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[This corrects the article DOI: 10.1371/journal.pone.0274322.].

Neurosífilis

Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the preferred method for detecting pulley injuries. This study aimed to determine the reliability and validity of US in identifying anatomical landmarks for diagnosing A2 pulley ruptures. Methods: This study was cross-sectional, involving 36 fingers from 4 cadaver arms. A Canon Aplio i800 US machine was used to measure two anatomical landmarks: the midpoint of the proximal phalanx and the distal edge of the A2 pulley. For the first anatomical landmark, the length of the proximal phalanx (PP distance), and for the second landmark, the distance between the distal edges of the proximal phalanx and the A2 pulley (“A” distance), were measured. Measurements were performed by two sonographers and compared to a digital caliper measurement taken post-cadaver dissection. Observers were blinded during measurements to ensure unbiased results. Results: Overall PP distance measured by US (O1: 37.5 ± 5.3 mm, O2: 37.8 ± 5.4 mm) tended to be shorter than caliper measurements (O3: 39.5 ± 5.5 mm). The differences between sonographers were minimal, but larger when compared to caliper measurements. High reliability for PP distance measurement was observed, especially between sonographers, with an ICC average of 0.99 (0.98, 1.00). However, reliability was lower for the “A” distance, with significant differences between US and caliper measurements. Regarding validity, US measurements were valid when compared to caliper measurements for PP distance, but not as reliable for the “A” due to wider confidence intervals. While US can substitute caliper measurements for PP distance (LR, Y:O2, X:O3, −0.70 (−3.28–1.38), 0.98 (0.93 ± 1.04)), its validity for “A” distance is lower (LR, Y:O2, X:O3, −2.37 (−13.53–4.83), 1.02 (0.62–1.75)). Conclusions: US is a reliable and valid tool in identifying anatomical landmarks for diagnosing A2 pulley ruptures, particularly for detecting the midpoint of the proximal phalanx. This is important to differentiate between complete and partial A2 pulley tears. However, the measurement of the “A” distance requires further refinement. These findings support efforts to standardize US examination protocols and promote consensus in diagnostic methodology, though further research is needed to address the remaining challenges.

Introducción. La implicación de los médicos asistenciales en tareas de investigación clínica presenta grandes diferencias entre las diversas instituciones Material y método. Estudio transversal basado en una encuesta enviada a los miembros del Grupo de Trabajo de Enfermedades Infecciosas (GTei) de la Sociedad Española de Medicina Interna (SEMI) durante el mes de mayo de 2022 Resultados. De 1.789 miembros del GTei, 169 miembros (9,45%) cumplimentaron la encuesta. La percepción de la conveniencia de participación de cada facultativo en una o varias líneas de investigación fue de 8 puntos (P25:7; P75: 9 puntos). La percepción sobre el estímulo para investigar del sistema sanitario o de la dirección del hospital fue de 2 puntos (1-4), respectivamente. El apoyo a la investigación fue valorado con de 5 (2-7) y 6 (3-7) puntos en relación con el jefe de servicio y los compañeros del departamento, respectivamente. Otros factores evaluados fueron la falta de tiempo por no poder reducir la actividad asistencial (9; 7-10 puntos), la priorización de las actividades de ocio durante el tiempo libre disponible (7; 5-8 puntos), la organización de la carga asistencial (6; 3-9 puntos), las dificultades en la coordinación con otros servicios clínicos o centrales (6; 5-7 puntos y 6; 5-8 puntos, respectivamente) Conclusiones. La investigación clínica es muy bien valorada por los internistas dedicados a la patología infecciosa. Las principales necesidades percibidas son un mayor apoyoinstitucional y de la dirección del hospital, una mejor organización del departamento, lacoordinación interdepartamental y disponer de más tiempo para esta actividad. Background. The involvement of attending physicians in clinical research activities differs greatly among institutions. Method. Cross-sectional study based on a survey submitted to the members of the Working Group on Infectious Diseases (GTei) of the Spanish Society of Internal Medicine (SEMI) during the month of May 2022. Results. Out of 1,789 members of the GTei, 169 members (9.45%) completed the survey. The perception of the convenience of participation of each physician in one or more lines of research was 8 points (P25:7; P75: 9 points). The perception of encouragement to do research by the health system or hospital management was 2 points (1-4), respectively. Support for research was rated at 5 (2-7) and 6 (3-7) points inrelation to the head of service and colleagues in the department, respectively. Other factors evaluated were the lack of time due to not being able to reduce the care activity (9; 7-10 points), prioritization of leisure activities during available free time (7; 5-8 points), organization of the care load (6; 3-9 points), difficulties in coordinating with other clinical or central services (6; 5-7 points and 6; 5-8 points, respectively). Conclusions. Clinical research is highly valued by internists dedicated to infectious diseases. The main perceived needs are greater institutional and hospital managementsupport, better organization of the department, interdepartmental coordination and more time for this activity.

High genetic overlap across traits requires methods that can be used to disentangle shared and unique biological pathways. Here, the authors introduce TSEM, a multivariate method for examining tissue-specific gene expression, and apply it to identify genes associated with cognitive traits.

Introduction: The A2 pulley tear is the most common injury in rock climbing. Whereas complete A2 pulley ruptures have been extensively researched, studies focused on partial A2 pulley ruptures are lacking. A2 pulleys rupture distally to proximally. High-resolution ultrasound imaging is considered the gold-standard tool for diagnosis and the most relevant ultrasound measurement is the tendon-to-bone distance (TBD), which increases when the pulley ruptures. The purpose of this study was to establish tendon-to-bone distance values for different sizes of partial A2 pulley ruptures and compare these values with those of complete ruptures.Material and methods: The sample consisted of 30 in vitro fingers randomly assigned to 5 groups: G1, no simulated tear (control); G2, simulated 5 mm tear (low-grade partial rupture); G3, simulated 10 mm tear (medium-grade partial rupture); G4, simulated 15 mm tear (high-grade partial rupture); and G5, simulated 20 mm or equivalent tear (complete rupture). A highly experienced sonographer blinded to the randomization process and dissections examined all fingers.Results: The tendon-to-bone distance measurements (medians and interquartile ranges) were as follows: G1, 0.95 mm (0.77–1.33); G2, 2.11 mm (1.78–2.33); G3, 2.28 mm (1.95–2.42); G4, 3.06 mm (2.79–3.28); and G5, 3.66 mm (3.55–4.76). Significant differences were found between non-torn pulleys and simulated partial and complete pulley ruptures.Discussion: In contrast, and inconsistent with other findings, no significant differences were found among the different partial rupture groups. In conclusion, the longer the partial pulley rupture, the higher the tendon-to-bone distance value. The literature is inconsistent regarding the tendon-to-bone distance threshold to diagnose a partial A2 pulley rupture. The minimum tendon-to-bone distance value for a partial rupture was 1.6 mm, and tendon-to-bone distance values above 3 mm suggest a high-grade partial pulley rupture (15 mm incision) or a complete pulley rupture.

