pilar; Solera-Muñoz, Mario; Vicente-Gutiérrez, María Del Mar; Martínez-Alfaro, Elisa

2018-05-01

There are few published studies on predictors of response to treatment with sofosbuvir and simeprevir in HCV patients. The objective of the study was to analyse possible predictors of response to simeprevir (SMV) and sofosbuvir (SOF) in patients infected with hepatitis C genotypes 1 or 4. Prospective observational cohort study in 12 hospitals. The primary efficacy endpoint was SVR rate 12 weeks after end of treatment (SVR12). 204 patients (62.3% male, mean age 55 years) were included: 186 (91.2%) genotype 1 (60.3% 1b 25% 1a) and 18 (8.8%) genotype 4. 132 (64.7%) cirrhotic (87.9% Child A), 33 (16.2%) F3, 31 (15.2%) F2, 8 (3.9%) F0-1. 80.8% MELD<10. 93 (45.6%) naive. Ribavirin was added in 68 (33.3%). Mean baseline viral load 2,151,549 IU/ml (SD: 2,391,840). Treatment duration 12 weeks in 93.1%. 4 discontinued therapy: suicide, psychotic attack, hyperbilirubinaemia and liver cancer recurrence. 190 (93.1%) achieved SVR12. There were no differences in SVR12 depending on the genotype, treatment duration, ribavirin use, prior therapy, viral load (VL) or baseline platelets. In univariate analysis, undetectable VL at 4 weeks (p=0.042), absence of cirrhosis (p=0.021), baseline albumin ≥ 4g/dl (p=0.001) and MELD<10 (p<0.0001) were associated with higher SVR12. In multivariate analysis, only baseline MELD score <10 patients had higher SVR12 (p<0.001). The combination of simeprevir and sofosbuvir in patients infected with genotype 1 and 4 hepatitis C is highly effective. It is a safe therapy, especially in patients without ribavirin. This combination was more effective in patients with a MELD score below 10. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Identifying priorities to improve paediatric in-hospital antimicrobial use by cross-sectional evaluation of prevalence and appropriateness of prescription.

PubMed

Goycochea-Valdivia, Walter Alfredo; Moreno-Ramos, Francisco; Paño-Pardo, José Ramón; Aracil-Santos, Francisco Javier; Baquero-Artigao, Fernando; Del Rosal-Rabes, Teresa; Mellado-Peña, María José; Escosa-García, Luis

2017-11-01

Information about paediatric in-hospital antimicrobial usage and prescribing patterns to guide improvement strategies is scant. We aim to use an evaluation of the prevalence and appropriateness of antimicrobial prescription to identify antimicrobial stewardship priorities in children. A cross-sectional point study was performed on hospitalised paediatric patients in a Spanish tertiary hospital, assessing the prevalence of antimicrobial prescription (PAP) and appropriateness of antimicrobial prescription (AAP). AAP was defined as a correct indication plus an appropriate prescribing pattern (dose, spectrum and interval). Evaluation was performed using established antimicrobial guidelines. Other factors that may have a bearing on antimicrobial prescription were also analysed. A total of 171 patients were included. PAP was 49.7% (85/171) and AAP was 60.9% (91/161). The most common indications for antimicrobial use were antimicrobial prophylaxis (28.3%, 32/113) and pneumonia (8.2%, 8/113). Overall, 161 antimicrobials were prescribed (1.9 antimicrobials per patient): 55.3% (89/161) were empiric, 16.1% (26/161) were targeted and 28.6% (46/161) were prophylactic. Amoxicillin/clavulanate (8.2%, 14/171) and sulfamethoxazole/trimethoprim (8.2%, 14/171) were the most prescribed antimicrobials. The prescription of antifungals (11.7%, 20/171) and antivirals (1.8%, 3/171) was analysed. Major causes of inappropriate antibiotic use were prolonged prescriptions (21.7%, 35/161) and use of agents with an excessively broad coverage spectrum (21.1%, 34/161). PAP and AAP varied between wards and antimicrobials. Measurement of PAP and AAP offers valuable information for detecting priorities in hospital settings and monitoring antimicrobial usage prior to the development of antimicrobial stewardship programmes. In our setting, the main areas for improvement are duration of therapy and proper use of broad-spectrum antimicrobials. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Contribution of microbiology in the diagnosis of tuberculosis in Castile and León (Spain): Findings of the GRUMICALE 2013 study.

PubMed

López-Medrano, Ramiro; Nebreda-Mayoral, Teresa; Brezmes-Valdivieso, M Fé; García-de Cruz, Susana; Nogueira-González, Begoña; Sánchez-Arroyo, Rafael; Tinajas-Puertas, Almudena; Gutiérrez-Zufiaurre, Nieves; Labayru-Echeverría, Cristina; Hernando-Real, Susana; López-Urrutia, Luis; Rivero-Lezcano, Octavio; Ullivarri-Francia, Belén; Rodríguez-Tarazona, Raquel; Antolín-Ayala, Isabel

2018-03-01

A retrospective study was conducted by collecting microbiological tuberculosis (TB) data in Castile and León during the year 2013 in order to determine the incidence and distribution of TB, and resistance to the tuberculostatic drug, and compare them with the epidemiological data provided by the Department of Epidemiological Surveillance (SIVE). Microbiologists of the 14 hospitals of the Castile and León public health network (GRUMICALE) collected epidemiological, microbiological, and management data from the Microbiology laboratories in the community during the year 2013. A single isolate of Mycobacterium tuberculosis complex (MTC) per patient was considered. The study included a total of 270 MTC isolates (an incidence rate of 11.63 cases/100,000 inhab./year). A total of 288 cases of TB (11.43 cases/100,000 inhab. year) were recovered using epidemiological data, which included 243 confirmed, 29 suspected, and 16 as probable cases. Pulmonary TB was predominant, followed a long way off by the pleural TB and the remaining locations. A total of 27,620 samples were processed for mycobacterial detection. Mycobacterial growth was observed in 3.46% of automated fluid cultures, and 50.37% were positive by direct staining of the smear. Resistance to one tuberculostatic drug, mostly to isoniazid, was observed in 16 (5.92%) isolates of Mycobacterium tuberculosis (MT). The province with greater incidence and number of isolates was León (24.23 cases/100,000 inhab./year), with the highest being observed in El Bierzo health area (30.46 cases/100,000 inhab./year). An adequate collection of microbiological information is essential to determine the epidemiology of TB in our region. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Legal, ethical, and economic implications of breaking down once-daily fixed-dose antiretroviral combinations into their single components for cost reduction.

PubMed

Ramiro, Miguel A; Llibre, Josep M

2014-11-01

The availability of generic lamivudine in the context of the current economic crisis has raised a new issue in some European countries: breaking up the once-daily fixed-dose antiretroviral combinations (FDAC) of efavirenz/tenofovir/emtricitabine, tenofovir/emtricitabine, or abacavir/lamivudine, in order to administer their components separately, thereby allowing the use of generic lamivudine instead of branded emtricitabine or lamivudine. The legal, ethical, and economic implications of this potential strategy are reviewed, particularly in those patients receiving a once-daily single-tablet regimen. An unfamiliar change in antiretroviral treatment from a successful patient-friendly FDAC into a more complex regimen including separately the components to allow the substitution of one (or some) of them for generic surrogates (in the absence of a generic bioequivalent FDAC) could be discriminatory because it does not guarantee access to equal excellence in healthcare to all citizens. Furthermore, it could violate the principle of non-maleficence by potentially causing harm both at the individual level (hindering adherence and favouring treatment failure and resistance), and at the community level (hampering control of disease transmission and transmission of HIV-1 resistance). Replacing a FDAC with the individual components of that combination should only be permitted when the substituting medication has the same qualitative and quantitative composition of active ingredients, pharmaceutical form, method of administration, dosage and presentation as the medication being replaced, and a randomized study has demonstrated its non-inferiority. Finally, a strict pharma-economic study supporting this change, comparing the effectiveness and the cost of a specific intervention with the best available alternative, should be undertaken before its potential implementation. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prevalence and concordance of high-risk papillomavirus infection in male sexual partners of women diagnosed with high grade cervical lesions.

PubMed

López Diez, Elena; Pérez, Sonia; Iñarrea, Amparo; de la Orden, Angel; Castro, Máximo; Almuster, Sheila; Tortolero, Leonardo; Rodríguez, Moises; Montero, Ruben; Ojea, Antonio

2017-05-01

Little is known about the characteristics of high-risk papillomavirus (HR-HPV) infection in men. The aims of this cross-sectional study were: (a) to investigate HR-HPV prevalence and genotype distribution in men, sexual partners of women presenting with high-grade cervical intraepithelial neoplasia (HG-CIN), according to epidemiological characteristics, and (b) to assess type-specific concordance between partners. A total of 125 men were recruited within the first 6 months after HG-CIN diagnosis of their partner. Samples from the coronal sulcus, glans penis shaft, and scrotum were tested with linear array HPV genotyping assay (Roche Diagnostics, Mannheim, Germany). Type-specific concordance within 120 couples was studied. Epidemiological factors were evaluated by multivariate logistic regression analysis. SPSS 19 (IBM, Chicago, USA). The prevalence of HR-HPV infection in males was 50.4% (63/125). HPV16/53/52/51/66/31 were the most frequent genotypes (24/10.4/9.6/8.8/8/7.2%, respectively). Current smoking was associated with an increased risk for HR-HPV infection in men (38.2% (21/55) vs 60% (42/70), OR 2.4, p=0.025). Among 60 infected couples, 62% shared at least one genotype: 41.7% couples were concordantly HPV16 positive and 18.3% were HPV16 negative (kappa value: 0.21). The proportion of women with the same genotype as their male partner was higher than the proportion of men sharing the same genotype as their female partner: 58.7% (37/63) vs 30.8% (37/120), p<0.0001. Sexual partners of women with HG-CIN are a significant reservoir and vector of HPV infection, a fact that could contribute to making viral clearance more difficult to achieve in their partners after treatment of their HG-CIN lesions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

A case-control study on the clinical impact of ventilator associated tracheobronchitis in adult patients who did not develop ventilator associated pneumonia.

