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To alleviate soil compaction, subsoiling practices using subsoiler implements are commonly implemented. However, subsoiler bodies are subjected to great draft forces because they work deep in the soil. Therefore, to contribute to draft force reduction, in this work, a bio-inspired attack edge for a subsoiler body based on the internal and external contour lines of the claws of the Mexican ground squirrel (Spermophilus mexicanus) is proposed. As a first step, computational fluid dynamic (CFD) modeling was used to select the best bionic subsoiler (BS) according to the draft force requirements. Then, the BS was fabricated and field-evaluated, and its real draft force during tillage was contrasted with those of a curve subsoiler (CS) and a straight subsoiler (SS). The field evaluation demonstrated that the BS demands, on average, 12.37% and 22.25% less draft force than the CS and SS, respectively. Additionally, the BS was better at entering the soil since its mean tillage depths were 24.86% and 5.73% higher than those of the SS and CS geometries, respectively. Therefore, it was found that modeling the attacking edge of a subsoiler body after the Mexican ground squirrel clearly reduced the draft force during tillage.

Background: Carbapenemase-producing Enterobacterales (CPE) represents a significant threat to global health. This study aimed to characterize clinically and molecularly the CPE isolated from rectal swabs of patients in the intensive care units (ICUs) of a tertiary hospital in Cali, Colombia. Methods: This was a cross-sectional observational study. Rectal swabs from patients admitted to the ICUs were collected. Bacterial identification and carbapenemase production were determined using phenotypic and molecular methods. Demographic and clinical data were extracted from electronic medical records. Results: The study included 223 patients. Thirty-six patients (36/223, 16.14 %) were found to be colonized or infected by CPE. Factors such as prolonged stay in the ICU, previous exposure to carbapenem antibiotics, use of invasive procedures, and admission due to trauma were associated with CPE. Klebsiella pneumoniae (52.5 %) was the most prevalent microorganism, and the dominant carbapenemases identified were KPC (57.8 %) and NDM (37.8 %). Conclusion: Distinguishing carbapenemase subtypes can provide crucial insights for controlling dissemination in ICUs in Cali, Colombia.

Abstract Background Few studies have evaluated the efficacy of short-term medical missions. This study was aimed to evaluate complication rates and determine the effects of protocol changes in a pediatric inguinal hernia campaign in Equatorial Guinea and analyze post-operative follow-up capacity. Methods In this prospective observational cohort study, we evaluated two patient cohorts (group A, 2017–2018; group B, 2019) treated during campaigns in Equatorial Guinea for congenital inguinal pathology (hernia, hydrocele, and cryptorchidism). Patients aged

Se requieren materias primas para elaborar biocombustibles y transitar hacia fuentes sostenibles de energía. El objetivo del estudio fue evaluar la morfología, productividad y calidad del grano en higuerilla (Ricinus communis) cultivada en el Centro-Norte de México. En primavera-verano de 2020, se sembraron cuatro variedades y un h.brido de higuerilla en Durango, Durango, y Pabellón, Aguascalientes, México. En la siembra se consideró una densidad de 15000 plantas ha−1. Se evalu. n.mero de d.as a floraci.n (DF), altura de planta (AP), longitud de la espiga (LE), rendimiento (kg ha−1), peso de 100 semillas (P100S), % de brotación (PB), % de germinación (PG) y el contenido de cenizas (CC), proteína (CP) y grasa (CG). El procesamiento estadístico incluyo estad.stica descriptiva (DF, PB y PG) y un análisis de varianza en un diseño en bloques completamente al azar con seis repeticiones y la comparación de medias se obtuvo con la prueba de Tukey (α ≤ 0.05). Se observaron diferencias altamente significativas (α ≤ 0.01) para altura de planta entre localidades (195.0 cm-282.7 cm) y entre materiales para AP, LE y P100S. En ambas localidades SAB 14 (2,906 kg ha−1 y 2,408 kg ha−1) y K 855 (2,669 kg ha−1 y 2,400 kg ha−1) mostraron el rendimiento m.s alto. En CG Guanajuato Oil (57.1%) y SAB 14 (55.4%) superaron estad.sticamente al resto de los materiales. Se corroboró la adaptación de SAB 14, la cual mostró rendimiento alto de grano y sus semillas, resultaron de calidad aceptable, con base en el contenido de grasa.

Abstract Background Antimicrobial stewardship programs (ASPs) have become a fundamental pillar in optimizing antimicrobial usage, improving patient care, and reducing antimicrobial resistance (AMR). Herein we evaluated the impact of an ASP on antimicrobial consumption and AMR in Colombia. Methods We designed a retrospective observational study and measured trends in antibiotic consumption and AMR before and after the implementation of an ASP using interrupted time series analysis over a 4-year period (24 months before and 24 months after ASP implementation). Results ASPs were implemented according to the available resources in each of the institutions. Before ASP implementation, there was a trend toward an increase in the antibiotic consumption of all measured antimicrobials selected. Afterward, an overall decrease in antibiotic consumption was observed. The use of ertapenem and meropenem decreased in hospital wards, while a decrease in the use of ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, and vancomycin was observed in intensive care units. After ASP implementation, the trend toward an increase of oxacillin-resistant Staphylococcus aureus, ceftriaxone-resistant Escherichia coli, and meropenem-resistant Pseudomonas aeruginosa was reversed. Conclusions In our study, we showed that ASPs are a key strategy in tackling the emerging threat of AMR and have a positive impact on antibiotic consumption and resistance.

El COVID-19 es una enfermedad ocasionada por el virus SARS-CoV-2. Con el aumento explosivo de casos confirmados, la Organización Mundial de la Salud declaró este brote como emergencia de salud pública de interés internacional el 30 de enero de 2020, y como pandemia el 11 de marzo de ese mismo año. Desde ese momento, se han llevado a cabo investigaciones para hallar medicamentos contra este patógeno. Un ejemplo son los anticuerpos monoclonales, una herramienta poderosa para tratar una amplia gama de condiciones, tales como: cáncer, enfermedades autoinmunes, neuronales, infecciosas y metabólicas. En poco tiempo, algunos mostraron resultados alentadores en el mejoramiento de los síntomas clínicos de pacientes con dicha patología. Unos actúan de manera directa contra el virus y otros mediante mecanismos farmacológicos asociados a su fisiopatología. Su utilización representa una alternativa para reducir hospitalizaciones y muertes por la infección. Actualmente existe uno con aprobación completa (casirivimab e imdevimab, se administran en conjunto) y tres aprobados para uso de emergencia (bamlanivimab más etesevimab, se administran en conjunto; sotrovimab y tocilizumab) por parte de la Administración de Alimentos y Medicamentos de los Estados Unidos. Sin embargo, es indispensable el desarrollo de más estudios clínicos para evidenciar su eficacia y su seguridad en diversas poblaciones, así como el estudio de nuevas moléculas. Palabras clave: COVID-19, Organización Mundial de la Salud, farmacoterapia, anticuerpos monoclonales, ensayos clínicos. Fuente: DeCS, BIREME.

