Measure daily bilirubin-binding capacity (BBC) variation using an automated, not as-yet FDA approved, Point-of-Care hematofluorometer. Measure the effects of prematurity, clinical instability and ...exposure to Intralipid on BBC.
Convenience sample of 109 infants from well-baby and intensive care nurseries. Gestational ages 28-41 weeks. 261 specimens obtained from postnatal ages 1-4 days. Unstable neonates were defined by need for at least noninvasive respiratory support and FiO2 ≥ 0.25.
Median interday variation was 2.9 ± 5.1 mg/dL. BBC (0.254 mg/dL/wk) and albumin (0.037 g/dL/wk) increased for each week of gestation. BBC was lower in unstable compared to well infants (26.1 ± 7.6 mg/dL v 28.6 ± 6.3 mg/dL). BBC was not significantly different in infants receiving or not receiving IL.
BBC measurements using the device had acceptable intraspecimen reproducibility and interday variability. BBC may be helpful in guiding the assessment of aggressive versus conservative management decisions in preterm and sick infants with hyperbilirubinemia.
IMPORTANCE: Understanding why and how extremely preterm infants die is important for practitioners caring for these infants. OBJECTIVE: To examine risk factors, causes, timing, and circumstances of ...death in a modern cohort of extremely preterm infants. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort review of infants enrolled in the Preterm Erythropoietin Neuroprotection Trial between December 13, 2013, and September 26, 2016, was conducted. A total of 941 infants born between 24 0/7 and 27 6/7 weeks of gestation enrolled at 19 US sites comprising 30 neonatal intensive care units were included. Data analysis was performed from October 16, 2020, to December 1, 2021. MAIN OUTCOMES AND MEASURES: Risk factors, proximal causes, timing, and circumstances of in-hospital death. RESULTS: Of the 941 enrolled infants, 108 died (11%) before hospital discharge: 38% (n = 41) at 24 weeks’ gestation, 30% (n = 32) at 25 weeks’ gestation, 19% (n = 20) at 26 weeks’ gestation, and 14% (n = 15) at 27 weeks’ gestation. An additional 9 infants (1%) died following hospital discharge. In descending order, the primary causes of death included respiratory distress or failure, pulmonary hemorrhage, necrotizing enterocolitis, catastrophic intracranial hemorrhage, sepsis, and sudden unexplained death. Fifty percent of deaths occurred within the first 10 days after birth. The risk of death decreased with day of life and postmenstrual age such that an infant born at 24 weeks’ gestation who survived 14 days had the same risk of death as an infant born at 27 weeks’ gestation: conditional proportional risk of death, 0.08 (95% CI, 0.03-0.13) vs 0.06 (95% CI, 0.01-0.11). Preterm labor was associated with a decreased hazard of death (hazard ratio HR, 0.45; 95% CI, 0.31-0.66). Infant clinical factors associated with death included birth weight below the tenth percentile for gestational age (HR, 2.11; 95% CI, 1.38-3.22), Apgar score less than 5 at 5 minutes (HR, 2.19; 95% CI, 1.48-3.24), sick appearance at birth (HR, 2.49; 95% CI, 1.69-3.67), grade 2b-3 necrotizing enterocolitis (HR, 7.41; 95% CI, 5.14-10.7), pulmonary hemorrhage (HR, 10.0; 95% CI, 6.76-18.8), severe intracranial hemorrhage (HR, 4.60; 95% CI, 3.24-5.63), and severe sepsis (HR, 4.93; 95% CI, 3.67-7.21). Fifty-one percent of the infants received comfort care before death. CONCLUSIONS AND RELEVANCE: In this cohort study, an association between mortality and gestational age at birth was noted; however, for each week that an infant survived, their risk of subsequent death approximated the risk observed in infants born 1 to 2 weeks later, suggesting the importance of an infant’s postmenstrual age. This information may be useful to include in counseling of families regarding prognosis of survival.
Objetivo: Determinar la efectividad de la dosis única comparada con la dosis triple de Cefazolina como profilaxis antibiótica para reducir las infecciones post-cesárea. Material y Métodos: Estudio ...observacional, analítico, retrospectivo, transversal y comparativo. Se incluyó 82 historias clínicas de pacientes sometidas a cesárea en el Hospital Nacional Guillermo Almenara Irigoyen que recibieron dosis única o dosis triple de Cefazolina en el año 2011. De acuerdo al esquema recibido, se evaluaron las complicaciones infecciosas. Resultados: No hubo diferencia estadísticamente significativa entre la dosis única y la dosis triple en la incidencia de infecciones totales (9,3% vs 16,4%, p= 0,422), infección del sitio operatorio (7% vs 12,8%, p= 0,793), endometritis (0% vs 2,6%, p= 1,116) e infección del tracto urinario (2,3% vs 0%, p= 0,918). Conclusión: La dosis única de Cefazolina como profilaxis antibiótica fue igual de efectiva como la dosis triple en la prevención de la morbilidad infecciosa post-cesárea.