PubMed

Cantón-Bulnes, María Luisa; González-García, María Ascensión; García-Sánchez, Manuela; Arenzana-Seisdedos, Ángel; Garnacho-Montero, José

2018-02-05

The main objective was to determine whether ventilator-associated tracheobronchitis (VAT) is related to increased length of ICU stay. Secondary endpoints included prolongation of hospital stay, as well as, ICU and hospital mortality. A retrospective matched case-control study. Each case was matched with a control for duration of ventilation (± 2 days until development of ventilator-associated tracheobronchitis), disease severity (Acute Physiology and Chronic Health Evaluation II) at admission ± 3, diagnostic category and age ±10 years. Critically ill adults admitted to a polyvalent 30-beds ICU with the diagnosis of VAT in the period 2013-2016. We identified 76 cases of VAT admitted to our ICU during the study period. No adequate controls were found for 3 patients with VAT. There were no significant differences in demographic characteristics, reasons for admission and comorbidities. Patients with VAT had a longer ICU length of stay, median 22 days (14-35), compared to controls, median 15 days (8-27), p=.02. Ventilator days were also significantly increased in VAT patients, median 18 (9-28) versus 9 days (5-16), p=.03. There was no significant difference in total hospital length of stay 40 (28-61) vs. 35days (23-54), p=.32; ICU mortality (20.5 vs. 31.5% p=.13) and hospital mortality (30.1 vs. 43.8% p=.09). We performed a subanalysis of patients with microbiologically proven VAT receiving adequate antimicrobial treatment and did not observe significant differences between cases and the corresponding controls. VAT is associated with increased length of intensive care unit stay and longer duration of mechanical ventilation. This effect disappears when patients receive appropriate empirical treatment. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Characteristics of HIV infected individuals traveling abroad. Results from the +REDIVI Collaborative Network.

PubMed

Pérez-Molina, Jose A; Martinez-Perez, Angela; Serre, Nuria; Treviño, Begoña; Ruiz-Giardín, José Manuel; Torrús, Diego; Goikoetxea, Josune; Echevarría, Esteban Martín; Malmierca, Eduardo; Rojo, Gerardo; Calabuig, Eva; Gutierrez, Belén; Norman, Francesca; Lopez-Velez, Rogelio

2016-02-01

The improvement in the prognosis of HIV infection, coupled with the increase in international travel and migration, has led to a rising number of HIV infected travelers. The objective of this study was to describe the epidemiological and clinical features of returning travelers, according to their HIV status. An observational prospective study was conducted including travelers and immigrants who traveled to visit friends and relatives (VFRs) registered in the +REDIVI collaborative network (January-2009; October-2014). +REDIVI is a national network that registers information regarding infections imported by travelers and immigrants at 21 different centers using a standardized protocol. A total of 3464 travellers were identified: 72 were HIV+ (2.1%) and 3.392 HIV- (98%). HIV+ vs. HIV- travelers were often older (40.5y vs. 34.2y P=.001), VFRs (79.1% vs. 44.4%; P<.001), and consulted less for pre-travel advice (27% vs. 37%; P=.078). The main destinations for both groups were sub-Saharan Africa and Latin America. The most frequent reasons for consultation after travel were fever, request for a health examination, gastrointestinal complaints, and abnormal laboratory tests (mainly eosinophilia and anemia), which differed between groups. The most frequent diagnoses in HIV+ travelers were malaria (38.8%), newly diagnosed HIV infection (25%), and intestinal parasites (19.4%), while for HIV- travelers the main diagnoses were "healthy" (17.9%), malaria (14%), and intestinal parasites (17.3%). The typical profile of an HIV+ traveler in +REDIVI was that of a VFR traveler who did not seek pre-travel advice and made high-risk trips. This may increase the chance of acquiring travel-related infections which may pose a special risk for HIV-infected travelers. The post-travel visit was a good opportunity for HIV infection screening. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Barriers to ART initiation in HIV infected subjects and with treatment indication in Spain. Why don't they start their treatment? Bridgap Study].

PubMed

Viciana-Fernández, Pompeyo; Falcó, Vicenç; Castaño, Manuel; de los Santos-Gil, Ignacio; Olalla-Sierra, Julián; Hernando, Asunción; Deig, Elisabet; Clotet, Bonaventura; Knobel, Hernando; Podzamczer, Daniel; Pedrol, Pere Domingo

2015-01-01

In Spain, HIV treatment guidelines are well known and generally followed. However, in some patients there are no plans to initiate ART despite having treatment indications. The current barriers to ART initiation are presented. A cross-sectional survey including every HIV infected patient in care in 19 hospitals across Spain in 2012, with ≥1 indication to start ART according to 2011 national treatment guidelines, who had not been scheduled for ART initiation. Reasons for deferring treatment were categorized as follows (non-exclusive categories): a) The physician thinks the indication is not absolute and prefers to defer it; b) The patient does not want to start it; c) The physician thinks ART must be started, but there is some limitation to starting it, and d) The patient has undetectable viral load in absence of ART. A total of 256 patients, out of 784 originally planned, were included. The large majority (84%) were male, median age 39 years, 57% MSM, 24% heterosexuals, and 16% IDUs. Median time since HIV diagnosis was 3 years, median CD4 count, 501 cells/mm3, median viral load 4.4 log copies/ml. Main ART indications were: CD4 count <500 cells/mm(3), 48%; having an uninfected sexual partner, 28%, and hepatitis C coinfection, 23%. Barriers due to, the physician, 55%; the patient, 28%; other limitations, 23%; and undetectable viral load, 6%. The majority of subjects with ART indication were on it. The most frequent barriers among those who did not receive it were physician-related, suggesting that the relevance of the conditions that indicate ART may need reinforcing. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Rectal pre-treatment with ozonized oxygen (O3) aggravates clinic status in septic rats treated with amoxicillin/clavulanate.

PubMed

Martín-Barrasa, José L; Méndez Cordovez, Charlín; Espinosa de los Monteros y Zayas, Antonio; Juste de Santa Ana, M Candelaria; Clavo Varas, Bernardino; Herráez Thomas, Pedro; Bordes Benitez, Ana; Montoya-Alonso, José Alberto; García-Bello, Miguel; Artiles Campelo, Fernando; Tejedor-Junco, M Teresa

2015-01-01

Despite the advanced antibiotic therapies, sepsis continues being a clinical entity with high morbidity and mortality. The ozone/oxygen mixture (O3/O2) has been reported to exhibit positive effects on immunity. The aim of our study was to analyze whether (O3/O2) combined with amoxicillin/clavulanate has any influence on the morbidity and mortality of septic rats. We used 48 Sprague-Dawley rats randomly allocated to 6 groups (n=8): healthy (C), septic (I), healthy+ozone therapy (O3), septic+amoxicillin/clavulanate (AMC), septic+amoxicillin/clavulanate+ozone therapy (AMC/O3) and septic+ozone therapy (I/O3). O3/O2 was administered rectally at increasing O3 concentrations during 10 days prior to the onset of sepsis model (intraperitoneally injection of fecal material) or saline administration in healthy control rats. Later (post-inoculation), 3 days per week, O3 was also administered. Vital signs were recorded, and microbiological, hematological and histopathological studies were performed. The number of surviving animal/total was higher in AMC (8/8) than in AMC/O3 (4/8) p=0.077. The percentage of surviving animals with pneumonia was higher in AMC/O3 than in AMC (100% vs 37.5%). In dead animals, AMC/O3 rats had a significantly higher percentage of lesions: Cardiac lesions, pulmonary hemorrhages and pleuritis (100%) and serositis/peritonitis (75%). Only Escherichia coli (2 different biotypes) was isolated from blood and/or peritoneal fluid from all infected groups. A significant decrease in the percentage of band neutrophils from the surviviors belonging to AMC/O3vs AMC was observed (p<0.05). Rectal pre-treatment with O3/O2 aggravates clinic status in septic rats treated with amoxicillin/clavulanate. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Emerging arboviruses and public health challenges in Brazil.

PubMed

Lima-Camara, Tamara Nunes

2016-06-27

Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country's public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. RESUMO A modificação do ambiente por ações antrópicas, o crescimento urbano desordenado, o processo de globalização do intercâmbio internacional e as mudanças climáticas são alguns fatores que vêm facilitando a emergência e disseminação de doenças infecciosas humanas transmitidas por vetores. Este comentário aborda a recente entrada de três arbovírus no Brasil, Chikungunya (CHIKV), West Nile (WNV) e Zika (ZIKV), com enfoque nos desafios para a Saúde Pública do País. Transmitidos por mosquitos vetores amplamente distribuídos no território nacional e associados ao homem, a população brasileira encontra-se exposta à infecção por esses três arbovírus. Na ausência de vacina eficaz e tratamento específico, são importantes a manutenção e integração de uma vigilância entomológica e epidemiológica contínua, a fim de direcionarmos métodos de controle e prevenção contra essas arboviroses no País.

[Isolation of environmental mycobacteria from soils of Córdoba city Argentina].