Introduction There is insufficient evidence supporting the use of rapid diagnostic tests (RDTs) for syphilis in people living with HIV (PLWH). We evaluated the diagnostic performance of two commercially available RDTs (Bioline and Determine) in PLWH in Cali, Colombia. Methods A cross-sectional field validation study on consecutive adults with confirmed HIV diagnosis attending three outpatient clinics. Both RDTs were performed on capillary blood (CB), obtained by finger prick, and sera, by venipuncture. A combination of treponemal enzyme linked immunosorbent assay (ELISA) and Treponema pallidum haemagglutination assay (TPHA) on serum samples was the reference standard. Rapid plasma reagin (RPR) and clinical criteria were added to define active syphilis. Sensitivity and specificity, predictive values and likelihood ratios (LR) of RDTs were estimated with their corresponding 95% confidence interval (95% CI). Stratified analyses by sample type, patient characteristics, non-treponemal titers, operator and re-training were performed. Results 244 PLWH were enrolled, of whom 112 (46%) had positive treponemal reference tests and 26/234 (11.1%) had active syphilis. The sensitivities of Bioline on CB and sera were similar (96.4% vs 94.6%, p = 0.6). In contrast, Determine had a lower sensitivity on CB than sera (87.5% vs 99.1%, p 95% in most analyses. Predictive values were 90% or higher. For active syphilis, the RDTs showed a similar performance pattern but with decreased specificities. Conclusion The studied RDTs have an excellent performance in PLWH to screen for syphilis and potentially for active syphilis, yet Determine performs better on sera than CB. Patient characteristics and potential difficulties operators may face in acquiring enough blood volume from finger pricks should be considered for the implementation and the interpretation of RDTs.

BackgroundOver the past years, information about the crosstalk between the epicardial adipose tissue (EAT) and the cardiovascular system has emerged. Notably, in the context of acute myocardial infarction (AMI), EAT might have a potential role in the pathophysiology of ventricular structural changes and function, and the clinical evolution of patients. This study aims to assess the impact of EAT on morpho-functional changes in the left ventricle (LV) and the outcome of patients after an AMI.MethodsWe studied prospectively admitted patients to our hospital with a first episode of AMI. All patients underwent percutaneous coronary intervention (PCI) during admission. Transthoracic echocardiography (TTE) was performed within 24–48 h after PCI, as well as blood samples to assess levels of galectin-3 (Gal-3). Cardiac magnetic resonance (CMR) was performed 5–7 days after PCI. Clinical follow-up was performed at 1 and 5 years after MI.ResultsMean age of our cohort (n = 41) was 57.5 ± 10 years, and 38 (93%) were male. Nine patients had normal BMI, 15 had overweight (BMI 25–30), and 17 were obese (BMI > 30). Twenty three patients (56%) had ≥ 4 mm thickness of EAT measured with echo. In these patients, baseline left ventricular ejection fraction (LVEF) after AMI was significantly lower, as well as global longitudinal strain. EAT thickness ≥ 4 m patients presented larger infarct size, higher extracellular volume, and higher T1 times than patients with EAT < 4 mm. As for Gal-3, the median was 16.5 ng/mL [12.7–25.2]. At five-year follow-up 5 patients had major cardiac events, and all of them had EAT ≥ 4 mm.ConclusionsPatients with EAT >4 mm have worse LVEF and GLS, larger infarct size and longer T1 values after a MI, and higher levels of Gal-3. EAT >4 mm was an independent predictor of MACE at 5-year follow-up. EAT thickness is a feasible, noninvasive, low-cost parameter that might provide important information regarding the chronic inflammatory process in the myocardium after an infarction.

Abstract Neutrophil gelatinase-associated lipocalin (NGAL) is involved in cardiovascular and renal diseases. Gene inactivation of NGAL blunts the pathophysiological consequences of cardiovascular and renal damage. We aimed to design chemical NGAL inhibitors and investigate its effects in experimental models of myocardial infarction (MI) and chronic kidney disease induced by 5/6 nephrectomy (CKD) on respectively 8–12 weeks old C57Bl6/j and FVB/N male mice. Among the 32 NGAL inhibitors tested, GPZ614741 and GPZ058225 fully blocked NGAL-induced inflammatory and profibrotic markers in human cardiac fibroblasts and primary mouse kidney fibroblasts. The administration of GPZ614741 (100 mg/kg/day) for three months, was able to improve cardiac function in MI mice and reduced myocardial fibrosis and inflammation. The administration of GPZ614741 (100 mg/kg/day) for two months resulting to no renal function improvement but prevented the increase in blood pressure, renal tubulointerstitial fibrosis and profibrotic marker expression in CKD mice. In conclusion, we have identified new compounds with potent inhibitory activity on NGAL-profibrotic and pro-inflammatory effects. GPZ614741 prevented interstitial fibrosis and dysfunction associated with MI, as well as tubulointerstitial fibrosis in a CKD model. These inhibitors could be used for other diseases that involve NGAL, such as cancer or metabolic diseases, creating new therapeutic options.

Abstract Background The HLA-B*57:01 allele is associated with a hypersensitivity reaction to abacavir. Due to the lack of knowledge of HLA-B*57:01 prevalence in Colombia, routine screening is not performed and is not recommended by the national guidelines. We aimed to determine the prevalence of HLA-B*57:01 in HIV population from Colombia. Methods This cross-sectional study included naïve HIV-infected adults from 13 cities of the country. The presence of HLA-B*57:01 was determined by using SSP-PCR in blood samples. Prevalence rates were stratified by sex, race, and region of origin. Results HLA-B*57:01 allele prevalence in Colombian HIV-infected individuals was 2.7%. When stratifying for the race, the prevalence was 4% for whites, 2.6% for other race (mainly mestizo), and 1.9% for Afro-Colombians. The prevalence varied from 0% up to 11.4% depending on the department of origin. The highest prevalence rates were found in Caldas (11.4%), Antioquia (5%), Risaralda (4.8%), and Valle del Cauca (4.3%). When distributed by country zones, the central, with a racial predominance of Caucasians and mestizos, was the highest (6.0%, 0R = 4.1, CI 1.2–12.8, p = 0,016). Conclusions The overall prevalence of HLA-B*57:01 in Colombia was lower than the reported rates for other Latin American countries such as Brazil, Costa Rica, and Argentina, but similar in comparison to Chile and Mexico. The diversity in the racial and ethnic heritage shown in our data supports the recommendation to implement routine screening for the HLA-B*57:01 allele before initiation of abacavir-containing antiretroviral therapy in the Colombian HIV management guidelines.

El desarrollo económico y social reciente ha llevado a nuevos paradigmas en las organizaciones, donde surge el concepto de organizaciones fractales basadas en proyectos, las cuales establecen alianzas estratégicas que comparten proyectos. Los requerimientos iniciales y sus cambios, así como los riesgos necesitan ser controlados en etapas tempranas del proyecto. Las propuestas tradicionales de (re)planificación de proyectos no capturan las relaciones complejas entre riesgos, requerimientos y el plan del proyecto. En este trabajo, se presenta un modelo integrado para (re)planificación de proyectos, incluyendo la gestión de cambios en requerimientos y riesgos asociados a cada proyecto dentro de la organización o alianza estratégica. Para ejemplificar su aplicación, se ha desarrollado un caso de estudio en el contexto de la industria farmacéutica, ya que la misma responde a las características de organizaciones fractales basadas en proyectos, donde el proyecto constituye su base y los riesgos reciben un tratamiento especial en dicha industria.

