INTRODUCCIÓN: la enfermedad ósea metabólica del prematuro resulta de la desmineralización ósea. Existen factores que deben vigilarse con la finalidad de realizar diagnóstico y tratamiento temprano. ...OBJETIVO: determinar los factores de riesgo asociados a osteopenia en prematuros. MATERIALES Y MÉTODOS: estudio transversal comparativo de octubre del 2011 a octubre del 2013. Se incluyeron 120 prematuros < 37 semanas gestacionales, ≤ 1,500 gramos al nacer y ≥ 21 días. Diagnóstico de la enfermedad: hipofosfatemia (< 3.5 mg/dL), normocalcemia (8.5- 10 mg/dL), hipocalcemia (< 8.5 mg/dL) elevación de fosfatasa alcalina (> 900 UI/L). Factores de riesgo determinados con razón de momios (OR). Estadística inferencial con c2 y t de Student. RESULTADOS: se diagnosticó enfermedad ósea metabólica en 58 prematuros (48%), peso 1067 ± 216 gramos, edad gestacional 28 ± 1.6 semanas, edad postnatal 41 ± 15.5 días. Género masculino 32 (55%). Factores de riesgo: peso < 1,000 gramos OR 4.64, (2.13-10.10), displasia broncopulmonar moderada o severa OR 3.13 (1.44-6.81), tres o más eventos de sepsis OR 3.43 (1.62 7.28), sedación prolongada OR 4.09 (1.06-15.73) y corticoide prolongado OR 9.54 (2.06-44.16). CONCLUSIONES: nuestros resultados muestran que los factores de riesgo para enfermedad ósea metabólica del prematuro fueron peso al nacer menor de 1,000 gramos, displasia broncopulmonar moderada o severa, tres o más eventos de sepsis, sedación y corticoides durante tiempo prolongado.
To analyze the association between ammonia and glutamine used for metabolic control in inherited urea cycle disorders (UCD) in a large series of patients.
Paired plasma amino acid-ammonia data from ...26 UCD patients were analyzed (
n
=
921).
Increased plasma glutamine values were consistently observed in UCD patients, despite normal plasma ammonia concentrations, especially for mitochondrial UCD.
Further therapeutic efforts are probably needed to control increased glutamine values, considering their potentially neurotoxic effect.
Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, ...prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures.
Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator.
A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101–500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500–1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity.
This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.
•The best benchmark cut-offs in Emergency General Surgery are unknown.•The present study established benchmark cut-off values in a low-risk cohort.•Benchmark cut-off was ≥40.9% for use of laparoscopy, and ≤3 days for hospital stays.•Benchmark cut-off was ≤17.7% for 30-day morbidity, and ≤1.1% for 30-day mortality.•These cut-offs values may guide quality improvement in Emergency General Surgery.
Three stresses, viz heat, oxidative and pH shocks, were applied to cultures of three species of
Acanthamoeba, free-living
Acanthamoeba rhysodes and pathogenic
Acanthamoeba castellanii and
...Acanthamoeba culbertsoni. The effect of each stressor on trophozoite integrity was evaluated by the amount of heat shock protein (HSP)60 and HSP70 produced and by exclusion of 0.2% Congo Red. HSP60 and HSP70 levels were estimated using Western blotting and subsequent densitometric analyses. Unstimulated trophozoites from
A. rhysodes produced the lowest background levels of HSP60 and HSP70 and were the amoebae most affected by (mammalian-type) stresses as judged by their enhanced HSP production and decreased viability upon exposure to such conditions. In contrast, unstimulated
Acanthamoeba of the pathogenic variety had relatively high background levels of test HSPs and seemed undisturbed by the types of stresses they must deal with when entering their hosts. These studies suggest that high HSP levels in amphizoic acanthamoebae may indicate their involvement in (i) tolerance induction to hosts’ stressors and/or (ii) in species’ virulence.
