The most common causes of congenital neutropenia are mutations in the
(Elastase, Neutrophil Expressed) gene (19p13.3), mostly in exon 5 and the distal portion of exon 4, which result in different ...clinical phenotypes of neutropenia. Here, we report two pathogenic mutations in
, namely, c.607G>C (p.Gly203Arg) and a novel variant c.416C>G (p.Pro139Arg), found in two Mexican families ascertained via patients with congenital neutropenia who responded positively to the granulocyte colony-stimulating factor (G-CSF) treatment. These findings highlight the usefulness of identifying variants in patients with inborn errors of immunity for early clinical management and the need to rule out mosaicism in noncarrier parents with more than one case in the family.
El catéter venoso central (CVC) es necesario para la monitorización y tratamiento de pacientes en estado crítico; sin embargo, su uso incrementa el riesgo de bacteriemia. El objetivo del estudio fue ...cuantificar la incidencia de bacteriemia relacionada con catéter venoso central (BRCVC) e identificar los factores asociados con esta infección.
Se realizó un estudio de cohorte prospectivo en un hospital de concentración del occidente de México. Para conocer la asociación entre BRCVC y las variables en estudio, se realizó un análisis multivariado con regresión de Cox.
Se estudiaron 204 pacientes con CVC. La edad promedio fue de 4.6 años; el 66.2% fue del sexo masculino. Los sitios de inserción del catéter fueron la vena subclavia (72.5%, n = 148), la vena yugular (20.1%, n = 41) o la vena femoral (7.4%, n = 15). La incidencia de BRCVC fue de 6.5 eventos por 1,000 días catéter. Los microorganismos identificados fueron cocos Gram positivos (37.5%, n = 6), bacilos Gram negativos (37.5%, n = 6) y Candida albicans (25%, n = 4). Se observó que la mayor manipulación del catéter por día se asoció con bacteriemia (HR 1.14, IC95% 1.06-1.23), mientras que el uso de antibióticos intravenosos mostró un efecto protector (HR 0.84, IC95% 0.76-0.92).
Además de las medidas máximas de precaución al momento de colocar o manipular el catéter, es conveniente disminuir lo más posible las desconexiones entre el equipo de venoclisis y el CVC. Los antibióticos mostraron un efecto protector; sin embargo, se debe considerar el riesgo de favorecer resistencias antimicrobianas.
Central venous catheters (CVC) are needed for monitoring and treatment of critically ill patients; however, their use increases the risk of bacteremia. The aim of the study was to quantify the incidence of central venous catheter-related bacteremia (CVCRB) and to identify factors associated with this infection.
A prospective cohort study was conducted in a concentration hospital of western Mexico. The association of CVCRB and study variables was investigated using multivariate Cox regression analysis.
Two hundred four patients with CVC were studied. The average age was 4.6 years; 66.2% were male. Insertion sites of the catheters were subclavian vein 72.5% (n = 148), jugular vein 20.1% (n = 41) and femoral vein 7.4% (n = 15). CVCRB incidence was 6.5 events/1,000 catheter days; microorganisms identified were gram-positive cocci 37.5% (n = 6), gram-negative bacilli 37.5% (n = 6) and Candida albicans 25% (n = 4). It was observed that the increase in catheter manipulations per day was associated with bacteremia (HR 1.14, 95% CI 1.06 - 1.23), whereas the use of intravenous antibiotics showed a protective effect (HR 0.84, 95% CI 0.76-0.92).
In addition to strategies of maximum caution when placing or manipulating the catheter, we recommend decreasing, as much as possible, disconnects between the CVC and infusion line. Antibiotics showed a protective effect, but the outcome is uncertain and promotion of antimicrobial resistance should be considered.
People living with HIV have accounted for 38–50% of those affected in the 2022 multicountry mpox outbreak. Most reported cases were in people who had high CD4 cell counts and similar outcomes to ...those without HIV. Emerging data suggest worse clinical outcomes and higher mortality in people with more advanced HIV. We describe the clinical characteristics and outcomes of mpox in a cohort of people with HIV and low CD4 cell counts (CD4 <350 cells per mm3).