Background: Diabetes mellitus is an established risk factor for bacterial infections, but its role in cryptococcosis is unclear. The study aimed to determine whether uncontrolled diabetes (HbA1c >7%) was an independent risk factor for mortality in cryptococcosis. Methods: A retrospective case–control study partially matched by age and gender was performed in patients tested for Cryptococcus infection at the University of Colorado Hospital from 2000 to 2019. A multivariable logistic regression model was used to identify mortality predictors. Cox proportional hazard model was used for survival analysis. Results: We identified 96 cases of cryptococcosis and 125 controls. Among cases, cryptococcal meningitis (49.0%) and pneumonia (36.5%) constituted most infections. Cases with pulmonary cryptococcosis with uncontrolled diabetes had a higher mortality at 10 weeks (50% versus 7%, p = 0.006) and 1 year (66.7% versus 13.8%, p = 0.005) compared to pulmonary cases with controlled or no diabetes. Unadjusted Cox proportional hazard model found an increased rate of death for uncontrolled diabetes at 10 weeks [hazard ratio 8.4, confidence interval (CI): 1.4–50.8, p = 0.02] and 1 year (hazard ratio 7.0, CI: 1.7–28.4, p = 0.007) among pulmonary cryptococcosis cases. Multivariable analysis showed a significantly increased odds of 10 weeks [odds ratio (OR) = 4.3, CI: 1.1–16.5, p = 0.035] and 1 year (OR = 5.0, CI: 1.4–18.3, p = 0.014) mortality for uncontrolled diabetes among pulmonary cryptococcosis cases. After adjustment for gender, age, and case/control, for every 1% increase in HbA1c levels, the odds of pulmonary cryptococcosis mortality at 1 year increased by 11% (OR = 1.6, CI 95%: 1.1–2.3, p = 0.006). Conclusion: Uncontrolled diabetes is associated with worse outcomes in pulmonary cryptococcosis, including a 4-fold and 6-fold increased odds of death at 10 weeks and 1 year, respectively. Glucose control interventions should be explored to improve clinical outcomes in patients with pulmonary cryptococcosis.

We have evaluated cardiac function and fibrosis in infarcted male Wistar rats treated with MitoQ (50 mg/kg/day) or vehicle for 4 weeks. A cohort of patients admitted with a first episode of acute MI were also analyzed with cardiac magnetic resonance and T1 mapping during admission and at a 12-month follow-up. Infarcted animals presented cardiac hypertrophy and a reduction in the left ventricular ejection fraction (LVEF) and E- and A-waves (E/A) ratio when compared to controls. Myocardial infarction (MI) rats also showed cardiac fibrosis and endoplasmic reticulum (ER) stress activation. Binding immunoglobulin protein (BiP) levels, a marker of ER stress, were correlated with collagen I levels. MitoQ reduced oxidative stress and prevented all these changes without affecting the infarct size. The LVEF and E/A ratio in patients with MI were 57.6 ± 7.9% and 0.96 ± 0.34, respectively. No major changes in cardiac function, extracellular volume fraction (ECV), or LV mass were observed at follow-up. Interestingly, the myeloperoxidase (MPO) levels were associated with the ECV in basal conditions. BiP staining and collagen content were also higher in cardiac samples from autopsies of patients who had suffered an MI than in those who had died from other causes. These results show the interactions between mitochondrial oxidative stress and ER stress, which can result in the development of diffuse fibrosis in the context of MI.

Obesity is defined by the World Health Organization (WHO) as abnormal or excessive fat accumulation that presents a health risk [...]

El desarrollo económico y social reciente ha llevado a nuevos paradigmas en las organizaciones, donde surge el concepto de organizaciones fractales basadas en proyectos, las cuales establecen alianzas estratégicas que comparten proyectos. Los requerimientos iniciales y sus cambios, así como los riesgos necesitan ser controlados en etapas tempranas del proyecto. Las propuestas tradicionales de (re)planificación de proyectos no capturan las relaciones complejas entre riesgos, requerimientos y el plan del proyecto. En este trabajo, se presenta un modelo integrado para (re)planificación de proyectos, incluyendo la gestión de cambios en requerimientos y riesgos asociados a cada proyecto dentro de la organización o alianza estratégica. Para ejemplificar su aplicación, se ha desarrollado un caso de estudio en el contexto de la industria farmacéutica, ya que la misma responde a las características de organizaciones fractales basadas en proyectos, donde el proyecto constituye su base y los riesgos reciben un tratamiento especial en dicha industria.

We have evaluated the role of mitochondrial oxidative stress and its association with endoplasmic reticulum (ER) stress activation in the progression of obesity-related cardiovascular fibrosis. MitoQ (200 µM) was orally administered for 7 weeks to male Wistar rats that were fed a high-fat diet (HFD, 35% fat) or a control diet (CT, 3.5% fat). Obese animals presented cardiovascular fibrosis accompanied by increased levels of extracellular matrix proteins and profibrotic mediators. These alterations were associated with ER stress activation characterized by enhanced levels (in heart and aorta vs. CT group, respectively) of immunoglobulin binding protein (BiP; 2.1-and 2.6-fold, respectively), protein disulfide-isomerase A6 (PDIA6; 1.9-fold) and CCAAT-enhancer-binding homologous protein (CHOP; 1.5- and 1.8-fold, respectively). MitoQ treatment was able to prevent (p < 0.05) these modifications at cardiac and aortic levels. MitoQ (5 nM) and the ER stress inhibitor, 4-phenyl butyric acid (4 µM), were able to block the prooxidant and profibrotic effects of angiotensin II (Ang II, 10−6 M) in cardiac and vascular cells. Therefore, the data show a crosstalk between mitochondrial oxidative stress and ER stress activation, which mediates the development of cardiovascular fibrosis in the context of obesity and in which Ang II can play a relevant role.

Automated negotiation between artificial agents is essential to deploy Cognitive Computing and Internet of Things. The behavior of a negotiation agent depends significantly on the influence of environmental conditions or contextual variables, since they affect not only a given agent preferences and strategies, but also those of other agents. Despite this, the existing literature on automated negotiation is scarce about how to properly account for the effect of context-relevant variables in learning and evolving strategies. In this paper, a novel context-driven representation for automated negotiation is introduced. Also, a simple negotiation agent that queries available information from its environment, internally models contextual variables, and learns how to take advantage of this knowledge by playing against himself using reinforcement learning is proposed. Through a set of episodes against other negotiation agents in the existing literature, it is shown using our context-aware agent that it makes no sense to negotiate without taking context-relevant variables into account. Our context-aware negotiation agent has been implemented in the GENIUS environment, and results obtained are significant and quite revealing.

Cardiorenal syndrome is a term that defines the complex bidirectional nature of the interaction between cardiac and renal disease. It is well established that patients with kidney disease have higher incidence of cardiovascular comorbidities and that renal dysfunction is a significant threat to the prognosis of patients with cardiac disease. Fibrosis is a common characteristic of organ injury progression that has been proposed not only as a marker but also as an important driver of the pathophysiology of cardiorenal syndromes. Due to the relevance of fibrosis, its study might give insight into the mechanisms and targets that could potentially be modulated to prevent fibrosis development. The aim of this review was to summarize some of the pathophysiological pathways involved in the fibrotic damage seen in cardiorenal syndromes, such as inflammation, oxidative stress and endoplasmic reticulum stress, which are known to be triggers and mediators of fibrosis.

The vascular system plays a central role in the transport of cells, oxygen and nutrients between different regions of the body, depending on the needs, as well as of metabolic waste products for their elimination. While the structure of different components of the vascular system varies, these structures, especially those of main arteries and arterioles, can be affected by the presence of different cardiovascular risk factors, including obesity. This vascular remodeling is mainly characterized by a thickening of the media layer as a consequence of changes in smooth muscle cells or excessive fibrosis accumulation. These vascular changes associated with obesity can trigger functional alterations, with endothelial dysfunction and vascular stiffness being especially common features of obese vessels. These changes can also lead to impaired tissue perfusion that may affect multiple tissues and organs. In this review, we focus on the role played by perivascular adipose tissue, the activation of the renin-angiotensin-aldosterone system and endoplasmic reticulum stress in the vascular dysfunction associated with obesity. In addition, the participation of oxidative stress in this vascular damage, which can be produced in the perivascular adipose tissue as well as in other components of the vascular wall, is updated.