OBJETIVODeterminar la efectividad de la dosis única comparada con la dosis triple de Cefazolina como profilaxis antibiótica para reducir las infecciones post-cesárea.MATERIAL Y MÉTODOEstudio ...observacional, analítico, retrospectivo, transversal y comparativo. Se incluyó 82 historias clínicas de pacientes sometidas a cesárea en el Hospital Nacional Guillermo Almenara Irigoyen que recibieron dosis única o dosis triple de Cefazolina en el año 2011. De acuerdo al esquema recibido,se evaluaron las complicaciones infecciosas.RESULTADOSNo hubo diferencia estadísticamente significativa entre la dosis única y la dosis triple en la incidencia de infecciones totales (9,3% vs 16,4%, p= 0,422), infección del sitio operatorio (7% vs 12,8%, p= 0,793), endometritis (0% vs 2,6%, p= 1,116) e infección del tracto urinario (2,3% vs 0%, p= 0,918).CONCLUSIONESLa dosis única de Cefazolina como profilaxis antibiótica fue igual de efectiva como la dosis triple en la prevención de la morbilidad infecciosa post-cesárea. (Horiz Med 2014; 14(3): 37-43)
Hemotropic mycoplasmas (aka hemoplasmas) are small bacteria which cause infectious anemia in several mammalian species including humans. Information on hemoplasma infections in Cuban bovines remains ...scarce and no studies applying molecular methods have been performed so far. The aim of the present study was to utilize real-time PCR and sequence analysis to investigate dairy cattle and buffalo from Cuba for the presence of bovine hemoplasma species.
A total of 80 blood samples from 39 buffalo and 41 dairy cattle were investigated for the presence of Mycoplasma wenyonii and "Candidatus Mycoplasma haemobos" using two species-specific real-time TaqMan PCR assays. PCR results revealed overall 53 (66.2%; 95% CI: 55.3-75.7%) positive animals for M. wenyonii and 33 (41.2%; 95% CI: 31.1-52.2%) for "Ca. M. haemobos"; the latter were all co-infections with M. wenyonii. The sample prevalences were similar in cattle and buffalo. Based on the sequence analysis of the nearly full-length 16S rRNA gene from two cattle and two buffalo, the presence of M. wenyonii and "Ca. M. haemobos" was confirmed. Statistical analysis revealed that buffalo and cattle one year of age or older were more frequently infected with M. wenyonii or "Ca. M. haemobos" than younger animals. PCR-positivity was not associated with anemia; however, the infection stage was unknown (acute infection versus chronic carriers).
The high occurrence of bovine hemoplasma infections in buffalo and dairy cattle may have a significant impact on Cuban livestock production. To the best of our knowledge, this is the first molecular evidence of bovine hemoplasma species infection in dairy cattle and buffalo from Cuba and the Caribbean.
Ixodid ticks, particularly Rhipicephalus sanguineus s.l., are important vectors of various disease-causing agents in dogs and humans in Cuba. However, our understading of interactions among ...tick-borne pathogens (TBPs) in infected dogs or the vector R. sanguineus s.l. remains limited. This study integrates microfluidic-based high-throughput real-time PCR data, Yule's Q statistic, and network analysis to elucidate pathogen-pathogen interactions in dogs and ticks in tropical western Cuba.
A cross-sectional study involving 46 client-owned dogs was conducted. Blood samples were collected from these dogs, and ticks infesting the same dogs were morphologically and molecularly identified. Nucleic acids were extracted from both canine blood and tick samples. Microfluidic-based high-throughput real-time PCR was employed to detect 25 bacterial species, 10 parasite species, 6 bacterial genera, and 4 parasite taxa, as well as to confirm the identity of the collected ticks. Validation was performed through end-point PCR assays and DNA sequencing analysis. Yule's Q statistic and network analysis were used to analyse the associations between different TBP species based on binary presence-absence data.
The study revealed a high prevalence of TBPs in both dogs and R. sanguineus s.l., the only tick species found on the dogs. Hepatozoon canis and Ehrlichia canis were among the most common pathogens detected. Co-infections were observed, notably between E. canis and H. canis. Significant correlations were found between the presence of Anaplasma platys and H. canis in both dogs and ticks. A complex co-occurrence network among haemoparasite species was identified, highlighting potential facilitative and inhibitory roles. Notably, H. canis was found as a highly interconnected node, exhibiting significant positive associations with various taxa, including A. platys, and E. canis, suggesting facilitative interactions among these pathogens. Phylogenetic analysis showed genetic diversity in the detected TBPs.
Overall, this research enhances our understanding of TBPs in Cuba, providing insights into their prevalence, associations, and genetic diversity, with implications for disease surveillance and management.