The tropical montane cloud forest is the most diverse and threatened vegetation type in Mexico. In the last decade, the number of described Ascomycetes species has notably increased, reaching more than 1300 species. This study describes six new species based on their molecular and morphological characteristics. Our results suggest that Mexico has the highest number of described species in the Neotropics. However, many other Mexican lineages still need to be described.

Abstract Background Oral health of the mother-infant dyad is important to preserve general health. However, there are few instruments in Spanish for the evaluation of knowledge, attitudes and practices that determine this construct. Therefore, this research aimed to develop and evaluate the psychometric properties of the Maternal Oral Health Knowledge, Attitudes and Practices Questionnaire (CAPSOM in Spanish). Methods In this instrument development study that carried out in 2018–2019, involving pregnant women between the ages of 18 and 45 in the city of Leon, Guanajuato, Mexico. The sample size was calculated based on 10 women per questionnaire item (n = 10 k). The study used Cronbach’s alpha, the modified Lawshe test of validity criteria, factor analysis, and the level of difficulty and discrimination of the items. Results 207 women took part with their signed, informed consent (25 ± 6 years). The internal consistency of the instrument, both total and by dimension was α = 0.70, α = 0.66 knowledge, α = 0.74 attitudes, and α = 0.66 practices. Values of Content Validity Ratio’ ≥ 0.60 were obtained for the final 10 items and Content Validity Index’ = 0.90. The average difficulty index of items was 0.40, and there were significant differences (Kruskall–Wallis, p

Abstract The aim of this study was to evaluate the efficacy and safety of outpatient antimicrobial therapy with piperacillin-tazobactam in continuous infusion using elastomeric pumps and to evaluate the economic impact compared with conventional hospital treatment in patients with Pseudomonas aeruginosa (PA) infections. This is an observational study. Patients with PA infection treated with continuous piperacillin-tazobactam infusion using elastomeric pumps in our hospital between January 2015 and December 2017 were included. Primary outcomes were mortality during antibiotic treatment and mortality at 30 days. Secondary outcomes were reinfection or relapse at 30 days and clinical cure rate. The cost of each episode was compared with theoretical cost of the same treatment using conventional hospitalization. 35 patients were included. One patient (2.9%) died during the treatment. Overall 30-day mortality was 5.7%. No death was related to infection by PA. One patient (2.9%) had a reinfection at 30 days. Cure was achieved in 93% of patients at the end of treatment. There were no severe complications related to elastomeric pumps. Treatment cost with outpatient antimicrobial therapy was 67% lower than theoretical cost with conventional hospital treatment. Oupatient antimicrobial therapy with piperacillin-tazobactam in continuous infusion using elastomeric pumps in patients with PA infections is safe and effective with lower costs.

Objectives: Sex differences in adult cellulitis, a frequent cause of hospitalization, have not been analyzed. These differences were investigated in a large cellulitis series. Methods: This was a prospective observational study of 606 Spanish hospitalized cellulitis patients. Different comorbidities, clinical, diagnostic, and treatment data were compared between the sexes. Multiple logistic regression modeling was performed to determine the variables independently associated with sex. Results: Overall 606 adult cellulitis patients were enrolled; 314 (51.8%) were male and 292 (48.2%) were female. Females were older (mean age 68.8 vs 58.9 years, p < 0.0001), less likely to have prior wounds (p = 0.02), and more likely to have venous insufficiency (p = 0.0002) and edema/lymphedema (p = 0.0003) than males. The location of the infection differed between the sexes (p = 0.02). Males were more likely to have positive pus cultures (p = 0.0008), the causing agent identified (p = 0.04), and higher rates of Staphylococcus aureus infection (p = 0.04) and received longer antibiotic treatment (p = 0.03). Factors independently associated with female sex in the multivariate analysis were older age (p < 0.0001), prior cellulitis (p = 0.01), presence of edema/lymphedema as the predisposing factor (p = 0.004), negative versus positive pus culture (p = 0.0002), and location of cellulitis other than in the lower extremities (p = 0.035). Conclusions: Differences between male and female patients with cellulitis were age, recurrence, presence of edema/lymphedema, positivity of pus culture, and topography of the infection.

Recent meta-analyses combining direct genome-wide association studies (GWAS) with those of family history (GWAX) have indicated very low SNP heritability of Alzheimer's disease (AD). These low estimates may call into question the prospects of continued progress in genetic discovery for AD within the spectrum of common variants. We highlight dramatic downward biases in previous methods, and we validate a novel method for the estimation of SNP heritability via integration of GWAS and GWAX summary data. We apply our method to investigate the genetic architecture of AD using GWAX from UK Biobank and direct case-control GWAS from the International Genomics of Alzheimer's Project (IGAP). We estimate the liability scale common variant SNP heritability of Clinical AD outside of APOE region at ~7-11%, and we project the corresponding estimate for AD pathology to be up to approximately 23%. We estimate that nearly 90% of common variant SNP heritability of Clinical AD exists outside the APOE region. Rare variants not tagged in standard GWAS may account for additional variance. Our results indicate that, while GWAX for AD in UK Biobank may result in greater attenuation of genetic effects beyond that conventionally assumed, it does not introduce appreciable contamination of signal by genetically distinct traits relative to direct case-control GWAS in IGAP. Genetic risk for AD represents a strong effect of APOE superimposed upon a highly polygenic background.

The tropical montane cloud forest in Mexico is the most diverse and threatened ecosystem. Mexican macrofungi numbers more than 1408 species. This study described four new species of Agaricomycetes (Bondarzewia, Gymnopilus, Serpula, Sparassis) based on molecular and morphological characteristics. Our results support that Mexico is among the most biodiverse countries in terms of macrofungi in the Neotropics.

