Disease outbreaks caused by introduced Phytophthora species have been increasing in British forests and woodlands in recent years. A better knowledge of the Phytophthora communities already present ...in the UK is of great importance when developing management and mitigation strategies for these diseases. To do this, soils were sampled in “disturbed” sites, meaning sites frequently visited by the public, with recent and new plantings or soil disturbances versus more “natural” forest and woodland sites with little disturbance or management. Phytophthora diversity was assessed using high-throughput Illumina sequencing targeting the widely accepted barcoding Internal Transcribed Spacer 1 (ITS1) region of rRNA and comparing it with the mitochondrial cytochrome c oxidase I (COI) gene. Isolation of Phytophthora was run in parallel. Nothophytophthora spp. and Phytophthora spp. were detected in 79 and 41 of the 132 locations of the 14 studied sites when using ITS or COI, respectively. A total of 20 Phytophthora amplicon sequence variants (ASVs) were assigned to known Phytophthora species from eight clades (1a, 2, 2b, 3a, 5, 6b, 7a, 8b, 8c, 8d, 10a, and 10b) and 12 ASVs from six clades (1a, 2c, 3a, 3b, 6b, 7a, 8b, 8c, and 8d) when using ITS or COI, respectively. Only at two locations were the results in agreement for ITS, COI, and isolation. Additionally, 21 and 17 unknown Phytophthora phylotypes were detected using the ITS and COI, respectively. Several Phytophthora spp. within clades 7 and 8, including very important forest pathogens such as P. austrocedri and P. ramorum, were identified and found more frequently at “disturbed” sites. Additionally, eight ASVs identified as Nothophytophthora spp. were detected representing the first report of species within this new genus in Britain. Only three species not known to be present in Britain (P. castaneae, P. capsici, and P. fallax) were detected with the ITS primers and not with COI. To confirm the presence of these or any potential new Phytophthora species, sites should be re-sampled for confirmation. Additionally, there is a need to confirm if these species are a threat to British trees and try to establish any eradication measures required to mitigate Phytophthora spread in Britain.
Noncentrifugal brown sugar (called panela in Colombia) is a natural sweetener obtained from the extraction, purification, and concentration of sugarcane juices. In this work, energy and productivity ...yield of a traditional furnace for panela production were evaluated, considering five performance indices. Experimental productions were developed in a pilot plant facility, analyzing furnace gas emissions of furnace and bagasse properties. Mass, energy, and exergy balances were performed. The following indices were obtained from the experimental runs: energy efficiency 12.726 ± 1.091%, exergy efficiency 9.013 ± 0.710%, energy losses through chimney 72.293 ± 11.507%, yield 0.144 ± 0.021 kgpanela/kgbagasse, productivity 7.450 ± 0.520 kgpanela/h, and bagasse consumption 1.258 ± 0.139 kgbagasse consumed/kgbagasse produced. It was found that these outcomes were strongly influenced by excess air and gas circulation velocity through the furnace, which affects the combustion rate and heat transfer between the gases and the juices. Finally, it was concluded that the traditional scheme is inefficient and requires various critical operational adjustments, such as combustion chamber, chimney draft control, and heat exchangers design.
BackgroundThe ROX index (Respiratory rate-OXygenation) has been described as a prediction tool to identify the need for invasive mechanical ventilation (IMV) in community-acquired pneumonia (CAP) ...with acute hypoxaemic respiratory failure treated with high-flow nasal cannula in order to avoid delay of a necessary intubation. However, its use in predicting the need for ventilatory support in hospitalised patients with CAP has not been validated.MethodsThis is a retrospective cohort study including subjects with CAP treated in the general ward, emergency service or intensive care unit of a third-level centre in Cundinamarca, Colombia, between January 2001 and February 2020. The ROX index was estimated as the ratio of oxygen saturation/fraction of inspired oxygen to respiratory rate.ResultsA total of 895 patients were included, of whom 93 (10%) required IMV. The ROX index proved to be a good predictor, presenting an area under the curve of receiver operating characteristics (AUROC) of 0.733 (95% CI 0.671 to 0.795, p<0.001) when determined by pulse oximetry and an AUROC of 0.779 (95% CI 0.699 to 0.859, p<0.001) when estimated by arterial blood gas (ABG) parameters, with an intraclass correlation of 0.894. The estimated cut-off point was 14.8; a score less than 14.8 indicates high risk of requiring IMV.ConclusionThe ROX index is a good predictor of IMV in hospitalised patients with CAP. It presents good performance when calculated through pulse oximetry and can replace the one calculated by ABG.