PubMed

Ballarino, Guillermo J; Eseverri, M Verónica; Salas, Andrea V; Giayetto, Víctor O; González, Silvia; Wolff, Lidia; Pessah, Oscar

2002-01-01

The interest for the research on enviromental mycobacteria has risen over the last decades, in part, due to a significant incidence rate rise. Reports from all over the world address the soil as the major source for human contamination. In Argentina two documents report the prevalence of atypical mycobacteriosis at Córdoba (1997), and the isolation of enviromental mycobacteria from soils of the Province of La Pampa (1999) respectively. The aim of our study was to confirm the presence of enviromental mycobacteria in soil of the city of Córdoba. The map of the city was divided in 9 regions according to avenues and major streets distribution. A total of 120 soil samples were recollected with spatula from a 10 x 10 cm square up to 1 cm deep. Samples were kept at 4 degrees C no more than 7 days. Soil samples were homogenized with destilled water in a 1:1 proportion, and decontaminated according to Petroff's method. The cultures were made in Lowestein-Jehnsen media and incubated at 37 degrees C controlling development every 7 days for 2 months. An acid-fast-bacilli smear was made from colonies obtained. Twenty three cultures (19%) were discarded due to contamination. Twenty cultures (17%) developed acid fast bacilli (AFB). Colonies obtained were sent to the Mycobacteria Service of the Instituto Nacional de Enfermedades Infecciosas Dr. Carlos G. Malbrán, in the city of Buenos Aires, for identification. A single isolation was identified as Mycobacterium triviale. A positive correlation was observed between the frequency of positive AFB isolation and the number of samples taken from park areas. The presence of enviromental mycobacteria in soils of Córdoba was confirmed. Results suggest higher odds of isolation in parklands and soils where animals live. Extensive works are needed to asset the features that allow and contribute the proliferation of mycobacteria in soils.

[Indicator condition guided human immunodeficiency virus requesting in primary health care: results of a collaboration].

PubMed

Cayuelas-Redondo, Laia; Menacho-Pascual, Ignacio; Noguera-Sánchez, Pablo; Goicoa-Gago, Carmen; Pollio-Peña, Gernónimo; Blanco-Delgado, Rebeca; Barba-Ávila, Olga; Sequeira-Aymar, Ethel; Muns, Mercè; Clusa, Thais; García, Felipe; León, Agathe

2015-12-01

The search of HIV infected patients guided by indicator conditions (IC) is a strategy used to increase the early detection of HIV. The objective is to analyze whether a collaboration to raise awareness of the importance of early detection of HIV in 3 primary care centers influenced the proportion of HIV serology requested. Multicenter retrospective study was conducted comparing the baseline and a post-collaboration period. The collaboration consisted of training sessions and participation in the HIDES study (years 2009-2010). Patients between 18 and 64 years old with newly diagnosed herpes zoster, seborrheic eczema, mononucleosis syndrome, and leucopenia/thrombocytopenia in 3 primary care centers in 2008 (baseline period) and 2012 (post-collaboration period). The sociodemographic variables, HIV risk conditions, requests for HIV serology, and outcomes were evaluated. A total of 1,219 ICs were included (558 in 2008 and 661 in 2012). In 2008 the number of HIV tests in patients with an IC was 3.9%, and rose to 11.8% in 2012 (P<.0001). The HIV infection rate was 2.2% (95% CI: 0.4-7.3) (n=2). It was estimated that 25 new cases (12 in 2008 and 13 in 2012) would have been diagnosed if they had performed the test on all patients with IC. Predictors of HIV request were, having an IC in 2012, a younger age, having an mononucleosis syndrome, and not being Spanish. The HIV request demand tripled, after the collaboration with primary care centers, however in 88% the test was not requested, resulting in diagnostic losses. New strategies are needed to raise awareness of the importance of early detection of HIV. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[High-risk sexual behaviour by partner type among men who have sex with men].

PubMed

Folch, Cinta; Fernández-Dávila, Percy; Ferrer, Laia; Soriano, Raúl; Díez, Mercedes; Casabona, Jordi

2014-01-01

To identify factors associated with high risk sexual practices among men who have sex with men (MSM) in Spain. An online survey was conducted in 2010, which included, among others, questions on HIV/STI sexual behaviours and prevention needs. Unprotected anal intercourse (UAI) with a partner of unknown or discordant HIV status in the past year was defined as a high risk sexual behaviour. Of the 13,111 participants, 49.4% had had sex with steady partners (SP) and 73.4% with non-steady partners (NSP) in the last 12months; and the prevalence of high risk UAI was 25.4% and 29.4%, respectively. Factors associated with high risk UAI with SP were: living in a city of less than 500,000 inhabitants (OR=1.42 <100,000 inhabitants), being out to no-one or only a few people (OR=1.42), and being HIV-positive with undetectable viral load among those with a high level of HIV/STI knowledge (OR=3.18). Factors associated with high risk UAI with NSP were mainly: having a higher number of sexual partners (OR=4.31 >50 partners), having used drugs for sex (OR=1.33), and at parties (OR=1.19), having a medium (OR=1.82) or low (OR=1.33) level of HIV/STI knowledge, and being HIV-positive (OR=1.56). Among MSM, the prevalence of high risk sexual practices is high with both SP and NSP. Factors associated with high risk UAI vary by type of sexual partner (e.g., having HIV with an undetectable viral load). These must be taken into account when planning strategies for primary and secondary prevention. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prevalence of relevant NS5A resistance-associated substitutions to elbasvir in genotype 1a hepatitis C virus patients in Spain.

PubMed

Palladino, Claudia; Esteban-Cartelle, Beatriz; Mate-Cano, Irene; Sánchez-Carrillo, Marta; Resino, Salvador; Briz, Verónica

2018-05-01

Resistance-associated substitutions (RASs) to the new HCV NS5A inhibitor elbasvir may limit its efficacy and lead to virological failure in HCV-GT1a-infected patients. There are no data outside clinical trials evaluating their prevalence and impact in grazoprevir/elbasvir in GT1a-infected patients in Spain. A multicentre cross-sectional study of 632 initial patients was conducted. In 13 of these patients, the sample could not be amplified or a consensus sequence by Sanger sequencing could not be performed. Ultimately, 617 HCV-G1a-infected individuals treated at 84 Spanish hospitals from the 17 autonomous communities plus the 2 autonomous cities of Spain were analysed. HCV population sequencing was used to identify RAS to elbasvir and the mutational pattern and drug sensitivity were confirmed by geno2pheno[HCV]. Viruses bearing RASs to elbasvir were present in 6.2% of HCV-G1a infected patients. The most common RASs were the Y93C/H/N and Q30E/H/R (2.4% and 2.3%, respectively). Only 3.4% of the identified RASs to elbasvir conferred reduced susceptibility to elbasvir by geno2pheno[HCV], which exclusively identified the positions Q30H/R (n=7) and Y93C/H/N (n=8) as single mutations and Q30H+Y93H (n=4) and Q30R+Y93H (n=2) as double mutations as the major RASs to elbasvir. A lower prevalence of RASs to elbasvir was observed in our HCV-G1a Spanish cohort than reported previously in clinical trials evaluating patients from the USA. This information may be essential to guide the implementation of grazoprevir/elbasvir in Spain and to manage G1a-infected patients. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[GeSIDA quality care indicators associated with mortality and hospital admission for the care of persons infected by HIV/AIDS].

PubMed

Delgado-Mejía, Elena; Frontera-Juan, Guillem; Murillas-Angoiti, Javier; Campins-Roselló, Antoni Abdon; Gil-Alonso, Leire; Peñaranda-Vera, María; Ribas Del Blanco, María Angels; Martín-Pena, María Luisa; Riera-Jaume, Melchor

2017-02-01

In 2010, the AIDS Study Group (Grupo de Estudio del SIDA [GESIDA]) developed 66 quality care indicators. The aim of this study is to determine which of these indicators are associated with mortality and hospital admission, and to perform a preliminary assessment of a prediction rule for mortality and hospital admission in patients on treatment and follow-up. A retrospective cohort study was conducted in the Hospital Universitario Son Espases (Palma de Mallorca, Spain). Eligible participants were patients with human immunodeficiency syndrome≥18 years old who began follow-up in the Infectious Disease Section between 1 January 2000 and 31 December 2012. A descriptive analysis was performed to evaluate anthropometric variables, and a logistic regression analysis to assess the association between GESIDA indicators and mortality/admission. The mortality probability model was built using logistic regression. A total of 1,944 adults were eligible (median age: 37 years old, 78.8% male). In the multivariate analysis, the quality of care indicators associated with mortality in the follow-up patient group were the items 7, 16 and 20, and in the group of patients on treatment were 7, 16, 20, 35, and 38. The quality of care indicators associated with hospital admissions in the follow-up patients group were the same as those in the mortality analysis, plus number 31. In the treatment group the associated quality of care indicators were items 7, 16, 20, 35, 38, and 40. Some GeSIDA quality of care indicators were associated with mortality and/or hospital admissions. These indicators are associated with delayed diagnosis, regular monitoring, prevention of infections, and control of comorbidities. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Missed opportunities in the diagnosis of human immunodeficiency virus infection in the Region of Aragon. Late diagnosis importance.

PubMed

Gargallo-Bernad, César; Sangrós-González, Francisco Javier; Arazo-Garcés, Piedad; Martínez-Álvarez, Rosa; Malo-Aznar, Carmen; Gargallo-Bernad, Alicia; Ballester-Luna, Alba; Cabrero-Pascual, Luis Eduardo; Gil-Orna, Pablo; Abadía-Gallego, Víctor José; Torres-Peña, Isabel; Ordiz-Suárez, Héctor

2018-04-30

Late Diagnosis (LD) of Human Immunodeficiency Virus (HIV) infection (CD4 lymphocytes <350/μl at diagnosis of the disease), deteriorates the condition of those affected and increases the probability of transmission. The objective of the present study was to analyse the prevalence of LD, to identify missed diagnostic opportunities (MDO) and to find out which level of the health care delivery system they took place. Retrospective, observational and descriptive study of the population diagnosed with infection of HIV/AIDS in the period 2011-2015 in Aragon. MDO were identified during the 3 years prior to diagnosis of the disease in all levels of the health care delivery system as well as frequentation of consultations. The indicator conditions (IC) that generated more MDO were analysed according to the latest recommendations for early diagnosis of HIV in the health care setting. 435 newly diagnosed HIV/AIDS cases were analysed. 45.1% were diagnosed in Primary Healthcare (PH). 49.4% presented criteria of LD and 61.1% were infected through heterosexual contact. The majority of MDO (68.5%) were given in PH. The IC that generated the most MDO were seborrheic dermatitis/exanthema (19.4%) and fever of unknown origin (10.3%). However, the IC that were associated with higher LD were pneumonia acquired in the community and unjustified weight loss. In Aragon, prevalence of LD is high, the main route of infection is heterosexual and most of MDO go unnoticed in PH. The dissemination of current guidelines for requesting IC guided HIV testing and HIV screening across the preoperative period will result in an effective measure to decrease the LD. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prediction of higher cost of antiretroviral therapy (ART) according to clinical complexity. A validated clinical index.