ObjectiveTo explore the moderating effects of sociodemographic and work-related variables on levels of burnout and mental health among medical residents.MethodA cross-sectional online survey was administered at the beginning of the second wave of COVID-19 at different public teaching hospitals where medical residents practiced in Mexico City. A total of 201 medical residents of different years completed the survey.ResultsDifferent univariate inferential analyses on the level of burnout and mental health indices showed significant differences between sex, marital status, previous reports of physical illness or psychological conditions, and residency ranking. However, the effect sizes of those differences were of low to medium size. A predictive path analysis revealed that the three stages of burnout (emotional exhaustion, depersonalization, and achievement dissatisfaction) negatively affect psychological wellbeing and positively affect psychological distress. Finally, even though sociodemographic variables showed some significant variation, the effect sizes were small and did not moderate the direct effect of burnout on mental health indices.ConclusionsMedical residents deling with every day medical situations, will be exposed to stressors that might increase the probability to experience emotional exhaustion. This would negatively affect levels of wellbeing and positively affect distress, despite their sociodemographic characteristics.

Introducción: El diagnóstico precoz de la infección por VIH es fundamental para mejorar el pronóstico de la enfermedad y evitar nuevos contagios. Atención Primaria (AP), al ser el primer nivel asistencial al que suele consultar el paciente, brinda la oportunidad de diagnosticar precozmente a muchos de ellos. El objetivo fue potenciar este diagnóstico mediante la identificación de condiciones indicadoras (CI) de seropositividad que permitan al profesional sospechar la infección. Métodos: Estudio observacional transversal descriptivo con participación de 89 centros de AP de Galicia (Septiembre 2013-Junio 2015). Se recogieron variables clínicas, analíticas y sociodemográficas de pacientes a los que se le realizaba el test de VIH, tanto por sospecha del médico como por petición del propio individuo. Resultados: De entre 1061 pacientes incluídos en el estudio DIVAPIS se obtuvieron 19 test positivos, con una prevalencia de nuevos diagnósticos del 1.76%. Las variables que resultaron estadísticamente predictores de seropositividad fueron: ser hombre que tiene sexo con hombres (p=0,02), serología positiva para VHB (p

Abstract Background To evaluate changes in perfusion computed tomography (PCT) parameters induced by treatment with conventional chemotherapy (CCT) alone or with CCT and radiation therapy (RT) in patients with non-small cell lung cancer (NSCLC) and to determine whether these changes correlate with response as defined by the response evaluation criteria in solid tumours version 1.1 (RECIST-1.1). Methods Fifty-three patients with a histological diagnosis of NSCLC prospectively underwent PCT of the whole tumour, before/after CCT or before/after CCT and RT. Blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) were compared before and after treatment and with the response as defined by RECIST-1.1. The relationship between changes in the perfusion parameters and in tumour size was also evaluated. Results PCT parameters decreased after treatment, significantly for BV (p = 0.002) and MTT (p = 0.027). The 30 patients with partial response had a significant decrease of 21% for BV (p = 0.006) and 17% for MTT (p = 0.031). A non-significant decrease in all perfusion parameters was found in patients with stable disease (p > 0.137). In patients with progressive disease, MTT decreased by 10% (p = 0.465) and the other parameters did not significantly vary (p > 0.809). No significant correlation was found between changes in size and PCT parameters (p > 0.145). Conclusions Treatment of NSCLC with platinum derivatives, with or without RT, induces changes in PCT parameters. Partial response is associated with a significant decrease in BV and MTT, attributable to the effect of the treatment on tumour vascularisation.

Objetivo: analizar a través de la visión del fundador y de la perspectiva de los alumnos, el proceso de gestión de un nuevo modelo educativo que ha seguido la Escuela Nacional de Estudios Superiores León (ENES León), UNAM institución de educación superior fundada en 2011. Diseño metodológico: investigación evaluativa en un escenario real que aplica el Modelo de Evaluación de Stufflebeam para conocer la situación del contexto, insumos, proceso y producto (CIPP) de la innovación con dos tipos de informantes. Se utilizaron técnicas como la entrevista semiestructurada y guiones para los grupos focales; los instrumentos se validaron con el coeficiente de V de Aiken y el juicio de expertos. Resultados: la innovación se evidencia en la creación de algunas licenciaturas pioneras en la UNAM y en México, se encontró un liderazgo político-académico que impulsó la cultura transformadora del nuevo modelo educativo, la incorporación de prácticas docentes innovadoras con alto impacto en el compromiso social, la aplicación de la interdisciplina y multidisciplina y la generación de identidad universitaria. Limitaciones de la investigación: debido a que la ENES León es de reciente creación, no fue posible conocer el efecto en la formación de los egresados ni determinar su formación como agentes de cambio. Hallazgos: se encuentra evidencia de la implementación de un nuevo modelo de educación superior en México.

Summary: Background: The rapid growth of the size of the older population is having a substantial effect on health and social care services in many societies across the world. Maintaining health and functioning in older age is a key public health issue but few studies have examined factors associated with inequalities in trajectories of health and functioning across countries. The aim of this study was to investigate trajectories of healthy ageing in older men and women (aged ≥45 years) and the effect of education and wealth on these trajectories. Methods: This population-based study is based on eight longitudinal cohorts from Australia, the USA, Japan, South Korea, Mexico, and Europe harmonised by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) consortium. We selected these studies from the repository of 17 ageing studies in the ATHLOS consortium because they reported at least three waves of collected data. We used multilevel modelling to investigate the effect of education and wealth on trajectories of healthy ageing scores, which incorporated 41 items of physical and cognitive functioning with a range between 0 (poor) and 100 (good), after adjustment for age, sex, and cohort study. Findings: We used data from 141 214 participants, with a mean age of 62·9 years (SD 10·1) and an age range of 45–106 years, of whom 76 484 (54·2%) were women. The earliest year of baseline data was 1992 and the most recent last follow-up year was 2015. Education and wealth affected baseline scores of healthy ageing but had little effect on the rate of decrease in healthy ageing score thereafter. Compared with those with primary education or less, participants with tertiary education had higher baseline scores (adjusted difference in score of 10·54 points, 95% CI 10·31–10·77). The adjusted difference in healthy ageing score between lowest and highest quintiles of wealth was 8·98 points (95% CI 8·74–9·22). Among the eight cohorts, the strongest inequality gradient for both education and wealth was found in the Health Retirement Study from the USA. Interpretation: The apparent difference in baseline healthy ageing scores between those with high versus low education levels and wealth suggests that cumulative disadvantage due to low education and wealth might have largely deteriorated health conditions in early life stages, leading to persistent differences throughout older age, but no further increase in ageing disparity after age 70 years. Future research should adopt a lifecourse approach to investigate mechanisms of health inequalities across education and wealth in different societies. Funding: European Union Horizon 2020 Research and Innovation Programme.