Incidentalomas, or tumors found incidentally, are very common. However, pancreatic tumors are usually not found as incidentalomas. To date, these tumors represent a diagnostic and therapeutic ...challenge, since the risks and benefits associated with surgeries that can be performed to remove these tumors must be evaluated due to perioperative complications. It is vitally important to always carry out a correct approach that includes a histopathological study to allow timely identification of tumors that require surgical management or other preoperative treatment, such as chemotherapy or radiotherapy. The majority of these tumors are benign cystic tumors; however, there are cases, like the one presented here, where the tumor turns out to be a solid pseudopapillary tumor (SPT) that requires a different diagnostic and surgical approach. Also, in this case, the importance of evaluating the patient's general health status is highlighted to determine whether or not the required surgery can be performed at that moment or if any prior intervention is required. This case report talks about a patient in whom an incidental pancreatic tumor was found and how its management was carried out from diagnosis to the postoperative period.
Abstract Background Partial pressure of carbon dioxide (PaCO 2 ) is generally known to influence outcome in patients with traumatic brain injury (TBI) at normal altitudes. Less is known about ...specific relationships of PaCO 2 levels and clinical outcomes at high altitudes. Methods This is a prospective single-center cohort of consecutive patients with TBI admitted to a trauma center located at 2600 m above sea level. An unfavorable outcome was defined as a Glasgow Outcome Scale-Extended (GOSE) score < 4 at the 6-month follow-up. Results We had a total of 81 patients with complete data, 80% (65/81) were men, and the median (interquartile range) age was 36 (25–50) years. Median Glasgow Coma Scale (GCS) score on admission was 9 (6–14); 49% (40/81) of patients had severe TBI (GCS 3–8), 32% (26/81) had moderate TBI (GCS 12–9), and 18% (15/81) had mild TBI (GCS 13–15). The median (interquartile range) Abbreviated Injury Score of the head (AISh) was 3 (2–4). The frequency of an unfavorable outcome (GOSE < 4) was 30% (25/81), the median GOSE was 4 (2–5), and the median 6-month mortality rate was 24% (20/81). Comparison between patients with favorable and unfavorable outcomes revealed that those with unfavorable outcome were older, (median age 49 30–72 vs. 29 22–41 years, P < 0.01), had lower admission GCS scores (6 4–8 vs. 13 8–15, P < 0.01), had higher AISh scores (4 4–4 vs. 3 2–4, P < 0.01), had higher Acute Physiology and Chronic Health disease Classification System II scores (17 15–23 vs. 10 6–14, P < 0.01), had higher Charlson scores (0 0–2 vs. 0 0–0, P < 0.01), and had higher PaCO 2 levels (mean 35 ± 8 vs. 32 ± 6 mm Hg, P < 0.01). In a multivariate analysis, age (odds ratio OR 1.14, 95% confidence interval CI 1.1–1.30, P < 0.01), AISh (OR 4.7, 95% CI 1.55–21.0, P < 0.05), and PaCO 2 levels (OR 1.23, 95% CI 1.10–1.53, P < 0.05) were significantly associated with the unfavorable outcomes. When applying the same analysis to the subgroup on mechanical ventilation, AISh (OR 5.4, 95% CI 1.61–28.5, P = 0.017) and PaCO 2 levels (OR 1.36, 95% CI 1.13–1.78, P = 0.015) remained significantly associated with the unfavorable outcome. Conclusions Higher PaCO 2 levels are associated with an unfavorable outcome in ventilated patients with TBI. These results underscore the importance of PaCO 2 levels in patients with TBI and whether it should be adjusted for populations living at higher altitudes.