PubMed

Velasco, Cesar; Pérez, Inaki; Podzamczer, Daniel; Llibre, Josep Maria; Domingo, Pere; González-García, Juan; Puig, Inma; Ayala, Pilar; Martín, Mayte; Trilla, Antoni; Lázaro, Pablo; Gatell, Josep Maria

2016-03-01

The financing of antiretroviral therapy (ART) is generally determined by the cost incurred in the previous year, the number of patients on treatment, and the evidence-based recommendations, but not the clinical characteristics of the population. To establish a score relating the cost of ART and patient clinical complexity in order to understand the costing differences between hospitals in the region that could be explained by the clinical complexity of their population. Retrospective analysis of patients receiving ART in a tertiary hospital between 2009 and 2011. Factors potentially associated with a higher cost of ART were assessed by bivariate and multivariate analysis. Two predictive models of "high-cost" were developed. The normalized estimated (adjusted for the complexity scores) costs were calculated and compared with the normalized real costs. In the Hospital Index, 631 (16.8%) of the 3758 patients receiving ART were responsible for a "high-cost" subgroup, defined as the highest 25% of spending on ART. Baseline variables that were significant predictors of high cost in the Clinic-B model in the multivariate analysis were: route of transmission of HIV, AIDS criteria, Spanish nationality, year of initiation of ART, CD4+ lymphocyte count nadir, and number of hospital admissions. The Clinic-B score ranged from 0 to 13, and the mean value (5.97) was lower than the overall mean value of the four hospitals (6.16). The clinical complexity of the HIV patient influences the cost of ART. The Clinic-B and Clinic-BF scores predicted patients with high cost of ART and could be used to compare and allocate costs corrected for the patient clinical complexity. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Scarlet fever: A not so typical exanthematous pharyngotonsillitis (based on 171 cases).

PubMed

García-Vera, César; de Dios Javierre, Bárbara; Castán Larraz, Beatriz; Arana Navarro, Teresa; Cenarro Guerrero, Teresa; Ruiz Pastora, Rafael; Sánchez Gimeno, Javier

2016-01-01

To describe the age, signs and clinical symptoms of children with scarlet fever at the present time, and to check whether they are equivalent to those with traditional streptococcal pharyngotonsillitis. An observational, retrospective study was conducted on the clinical records of 5500 children aged from 0 to 15 years attending a primary health care center. A record was made of the percentage of the cases in which signs and symptoms appear and the Centor score was calculated. Microbiological diagnosis of the disease was made using the rapid antigen-detection test or traditional culture. A total of 171 out of 252 scarlet fever diagnoses were microbiologically verified in 158 patients. The median age was 3.8 years (interquartile range: 2.91-4.78), with the majority (57%) under the age of 4 years. There was fever in 89% of the processes (95% CI: 84-94%), with a temperature of >38°C in 73% (95% CI: 65-80%), enlarged lymph nodes in 70% (95% CI: 58-82%), absence of cough in 73% (95% CI: 65-80%), and tonsillar exudate in only 24% (95% CI: 17-31%). The Centor score (n=105) was ≤2 points in 86% (95% CI: 79-92%). The only difference regarding age is that episodes in patients under the age of 4 years old have significantly higher fever (>38°C) than the older ones (80% versus 63%. OR 3.13; 95% CI: 1.46-6.71). Scarlet fever pharyngotonsillitis differs from the traditional streptococcal pharyngotonsillitis, and its evaluation using clinical prediction rules such as Centor or McIsaac is questionable. The main diagnostic key must certainly be rash, regardless of patient age. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Economic impact of optimising antiretroviral treatment in human immunodeficiency virus-infected adults with suppressed viral load in Spain, by implementing the grade A-1 evidence recommendations of the 2015 GESIDA/National AIDS Plan.

PubMed

Ribera, Esteban; Martínez-Sesmero, José Manuel; Sánchez-Rubio, Javier; Rubio, Rafael; Pasquau, Juan; Poveda, José Luis; Pérez-Mitru, Alejandro; Roldán, Celia; Hernández-Novoa, Beatriz

2018-03-01

The objective of this study is to estimate the economic impact associated with the optimisation of triple antiretroviral treatment (ART) in patients with undetectable viral load according to the recommendations from the GeSIDA/PNS (2015) Consensus and their applicability in the Spanish clinical practice. A pharmacoeconomic model was developed based on data from a National Hospital Prescription Survey on ART (2014) and the A-I evidence recommendations for the optimisation of ART from the GeSIDA/PNS (2015) consensus. The optimisation model took into account the willingness to optimise a particular regimen and other assumptions, and the results were validated by an expert panel in HIV infection (Infectious Disease Specialists and Hospital Pharmacists). The analysis was conducted from the NHS perspective, considering the annual wholesale price and accounting for deductions stated in the RD-Law 8/2010 and the VAT. The expert panel selected six optimisation strategies, and estimated that 10,863 (13.4%) of the 80,859 patients in Spain currently on triple ART, would be candidates to optimise their ART, leading to savings of €15.9M/year (2.4% of total triple ART drug cost). The most feasible strategies (>40% of patients candidates for optimisation, n=4,556) would be optimisations to ATV/r+3TC therapy. These would produce savings between €653 and €4,797 per patient per year depending on baseline triple ART. Implementation of the main optimisation strategies recommended in the GeSIDA/PNS (2015) Consensus into Spanish clinical practice would lead to considerable savings, especially those based in dual therapy with ATV/r+3TC, thus contributing to the control of pharmaceutical expenditure and NHS sustainability. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Nosocomial infection in patients receiving a solid organ transplant or haematopoietic stem cell transplant].

PubMed

Moreno Camacho, Asunción; Ruiz Camps, Isabel

2014-01-01

Bacterial infections are the most common infections in solid organ transplant recipients. These infections occur mainly in the first month after transplantation and are hospital-acquired. Nosocomial infections cause significant morbidity and are the most common cause of mortality in this early period of transplantation. These infections are caused by multi-drug resistant (MDR) microorganisms, mainly Gram-negative enterobacteria, non-fermentative Gram-negative bacilli, enterococci, and staphylococci. The patients at risk of developing nosocomial bacterial infections are those previously colonized with MDR bacteria while on the transplant waiting list. Intravascular catheters, the urinary tract, the lungs, and surgical wounds are the most frequent sources of infection. Preventive measures are the same as those applied in non-immunocompromised, hospitalized patients except in patients at high risk for developing fungal infection. These patients need antifungal therapy during their hospitalization, and for preventing some bacterial infections in the early transplant period, patients need vaccinations on the waiting list according to the current recommendations. Although morbidity and mortality related to infectious diseases have decreased during the last few years in haematopoietic stem cell transplant recipients, they are still one of the most important complications in this population. Furthermore, as occurs in the general population, the incidence of nosocomial infections has increased during the different phases of transplantation. It is difficult to establish general preventive measures in these patients, as there are many risk factors conditioning these infections. Firstly, they undergo multiple antibiotic treatments and interventions; secondly, there is a wide variability in the degree of neutropenia and immunosuppression among patients, and finally they combine hospital and home stay during the transplant process. However, some simple measures could be implemented to improve the current situation. Copyright © 2014 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[10 years of literature on AIDS (1983-1992): bibliometric analysis].

PubMed

Aleixandre, R; de la Cueva, A; Almero, A; Osca, J; Giménez, J V

1995-01-01

Reasons for the quantitative study of the Spanish publications on AIDS are both the huge volume attained by the printed material on the subject since the first case was described in 1981 by the Center for Disease Control, and the high incidence of the cases reported on this disease. Searches have been performed on the subject through the database of the Indice Médico Español (IME), the Indice Español de Ciencia y Technología (ICYT), the ISBN and Bibliografía Española in order to retrieve all possible Spanish journal papers' and books. The references were distributed using criteria of documentary tipology, publication date, institutions involved, autonomous communities, and, finally, after its relation with the confirmed cases of AIDS. A total 2,013 items have been retrieved, 1,821 journal papers' and 192 books. More than 50% of the papers are published only by five journals, being 139 the total number of journals able to carry pertinent information. The most productive journals were Medicina Clínica and Enfermedades Infecciosas y Microbiología Clínica. The results confirm exponential growth of the publications from 1983, the first year when a paper was published on AIDS in Spain. The grow is similar to the tend observed in other countries. Parallelism has been detected between growth in the number of publications and in the number of journals publishing on the subject, the growth in the number of journals publishing on the subject, the growth in the number of institutions which collaborate and the growing tend of reported cases in Spain. The results of the bibliometric study, showing an epidemiological growth out of comparison in the history of the scientific literature, could be useful both to information scientists, and to the research inside this scientific field.