A network of clinicians from 19 countries provided data of confirmed mpox cases between May 11, 2022, and Jan 18, 2023, in people with HIV infection. Contributing centres completed deidentified structured case report sheets to include variables of interest relevant to people living with HIV and to capture more severe outcomes. We restricted this series to include only adults older than 18 years living with HIV and with a CD4 cell count of less than 350 cells per mm3 or, in settings where a CD4 count was not always routinely available, an HIV infection clinically classified as US Centers for Disease Control and Prevention stage C. We describe their clinical presentation, complications, and causes of death. Analyses were descriptive.
We included data of 382 cases: 367 cisgender men, four cisgender women, and ten transgender women. The median age of individuals included was 35 (IQR 30–43) years. At mpox diagnosis, 349 (91%) individuals were known to be living with HIV; 228 (65%) of 349 adherent to antiretroviral therapy (ART); 32 (8%) of 382 had a concurrent opportunistic illness. The median CD4 cell count was 211 (IQR 117–291) cells per mm3, with 85 (22%) individuals with CD4 cell counts of less than 100 cells per mm3 and 94 (25%) with 100–200 cells per mm3. Overall, 193 (51%) of 382 had undetectable viral load. Severe complications were more common in people with a CD4 cell count of less than 100 cells per mm3 than in those with more than 300 cells per mm3, including necrotising skin lesions (54% vs 7%), lung involvement (29% vs 0%) occasionally with nodules, and secondary infections and sepsis (44% vs 9%). Overall, 107 (28%) of 382 were hospitalised, of whom 27 (25%) died. All deaths occurred in people with CD4 counts of less than 200 cells per mm3. Among people with CD4 counts of less than 200 cells per mm3, more deaths occurred in those with high HIV viral load. An immune reconstitution inflammatory syndrome to mpox was suspected in 21 (25%) of 85 people initiated or re-initiated on ART, of whom 12 (57%) of 21 died. 62 (16%) of 382 received tecovirimat and seven (2%) received cidofovir or brincidofovir. Three individuals had laboratory confirmation of tecovirimat resistance.
A severe necrotising form of mpox in the context of advanced immunosuppression appears to behave like an AIDS-defining condition, with a high prevalence of fulminant dermatological and systemic manifestations and death.
None.
Abstract The study aims to compare the outcomes of initiating ART early versus late in PWH and mpox. No worse outcomes were found associated with mpox-related IRIS among those who started ...antiretroviral treatment early, suggesting initiation as soon as possible.
Growth of PbS： Ni2＋ Nanocrystals Thin Films by Chemical Bath Melissa Chavez Portillo Javier Martinez Juarez Gustavo Abarca Avila Marcial Zamora Tototzintle MacarioMartinez Barragan Jorge. R. Cema Martin Lazcano Hernandez Salvador Rosas Castilla Brenda CrespoSnchez Andrea Celeste Palacios Lopez and Oscar Portillo Moreno
材料科学与工程：中英文A版,
2012, Letnik:
2, Številka:
5
Journal Article
PbS nanocrystalline films growth by chemical bath deposition （CBD） onto glass at deposition temperature of 20 ℃. Different doping level was obtained by changing the volume of regent solution VNi2＋ ...into PbS growing solution. Scanning Electron Microscopy （SEM）, atomic force microscopy （AFM）, X-ray diffraction （XRD）, optical absorption （OA） and Transmission Microscopy Electronic （TEM） measurements were carried out to characterize the films. Using the SEM and AFM, the morphological changes were analyzed.The spectra of x-rays show the angular positions of peaks： 20= （26.00, 30.07, 43.10, 51.00 and 53.48）, growth on zinc blende face. The grain size （GS） of the sample undoped -36 nm and doped in range of-32-5 nm, calculated by employing Scherer＇s formula. The average GS in the prepared films is observed to be increased wit increase VNi2 doping. Samples are found to be crystalline by TEM in range of 3.5-5 nm very similar to size calculated from XRD. Due to the doping, forbidden band gap energy （Eg） shift show a r
Abstract
Background
Patients with severe SARS-CoV-2 infection are at high risk of complications due to the intensive care unit stay. Hospital-acquired infections (HAI) are one of the most common ...complication and cause of death in this group of patients, it is important to know the epidemiology and microbiology of this hospital-acquired infections in order to begin to the patients a proper empirical treatment. We describe the epidemiologic and microbiologic characteristics of HAI in patients with COVID-19 hospitalized at intensive care unit (ICU) in a tertiary level private hospital in Mexico City.