Background: The objective of this study is to determine the role of mitochondrial oxidative stress in the dysbiosis associated with a high fat diet in rats. In addition, the impact of gut microbiota (GM) in the cardiometabolic consequences of diet-induced obesity in rats has been evaluated. Methods: Male Wistar rats were fed either a high fat diet (HFD) or a control (CT) one for 6 weeks. At the third week, one-half of the animals of each group were treated with the mitochondrial antioxidant MitoTempo (MT; 0.7 mgKg−1day−1 i.p). Results: Animals fed an HFD showed a lower microbiota evenness and diversity in comparison to CT rats. This dysbiosis is characterized by a decrease in Firmicutes/Bacteroidetes ratio and relevant changes at family and genera compared with the CT group. This was accompanied by a reduction in colonic mucin-secreting goblet cells. These changes were reversed by MT treatment. The abundance of certain genera could also be relevant in the metabolic consequences of obesity, as well as in the occurrence of cardiac fibrosis associated with obesity. Conclusions: These results support an interaction between GM and mitochondrial oxidative stress and its relation with development of cardiac fibrosis, suggesting new approaches in the management of obesity-related cardiometabolic consequences.

The impact of the mitochondria-targeted antioxidant MitoQ was evaluated in the cardiac alterations associated with obesity. Male Wistar rats were fed either a high fat diet (HFD, 35% fat) or a standard diet (CT, 3.5% fat) for 7 weeks and treated with MitoQ (200 µM). The effect of MitoQ (5 nM) in rat cardiac myoblasts treated for 24 h with palmitic acid (PA, 200 µM) was evaluated. MitoQ reduced cardiac oxidative stress and prevented the development of cardiac fibrosis, hypertrophy, myocardial 18-FDG uptake reduction, and mitochondrial lipid remodeling in HFD rats. It also ameliorated cardiac mitochondrial protein level changes observed in HFD: reductions in fumarate hydratase, complex I and II, as well as increases in mitofusin 1 (MFN1), peroxisome proliferator-activated receptor gamma coactivator 1-alpha, and cyclophilin F (cycloF). In vitro, MitoQ prevented oxidative stress and ameliorated alterations in mitochondrial proteins observed in palmitic acid (PA)-stimulated cardiac myoblasts: increases in carnitine palmitoyltransferase 1A, cycloF, and cytochrome C. PA induced phosphorylation of extracellular signal-regulated kinases and nuclear factor-κB p65. Therefore, the data show the beneficial effects of MitoQ in the cardiac damage induced by obesity and suggests a crosstalk between lipotoxicity and mitochondrial oxidative stress in this damage

In a multi-project context within enterprise networks, reaching feasible solutions to the (re)scheduling problem represents a major challenge, mainly when scarce resources are shared among projects. The multi-project (re)scheduling must achieve the most efficient possible resource usage without increasing the prescribed project constraints, considering the Resource Leveling Problem (RLP), whose objective is to level the consumption of resources shared in order to minimize their idle times and to avoid overallocation conflicts. In this work, a multi-agent solution that allows solving the Resource Constrained Multi-project Scheduling Problem (RCMPSP) and the Resource Investment Problem is extended to incorporate indicators on agents’ payoff functions to address the Resource Leveling Problem in a decentralized and autonomous way, through decoupled rules based on Trial-and-Error approach. The proposed agent-based simulation model is tested through a set of project instances that vary in their structure, parameters, number of resources shared, etc. Results obtained are assessed through different scheduling goals, such as project total duration, project total cost and leveling resource usage. Our results are far better compared to the ones obtained with alternative approaches. This proposal shows that the interacting agents that implement decoupled learning rules find a solution which can be understood as a Nash equilibrium.

Obesity is accompanied by metabolic alterations characterized by insulin resistance and cardiac lipotoxicity. Galectin-3 (Gal-3) induces cardiac inflammation and fibrosis in the context of obesity; however, its role in the metabolic consequences of obesity is not totally established. We have investigated the potential role of Gal-3 in the cardiac metabolic disturbances associated with obesity. In addition, we have explored whether this participation is, at least partially, acting on mitochondrial damage. Gal-3 inhibition in rats that were fed a high-fat diet (HFD) for 6 weeks with modified citrus pectin (MCP; 100 mg/kg/day) attenuated the increase in cardiac levels of total triglyceride (TG). MCP treatment also prevented the increase in cardiac protein levels of carnitine palmitoyl transferase IA, mitofusin 1, and mitochondrial complexes I and II, reactive oxygen species accumulation and decrease in those of complex V but did not affect the reduction in 18F-fluorodeoxyglucose uptake observed in HFD rats. The exposure of cardiac myoblasts (H9c2) to palmitic acid increased the rate of respiration, mainly due to an increase in the proton leak, glycolysis, oxidative stress, β-oxidation and reduced mitochondrial membrane potential. Inhibition of Gal-3 activity was unable to affect these changes. Our findings indicate that Gal-3 inhibition attenuates some of the consequences of cardiac lipotoxicity induced by a HFD since it reduced TG and lysophosphatidyl choline (LPC) levels. These reductions were accompanied by amelioration of the mitochondrial damage observed in HFD rats, although no improvement was observed regarding insulin resistance. These findings increase the interest for Gal-3 as a potential new target for therapeutic intervention to prevent obesity-associated cardiac lipotoxicity and subsequent mitochondrial dysfunction.

Extracellular matrix (ECM) remodelling of the adipose tissue plays a pivotal role in the pathophysiology of obesity. The lysyl oxidase (LOX) family of amine oxidases, including LOX and LOX-like (LOXL) isoenzymes, controls ECM maturation, and upregulation of LOX activity is essential in fibrosis; however, its involvement in adipose tissue dysfunction in obesity is unclear. In this study, we observed that LOX is the main isoenzyme expressed in human adipose tissue and that its expression is strongly upregulated in samples from obese individuals that had been referred to bariatric surgery. LOX expression was also induced in the adipose tissue from male Wistar rats fed a high-fat diet (HFD). Interestingly, treatment with β-aminopropionitrile (BAPN), a specific and irreversible inhibitor of LOX activity, attenuated the increase in body weight and fat mass that was observed in obese animals and shifted adipocyte size toward smaller adipocytes. BAPN also ameliorated the increase in collagen content that was observed in adipose tissue from obese animals and improved several metabolic parameters – it ameliorated glucose and insulin levels, decreased homeostasis model assessment (HOMA) index and reduced plasma triglyceride levels. Furthermore, in white adipose tissue from obese animals, BAPN prevented the downregulation of adiponectin and glucose transporter 4 (GLUT4), as well as the increase in suppressor of cytokine signaling 3 (SOCS3) and dipeptidyl peptidase 4 (DPP4) levels, triggered by the HFD. Likewise, in the TNFα-induced insulin-resistant 3T3-L1 adipocyte model, BAPN prevented the downregulation of adiponectin and GLUT4 and the increase in SOCS3 levels, and consequently normalised insulin-stimulated glucose uptake. Therefore, our data provide evidence that LOX plays a pathologically relevant role in the metabolic dysfunction induced by obesity and emphasise the interest of novel pharmacological interventions that target adipose tissue fibrosis and LOX activity for the clinical management of this disease.