Costs and cost-efficacy analysis of the 2017 GESIDA/Spanish National AIDS Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

PubMed

Rivero, Antonio; Pérez-Molina, José Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Asensi, Víctor; Crespo, Manuel; Domingo, Pere; Iribarren, José Antonio; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Martínez, Esteban; Moreno, Santiago; Palacios, Rosario; Pineda, Juan Antonio; Pulido, Federico; Rubio, Rafael; Santos, Jesús; de la Torre, Javier; Tuset, Montserrat; Gatell, Josep M

2018-05-01

GESIDA and the Spanish National AIDS Plan panel of experts have recommended preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral therapy (ART) as initial therapy in HIV-infected patients for 2017. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. Economic assessment of costs and efficiency (cost-efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied considering only differential direct costs: ART (official prices), management of adverse effects, resistance studies and HLA B*5701 screening. The setting was Spain and the costs correspond to those of 2017. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranged from 6882 euro for TFV/FTC/RPV (AR) to 10,904 euros for TFV/FTC+RAL (PR). The efficacy varied from 0.82 for TFV/FTC+DRV/p (AR) to 0.92 for TAF/FTC/EVG/COBI (PR). The efficiency, in terms of cost-efficacy, ranged from 7923 to 12,765 euros per responder at 48 weeks, for ABC/3TC/DTG (PR) and TFV/FTC+RAL (PR), respectively. Considering ART official prices, the most efficient regimen was ABC/3TC/DTG (PR), followed by TFV/FTC/RPV (AR) and TAF/FTC/EVG/COBI (PR). Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Prevalence of nasal carriage of Staphylococcus aureus and Streptococcus pneumoniae in Primary Care and factors associated with colonization].

PubMed

Boada, Albert; Almeda, Jesús; Grenzner, Elisabet; Pons-Vigués, Mariona; Morros, Rosa; Juvé, Rosa; Simonet, Pere J; den Heijer, Casper D J; Bolíbar, Bonaventura

2015-01-01

To determine (i) the prevalence of Staphylococcus aureus (S.aureus) and Streptococcus pneumoniae (S.pneumoniae) nasal carriage in Primary Health Care patients in area of Barcelona, and (ii) the factors associated with S.aureus and S.pneumoniae colonization. Multi-center cross-sectional study conducted in 2010-2011 with the participation of 27 Primary Health Care professionals. Nasopharyngeal swabs were obtained from 3,969 patients over 4 years of age who did not present with any sign of infection. S.aureus and/or S.pneumoniae carrier state. socio-demographic characteristics, health status, vaccination status, occupation, and living with children. A descriptive analysis was performed. The prevalence of carriers of S.aureus and/or S.pneumoniae was calculated and logistic regression models were adjusted by age. In children from 4 to 14 years old, the prevalence of S.aureus carriers was 35.7%, of S.pneumoniae 27.1%, and 5.8% were co-colonized. In adults older than 14 years old, the prevalence was 17.8%, 3.5%, and 0.5%, respectively. In children, S.aureus carrier state was inversely associated with S.pneumoniae carrier state; S.pneumoniae was associated with younger age, and inversely associated with S.aureus carrier state. In adults, being a carrier of S.aureus was associated with male gender, younger age, and a health-related occupation, whereas S.pneumoniae carrier state was associated with living with children under 6 years of age. The proportion of co-colonized carriers was low (1.0%). The proportion of S.aureus and S.pneumoniae carriers was higher in children than in adults. Age was the only factor associated with healthy carrier status for S.aureus and for S.pneumoniae. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Identification of a new variant of Chlamydia trachomatis in Mexico.

PubMed

Escobedo-Guerra, Marcos R; Katoku-Herrera, Mitzuko; Lopez-Hurtado, Marcela; Villagrana-Zesati, Jesus Roberto; de Haro-Cruz, María de J; Guerra-Infante, Fernando M

2018-04-07

Chlamydia trachomatis is one of the main etiological agents of sexually transmitted infections worldwide. In 2006, a Swedish variant of C. trachomatis (Swedish-nvCT), which has a deletion of 377bp in the plasmid, was reported. In Latin America, Swedish-nvCT infections have not been reported. We investigated the presence of Swedish-nvCT in women with infertility in Mexico. Swedish-nvCT was searched in 69C. trachomatis positive samples from 2339 endocervical specimens. We designed PCR primers to identify the deletion in the plasmid in the ORF1, and the presence of a repeated 44bp in the ORF3. The sample with the deletion was genotyped with the genes of the major outer membrane protein A (ompA) and the polymorphic membrane protein (pmpH). The deletion was detected in one of the 69 samples positive C. trachomatis of 2339 endocervical exudates. The nucleotide sequence analysis of the ompA shows a high degree of similarity with the Swedish nvCT (98%), however the variant found belongs to serovar D. The nucleotide sequence of the pmpH gene associates to the variant found in the genitourinary pathotype of the Swedish-nvCT but in different clusters. Our results revealed the presence of a new variant of C. trachomatis in Mexican patients. This variant found in Mexico belongs to serovar D based on the in silico analysis of the ompA and pmpH genes and differs to the Swedish-nvCT (serovars E). For these variants of C. trachomatis that have been found it is necessary to carry out a more detailed analysis, although the role of this mutation has not been demonstrated in the pathogenesis. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Analysis of the costs and cost-effectiveness of the guidelines recommended by the 2018 GESIDA/Spanish National AIDS Plan for initial antiretroviral therapy in HIV-infected adults.

PubMed

Pérez-Molina, José Antonio; Martínez, Esteban; Blasco, Antonio Javier; Arribas, José Ramón; Domingo, Pere; Iribarren, José Antonio; Knobel, Hernando; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Mariño, Ana; Miró, José M; Moreno, Santiago; Negredo, Eugenia; Pulido, Federico; Rubio, Rafael; Santos, Jesús; de la Torre, Javier; Tuset, Montserrat; von Wichmann, Miguel A; Gatell, Josep M

2018-06-05

The GESIDA/National AIDS Plan expert panel recommended preferred regimens (PR), alternative regimens (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2018. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. Economic assessment of costs and efficiency (cost-effectiveness) based on decision tree analyses. Effectiveness was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug-resistance studies) over the first 48 weeks. The payer perspective (National Health System) was applied considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting was Spain and the costs correspond to those of 2018. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base-case scenario, the cost of initiating treatment ranges from 6788 euros for TAF/FTC/RPV (AR) to 10,649 euros for TAF/FTC+RAL (PR). The effectiveness varies from 0.82 for TAF/FTC+DRV/r (AR) to 0.91 for TAF/FTC+DTG (PR). The efficiency, in terms of cost-effectiveness, ranges from 7814 to 12,412 euros per responder at 48 weeks, for ABC/3TC/DTG (PR) and TAF/FTC+RAL (PR), respectively. Considering ART official prices, the most efficient regimen was ABC/3TC/DTG (PR), followed by TAF/FTC/RPV (AR) and TAF/FTC/EVG/COBI (AR). Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Initial experience with imported Zika virus infection in Spain.

PubMed

Díaz-Menéndez, Marta; de la Calle-Prieto, Fernando; Montero, Dolores; Antolín, Eugenia; Vazquez, Ana; Arsuaga, Marta; Trigo, Elena; García-Bujalance, Silvia; de la Calle, María; Sánchez Seco, Paz; de Ory, Fernando; Arribas, Jose Ramón

2018-01-01

A considerable increase of imported Zika virus (ZIKV) infection has been reported in Europe in the last year. This is the result of the large outbreak of the disease in the Americas, along with the increase in the numbers of travellers and immigrants arriving from ZIKV endemic areas. A descriptive study was conducted in the Tropical Medicine Unit of Hospital La Paz-Carlos III in Madrid on travellers returning from an endemic area for ZIKV from January to April 2016. Demographic, clinical and microbiological data were analyzed. A total of 185 patients were screened for ZIKV (59.9% women, median age of 37.7±10.3 years). Main purpose of the travel was tourism to Colombia, Brazil, and México. Just under three-quarters (73%) were symptomatic, mostly with fever and headache. A total of 13 patients (7% of those screened) were diagnosed with ZIKV infections, of which four of them were pregnant. All of them were symptomatic patients, the majority immigrants, and mainly from Colombia. Diagnostic tests were based on positive neutralization antibodies (8 cases, 61.6%) and a positive RT-PCR in different organic fluids (7 cases, 53.8%) The four infected pregnant women underwent a neurosonography every 3 weeks, and no alterations were detected. RT-PCR in amniotic fluid was performed in three of them, with negative results. One of the children has already been born healthy. Our cases series represents the largest cohort of imported ZIKV to Spain described until now. Clinicians must increase awareness about the progression of the ZIKV outbreak and the affected areas so that they can include Zika virus infection in their differential diagnosis for travellers from those areas. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Heterogeneous production of proteases from Brazilian clinical isolates of Pseudomonas aeruginosa.

PubMed

Galdino, Anna Clara M; Viganor, Lívia; Ziccardi, Mariangela; Nunes, Ana Paula F; Dos Santos, Kátia R N; Branquinha, Marta H; Santos, André L S

2017-12-01

Pseudomonas aeruginosa is an important human pathogen that causes severe infections in a wide range of immunosuppressed patients. Herein, we evaluated the proteolytic profiles of 96 Brazilian clinical isolates of P. aeruginosa recovered from diverse anatomical sites. Cell-associated and extracellular proteases were evidenced by gelatin-SDS-PAGE and by the cleavage of soluble gelatin. Elastase was measured by using the peptide substrate N-succinyl-Ala-Ala-Ala-p-nitroanilide. The prevalence of elastase genes (lasA and lasB) was evaluated by PCR. Bacterial extracts were initially applied on gelatin-SDS-PAGE and the results revealed four distinct zymographic profiles as follows: profile I (composed by bands of 145, 118 and 50kDa), profile II (118 and 50kDa), profile III (145kDa) and profile IV (118kDa). All the proteolytic enzymes were inhibited by EDTA, identifying them as metalloproteases. The profile I was the most detected in both cellular (79.2%) and extracellular (84.4%) extracts. Overall, gelatinase and elastase activities measured in the spent culture media were significantly higher (around 2-fold) compared to the cellular extracts and the production level varied according to the site of bacterial isolation. For instance, tracheal secretion isolates produced elevated amount of gelatinase and elastase measured in both cellular and extracellular extracts. The prevalence of elastase genes revealed that 100% isolates were lasB-positive and 85.42% lasA-positive. Some positive/negative correlations were showed concerning the production of gelatinase, elastase, isolation site and antimicrobial susceptibility. The protease production was highly heterogeneous in Brazilian clinical isolates of P. aeruginosa, which corroborates the genomic/metabolic versatility of this pathogen. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Quality of the aetiological diagnosis of ventilator-associated pneumonia in Spain in the opinion of intensive care specialists and microbiologists.