Methods
From April to December 2020, data from all HAIs in patients with severe pneumonia due to SARS-CoV-2 infection with mechanical ventilation at ICU were obtained. The type of infection, microorganisms and antimicrobial susceptibility patterns were determined.
Results
A total of 61 episodes of HAIs were obtained, the most common was ventilator associated pneumonia (VAP) in 52.4% (n=32) followed by urinary tract infection (UTI) 34.4%(n=21) and bloodstream infection (BSI) 9.84% (n=6). Only two episodes corresponded to C. difficile associated diarrhea. We identified 82 different microorganisms, the most frequent cause of VAP was P. aeruginosa 22% (10/45) followed by K. pneumoniae 20% (9/45); for UTI, E. coli 28.5% (6/21), and S. marcescens 19% (4/21); for BSI the most frequent microorganism was S. aureus 28.5 (2/7). Regarding the antimicrobial susceptibility patters the most common were Extended Spectrum Beta-Lactamase (ESBL) Gram-negative rods followed by Methicillin-resistant Staphylococcus aureus.
Conclusion
In patients with severe COVID-19 hospitalized in the ICU the most frequent HAIs were VAP and UTI caused by P. aeruginosa and E. coli respectively. ESBL enterobacteriaceae was the most common resistant pattern identifed in the bacterial isolations in our series.
Disclosures
All Authors: No reported disclosures
Cervical cancer (CCU), or cancer of the cervix, is the most common carcinoma in women worldwide; is the malignancy that occurs regularly in the cervical epithelium, so it requires periodic analysis. ...Aim. To determine the impact of gender violence and level of schooling, as well as factors and barriers that interfere in the timely detection of cervical cancer. Methodology. An observational cross-sectional and analytic study was conducted on 384 women from the La Providencia and Bosques del Peñar neighborhoods in Pachuca Hidalgo, Mexico. through a structured survey with prior consent. Results. 12% of women report having a restrictive partner, 23% frequently bother with her, 16% have a possessive partner and 11% have a low level of education. The number of women who underwent the cervical cytology examination once a year were (52%), 11% are performed twice a year, 12% are not performed regularly. The restrictive behavior of the couple is associated with variables such as the level of schooling, with the frequency of attendance at cervical cytology and fundamentally, level of schooling with Couple / Possessive, obtaining the following OR value: 1.66 (p <0.05) and Level of schooling with cervical cytology, with an OR: 1.32. with (p <0.05). Conclusions. School attendance and attendance at the gynecology service, as well as the restrictive / possessive, possessive / aggressive nature of the couple represent barriers that are associated and interfere in the timely detection of cervical cancer.
The Mexican government passed a new reform of article 11 of the General Law in 2014 regarding Women's Access to a Life Free of Violence, which states that a cesarean section may not be performed if a ...vaginal birth is viable. Cesarean sections are excessively indicated in Northen Mexico, using the diagnosis of cephalopelvic disproportion due to a narrow pelvis. Currently, there is no standardized morphometry of the female pelvis in a Mexican population to establish adequate diagnostic parameter. Our study measures the pelvic diameters of the birth canal using abdominopelvic computed tomography (CT). Two hundred and ninety CT from Mexican women between the ages of 18 and 50 were collected and 3D reformatted in order to morphologically measure the pelvic diameters of clinical relevance. Measurements were conducted by two diagnostic imaging specialists. The mean and standard deviation of the measured diameters were: anatomical conjugate diameter (ACD) 11.65±0.99 cm, the obstetric conjugate diameter (OCD) 11.73±0.98 cm, diagonal conjugate diameter (DCD) 12.49±0.98 cm and Interspinous distance (ISD) 10.41±0.78 cm. Significant differences were found in all four mean diameters in between the 2029 age groups versus the >40, as well as between the 3039 groups versus the >40. Our study shows that as Mexican women get older, the mean pelvic diameters become narrower.
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