La técnica de radiotrazadores es ampliamente utilizada en la industria para optimizar procesos, localizar mal funcionamientos y mejorar la calidad de los productos. En los últimos años, científicos cubanos han estudiado la extracción del 99mTcO4-, eluido del generador de 99Mo/99mTc, con la mezcla 30 % tributilfosfato -16 % trioctilamina en ciclohexano con el objetivo de obtener un radiotrazador para fase orgánica. En el presente trabajo se estudió la influencia en el rendimiento de extracción de la velocidad de agitación, el tiempo de contacto y la concentración de NaCl. Adicionalmente, se exploró el papel de los extrayentes y se evaluó la homogeneidad del radiotrazador en diesel, gasolina especial y crudos venezolanos, a temperatura y presión normal. Los resultados mostraron que solamente la concentración de NaCl influye en el proceso de extracción cuando es menor que 0,17 %. Se observó el sinergismo de la mezcla empleada para la extracción del 99mTcO4- y se concluyó que, el trazador obtenido constituye un radiotrazador físico para los soportes industriales empleados, a un 95 % de confianza.

Introducción. Las infecciones hospitalarias son una amenaza para la salud pública. A pesar de los esfuerzos para contenerlas, su incidencia sigue siendo grande y genera altos costos en la atención en salud. Objetivo. Determinar los factores asociados a mortalidad en pacientes con diagnóstico de infecciones hospitalarias en nuestra institución. Materiales y métodos. Se llevó a cabo un estudio prospectivo de cohortes entre enero y diciembre del 2011 por medio de la observación de 1.015 pacientes con diagnóstico de infección de acuerdo a los criterios del sistema de vigilancia hospitalaria sugeridos por los Centers for Disease Control and Prevention (CDC). Se excluyó a quienes no tenían cultivo microbiológico de la infección o habían tenido reingresos hospitalarios en menos de un año. Se evaluaron variables sociodemográficas y clínicas, perfiles de resistencia microbiológica y uso de antibióticos. La variable de desenlace fue la muerte. Se realizó un análisis de supervivencia para cada variable, estableciendo significación estadística con la prueba de log-rank, así como un análisis multivariado mediante regresión de Cox. Se consideraron significativos los valores de p menores de 0,05. Resultados. El promedio de edad fue de 43 años (57 % hombres y 43 % mujeres); 53 % de los pacientes tuvo diagnóstico clínico y 47 %, quirúrgico; 54 % de las infecciones se presentó en la herida quirúrgica y 62 % de ellas se asociaron a microorganismos Gram negativos. La mortalidad durante el seguimiento fue de 24,4 %. En el análisis multivariado se encontró asociación con mortalidad para las variables de estancia en cuidado intensivo (hazard ratio (HR)=1,51; IC95% 1,13-2,01), uso inapropiado de antibióticos (HR=3,05; IC95% 2,34-3,98) y uso de antibiótico genérico o copia (HR=1,91; IC IC95% 1,43-2,55). Conclusiones. El empleo de moléculas genéricas y el uso inadecuado de antibióticos en pacientes con infecciones hospitalarias son factores que pueden modificarse para disminuir la mortalidad.

The study of gut microbiota's (GM) role in autism spectrum disorder (ASD) is a new and expanding research field, and bibliometric reviews can be very useful to interpret the scientific production and research trends within it. To that end, this work presents a scientometric study on ASD and GM based on 1069 publications, published between 1992 and 2020, that were found in the Web of Science© database. Journal, author, and institution productivity patterns were found using Lotka's law and "Plos One," USA, and University College Cork (Ireland) were the most productive journal, country, and institution, respectively. Keyword analysis revealed a close relationship between GM, brain, and behavior in ASD, making this a novel research field with interdisciplinary implications.

En el presente estudio se estimó el precio de la leche de forma determinística y estocástica para el periodo 2023-2027, con el objetivo de analizar la situación económica de la producción de la leche de vaca en México, a través del método estadístico univariado de series de tiempo (ARIMA). Se estableció un precio medio base, así como sus intervalos de confianza reflejados en precio de límite inferior y precio de límite superior. La distribución estadística que mejor explicó el comportamiento de los precios base fue la geométrica, misma que se utilizó para la estimación del modelo estocástico. Se espera que el precio de la leche tenga un comportamiento promedio determinístico de 9.38±0.76 pesos por litro para los próximos seis años. Lo anterior sugiere una aproximación metodológica mediante la cual, se puede explorar y mejorar la estimación del precio de productos agrícolas para obtener un precio diferenciado por efecto de calidad.

BackgroundAortic stenosis (AS) is a chronic inflammatory disease, and calcification plays an important role in the progression of the disease. Galectin‐3 (Gal‐3) is a proinflammatory molecule involved in vascular osteogenesis in atherosclerosis. Therefore, we hypothesized that Gal‐3 could mediate valve calcification in AS. Methods and ResultsBlood samples and aortic valves (AVs) from 77 patients undergoing AV replacement were analyzed. As controls, noncalcified human AVs were obtained at autopsy (n=11). Gal‐3 was spontaneously expressed in valvular interstitial cells (VICs) from AVs and increased in AS as compared to control AVs. Positive correlations were found between circulating and valvular Gal‐3 levels. Valvular Gal‐3 colocalized with the VICs markers, alpha‐smooth muscle actin and vimentin, and with the osteogenic markers, osteopontin, bone morphogenetic protein 2, runt‐related transcription factor 2, and SRY (sex‐determining region Y)‐box 9. Gal‐3 also colocalized with the inflammatory markers cd68, cd80 and tumor necrosis factor alpha. In vitro, in VICs isolated from AVs, Gal‐3 induced expression of inflammatory, fibrotic, and osteogenic markers through the extracellular signal‐regulated kinase 1 and 2 pathway. Gal‐3 expression was blocked in VICs undergoing osteoblastic differentiation using its pharmacological inhibitor, modified citrus pectin, or the clustered regularly interspaced short palindromic repeats/Cas9 knockout system. Gal‐3 blockade and knockdown decreased the expression of inflammatory, fibrotic, and osteogenic markers in differentiated VICs. ConclusionsGal‐3, which is overexpressed in AVs from AS patients, appears to play a central role in calcification in AS. Gal‐3 could be a new therapeutic approach to delay the progression of AV calcification in AS.