Objective. To compare peer-led dental education (PLDE) versus conventional dental instruction (CDI) in modifying children’s oral self-care. Materials and methods. The intervention group (two schools) received PLDE and the control group (two schools) received CDI. The quality of oral self-care practice (OSC-P) and oral self-care skills (OSC-S) were indicated by dental plaque levels (%) and compared before and after dental education. Results. There were no baseline OSC-P differences between the control (55.8 ± 12.8%) and intervention (55.5 ± 14.6%) groups or OSC-S differences between the intervention (38.5 ± 13.2%) and control (38.1 ± 12.5%) groups. At the three-month follow-up we observed OSC-P deterioration in the control group (63.2 ± 15.0%) and OSC-P improvement in the intervention group (52.2 ± 15.6%). The OSC-P/OSC-S regression models found these predictors: baseline oral self-care, group affiliation, and mother’s education (p

La reciente aparición de multitud de vacunas contra la infección por SARS-Cov2 (COVID-19) acuciada por la actual pandemia mundial ha hecho crecer la preocupación acerca del perfil de seguridad o reacciones adversas de las mismas. Presentamos el caso de una paciente con antecedente reciente de neumonía por SARS-Cov2 que presentó reacción exantemática y tromboembolismo pulmonar tras ser inmunizada con la vacuna Janssen COVID-19 Vaccine ( Ad26.COV2-S ) Several vaccines have appeared in recent times given the need for vaccinations against SARS-Cov2 (COVID-19) infection. General concern about their safety and possible adverse events has also emerged. We present the case of a patient with recent history of COVID-19 pneumonia who presented generalized exanthema and pulmonary embolism after being immunized with COVID-19 Vaccine Janssen ( Ad26.COV2-S ).

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Objective. To perform a literature review regarding current dental fluorosis prevalence in Mexico reported from 2005 to 2015. Materials and methods. A comprehensive scientific literature review, in both English and Spanish, was performed in four databases up to June 2015. Search terms: fluorosis or dental fluorosis (mesh), prevalence (mesh), distribution (mesh), cases (mesh), epidemiology (mesh), Mexico. Results. 17 publications were included. Reported prevalence of dental fluorosis in Mexico ranged from 15.5 to 100%. Most of the studies were conducted in areas where water fluoride levels are low or optimal (1.5ppmF), prevalence ranged from 92 to 100%. Fluorosis severity ranged from questionable to severe. Conclusion. High prevalence of dental fluorosis was observed even in areas where fluoride concentration in water was low or optimal. In addition to fluoride in groundwater, there are multiple risk factors that should be controlled.

La enfermedad de Creuztfeldt-Jakob es un trastorno neurodegenerativo poco frecuente, caracterizado por demencia rápidamente progresiva, asociada a signos y síntomas de afectación piramidal, extrapiramidal, cerebelosa, afectación cortical y mioclonías. Forma parte del grupo de las enfermedades priónicas, con períodos de incubación prolongados asociados a una evolución lenta, irreversible e invariablemente mortal. Dado la rareza de esta entidad, presentamos dos casos clínicos ocurridos en nuestro centro en dos años consecutivos, y realizamos una revisión sistémica sobra dicha patología.

BackgroundUrinary tract infections caused by extended-spectrum beta-lactamase producing Enterobacterales (ESBL-EB) are a problem increasing in our clinical practice.ObjectivesThe aim of this study was to evaluate the clinical outcome in patients who received short (≤ 7 days) versus long courses (>7 days) of antimicrobial therapy for complicated ESBL-EB urinary tract infections.MethodsThis is a retrospective and observational study. Positive urine cultures for ESBL-EB in our hospital between March 2015 and July 2017 were identified. Patients with complicated urinary tract infection were included. Differences between treatment groups (7 days or less vs more than 7 days) were analyzed according to baseline characteristics and severity of clinical presentation. Primary outcome was all cause 30-day mortality. Secondary outcome was a combined item of all cause mortality and reinfection by the same enterobacteria at 30 days.Results273 urine cultures were positive for ESBL-EB during the study period. 75 episodes were included, 40 in the long treatment group and 35 in the short treatment group. Mean treatment duration in short and long treatment groups was 6,1 and 13,8 days respectively. Mortality at 30 days was 5,7% in the short treatment group and 5% in the long treatment group without significant differences (P = 0,8). Mortality or reinfection by the same ESBL-EB at 30 days was 8,6% in the short treatment group and 10% in the long treatment group, without significant differences (P = 0,8).ConclusionsShort courses of antimicrobial treatment seems to be effective as treatment of complicated urinary tract infections by ESBL-EB.

Introduction: In recent decades, dental implants have become one of the best options for comprehensive dental restoration; their placement is a multidisciplinary task that requires a solid understanding of biological, periodontal, surgical and prosthetic principles. Objective: The aim of this study was to quantify in vitro the adhesion and proliferation of human gingival fibroblasts (HGF) response on titanium (Ti) and zirconia (Zr) surfaces. Methodology: Samples of Ti and Zr were observed under atomic force microscopy (AFM). HGFs were inoculated in each sample to determine adhesion and cell proliferation. The reagent MTT was mixed with medium DMEM and inoculated in each plate; formazan was dissolved with dimethyl sulfoxide and analyzed at 540nm in a microplate spectrophotometer. The test was performed with three independent experiments. Data were analyzed with Kolmogorov-Smirnov tests (Lilliefors), Kruskal-Wallis tests and Mann-Whitney test comparisons. Results: Topography of the Zr plates showed greater roughness (Ra=0.39μm) than Ti (Ra=0.049μm). Quantification of HGF adhesion was significantly higher (p

The ability of finger flexors to generate force has been studied in relation to climbing performance. However, not much attention has been paid to the decrease in finger grip force in relation to annular pulley injuries. The purpose of the present study was to determine if an injured annular pulley implies a finger flexor force decrease, as well as its relation to clinical and sonographic changes. We performed an observational study in 39 rock climbers with A2 or A4 pulley injuries to the 3rd or 4th fingers. The variables considered were pain upon palpation, ultrasound tendon–bone distance, and finger grip strength decrease. Three rock climbing grip types were considered: the one finger crimp, open crimp, and close crimp. Injured rock climbers presented a decrease in finger grip strength compared to non-injured controls when performing a one finger crimp (p < 0.001). There exists a significant correlation between a tendon–bone distance at the level of the injured pulley and a decreased finger grip strength measured by performing a one finger crimp (p = 0.006). A decrease in finger grip strength could be considered in the diagnostic and follow-up process of A2 and A4 pulley injuries to the 3rd and 4th fingers.