Introduction: In Chile, the employment situation of the nutritionist has been affected by the numerous competition and limited vacancies in traditional work areas. Consequently, the career of ...Nutrition and Dietetics at the University of Chile decided to open a new professional practice in emerging fields of performance from the year 2021. The objective of this study was to evaluate its implementation and assessment, considering the opinion of all those involved.Methodology: Mixed cross-sectional descriptive study with non-probabilistic sampling. To obtain the opinion of the participants, online surveys were designed and carried out with students in the last level and their supervisors, semi-structured interviews with tutors of practice centers and discussion groups with undergraduate professors. Descriptive statistics were used for quantitative results and thematic analysis for qualitative questions.Results: The opinions of 27 students, 8 supervisors, 10 tutors and 13 undergraduate professors were obtained. Regarding the implementation, both the structure and the centers and their modality of practice were adequate. The assessment was high by those involved, highlighting the development and management of generic competencies among students, and their contribution to expanding the labor field, as well as the role of the nutritionist in emerging areas. As an aspect to be improved, the activities to be carried out in each center need to be more detailed.Conclusions: The implementation of this practice was successful, with a high level of assessment. Its inclusion in the curriculum responds adequately to the profile of the graduate and the development objectives of the unit, responding to needs previously detected in the curriculum and in the environment, thus contributing to the labor insertion of the graduates and to the diversification of the current field of the discipline.
Introducción: En Chile, la situación laboral del nutricionista se ha visto afectada por la numerosa compe-tencia y limitados cupos en las áreas laborales tradicionales. En consecuencia, la carrera de Nutrición y Dietética de la Universidad de Chile decide abrir una nueva práctica profesional en áreas de desempeño emergentes a partir del año 2021. El objetivo de este estudio fue evaluar su implementación y valoración, considerando la opinión de todos los involucrados.Metodología: Estudio descriptivo transversal mixto con muestreo no probabilístico. Para recoger la opinión de los/as participantes se diseñaron y realizaron encuestas online a alumnos/as del último nivel y a sus supervisores, entrevistas semiestructuradas a tutores de centros de prácticas y grupos de discusión a pro-fesores de pregrado. Se utilizó estadística descriptiva para los resultados cuantitativos y análisis temático para las cuestiones cualitativas.Resultados: Se obtuvo la opinión de 27 estudiantes, 8 supervisores, 10 tutores y 13 profesores de pregrado. En cuanto a la implementación, tanto la estructura como los centros y su modalidad de práctica fueron adecuados. La valoración fue alta por parte de los implicados, destacando el desarrollo y gestión de compe-tencias genéricas entre los/as alumnos/as, y su contribución a ampliar el campo laboral, así como el papel del nutricionista en áreas emergentes. Como aspecto a mejorar, es necesario detallar más las actividades a realizar en cada centro.Conclusiones: La implementación de esta práctica fue exitosa, con un alto nivel de valoración. Su inclusión en el plan de estudios responde adecuadamente al perfil del egresado y a los objetivos de desarrollo de la unidad, respondiendo a necesidades previamente detectadas en el plan de estudios y en el entorno, contribuyendo así a la inserción laboral de los/as egresados/as y a la diversificación del campo actual de la disciplina.
Introducción: En Chile, la situación laboral del nutricionista se ha visto afectada por la numerosa competencia y limitados cupos en las áreas laborales tradicionales. En consecuencia, la carrera de ...Nutrición y Dietética de la Universidad de Chile decide abrir una nueva práctica profesional en áreas de desempeño emergentes a partir del año 2021. El objetivo de este estudio fue evaluar su implementación y valoración, considerando la opinión de todos los involucrados.
Metodología: Estudio descriptivo transversal mixto con muestreo no probabilístico. Para recoger la opinión de los/as participantes se diseñaron y realizaron encuestas online a alumnos/as del último nivel y a sus supervisores, entrevistas semiestructuradas a tutores de centros de prácticas y grupos de discusión a profesores de grado. Se utilizó estadística descriptiva para los resultados cuantitativos y análisis temático para las cuestiones cualitativas.
Resultados: Se obtuvo la opinión de 27 estudiantes, 8 supervisores, 10 tutores y 13 profesores de pregrado. En cuanto a la implementación, tanto la estructura como los centros y su modalidad de práctica fueron adecuados. La valoración fue alta por parte de los implicados, destacando el desarrollo y gestión de competencias genéricas entre los/as alumnos/as, y su contribución a ampliar el campo laboral, así como el papel del nutricionista en áreas emergentes. Como aspecto a mejorar, es necesario detallar más las actividades a realizar en cada centro.
Conclusiones: La implementación de esta práctica fue exitosa, con un alto nivel de valoración. Su inclusión en el plan de estudios responde adecuadamente al perfil del egresado y a los objetivos de desarrollo de la unidad, respondiendo a necesidades previamente detectadas en el plan de estudios y en el entorno, contribuyendo así a la inserción laboral de los/as egresados/as y a la diversificación del campo actual de la disciplina.
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