Objetivo: Evaluar el impacto de un programa de uso regulado de antibióticos en adherencia, consumo antibiótico y resistencia bacteriana en 2 unidades de cuidados intensivos (UCI) de un hospital universitario de tercer nivel en Colombia. Materiales y Método: Estudio prospectivo observacional de intervención que analiza 2 períodos en el tiempo en 2 UCI: preintervención (agosto de 2008 a febrero de 2009) y posintervención (marzo a septiembre de 2009). El estudio se llevó a cabo en el Hospital Universitario del Valle Evaristo García E.S.E. Se evaluaron: adherencia a guías de uso de antibióticos creadas por epidemiología hospitalaria, consumo antibiótico en dosis diaria definida e incidencia acumulada mensual de infección por Escherichia coli (E. coli) y Klebsiella pneumoniae (K. pneumoniae) BLEE, Pseudomonas aeruginosa (P. aeruginosa) resistente a quinolonas y cefalosporinas de cuarta generación, Staphylococcus aureus resistente a oxacilina y Acinetobacter baumannii multirresistente. Resultados: Se encontró adherencia a guías de uso de antibióticos superior al 80% para ambas UCI durante la intervención. Se redujo significativamente el consumo de meropenem (UCI-1 p = 0,009/UCI-2 p = 0,000), vancomicina (UCI-1 y UCI-2 p = 0,018), ceftriaxona (UCI-1 p = 0,015/ UCI-2 p = 0,018), ciprofloxacina (UCI-1 p = 0,027/UCI-2 p = 0,018), se incrementó el consumo de piperacilina/tazobactam (UCI-1 p = no significativa/UCI-2 p = 0,017) y cefepime (UCI-1 p = 0,028/UCI-2 p = 0,004). Se redujo la incidencia de infección por E. coli y K. pneumoniae BLEE + (UCI-1 83%/UCI-2 78%), P. aeruginosa resistente a ciprofloxacina (UCI-1 87%/UCI-2 82%) y cefalosporinas de cuarta generación (UCI-1 83%/UCI-2 76%). Conclusiones: La creación de un programa de uso regulado de antibióticos reduce significativamente el consumo y los costos de antibióticos en las UCI del Hospital Universitario del Valle y la infección por microorganismos resistentes.Objective: To determine the impact of a Program of Regulated Use of Antibiotics in adherence, antibiotic use and bacterial resistance in two medical-surgical Intensive Units Care (ICU´s) in a third level mayor teaching hospital in Colombia. Materials and Methods: Prospective observational study of intervention that examines two time periods in two ICU: pre-intervention (august/2008 to February/2009) and post-intervention (march to September/2009). The study was carried out in the Hospital Universitario del Valle Evaristo García E.S.E. (H.U.V). We evaluated adherence to the antibiotic therapy guidelines established by Hospital Epidemiology, antibiotic use measured by Defined Daily Doses and monthly incidence of infection by ESBL producer E.coli and K.pneumoniae, P.aeruginosa fluoroquinolone and four generation cephalosporin resistant, oxacilin resistant S.aureus and multidrug resistant A.baumannii. Results: The adherence to the antibiotic guidelines of antibiotic use was greater to 80% for the both ICU during the intervention period. Antibiotic use was significantly reduced for meropenem (ICU1 p=0,009/ICU2 p=0,000), vancomycin (ICU1-ICU2 p=0,018), ceftriaxone (ICU1 p=0,015/ICU2 p=0,018), ciprofloxacin (ICU1 p=0,027/ICU2 p=0,018), and increased the used of piperacilin/tazobactam (ICU2 p=0,017), and cefepime (ICU1 p=0,028/ICU2 p=0,004). The incidences of infection by ESBL producer E.coli and K.pneumoniae (ICU1 83%/ ICU2 78%), ciprofloxacin resistant and four generation cephalosporin resistant P.aeruginosa (ICU1 87%/ ICU2 82%) and (ICU1 83%/ICU2 76%) ware also reduced. Conclusions: The implementation of a Program of Regulated Use of Antibiotics reduces antibiotics use and resistant micro-organism specific infection rate in the Hospital Universitario del Valle´s ICU.

Las manifestaciones en el sistema nervioso central por Listeria monocytogenes son variadas, e incluyen desde la meningitis hasta las presentaciones más infrecuentes como los abscesos cerebrales. Éstos son clínicamente indistinguibles de otros tipos de abscesos y sugieren una alteración de la inmunidad celular. Se describe el caso de una mujer seropositiva para el virus de la inmunodeficiencia humana (VIH) que consultó al servicio de urgencias con un síndrome convulsivo tónico-clónico generalizado de un mes de evolución y deterioro progresivo de su estado de conciencia. En el estudio del líquido cefalorraquídeo se encontró pleocitosis linfocitaria, con elevación de las proteínas e hipoglucorraquia. En el estudio del sistema nervioso central por resonancia magnética se observaron múltiples lesiones hipodensas que se realzaban con el medio contraste. Se aisló L. monocytogenes en el cultivo del líquido cefalorraquídeo. Después de un esquema de tratamiento antibiótico específico asociado a esteroides, los síntomas neurológicos mejoraron y, concomitantemente, se observó una disminución progresiva hasta la desaparición de las lesiones en el seguimiento imaginológico del sistema nervioso central. L. monocytogenes es causa de abscesos cerebrales en pacientes inmunosuprimidos, en especial, con VIH sin terapia antirretroviral o sin profilaxis con trimetoprim-sulfametoxazol.The manifestations of Listeria monocytogenes central nervous system infection are wide, ranging from meningitis to cerebral abscesses. Those are clinically indistinguishable from other forms of cerebral abscesses. We are describing a HIV positive woman who presented with generalized tonicclonic seizures, progressive alter mental status, evidence of lymphocytic pleocytosis and multiple hypodense lesions that enhanced with contrastae on imaging studies (CT and MRI) Listeria monocytogenes was isolated of cefaloraquid liquid cultures. After a specific antibiotic treatment regimen associated with steroids, improved neurological symptoms and concomitant documented a progressive decrease until disappearance of the lesions in the CNS imaging follow. Listeria monocytogenes is a cause of brain abscesses in immunosuppressed patients especially HIV patients without antiretroviral therapy and without prophylaxis with trimethoprim / sulfamethoxazole.

El “REPE” (Re-expansion Pulmonary Edema) es una complicación poco común que puede ocurrir después del drenaje rápido de un neumotórax o de abundante líquido pleural (1,2). La incidencia en adultos es del el 0-1%. Su mortalidad puede alcanzar el 20% (1,3). Las hipótesis propuestas para el desarrollo de dicha entidad incluyen, el aumento de la permeabilidad de la microvasculatura pulmonar, cambios en el flujo linfático, disminución de la producción de surfactante y aumento de la presión hidrostática del flujo vascular del pulmón reexpandido (4). Se caracteriza por el desarrollo agudo de hipoxemia refractaria al oxígeno y la aparición de infiltrados alveolares intersticiales en un plazo de 24 horas tras el drenaje (5). Son factores de riesgo de REPE: la edad comprendida entre los 20 y 40 años, la duración del colapso pulmonar mayor de 72 horas, la aplicación de altas presiones negativas durante la toracocentesis (20 cm H2O), una rápida reexpansión tras drenajes de altos volúmenes de líquido pleural (> 1.5 L) o la existencia de factores predisponentes para el edema pulmonar (hipoalbuminemia, estasis en la circulación pulmonar). ABSTRACT Intraoperative reexpansion pulmonary edema “REPE” following thoracoscopy by one lung ventilation The sudden pulmonar expansion which has remained collapsed among different hours or days, likewise the fast pneumothorax or pleural effusion drainage, can cause a flash or acute edema on the affected lung. It is believed that the rexpansive pulmonary syndrome (REPE), is caused due to an increment in the capillary permeability after being exposed the affected lung to high negative intra-pleural pressure. The ocurrence of REPE is a rare event with most cohort studies reporting an incidence of between 0%- 1%. It may extend with hypoxaemia, hypotension and even cardiac arrest. The treatment of these patients include mechanical ventilation with optimal PEEP levels, the use of vasopressors and an intesive electrolyte resuscitation. We expose the case of a 16 year old patient with mediastinal mass diagnosis and massive left-pleural effusion, where after a thorascocopy for biopsy and pleuritic drainage, it is observed a reexpansion pulmonary edema with respiratory repercussion, haemodynamics and the requirement of endotracheal reintubation.