Se hace una revisión de los conocimientos neuropsicológicos de procesos involucrados en el aprendizaje y, a partir de ellos, se aplica el método analítico-sintético para comentar algunas de sus implicaciones en la metodología pedagógica. Esta revisión presenta conceptos actuales que relacionan los centros nerviosos participantes, las vías que los conectan y su integración con otras funciones cerebrales importantes en el proceso de aprendizaje. Estos conocimientos tienen importancia en el área educativa debido a su potencial para dar sustento a diversas estrategias útiles en el proceso de enseñanza-aprendizaje.

Background: The surface energy of titanium (Ti) implants is very important when determining hydrophilicity or hydrophobicity, which is vital in osseointegration. The purpose of this study was to determine how Ti plates with an alkaline treatment (NaOH) affect the adhesion and proliferation of human periodontal ligament fibroblasts (HPLF). Materials and Methods: In vitro experimental study was carried out. Type 1 commercially pure Ti plates were analyzed with atomic force microscopy to evaluate surface roughness. The plates were treated ultrasonically with NaOH at 5 M (pH 13.7) for 45 s. HPLF previously established from periodontal tissue was inoculated on the treated Ti plates. The adhered and proliferated viable cell numbers were determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method for 60 min and 24 h, respectively. The data were analyzed using Kruskal–Wallis tests and multiple comparisons of the Mann–Whitney U-test,P value was fixed at 0.05. Results: The mean roughness values equaled 0.04 μm with an almost flat surface and some grooves. The alkaline treatment of Ti plates caused significantly (P < 0.05) more pronounced HPLF adhesion and proliferation compared to untreated Ti plates. Conclusion: The treatment of Ti plates with NaOH enhances cell adhesion and the proliferation of HPLF cells. Clinically, the alkaline treatment of Ti-based implants could be an option to improve and accelerate osseointegration.

Composite resins are the material of choice to restore minimal invasive cavities; conversely, it is important to explore the mechanical properties of commercially available dental materials. Objective: To compare the Vickers microhardness (VHN) of four available commercial composite resins using standardized samples and methods. Methodology: Composite cylinders were manufactured in a Teflon mould. We used the follow composite resins (n=4/gp): Microhybrid resins [Feeling Lux (Viarden) and Amelogen Plus (Ultradent)], Hybrid resin [Te-Econom Plus (Ivoclar)] and Nanohybrid resin [Filtek Z350 (3M ESPE)]. All samples were incubated in distilled water at 37ºC for five days. The test was carried out with microhardness indenter at 10 N, and a dwelling time of 10 s for 9 indentations across the specimens resulting in a total of 36 indentations for each group. Data were subjected to Kolmogorov-Smirnov normality test and ANOVA (post-hoc) Tukey test. Results: The VHN mean values ranged from harder to softer as follows: Filtek Z350 (71.96±6.44) (p Amelogen Plus (59.90±4.40) (p Feeling lux (53.52±5.72)> Te-Econom Plus (53.26±5.19). Conclusion: According to our results, the microhardness of the evaluated conventional composite resins can withstand the masticatory forces; however nanohybrid composite resins showed better Vickers microhardness and therefore are a more clinically suitable option for minimal invasion treatments.

BACKGROUND:Cellulitis is a frequent cause of hospital admission of adult patients. Increasing prevalence of multiresistant microorganisms, comorbidities, predisposing factors and medical and surgical therapies might affect cellulitis response and recurrence rate. METHODS:Prospective and observational study of 606 adult patients with cellulitis admitted to several Spanish hospitals. Comorbidities, microbiological, clinical, diagnostic, treatment (surgical and antibiotic) data were analyzed according to the cellulitis response. Good response implied cure. Poor response implied failure to cure or initial cure but relapse within 30 days of hospital discharge. RESULTS:Mean age was 63.3 years and 51.8% were men. Poor responses were significantly associated with age, previous episodes of cellulitis, prior wounds and skin lesions, venous insufficiency, lymphedema, immunosuppression and lower limbs involvement. No differences in ESR or CRP blood levels, leukocyte counts, pus or blood cultures positivity or microbiological or imaging aspects were observed in those with good or poor responses. Regarding antimicrobials, no differences in previous exposition before hospital admission, treatment with single or more than one antibiotic, antibiotic switch, days on antimicrobials or surgical treatment were observed regarding good or poor cellulitis response. Prior episodes of cellulitis (P = 0.0001), venous insufficiency (P = 0.004), immunosuppression (P = 0.03), and development of sepsis (P = 0.05) were associated with poor treatment responses, and non-surgical trauma (P = 0.015) with good responses, in the multivariate analysis. CONCLUSIONS:Prior episodes of cellulitis, non-surgical trauma, venous insufficiency, sepsis and immunosuppression were independently associated with treatment response to cellulitis, but not the causative microorganism, the number of antimicrobials administered or its duration.