PubMed

Bouza, Emilio; Martínez-Alarcón, José; Maseda, Emilio; Palomar, Mercedes; Zaragoza, Rafael; Pérez-Granda, María Jesús; Muñoz, Patricia; Burillo, Almudena

2017-03-01

Current guidelines for the microbiological diagnosis of ventilator-associated pneumonia (VAP) are imprecise. Based on data provided by intensive care specialists (ICS) and microbiologists, this study defines the clinical practices and microbiological techniques currently used for an aetiological diagnosis of VAP and pinpoints deficiencies. Eighty hospitals in the national health network with intensive care and microbiology departments were sent two questionnaires, one for each department, in order to collect data on VAP diagnosis for the previous year. Out of the 80 hospitals, 35 (43.8%) hospitals participated. These included 673 ICU beds, 32,020 ICU admissions, 173,820 ICU days stay, and generated 27,048 lower respiratory tract specimens in the year. A third of the hospitals (35%) had a microbiology department available 24/7. Most samples (83%) were tracheal aspirates. Gram stain results were immediately reported in around half (47%) of the hospitals. Quantification was made in 75% of hospitals. Molecular techniques and direct susceptibility testing were performed in 12% and one institution, respectively. Mean turnaround time for a microbiological report was 1.7 (SD; 0.7), and 2.2 (SD; 0.6) days for a negative and positive result, respectively. Telephone/in-person information was offered by 65% of the hospitals. Most (89%) ICS considered microbiological information as very useful. No written procedures were available in half the ICUs. Both ICS and microbiologists agreed that present guidelines for the diagnosis of VAP could be much improved, and that a new set of consensus guidelines is urgently required. A need for guidelines to be more effectively implemented was also identified in order to improve outcomes in patients with VAP. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Staphylococcus aureus carriage in older populations in community residential care homes: Prevalence and molecular characterization of MRSA isolates.

PubMed

Galán-Sánchez, Fátima; Pérez-Eslava, Maria; Machuca, Jesús; Trujillo-Soto, Teresa; Arca-Suarez, Jorge; Rodríguez-Iglesias, Manuel

2018-06-20

The epidemiology of S. aureus depends on conditions in specific populations. Few studies of S. aureus colonization in the older population have been performed in Spain. The aim of this study was to determine the prevalence of methicillin-resistant S. aureus (MRSA) colonization and its molecular epidemiological characteristics in an institutionalized population in community residential care homes in Cadiz, Spain. A cross-sectional epidemiological study was conducted in three residential care homes for older people. Axilla and nostril samples were tested. Identification of S. aureus and antimicrobial susceptibility testing were by MALDI-TOF and MicroScan panels. MRSA strains were subjected to SCCmec typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The presence of Panton-Valentine leukocidin (PVL) genes was determined by PCR in all S. aureus strains. A total of 293 residents were included. Fifty-one residents (17.4%) were colonized with methicillin-sensitive S. aureus (MSSA) and 11 (3.8%) with MRSA. Resistance to at least two aminoglycosides was observed in 25.4% of MSSA and 90.9% and of MRSA isolates, and resistance to levofloxacin in 80.3% of MSSA and 100% of MRSA isolates. SCCmecIV was detected in all isolates and all except one (ST-125) were ST-8. None of the S. aureus isolates were positive for PVL. A low rate of S. aureus carriage was detected and the prevalence of MRSA was very low. ST8-MRSA-IVc was the dominant clone, and only one strain belonged to ST125-MRSA-IVc. We found MRSA transmission within the residential care homes and a very high rate of quinolone resistance in MSSA and MRSA. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prevalence of quinolone resistance mechanisms in Enterobacteriaceae producing acquired AmpC β-lactamases and/or carbapenemases in Spain.

PubMed

Machuca, Jesús; Agüero, Jesús; Miró, Elisenda; Conejo, María Del Carmen; Oteo, Jesús; Bou, Germán; González-López, Juan José; Oliver, Antonio; Navarro, Ferran; Pascual, Álvaro; Martínez-Martínez, Luis

2017-10-01

Quinolone resistance in Enterobacteriaceae species has increased over the past few years, and is significantly associated to beta-lactam resistance. The aim of this study was to evaluate the prevalence of chromosomal- and plasmid-mediated quinolone resistance in acquired AmpC β-lactamase and/or carbapenemase-producing Enterobacteriaceae isolates. The presence of chromosomal- and plasmid-mediated quinolone resistance mechanisms [mutations in the quinolone resistance determining region (QRDR) of gyrA and parC and qnr, aac(6')-Ib-cr and qepA genes] was evaluated in 289 isolates of acquired AmpC β-lactamase- and/or carbapenemase-producing Enterobacteriaceae collected between February and July 2009 in 35 Spanish hospitals. Plasmid mediated quinolone resistance (PMQR) genes were detected in 92 isolates (31.8%), qnr genes were detected in 83 isolates (28.7%), and the aac(6')-Ib-cr gene was detected in 20 isolates (7%). qnrB4 gene was the most prevalent qnr gene detected (20%), associated, in most cases, with DHA-1. Only 14.6% of isolates showed no mutations in gyrA or parC with a ciprofloxacin MIC of 0.5mg/L or higher, whereas PMQR genes were detected in 90% of such isolates. qnrB4 gene was the most prevalent PMQR gene detected, and was significantly associated with acquired AmpC β-lactamase DHA-1. PMQR determinants in association with other chromosomal-mediated quinolone resistance mechanisms, different to mutations in gyrA and parC (increased energy-dependent efflux, altered lipopolysaccharide or porin loss), could lead to ciprofloxacin MIC values that exceed breakpoints established by the main international committees to define clinical antimicrobial susceptibility breakpoints. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas.

PubMed

Solera, J; Rodríguez-Zapata, M; Geijo, P; Largo, J; Paulino, J; Sáez, L; Martínez-Alfaro, E; Sánchez, L; Sepulveda, M A; Ruiz-Ribó, M D

1995-09-01

Brucellosis is a common zoonosis in many parts of the world; the best regimen for the treatment of brucellosis has not been clearly determined. We have carried out a multicenter, open, controlled trial in five general hospitals in Spain to compare the efficacy and safety of doxycycline and rifampin (DR) versus doxycycline and streptomycin (DS) for the treatment of human brucellosis. The study included 194 ambulatory or hospitalized patients with acute brucellosis, without endocarditis or neurobrucellosis. The diagnostic criterion was isolation of Brucella species from blood or other tissues (n = 120) or a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies with compatible clinical findings (n = 74). Patients were randomly assigned to receive either 100 mg of doxycycline twice daily plus rifampin, 900 mg/day, in a single morning dose for 45 days (DR group) or the same dose of doxycycline for 45 days plus streptomycin, 1 g/day, intramuscularly for 14 days (DS group). A lack of therapeutic efficacy developed in 8 of the 100 patients in the DR group (8%) and in 2 of the 94 patients in the DS group (2%)(P = 0.10). Relapses occurred in 16 of the 100 patients in the DR group (16%) but in only 5 of the 94 patients in the DS group (5.3%) (P = 0.02). When relapse was considered in combination with initial lack of efficacy, 26 patients in the DR group (24%) and 7 patients in the DS group (7.45%) failed to respond to therapy (P = 0.0016). In general, therapy was well tolerated and only four patients (4%) in the DR group and two (2%) in the DS group had episodes of adverse effects necessitating discontinuation of treatment (P> 0.2). We conclude that a doxycycline-and-rifampin regimen is less effective than the doxycycline-and-streptomycin regimen in patients with acute brucellosis.

Acinetobacter baumannii in critically ill patients: Molecular epidemiology, clinical features and predictors of mortality.

PubMed

Garnacho-Montero, José; Gutiérrez-Pizarraya, Antonio; Díaz-Martín, Ana; Cisneros-Herreros, José Miguel; Cano, María Eugenia; Gato, Eva; Ruiz de Alegría, Carlos; Fernández-Cuenca, Felipe; Vila, Jordi; Martínez-Martínez, Luis; Tomás-Carmona, M Del Mar; Pascual, Álvaro; Bou, Germán; Pachón-Diaz, Jerónimo; Rodríguez-Baño, Jesús

2016-11-01

The main aim of this study was to assess changes in the epidemiology and clinical presentation of Acinetobacter baumannii over a 10-year period, as well as risk factors of mortality in infected patients. Prospective, multicentre, hospital-based cohort studies including critically ill patients with A. baumannii isolated from any clinical sample were included. These were divided into a first period ("2000 study") (one month), and a second period ("2010 study") (two months). Molecular typing was performed by REP-PCR, PFGE and MSLT. The primary endpoint was 30-day mortality. In 2000 and 2010, 103 and 108 patients were included, and the incidence of A. baumannii colonization/infection in the ICU decreased in 2010 (1.23 vs. 4.35 cases/1000 patient-days; p<0.0001). No differences were found in the colonization rates (44.3 vs. 38.6%) or infected patients (55.7 vs. 61.4%) in both periods. Overall, 30-day mortality was similar in both periods (29.1 vs. 27.8%). The rate of pneumonia increased from 46.2 in 2000 to 64.8% in 2010 (p<0.001). Performing MSLT, 18 different sequence types (ST) were identified (18 in 2000, 8 in 2010), but ST2 and ST79 were the predominant clones. ST2 isolates in the ICU increased from 53.4% in the year 2000 to 73.8% in 2010 (p=0.002). In patients with A. baumannii infection, the multivariate analysis identified appropriate antimicrobial therapy and ST79 clonal group as protective factors for mortality. At 10 years of the first analysis, some variations have been observed in the epidemiology of A. baumannii in the ICU, with no changes in mortality. Epidemic ST79 clone seems to be associated with a better prognosis and adequate treatment is crucial in terms of survival. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Pertussis in fully vaccinated infants and children. Are new vaccination strategies required?].