Introducción:la tigeciclina, el primer representante del grupo de las glicilciclinas, nueva clase de antibióticos, ha sido recientemente introducida en Colombia y no se disponen aún de datos en el país de su actividad in vitro. Objetivo: evaluar la actividad in vitro de la tigeciclina contra aislamientos clínicos de pacientes hospitalizados en tres hospitales colombianos de tercer nivel. Materiales y métodos: los aislamientos de bacterias aerobias y anaerobias facultativas de pacientes hospitalizados de tres centros de alta complejidad fueron remitidos a un laboratorio de referencia para la determinación de la concentración inhibitoria mínima (CIM) por el método de microdilución en caldo para la tigeciclina y otros antibióticos. Para los puntos de corte se utilizaron los criterios de interpretación de la CLSI 2006 y para la tigeciclina sugeridos por la FDA. Resultados: la susceptibilidad a la tigeciclina de las cepas evaluadas y sus respectivas CIM50-90 fueron las siguientes: Staphylococcus aureus (n=78), 100%, 0,12 y 0,12 mg/L; Streptococcus pneumoniae (n=24) 100%, 0,015 y 0,5 mg/L; Streptococcus agalactiae (n=10), 100%, 0,03 y 0,06 mg/L; Enterococcus spp. (n=43) 100%, 0,06 y 0,12 mg/L; Klebsiella pneumoniae (n=56), 96,4%, 0,5 y 1 mg/L; Klebsiella oxytoca (n=15), 93,3%, 0,25 y 2 mg/L; Escherichia coli (n=89) 100%, 0,12 y 0,5 mg/L; Enterobacter cloacae (n=48), 100%, 0,5 y 2 mg/L; Serratia marscescens (n=42) 96,2%, 0,5 y 2 mg/L. Para Haemophilus influenza (n=15) y Acinetobacter baumannii (n=36), que no tienen puntos de corte definidos, las CIM50-90 fueron 0,06 y 0,12 y 0,5 y 2 mg/L, respectivamente. El 100% de los aislamientos productores de beta-lactamasas de espectro extendido de Escherichia coli (n=18) y el 94,4% de los de Klebsiella pneumoniae (n=18) fueron susceptibles a tigeciclina. Las CIM50-90 para Pseudomonas aeruginosa (n=63) fueron 8 y 16 mg/L. Discusión: la tigeciclina mostró gran actividad in vitro contra cocos Gram positivos y bacilos Gram negativos recuperados de pacientes hospitalizados en Colombia. Dicha actividad fue independiente de la presencia de la resistencia a otros antimicrobianos.Introduction: Tigecycline, the first agent of a new antibiotic class, the glicylcyclines, has been recently introduced in Colombia and there is no local data available regarding its in vitro activity. Objective: To evaluate in vitro activity of tigecycline on clinically relevant bacterial isolates from hospitalized patients in three institutions in Colombia. Methods: Aerobic and facultative anaerobic isolates from infections in inpatients from the three participant institutions were sent to a central referral laboratory to determine minimal inhibitory concentration (MIC) by microdilution broth method for tigecycline and other antimicrobials. Breakpoints for tigecycline and others antibiotics were adopted from the FDA and the CLSI recommendations, respectively. Results: In vitro susceptibility in percentage and MIC50/90 values were as follows: Staphylococcus aureus (n=78) 100%, 0.12/0.12 mg/L; Streptococcus pneumoniae (n=24) 100%, 0.015/0.5 mg/L; Streptococcus agalactiae (n=10) 100%, 0.03/0.06 mg/L; Enterococcus spp (n=43) 100%, 0.06/0.12 mg/L; Klebsiella pneumoniae (n=56) 96.4%, 0.5/1 mg/L; Klebsiella oxytoca (n=15) 93.3%, 0.25/2 mg/L; Escherichia coli (n=89) 100%, 0.12/0.5 mg/L; Enterobacter cloacae (n=48) 100%, 0.5/2 mg/L; Serratia marscescens (n=42) 96.2%, 0.5/2 mg/L. For Haemophilus influenza (n=15) and Acinetobacter baumannii (n=36), which still lack defined breakpoints, MIC50/90 were 0.06/0.12 and 0.5/2 mg/L, respectively. 100% of extended espectrum betalactamase producers of Escherichia coli (n=18) and 94.4% of those of Klebsiella pneumoniae (n=18) were susceptible to tigecycline. MIC50/90 for Pseudomonas aeruginosa (n=63) were 8/16 mg/L. Discussion: Tigecycline showed excellent in vitro activity against gram positive cocci and gram negative bacilli recovered from hospitalized patients in Colombia regardless of the presence of resistance to others antimicrobial agents.

Objetivo: Identificar factores de riesgo de infección del tracto urinario en pacientes de cuidado intensivo, con sonda vesical. Diseño: Estudio de casos y controles. Localización: Unidad de cuidados intensivos general de adultos, de una clínica no universitaria (Clínica Comfandi-Tequendama, Cali, Colombia). Métodos: Se empleó el registro del Comité de Vigilancia Epidemiológica para identificar los casos (individuos hospitalizados en la unidad de cuidados intensivos, con sonda vesical como parte de su manejo y en quienes se desarrolló infección del tracto urinario). Del mismo registro se seleccionaron al azar tres controles por cada caso, del grupo de pacientes manejados en la unidad de cuidados intensivos con sonda vesical y que no presentaron infección urinaria. Mediciones y resultados: Se analizaron 132 pacientes, 33 casos y 99 controles. Se registraron datos demográficos, características de los pacientes y variables del manejo de la sonda. La distribución por sexos y la severidad del compromiso sistémico, determinada por el APACHE II de las primeras 24 horas, fueron iguales en ambos grupos. La edad > 74 años, la inserción de la sonda vesical antes del ingreso a la unidad de cuidados intensivos, la duración del cateterismo por más de dos semanas, la coexistencia de peritonitis y el manejo con abdomen abierto se asociaron con mayor riesgo de infección del tracto urinario El género, la puntuación de APACHE II, la existencia de patología estructural del tracto urinario, los cambios de sonda, la medición de la presión intravesical, la existencia de infecciones diferentes a peritonitis y la administración previa de antibióticos no aumentaron el riesgo.Objective. To identify risk factors of urinary tract infection in patients with bladder catheterization in patients hospitalized in the Intensive Care Unit. Design. Case and controls study. Location. Adult ICU of a non-university clinic (Clínica Comfandi-Tequendama, Cali, Colombia). Methods. We used the registry of the Committee on Epidemiologic Surveillance for the identification of patients in the ICU that had a bladder catheter as part of their management and who developed a urinary tract infection. From the same registry we selected at random three controls for each case, patients also in the ICU that had bladder catheters but had not developed a urinary tract infection. Measurements and results. We analyzed 132 patients, 33 cases and 99 controls, recording demographic data, patients characteristics, and variables in the management of the catheter. Distribution by gender and severity of systemic compromise, determined by APACHE II in the first 24 hours, were equal in both groups. Age >70 years, placement of the catheter before admission to the ICU, length of catheterization for more than two weeks, concomitant peritonitis and management by the open abdomen method, were all associated with greater risk of infection of the urinary tract. Sex, APACHE II score, coexistence of structural pathology of the urinary tract, measurement of intravesical pressure, coexitance of infections different from peritonitis, and the previous administration of antibiotics did not appear to augment risk.

Background: In many countries in the last few years, there has been an increasing interest for the assessment of the Nutritional System which can be defined as a systemic and permanent process of collection, transmission analysis and interpretation of the information that allows to keep updated knowledge of the nutritional state. The follow up of the children´s growth and development has the importance not only to assist the children´s needs at a determined age but also to assist them with a preventive criteria taking into account their dynamic and changing characteristics. Objectives: To assess nutritionally the children gathered at the ages from 2 to 6 years that attend the day care center ¨Marineritos del Sur¨ for more than one year during the period September 1 st - March 2000. Methods: The variables under study were age, sex, weight, folds brachial circumference and past illnesses. Results: According to the indicators weight/size, size/age, weight / age, tricipital fold/ age, brachial circumference / age, patients between 10 and 90 percentile had a predominance. The calculus of the Z point showed that 67,66 % of the children were eutrophic, 27,=6 tended to obesity and 5,28 malnourished. Giardia Lambia was the most frequent isolated parasite.