BACKGROUND:Bacteremia is common in severe urinary infections, but its influence on the outcomes is not well established. The aim of this study was to assess the association of bacteremia with outcomes in elderly patients admitted to hospital with pyelonephritis or urinary sepsis. METHODS:This prospective muticenter observational study was conducted at 5 Spanish hospitals. All patients aged >65 years with pyelonephritis or urinary sepsis admitted to the departments of internal medicine and with urine and blood cultures obtained at admission to hospital were eligible. Transfer to ICU, length of hospital stay, hospital mortality and all cause 30-day mortality in bacteremic and non-bacteremic groups were compared. Risk factors for all cause 30-day mortality was also estimated. RESULTS:Of the 424 patients included in the study 181 (42.7%) had bacteremia. Neither transfer to ICU (4.4% vs. 2.9%, p = 0.400), nor length of hospital stay (9.7±4.6 days vs. 9.0±7.3 days, p = 0.252), nor hospital mortality (3.3% vs. 6.2%, p = 0.187), nor all cause 30-day mortality (9.4% vs. 13.2%, p = 0.223) were different between bacteremic and non-bacteremic groups. By multivariate analysis, risk factors for all cause 30-day mortality were age (OR 1.05, 95% CI 1.00-1.10), McCabe index ≥2 (OR 10.47, 95% CI 2.96-37.04) and septic shock (OR 8.56, 95% CI 2.86-25.61); whereas, bacteremia was inversely associated with all cause 30-day mortality (OR 0.33, 95% CI 0.15-0.71). CONCLUSIONS:In this cohort, bacteremia was not associated with a worse prognosis in elderly patients with pyelonephritis or urinary sepsis.

Existe un gran ecosistema microbiano en la cavidad oral donde Staphylococcus aureus ( S. aureus ) se puede encontrar, causando patologías orales tales como quelitis angular, las paperas y la mucositis estafilocócica. Estas enfermedades producidas por S. aureus en la cavidad oral son consecuencia de los factores de virulencia, toxinas y multiresistencia a los antibióticos, lo que contribuye a la infección. La colonización en la cavidad oral por S. aureus en pacientes sanos es de 24% a 36%. Sin embargo, la incidencia aumenta a 48% en pacientes con prótesis debido a la formación de biofilms en la superficie de las dentaduras postizas. Actualmente, no existe ningún tratamiento para infecciones orales sin el uso de antibióticos. Investigaciones recientes indican que las nanopartículas de plata (AgNPs) son un material o estrategia para eliminar S. aureus debido a su efecto antibacteriano. Sin embargo, el mecanismo del efecto inhibidor de los iones de Ag sobre S. aureus es sólo parcialmente conocida y muy poco se ha informado. Por lo tanto, el propósito de la presente revisión sistemática es determinar las estrategias y retos de la utilización de biomateriales antimicrobianos con AgNPs frente a las infecciones orales de S. aureus.

Los determinantes sociales son aquellas condiciones sociales de desarrollo que impactan la salud. Existe asociación entre algunos problemas bucales con una inequitativa distribución económica. Objetivo : Identificar la asocia - ción entre algunos determinantes sociales y la experiencia de caries en niños de San Felipe del Progreso. Metodología: Estudio transversal. Se seleccionaron 83 niños de 6 a 12 años y se les aplicó un cuestionario socio-demográfico. Se evaluó la experiencia de caries siguiendo los criterios de la OMS. Se obtuvieron medidas descriptivas de variables sociodemo - gráficas y una prueba de ANOVA para las medias de CPOD/ceod por nivel socioeconómico. Resultados : 47.0% de la po - blación pertenece a una clase baja, presentando un mayor promedio de dientes cariados (4.53±2.57) y 33.3% de los niños con higiene regular. Conclusiones : Se encontró un mayor promedio de dientes cariados en los niveles socioeconómicos más bajos así como en los niveles escolares básicos de los padres.

Copper sulfide is a promising p-type inorganic semiconductor for optoelectronic devices such as solar cells, due its small band gap energy and its electrical properties. In this work nanocrystalline copper sulfide (CuxS), with two stoichiometric ratios (x = 2, 1.8) was obtained by one-pot synthesis at 220, 230, 240 and 260 °C in an organic solvent and amorphous CuxS was obtained in aqueous solution. Nanoparticle-like nucleation centers are formed at lower temperatures (220 °C), mixtures of morphologies (nanorods, nanodisks and nanoprisms) are seen at 230 and 240 °C, in which the nanodisks are predominant, while big hexagonal/prismatic crystals are obtained at 260 °C according to TEM results. A mixture of chalcocite and digenite phases was found at 230 and 240 °C, while a clear transition to a pure digenite phase was seen at 260 °C. The evolution of morphology and transition of phases is consistent to the electrical, optical, and morphological properties of the copper sulfide. In fact, digenite Cu1.8S is less resistive (346 Ω/sq) and has a lower energy band gap (1.6 eV) than chalcocite Cu2S (5.72 × 105 Ω/sq, 1.87 eV). Low resistivity was also obtained in CuxS synthesized in aqueous solution, despite its amorphous structure. All CuxS products could be promising for optoelectronic applications.

Aim of study: Determining the main physical and mechanical properties of Spanish juniper wood from Soria (Spain) considering the effects of heartwood formation and the presence of defects and imperfections; and comparing the resulting characteristics with similar existing data for other regional softwood species of commercial interest. Area of study: Berlanga de Duero (Soria, Castilla y León), Spain.Material and Methods: Wood physico-mechanical performance was determined by Spanish UNE standards in order to provide proper comparisons to other regional softwood species. An individual tree representing average plot characteristics was selected in all eight 10 m radius circular plots that were established well-representing the heterogeneity of this woodland. The age of every tree was determined reading the number of growth rings at the base of each sampled tree. Every physico-mechanical property was assessed at least 4 times for every wood sample type (sapwood and heartwood, whether clear or with the presence of defects) of each tree. Two-way ANOVA was run to assess significant differences in the results. Post hoc all pairwise comparisons were performed using Tukey's test (p < 0.05).Research highlights: Spanish juniper wood resulted harder than other regional commercial conifers, and showed semi-heavyweight heartwood and lightweight sapwood; whereas shrinkage figures remarked its great dimensional stability. The high presence of knots within heartwood made it even heavier, harder, and more resistant to compression parallel to grain. A commercial use of this rare precious wood may contribute to juniper forests preservation in the frame of forest sustainable management plans. Key words: heartwood effect; Juniperus thurifera L.; physico-mechanical wood properties; wood classification; wood defects.