El propósito de este artículo es analizar los factores que favorecen la intención de llevar a cabo proyectos de investigación por parte de estudiantes universitarios. Se desarrolló una investigación ...cuantitativa tipo exploratoria-descriptiva y se recolectó la información mediante una encuesta a 141 estudiantes. A partir de las variables del instrumento, se agruparon unos componentes (factores) para aplicar el análisis exploratorio y confirmatorio y así identificar respectivas asociaciones. Se encontró que los aprendizajes que permanecerán a lo largo de la vida del estudiante tienen una influencia positiva frente a la utilidad que este le asigna al trabajo de grado como elemento complementario y necesario en su formación académica. Se concluye que el docente deberá ejercer un papel dinámico y fuertemente activo a la hora de dirigir las sesiones de asesoría de trabajo de grado con el estudiante, ya que, según su experiencia en dichos espacios, será su percepción de utilidad del trabajo de investigación.
Using hourly records from 51 rain gauges, spanning between 22 and 28 yr, the authors study the diurnal cycle of precipitation over the tropical Andes of Colombia. Analyses are developed for the ...seasonal march of the diurnal cycle and its interannual variability during the two phases of El Nino-Southern Oscillation (ENSO). Also, the diurnal cycle is analyzed at intra-annual time scales, associated with the westerly and easterly phases of the Madden-Julian oscillation, as well as higher-frequency variability ( < 10 days), mainly associated with tropical easterly wave activity during ENSO contrasting years. Five major general patterns are identified: (i) precipitation exhibits clear-cut diurnal (24 h) and semidiurnal (12 h) cycles; (ii) the minimum of daily precipitation is found during the morning hours (0900-1100 LST) regardless of season or location; (iii) a predominant afternoon peak is found over northeastern and western Colombia; (iv) over the western flank of the central Andes, precipitation maxima occur either near midnight, or during the afternoon, or both; and (v) a maximum of precipitation prevails near midnight amongst stations located on the eastern flank of the central Cordillera. The timing of diurnal maxima is highly variable in space for a fixed time, although a few coherent regions are found in small groups of rain gauges within the Cauca and Magdalena River valleys. Overall, the identified strong seasonal variability in the timing of rainfall maxima appears to exhibit no relationship with elevation on the Andes. The effects of both phases of ENSO are highly consistent spatially, as the amplitude of hourly and daily precipitation diminishes (increases) during El Nino (La Nina), but the phase remains unaltered for the entire dataset. We also found a generalized increase (decrease) in hourly and daily rainfall rates during the westerly (easterly) phase of the Madden-Julian oscillation, and a diminished (increased) high-frequency activity in July-October and February-April during El Nino (La Nina) years, associated, among others, with lower (higher) tropical easterly wave (4-6 day) activity over the Caribbean.
Paracoccidiodomicosis suprarrenal Román-González, Alejandro; Toro, Juan Pablo; Arias, Luis F.
Biomédica,
05/2020, Letnik:
40, Številka:
Supl. 1
Journal Article
Recenzirano
Odprti dostop
La insuficiencia suprarrenal primaria es un defecto en la producción de glucocorticoides, mineralocorticoides y andrógenos sexuales. Los pacientes afectados por esta condición se caracterizan por ...concentraciones bajas de cortisol y deficiencia de aldosterona con hiponatremia e hiperpotasemia concomitantes.La etiología más común es el desarrollo de anticuerpos contra la enzima 21 hidroxilasa.Otra causa importante de la insuficiencia suprarrenal primaria son las enfermedades infecciosas, en especial en los países de bajos ingresos. Entre las causas infecciosas que se han descrito se encuentran: Mycobacterium tuberculosis, el complejo de Mycobacterium avium, Neisseria meningitidis, Pseudomonas aeruginosa, Haemophilus influenzae, citomegalovirus, Pneumocystis jirovecii, Histoplasma capsulatum, Blastomyces dermatiditis, Cryptococcus neoformans, Cocciodiodes immitis, Nocardia spp. y Paracoccidioides brasiliensis.En este artículo se presenta la imagen de la tomografía de un paciente que presentó falla suprarrenal, con masas en las glándulas suprarrenales, cuya biopsia permitió establecer el diagnóstico final de paracoccidioidomicosis.
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