La intubación endotraqueal es una técnica que se realiza de forma rutinaria en el manejo anestésico y de cuidados críticos en niños (figura 1). Durante más de 50 años, los tubos endotraqueales sin balón han sido comúnmente utilizados para la intubación de niños menores de 8 años (1) debido a la anatomía laríngea pediátrica y al miedo a que el balón cause lesión en la mucosa de la vía aérea, resultando en una estenosis subglótica (2,3). Sin embargo, hay limitaciones en los tubos sin balón, como fuga alrededor del tubo durante la ventilación lo cual incluye una monitorización de dióxido de carbono espirado poco fiable, desperdicio y aumento del costo de anestésicos inhalados, aumento de la contaminación del medio ambiente (4) y aumento del riesgo de aspiración (5). Recientemente algunos estudios clínicos han mostrado que los tubos con balón pueden usarse de forma segura en el manejo de la vía aérea pediátrica. Los beneficios de los tubos con balón son características de sellado más fiable y evidencia de que no aumentan el riesgo de morbilidad en la vía aérea, siempre y cuando se elija un tamaño apropiado y se monitorice la presión del balón.

The development of radioisotope generators for industrial use, and of radiotracers from those already existing as that of /, has been strengthened in the last 10 years like an attractive option to solve the difficulties in guaranteeing the availability of radiotracers for application in the industry. Extraction with the mixture 30 % TBP-16 % TOA/cyclohexane has been successfully used to adapt the , eluted from / generator, as an organic fluid radiotracer. This work presents an optimization study of volumetric composition of this mixture, to guide the extraction process towards the best cost benefit relation according to necessary activity at a given application. Based on experimental results, a model that predicts extraction yield (R %) as a dependent variable of TOA and TBP volumetric concentrations was established, for 3.1 MBq of . Moreover, the outcomes show that even when TBP volumetric concentration decreases from 30 to 1 % and TOA concentration, from 16 to 0.3 %, the extraction yield was 96.44 ± 0.21%.

Thermal stress is a health and welfare concern in the poultry industry. Poultry have specific thermoregulation strategies for heat stress (i.e., vasodilatation) or cold stress (i.e., vasoconstriction). Infrared thermal (IRT) analysis is a non-invasive temperature assessment technology with significant benefits compared to conventional temperature measurements, which are invasive and time-consuming. However, a wide range of IRT methodologies and equipment are used for temperature assessment in poultry. The aim of this study was to perform a systematic review and meta-analysis of IRT applications in poultry undergoing thermal stress. The bibliographic search yielded 17 records for qualitative synthesis and 10 for quantitative analysis. The results showed IRT is more commonly studied during heat stress than cold stress, and more research is being conducted on laying hens than other poultry species. Also, four body areas (parts of the head, body, face, and leg) were identified as common areas of interest for body surface temperature measurement. There is a clear thermoregulation response to thermal stress in poultry, with marked differences between featherless and feather-covered areas. IRT in poultry undergoing thermal stress has a good diagnostic value and represents an important welfare assessment tool for future research, particularly when combined with other welfare assessment methods.

BackgroundThe function of the Interleukin-33 (IL-33)/ST2 system has been mainly investigated on immunological aspects, but recent data suggest that this pathway plays also an important role in cardiovascular system and adipose tissue. Whereas IL-33 has been demonstrated to exert anti-inflammatory and protective effects, circulating soluble ST2 (sST2) has emerged as a prognostic biomarker in patients with myocardial infarction and heart failure. Furthermore, sST2 is increased in severe obesity, although its role in the pathogenesis of vascular remodeling associated with obesity is still not well defined.Methodology/principal findingsMale Wistar rats fed standard diet (Control) or high fat diet (HFD) for 6 weeks. Aortic tunica media from diet-induced obese animals showed hypertrophy and fibrosis. The IL-33/ST2 system was spontaneously expressed in the aorta from Wistar rats. Administration of HFD in animals did not modify IL-33 expression at the transcriptional level. By contrast, HFD group showed an increase in aortic soluble sST2 and a decrease in the transmembrane isoform (ST2L) levels, resulting in decreased protective pathway activity. Aortic sST2 mRNA levels were associated with parameters showing vascular hypertrophy and fibrosis. In vitro experiments showed that primary cultured vascular smooth muscle cells (VSMCs) spontaneously expressed the IL-33/ST2 system. VSMCs stimulated with sST2 showed an increase in collagen type I, fibronectin and profibrotic factors.ConclusionsThis is the first study demonstrating a deleterious role for sST2 in the vascular remodeling associated with obesity. In addition, we demonstrated that sST2 may act not only as a decoy receptor by binding IL-33 and preventing ST2L, but also modulating ECM remodeling and turnover. Thus, sST2 could be a new therapeutic target to reduce vascular remodeling in the context of obesity.

BackgroundThe natural triterpenes, erythrodiol and uvaol, exert anti-inflammatory, vasorelaxing and anti-proliferative effects. Angiotensin II is a well-known profibrotic and proliferative agent that participates in the cardiac remodeling associated with different pathological situations through the stimulation and proliferation of cardiac fibroblasts. Therefore, the aim of the study was to investigate the preventive effects of the natural triterpenes erythrodiol and uvaol on the proliferation and collagen production induced by angiotensin II in cardiac myofibroblasts. Their actions on cardiac hypertrophy triggered by angiotensin II were also studied.Methodology/principal findingsThe effect of erythrodiol and uvaol on angiotensin II-induced proliferation was evaluated in cardiac myofibroblasts from adult rats in the presence or the absence of the inhibitors of PPAR-γ, GW9662 or JNK, SP600125. The effect on collagen levels induced by angiotensin II was evaluated in cardiac myofibroblasts and mouse heart. The presence of low doses of both triterpenes reduced the proliferation of cardiac myofibroblasts induced by angiotensin II. Pretreatment with GW9662 reversed the effect elicited by both triterpenes while SP600125 did not modify it. Both triterpenes at high doses produced an increase in annexing-V binding in the presence or absence of angiotensin II, which was reduced by either SP600125 or GW9662. Erythrodiol and uvaol decreased collagen I and galectin 3 levels induced by angiotensin II in cardiac myofribroblasts. Finally, cardiac hypertrophy, ventricular remodeling, fibrosis, and increases in myocyte area and brain natriuretic peptide levels observed in angiotensin II-infused mice were reduced in triterpene-treated animals.Conclusions/significanceErythrodiol and uvaol reduce cardiac hypertrophy and left ventricle remodeling induced by angiotensin II in mice by diminishing fibrosis and myocyte area. They also modulate growth and survival of cardiac myofibroblasts. They inhibit the angiotensin II-induced proliferation in a PPAR-γ-dependent manner, while at high doses they activate pathways of programmed cell death that are dependent on JNK and PPAR-γ.

Las Mucopolisacaridosis (MPS) engloban un conjunto de desórdenes en el almacenaje celular lisosomal y se asocia al acúmulo de glucosaminoglicanos (GAG) en órganos y tejidos. La organomegalia, la disostosis múltiple, las valvulopatías, el retraso metal y del crecimiento, y la inestabilidad cervical son hallazgos frecuentes de estas entidades. El manejo de la vía aérea en estos pacientes puede suponer un reto para el anestesiólogo debido a alteraciones tanto anatómicas como fisiológicas.