Aim of study: Assessing the effect of soil development on the stand structure of a Spanish juniper forest traditionally shaped by livestock browsing and wood extraction. Area of study: Berlanga de Duero (Soria, Castilla y León), Spain.Material and Methods: A stand inventory served to record stand structure. Tree age, height, DBH, basal area, and overbark volume were determined in each plot. Results were pooled considering two well-differentiated degrees of soil evolution. One-way ANOVAs (and Tukey’s test) and regressions between growth parameters were performed to assess significant differences between growth performances on both types of soils. Research highlights: Deeper soils yielded significant higher plant density and stand stock figures than stony shallower profiles despite the intense past livestock activity in the area; and single tree-size was also significantly greater. Non-significant differences were found for merchantable junipers age (≈120-160 years). Wood extraction and livestock browsing should be limited on shallower soils to allow soil and forest evolution; as well as to preserve the genetic pool better adapted to hardest growing conditions.Keywords: livestock browsing; forest development; Juniperus thurifera L.; soil evolution; stand stock.

La llegada de los meses fríos trae cada año una nuevo brote de gripe, ya sea de carácter estacional o pandémico, como la producida por el virus A (H1N1) en 2009-20101. Las epidemias anuales de gripe conllevan una importante morbimortalidad y suponen un reto para los sistemas de salud de nuestro país

La hermenéutica de la verosimilitud tiene su fundamento en la búsqueda de la máxima coherencia posible para la interpretación de los elementos de información que están contenidos en las representaciones fenoménicas que aparecen en la comprensión. Tal coherencia permanente resulta ser un camino para el conocimiento y la acción. Se analizan las posibilidades de objetivación racional de la evidencia empírica con la que el médico se enfrenta. Se demostró que la evidencia empírica no es el resultado del consenso interpretativo, pues es sólo la aplicación metódica de la hermenéutica racional, donde el contenido cognitivo implicado en toda su estructura muestra el máximo de coherencia posible. Tal es la hermenéutica de la verosimilitud.

The aim of this study was to analyze the mortality and predictors of 30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary tract infection (PAUTI) and the impact of antibiotic treatment on survival.Patients admitted to our hospital with PAUTI or those diagnosed of PAUTI during hospitalization for other disease between September 2012 and September 2014 were included. Repeated episodes from the same patient were excluded. Database with demographic, clinical and laboratory ítems was created. Empirical and definitive antibiotic therapy, antimicrobial resistance and all-cause mortality at 30 and 90 days were included.62 patients were included, with a mean age of 75 years. 51% were male. Mortality was 17.7% at 30 days and 33.9% at 90 days. Factors associated with reduced survival at 30 days were chronic liver disease with portal hypertension (P 3 (P = 0.02) and inadequated definitive antibiotic treatment (P

El presente trabajo es una revisión bibliográfica de las tendencias actuales y futuras de los cementos selladores y de las soluciones irrigantes en relación a su efecto bactericida, así como del tamaño de partícula del que están constituidos. Son propuestos diversos desinfectantes del conducto radicular con la intención de garantizar la no formación de biopelículas.Hoy en día los fracasos endodóncicos son más frecuentes y representan un alto riesgo de infecciones en los pacientes más complejos, por lo que está llevando a la mejora continua de los productos utilizados para la limpieza y sellado intra-conducto, para asegurar la eliminación completa de los microorganismos. La nanotecnología está ayudando a crear nuevos materiales para aplicaciones biológicas, como biomateriales y dispositivos dentales para aplicaciones a corto o largo plazo que estén en contacto con los fluidos corporales, para los que se exige alto efecto antimicrobiano y biocompatibilidad.Existen diversos biomateriales disponibles, bajo continua investigación ya que se ha logrado cultivar biofilm hasta en un 10 % de los pacientes con necesidad de retratamiento de conductos. Esto lleva a la mejora continua de los productos utilizados para la limpieza y sellado intraconducto que aseguren la eliminación completa de los microorganismos.

Gingival masses are commonly encountered in clinical practice and can be a result of many conditions one of them could be metaplasia. Metaplasia is defined as the replacement of the lining of an organ with the type of lining normally found at another site. We are reporting a case of a 17-year-old Mexican male who presented with a pedunculated nodule associated to maxillary anterior gingiva. The histopatological examination revealed a chondroid material covered by stratified squamous epithelium and was diagnosed as chondroid metaplasia.

Zinc based or doped ceramics have shown to be capable of increasing osteoblasts proliferation, biomineralization and bone formation. However, studies regarding the biological applications processes in ZnAl2O4 ceramic films are very scarce. For this reason, the objective of this in vitro study was to investigate the response of osteoblasts cells cultured onto ZnAl2O4 films. Our results showed a good biological response related to attachment and viability, with good cell morphology attached to the semi-spherical grains of the ceramic and the analysis of mineral-like tissue showed a high quantity of mineral deposited and organized as tiny spherical-like nodules attached to nanostructure surface of ZnAl2O4 material films. Based in our results, ZnAl2O4 films stimulated the bioactivity of osteoblasts cells and provide a microenvironment that favors cell differentiation and mineralization processes, suggesting their potential use as osteoconductive coating onto currently orthopedic and dental implants.

OBJETIVOS: Conocer la prevalencia de caries y pérdida dental para calcular las necesidades terapéuticas en estudiantes de educación media superior que ingresan a la Universidad Nacional Autónoma de México (UNAM). MATERIAL Y MÉTODOS: Se realizó un estudio transversal descriptivo en el que se obtuvo una muestra de 77 191 estudiantes correspondientes a las generaciones de ingreso al bachillerato 2003, 2004 y 2005. Los datos de salud bucal se obtuvieron a partir del índice CPOD incluido en el Examen Médico Automatizado (EMA), instrumento de autorrespuesta estandarizado que aplica la Dirección General de Servicios Médicos (DGSM). El análisis del EMA fue univariado con la finalidad de identificar la distribución y la frecuencia de las variables. RESULTADOS: La prevalencia de caries y pérdida dental fue de 48.0 y 34.2%, respectivamente, con una cuantificación del índice CPOD de 5. Las necesidades de tratamiento para caries y pérdida dental se obtuvieron en al menos un diente por estudiante. CONCLUSIONES: Cerca de la mitad de los alumnos que ingresan al bachillerato de la UNAM requiere al menos la atención de una caries o prótesis dental. Lo anterior evidencia que las políticas en salud bucal instrumentadas no han alcanzado los índices en salud esperados en relación con los objetivos internacionales, así como la necesidad de impulsar nuevas líneas de investigación orientadas a identificar la gravedad de la enfermedad y factores vinculados con el deterioro de la salud bucal.OBJECTIVE: To determine the prevalence of dental decay and tooth loss, and to consider the treatment needs for students at the Mexican National Autonomous University (UNAM). MATERIALS AND METHODS: A cross sectional study was designed including 77 191 students corresponding to the years of entrance to high school 2003, 2004 and 2005. Oral health data were obtained from the DMF-T index included in the Automatized Medical Exam (AME), a student self-answer instrument administered by the General Medical Services Department, UNAM. The analysis of the AME was univaried with the purpose of identifying the distribution and frequency of the variables. RESULTS: The prevalence of dental decay and tooth loss was 48.0% and 34.2%, respectively. The DMF-T index was 5. The treatment needs for dental decay and tooth loss for a student were considered as at least one lost tooth. CONCLUSIONS: Approximately half of the students from UNAM high schools need at least restorations and dental prosthesis. This suggests that oral health programs have not yet reached the expected health indexes according to international regulations, as well as the need to develop new research projects directed toward identifying disease severity and the factors that are detrimental to oral health.