PubMed

Moraga-Llop, Fernando A; Mendoza-Palomar, Natàlia; Muntaner-Alonso, Antoni; Codina-Grau, Gemma; Fàbregas-Martori, Anna; Campins-Martí, Magda

2014-04-01

To analyse the vaccination status of children diagnosed with pertussis and to compare the clinical manifestations of fully vaccinated with unvaccinated, or incompletely-vaccinated, children. The clinical histories and vaccination cards of patients under 16years of age seen in the Emergency Room of the University Hospital Vall d'Hebron, Barcelona (Spain), for pertussis confirmed by a microbiological study were reviewed. The study period lasted from January 1, 2009 to December 31, 2011. Two hundred and twelve cases were studied: 35 in 2009, 28 in 2010 and 149 in 2011. RT-PCR was positive in 210 patients, and 73 had a positive culture. Infants under 6months of age account for 36.8% of all cases. Forty-four patients (21.5%) were not vaccinated. Forty-four (21.5%) children were between 2 and 5months of age and had received 1-2vaccine doses. One hundred and seventeen (57%) children were fully vaccinated; 76.9% (90cases) had received the last dose less than 4years ago. When clinical manifestations of the fully vaccinated patients were compared with those of the non-vaccinated or incompletely-vaccinated children, only cyanosis was found with a higher frequency in the latter group (P<.001). The age-adjusted probability of hospitalisation was significantly associated with non-vaccination (P=.001). The case mortality rate among inpatients was 1.3%. The number of pertussis cases seen in our centre has risen significantly in the last year. More than half (57%) of the patients were fully vaccinated, and 76.9% had received the last dose in the previous 4years. Other vaccination strategies, such as vaccination of adolescents, adults, and pregnant women, as well as a cocoon strategy are required to protect infants under 6months of age. More effective vaccines need to be developed. Copyright © 2012 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

An outbreak of monophasic and biphasic Salmonella Typhimurium, and Salmonella Derby associated with the consumption of dried pork sausage in Castellon (Spain).

PubMed

Arnedo-Pena, Alberto; Sabater-Vidal, Susana; Herrera-León, Silvia; Bellido-Blasco, Juan B; Silvestre-Silvestre, Esther; Meseguer-Ferrer, Noemi; Yague-Muñoz, Alberto; Gil-Fortuño, Maria; Romeu-García, Angeles; Moreno-Muñoz, Rosario

2016-11-01

An outbreak of S.Typhimurium occurred in several towns and cities in the province of Castellon (Spain) between 23 February and 27 May 2011. On April 5, the microbiology laboratory of a hospital in Castellon alerted the health authorities to the increase in S.Typhimurium isolated in fecal culture of children with gastroenteritis. The serotype and phage-type of 83 positive cases of S.Typhimurium isolated in these period included 49 monophasic/biphasic S.Typhimurium phage type 138, phage type 193, S.Derby, and 34 other S.Typhimurium phage-types. The median of age of patients was 4 years with a range of 0.6-80 years, and the 18% of patients were hospitalised. Two incident matched case-control studies were carried out; the first with S.Typhimurium phage type 138, 193, and S.Derby cases and the second with the other cases. The two studies found that the consumption of brand X dried pork sausage, purchased in a supermarket chain A, was associated with the disease (matched Odds Ratio [mOR]=13.74 95% Confidence Interval [CI] 4.84-39.06 and mOR=8.20 95% CI 2.32-28.89), respectively). S.Typhimurium phage type 193 and S.Derby were isolated in the food taken from the household of two patients and from the supermarket chain's A central warehouse. The pulsed-field gel electrophoresis study confirmed the similarity of the strains from the patients and the food. On May 25 2011, a national food alert led to the withdrawal of the food from the chain A and the outbreak ended. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Comparison of sporadic cases of Salmonella Typhimurium with other Salmonella serotypes in Castellon (Spain): case-case study.

PubMed

Arnedo-Pena, Alberto; Vivas-Fornas, Iraya; Meseguer-Ferrer, Noemi; Tirado-Balaguer, María Dolores; Yagüe-Muñoz, Alberto; Herrera-León, Silvia; Sabater-Vidal, Susana; Romeu-García, María Ángeles; Vizcaino Batllés, Ana; Bellido-Blasco, Juan Bautista; Moreno-Muñoz, Rosario

2017-10-07

Salmonella infections (SI) are common in Spain. The aim of this study was to appraise risk factors and the clinical characteristics of sporadic Salmonella Typhimurium infections compared with other sporadic salmonella serotype infections (OSI). From September 2014 to August 2015, a case-case study was carried out by the Epidemiology Division of the Public Health Centre of Castellon. Case 1 consisted of patients with sporadic S. Typhimurium infections, while case 2 comprised OSI patients, assessed according to the stool cultures analyzed by the Microbiology Laboratories of Hospital General de Castellon and Hospital de La Plana in Vila-real. Patients from detected outbreaks were not included. The salmonella serotype was identified by the National Centre of Microbiology (Madrid). The total number of SI patients reported was 327, 242 of whom were studied (74.0%). 148 patients had sporadic S. Typhimurium infection and 64 had OSI, with median ages of 4 and 8.5 years, respectively. Sporadic S. Typhimurium infection patients presented more blood in feces and diarrhea episodes. Consumption of pork meat (OR=2.22; 95% CI 1.12-4.43), cold pork meats (OR=2.49; 95% CI 1.32-4.68) and playing in the dirt (OR=3.02; 95% CI 1.55-5.88), were associated with sporadic S. Typhimurium infection. In the 0-4 year-old group, the associated factors were consumption of cold pork meats, omelets and female gender. In the 5-year-old and over group, only playing in soil was associated with sporadic S. Typhimurium infection. The consumption of pork and omelets, as well as playing in the dirt, were the main factors associated with infection. Children were most affected by sporadic S. Typhimurium infection. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Emergencias

EPA Pesticide Factsheets

Aprenda cómo usted puede prepararse y recuperarse de los desastres naturales como los huracanes y las inundaciones, aceite informe y derrames de sustancias peligrosas, y cómo la EPA responde a derramar emergencia.

Geophysical investigations of the Olonium Roman site (Northern Como Lake)

NASA Astrophysics Data System (ADS)

Arlsan, Ermanno; Biella, Giancarlo; Boniolo, Graziano; Caporusso, Donatella; de Franco, Roberto; Lozej, Alfredo; Veronese, Luigi

1999-03-01

The study area is located at S. Agata (Gera Lario), a small center at the northern end of Como Lake, near the junction of Valchiavenna and Valtellina Valleys. This site played a strategic role since ancient times, providing the control on the communications routes to both the Como Lake and the Spluga and Septimer alpine passes. Since the end of the last century archaeological findings are reported in literature, also supported, from the early XI century, by archival documents confirming the existence of the `Olonium' settlement, an administrative and fiscal center of primary importance, as well as a parish amongst the most influential in the Como Lake area. Within an area of 45,000 m 2 an electrical survey has been carried out in conjunction with magnetic and GPR investigations. These studies have indicated the presence of a number of sub-areas characterized by significant anomalies defined by the overlapping of the results obtained from two or more geophysical methods. In two of such sub-areas, excavation tests have been conducted, which have brought to light a number of archaeological findings of interest. In one of the two sub-areas, which is characterized by the superimposition of electrical and radar anomalies, a deposit of large pebbles has been found. The origin of this deposit has not been ascertained, whether it is of fluvial origin, related to the deviation of the Adda river in the Pian di Spagna region in Roman times, or it is part of reclamation works, still of Roman times, of paleolacustrine marshes. The overlapping stratigraphy, however, suggests the development of fluvial channels between Roman and Low-Medieval times. In the other sub-area, excavations were carried out on sites defined by electrical and radar anomalies, and confirmed by the results from magnetic survey. The excavations brought to light, below the fluvial deposits, a large medieval edifice, which could be identified as the S. Stefano church abandoned in 1444. The church is built on earlier structures, amongst which an apse with a single aisle has been interpreted as a paleochristian sacellum.

The Reflective Abstraction Theory and the History of Astronomy. (Spanish Title: La Teoría de la Abstracción Reflexionante y la Historia de la Astronomía.) A Teoria da Abstração Reflexionante e a História da Astronomia.