OBJETIVO: Evaluar el efecto que tiene el estado de la dentición en la capacidad de los ancianos para desempeñar sus actividades habituales en los últimos seis meses. MATERIAL Y MÉTODOS: Estudio transversal en ancianos derechohabientes del Instituto Mexicano del Seguro Social del suroeste de la Ciudad de México. Se realizaron entrevistas domiciliarias para recabar datos sociodemográficos, utilización de los servicios de salud bucodental, problemas para realizar actividades regulares y su relación con el estado de la dentición en los últimos seis meses, mediante el índice OIDP (Oral Impacts on Daily Performances). Con posterioridad, tres profesionales de la salud bucodental, capacitados para determinar el estado de la dentición de acuerdo con los criterios de la Organización Mundial de la Salud, realizaron un examen clínico. RESULTADOS: Se estudió a 540 ancianos. La prevalencia de pacientes geriátricos con problemas para llevar a cabo sus actividades habituales fue de 21.5%. Los principales problemas en las actividades habituales fueron comer (14.4%), hablar (8.7%), incapacidad de no irritarse (5.4%), lavarse los dientes (5%) e imposibilidad de disfrutar el contacto con la gente (4.4 %). Existe una correlación del OIDP positiva entre el número de dientes perdidos y el índice CPO-D (pOBJECTIVE: The aim of this study was to evaluate the effect of dental state on the capacity of elderly individuals to carry out their daily activities during the previous six months. MATERIAL AND METHODS: A transversal study was conducted in the Mexican Institute of Social Security (IMSS) with insured elderly persons residing in southwestern Mexico City. Home interviews were conducted to gather sociodemographic data, data on the use of oral health services, problems in carrying out daily activities, and their relationship with the state of dentition over the past six months, utilizing the Oral Impacts on Daily Performance (OIDP) index. Later, three oral health professionals trained in determining the state of dentition according to World Health Organization (WHO) criteria performed a clinical examination on each elderly subject. RESULTS: A total of 540 elderly individuals were studied. The prevalence of elderly persons with problems in carrying out their daily activities was 21.5%. The main problems in daily activities were eating (14.4%), speaking (8.7%), not becoming irritated (5.4%), brushing their teeth(5%), and inability to enjoy contact with people (4.4%). There is a positive OIDP correlation between number of teeth lost and the decayed, missing, filled teeth(DMFT) index (p

RESUMEN: La enfermedad celiaca típicamente se diagnostica en niños y adultos jóvenes con historia de diarrea o malabsorción. Sin embargo, cada vez es más frecuente detectar esta patología en mayores de 55 años. Por este motivo, nos ha parecido interesante describir un nuevo caso en una paciente anciana y realizar una breve actualización. ABSTRACT: Celiac disease is typically diagnosed in children and young adults with a history of diarrhea or malabsorption. However, this disease is increasingly detected in patients older than 55 years. For this reason, it seemed interesting to describe a new case in an elderly patient and to make a brief update

El programa formativo de la especialidad de Medicina Interna viene definido en la Orden SCO/227/2007, de 24 de enero. En ella se establecen las competencias que deben ser adquiridas por los futuros especialistas tanto en el ámbito asistencial como en el docente e investigador.

RESUMEN La pancreatitis del surco o pancreatitis groove es una forma segmentaria de pancreatitis crónica caracterizada por la presencia de fibras cicatriciales en el área del surco pancreatoduodenal. Dada la infrecuencia de dicha patología se expone el caso de un varón de 60 años que acude a las consultas externas por dolor epigástrico episódico de años de evolución asociado en los últimos meses a un cuadro constitucional. Se realizaron análisis sanguíneos incluyendo marcadores tumorales y una TAC abdominal que fueron normales. Ante la persistencia de los síntomas se realizó una colangiorresonancia en la que se evidenció la presencia de una lesión compatible con una pancreatitis del surco. Se inició tratamiento conservador con analgésicos y abstención del tabaco con remisión de los síntomas hasta el momento actual. Es una entidad rara, pero que habría que tener presente en el paciente con dolor abdominal de origen inexplicado y como diagnóstico diferencial del carcinoma de cabeza de páncreas, ya que tanto el tratamiento como el pronóstico difieren en gran medida, por lo que creemos importante la comunicación de un nuevo caso. ABSTRACT Groove pancreatitis is a segmental chronic pancreatitis characterized by the presence of fibrous scars of the anatomic space between the dorsocranial part of the head of the pancreas, the duodenum and the common bile duct. Due to this disease is very unusual we report the case of a 60-year-old man who presents episodic epigastric pain since several years. In the last months he was very tired and he had unintentional weight loss. Blood tests, including tumour markers and CT scan were normal. Like symptoms did not cease, an abdominal MRI was performed, which showed an image that supports the diagnosis of groove pancreatitis. The patient was treated with painkillers and we recommend smoking cessation. Until now, the patient is free of symptoms. It is a rare disease, but we must keep it in mind when we make the differential diagnosis of patients with abdominal pain of unknown origin. It is very important to distinguish this pathology from a pancreatic head carcinoma, as both treatments and prognosis differ greatly, so we believe important communication of a new case.

Endogenous bacterial endophthalmitis is an uncommon disease, secondary to hematogenous spread of a septic focus. Despite advances in diagnostic and therapeutic methods, it remains a potential cause of blindness. We report a case of a diabetic patient with endogenous endophthalmitis of the right eye secondary to an Escherichia coli bacteremia of urinary origin. The evolution was torpid, with loss of visual acuity and evisceration of the right eye.