NASA Astrophysics Data System (ADS)

Chiesa Bartelmebs, Roberta; Batista Siqueira Harres, João; da Silva, João Alberto

2014-12-01

This work is presented as a theoretical essay on some facts from the history of astronomy analyzed according to the theory of reflective abstraction developed by Jean Piaget and collaborators (1970). Its aim is to understand the reasons that led to different astronomers, at the same historical period and culture, to "see" quite different evidences about the same phenomenon. In addition, we intend to facilitate the understanding of science as a human construction, subject to a time epoch and the ways of understanding of each scientist. Este trabajo se presenta como un ensayo teórico sobre algunos hechos históricos de la astronomía, analizados según la teoría de la abstracción reflexionante de Jean Piaget y sus colaboradores (1970). Se trata de comprender los motivos que llevaran a distintos astrónomos, de una misma época histórica y cultural, a "ver" diferentes evidencias sobre un mismo fenómeno. Además, se intenta posibilitar la comprensión de la ciencia como construcción humana, la cual es condicionada por su momento histórico y por las creencias y las formas de entender de los científicos. Este trabalho configura-se como um ensaio teórico a respeito de alguns fatos da história da astronomia analisados segundo a teoria da abstração reflexionante elaborada por Jean Piaget e seus colaboradores (1970). Trata-se de compreender os motivos que levaram diferentes astrônomos, da mesma época histórica e cultural, a "enxergarem" evidências tão diferentes sobre um mesmo fenômeno. Além disso, pretendemos possibilitar a compreensão das Ciências como construção humana, condicionadas a uma época e às crenças e os modos de compreender de cada cientista.

Sunspots and the Newcomb-Benford Law. (Spanish Title: Manchas Solares y la Ley de Newcomb-Benford.) Manchas Solares e a Lei de Newcomb-Benford

NASA Astrophysics Data System (ADS)

Alves, Mauro A.; Lyra, Cássia S.

2008-12-01

The Newcomb-Benford's Law (LNB) of first digits is introduced to high school students in an extracurricular activity through the study of sunspots. The LNB establishes that the first digits of various sets of data describing natural occurrences are not distributed uniformly, but according to a logarithmic distribution of probability. The LNB is counter-intuitive and is a good example of how mathematics applied to the study of natural phenomena can provide surprising and unexpected results serving also as a motivating agent in the study of physical sciences. En este trabajo se describe una actividad extracurricular donde se presenta a los estudiantes la ley de los primeros dígitos de Newcomb-Benford (LNB) con el estudio de manchas solares. La LNB establece que los primeros dígitos de algunos tipos de dados de ocurrencia natural no están distribuidos en manera uniforme, pero sí de acuerdo con una distribución logarítmica de probabilidad. La LNB es contra-intuitiva y es un excelente ejemplo de como las matemáticas aplicadas al estudio de fenómenos naturales pueden sorprender al estudiante, sirviendo también como elemento motivador en la educación de ciencias y de matemáticas. Este trabalho descreve uma atividade extracurricular na qual a lei dos primeiros dígitos de Newcomb-Benford (LNB) é introduzida a estudantes através do estudo de manchas solares. A LNB estabelece que os primeiros dígitos de vários tipos de conjunto de dados de ocorrência natural não são distribuídos de maneira uniforme, mas sim de acordo com uma distribuição logarítmica de probabilidade. A LNB é contra-intuitiva e é um ótimo exemplo de como a matemática aplicada ao estudo de fenômenos naturais pode fornecer resultados surpreendentes e inesperados, servindo também como um agente motivador no ensino de ciências e matemática.

Variación temporal de las constantes fundamentales

NASA Astrophysics Data System (ADS)

Landau, S. J.; Vucetich, H.

La variación temporal de las constantes fundamentales es un problema que ha motivado numerosos trabajos teóricos y experimentales desde la hipótesis de los grandes números de Dirac en 1937. Entre los métodos experimentales y observacionales para establecer restricciones sobre la variación de las constantes fundamentes es importante mencionar: comparación entre relojes atómicos[1], métodos geofísicos[2][3], análisis de sistemas de absorción en quasares[4][5][6] y cotas provenientes de la nucleosíntesis primordial[7]. En un trabajo reciente[5], se reportó una significativa variación en la constante de estructura fina. Intentos de unificar las cuatro interacciones fundamentales dieron como resultado teorías con múltiples dimensiones como las teorías de Kaluza-Klein y teorías de supercuerdas. Estas teorías proporcionan un marco teórico natural para el estudio de la variación temporal de las constantes fundamentales. A su vez, un modelo sencillo para estudiar la variación de la constante de estructura fina, fue propuesto en [8], a partir de premisas muy generales como ser covarianza, invarianza de gauge, causalidad y invarianza ante reversiones temporales en el electromagnetismo. Diferentes versiones de las teorías antes mencionadas coinciden en predecir variaciones temporales de las constantes fundamentales pero difieren en la forma de esta variación[9][10]. De esta manera, las restricciones establecidas experimentalmente sobre la variación de las constantes fundamentales pueden ser una herramienta importante para testear estas diferentes teorías. En este trabajo, utilizamos las cotas provenientes de diversas técnicas experimentales, para testear si las mismas son consistentes con alguna de las teorías antes mencionadas. En particular, establecemos cotas sobre la variación de los parámentros libres de las diferentes teorías como por ejemplo el radio de las dimensiones extras en las teorías tipo Kaluza-Klein.

Competencias en ética biocéntrica

PubMed Central

Stepke, Fernando Lolas

2013-01-01

Resumen Este artículo explora el origen y la conceptualización de la bioética en tanto ética biocéntrica, definida por el pionero Fritz Jahr como un imperativo hipotético que llama a respetar la vida en todas sus formas. Tras describirla como proceso social, procedimiento técnico y producto académico, se enumeran y comentan algunas competencias que debieran presidir el empleo del discurso bioético en cualquier punto del complejo social “investigación médica”: miembros de comités de ética de investigación, investigadores, empresarios, administradores. Cada uno de estos grupos, en su “cultura epistémica” propia, define y explicita los principios básicos en tanto expresión de valores y leyes generales. PMID:23459767

Weathering resistance of thin plasma polymer films on pre-coated steel =

NASA Astrophysics Data System (ADS)

Serra, Ricardo Gil Henriques

O trabalho apresentado teve origem no projecto de investigacao “Tailored Thin Plasma Polymers Films for Surface Engineering of Coil Coated Steel”, financiado pelo Programa Europeu ECSC Steel Research. Sistemas de aco galvanizado pre-pintado em banda a base de poliester e poliuretano foram submetidos a um processo de polimerizacao por plasma onde um filme fino foi depositado de modo a modificar as propriedades de superficie. Foram usados reactores de catodo oco, microondas e radio frequencia para a deposicao do polimero fino. Os sistemas preparados foram analisados de modo a verificar a influencia do processo de polimerizacao por plasma na alteracao das propriedades barreira dos sistemas pre-pintados em banda. Foi estudado o efeito dos diferentes passos do processo de polimerizacao por plasma, bem como o efeito de diferentes variaveis operatorias. A mistura precursora foi variada de modo a modificar as propriedades da superficie de modo a poder vir a obter maior hidrofobicidade, maior resistencia a marcas digitais, bem como maior facilidade de limpeza. Os testes foram conduzidos em solucao de NaCl 0,5 M. Para o trabalho foram usadas tecnicas de analise da morfologia da superficie como Microscopia de Forca Atomica e Microscopia Electronica de Varrimento. As propriedades electroquimicas dos sistemas foram estudadas por Espectroscopia de Impedancia Electroquimica. A estrutura dos filmes gerados no processo de polimerizacao por plasma foi caracterizada por Microscopia de Transmissao Electronica. A modificacao das propriedades opticas devido ao processo de polimerizacao por plasma foi tambem obtida.

Improving seasonal forecast through the state of large-scale climate signals

NASA Astrophysics Data System (ADS)

Samale, Chiara; Zimmerman, Brian; Giuliani, Matteo; Castelletti, Andrea; Block, Paul

2017-04-01

Increasingly uncertain hydrologic regimes are challenging water systems management worldwide, emphasizing the need of accurate medium- to long-term predictions to timely prompt anticipatory operations. In fact, forecasts are usually skillful over short lead time (from hours to days), but predictability tends to decrease on longer lead times. The forecast lead time might be extended by using climate teleconnection, such as El Nino Southern Oscillation (ENSO). Despite the ENSO teleconnection is well defined in some locations such as Western USA and Australia, there is no consensus on how it can be detected and used in other river basins, particularly in Europe, Africa, and Asia. In this work, we propose the use of the Nino Index Phase Analysis for capturing the state of multiple large-scale climate signals (i.e., ENSO, North Atlantic Oscillation, Pacific Decadal Oscillation, Atlantic Multidecadal Oscillation, Dipole Mode Index). This climate state information is used for distinguishing the different phases of the climate signals and for identifying relevant teleconnections between the observations of Sea Surface Temperature (SST) that mostly influence the local hydrologic conditions. The framework is applied to the Lake Como system, a regulated lake in northern Italy which is mainly operated for flood control and irrigation supply. Preliminary results show high correlations between SST and three to six months ahead precipitation in the Lake Como basin. This forecast represents a valuable information to partially anticipate the summer water availability, ultimately supporting the improvement of the Lake Como operations.

Thermophysical properties of undercooled liquid Co-Mo alloys

NASA Astrophysics Data System (ADS)

Han, X. J.; Wei, B.

2003-05-01

Using electromagnetic levitation in combination with the oscillating drop technique and drop calorimeter method, the surface tensions and specific heats of undercooled liquid Co-10 wt% Mo, Co-26.3 wt% Mo, and Co-37.6 wt% Mo alloys were measured. The containerless state during levitation produces substantial undercoolings up to 223 K (0.13TL), 213 K (0.13TL) and 110 K (0.07TL) respectively for these three alloys. In their respective undercooling ranges, the surface tensions were determined to be 1895 m 0.31(T m 1744), 1932 m 0.33(T m 1682), and 1989 m 0.34(T m 1607) mN mу. According to the Butler equation, the surface tensions of these three Co-Mo alloys were also calculated, and the results agree well with the experimental data. The specific heats of these three alloys are determined to be 41.85, 43.75 and 44.92 J molу Kу. Based on the determined surface tensions and specific heats, the changes in thermodynamics functions such as enthalpy, entropy and Gibbs free energy are predicted. Furthermore, the crystal nucleation, dendrite growth and Marangoni convection of undercooled Co-Mo alloys are investigated in the light of these measured thermophysical properties.