The aim of this study was to evaluate the effect of different supplemental levels (0, 1.5, 3 and 4.5%) of zeolite in partial substitution of dry rolled corn and soybean meal in a finishing diet ...formulated on dry-rolled corn basis (16.51% CP and 1.39 Mcal/kg NEg) on carcass characteristics, tissue composition and visceral organ mass in hairy lambs. Total quantity of zeolite included replaces corn and soybean meal in equal parts, so that, for each level of which corn and soybean meal were substituted, CP concentration decreased 0.11 percentage points and net energy decreased 0.03 Mcal NEg/kg. Feeding phase was performed with 40 lambs ¾ Kathadin × ¼ Pelibuey (initial weight = 32.28 ± 2.34 kg) which were assigned to 20 pens (2 lambs/pen, 5 pens/treatment) and were feeding for 75 days with one of the four treatments. Zeolite inclusion did not affect carcass characteristics, but tended to linearly increase (p=0.10) LM area. Zeolite inclusion linearly increased (p≤0.04) the quantity and the proportion of muscle, and decreased (p=0.02) the quantity and the proportion of fat in shoulder, thus increasing (linear component, p=0.02) the muscle:fat ratio. In proportion to the half carcass, the weight of forequarter tended (p=0.08) to increase, while the weight of hindquarter tended (p=0.08) to decrease with zeolite inclusion. Zeolite inclusion tended (linear component, p=0.08) to increase the weight (as g/kg of EBW) of intestines. As result of a linearly decreases of mesenteric (p
El objetivo de este estudio fue evaluar el efecto de la adición de diferentes niveles (0, 1,5, 3 y 4,5%) de zeolita en sustitución parcial de maíz quebrado y de pasta de soja de una dieta de finalización formulada en base de maíz quebrado (16,51% proteína bruta y 1,39 Mcal/kg ENg) sobre las características de la canal, composición tisular y masa visceral de ovinos de pelo. La cantidad total de zeolita incluida en cada tratamiento sustituyó al maíz y a la pasta de soja en partes iguales por lo que con cada nivel de sustitución del maíz y de pasta de soja se disminuyó la concentración de proteína bruta (PB) en 0,11 puntos porcentuales y la energía neta en 0,03 Mcal/kg. La fase de alimentación se llevó a cabo con 40 ovinos machos ¾ Kathadin × ¼ Pelibuey (peso inicial = 32,28±2,34 kg) asignados a 20 corraletas (2 ovinos/corraleta, 5 corrales/tratamiento) alimentándose durante 75 días con alguno de los 4 tratamientos hasta su sacrificio. La inclusión de zeolita no afectó las características de la canal aunque tendió a aumentar linealmente (p=0,10) el área del ojo de la costilla. La zeolita aumentó linealmente (p≤0,04) la cantidad y proporción de músculo y disminuyó (p=0,02) la cantidad y proporción de grasa en la paleta aumentando (componente lineal, p=0,02) la proporción músculo:grasa. En proporción relativa a la media canal, el peso del cuarto delantero tendió (p=0,08) a incrementarse, mientras que el peso del cuarto trasero tendió (p=0,08) a disminuir con la inclusión de zeolita. La inclusión de zeolita tendió (componente lineal, p=0,08) a incrementar el peso (g/kg del peso corporal vacío) de los intestinos. Como resultado de una disminución lineal de la grasa mesentérica (p
A rotating biological contactor (RBC) system operating in a full-scale wastewater treatment plant has been described by several approaches accounting for performance, composition and structure of ...biofilms in three stages through biological wastewater treatment (RBC1, RBC 2, RBC 3). RBC biofilms were effective in removing the BOD loading from 13 g BOD5 d(-1) m(-2) in RBC 1 to 6 g BOD5 d(-1) m(-2) in RBC 3. Analysis of biofilm composition showed: i) the volatile solids were similar in the three RBCs (0.6 g m(-2) VS per g m(-2) of TS); ii) the protozoan and metazoan biocenosis was mainly made up of ciliated protozoa, which were most abundant in RBC 2 (1.84 x 10(6) ciliates g(-1) VS). Relationship between ciliate species and physical-chemical profile of the system by cluster analysis indicated that the species Acineria uncinata, Amphileptus punctatus, Cinetochilum margaritaceum and Holosticha mancoidea were associated with the best RBC performance; iii) the exopolymeric matrix of the three RBC biofilms was mainly constituted by proteins, although humic substances, polysaccharides, uronic acids and DNA were also found. Analysis of biofilm structure by confocal microscopy indicated changes in biofilm organisation with depth. Results have been brought together and a graphic representation of the composition and architecture of RBC biofilms is presented.
A high level of cerebrospinal fluid (CSF) neopterin is a marker of central nervous system inflammatory-immune mediated processes. We aimed to assess data from 606 neuropediatric patients, describing ...the clinical and biochemical features of those neurological disorders presenting CSF neopterin values above a new cut-off value that was defined in our laboratory.
To establish the new CSF neopterin cut-off value, we studied two groups of patients: Group 1 comprised 68 patients with meningoencephalitis, and Group 2 comprised 52 children with a confirmed peripheral infection and no central nervous system involvement. We studied 606 CSF samples from neuropediatric patients who were classified into 3 groups: genetic diagnosis (A), acquired/unknown etiologic neurologic diseases (B) and inflammatory-immune mediated processes (C).
The CSF neopterin cut-off value was 61 nmol/L. Out of 606 cases, 56 presented a CSF neopterin level above this value. Group C had significantly higher CSF neopterin, protein and leukocyte values than the other groups. Sixteen of twenty-three patients in this group had a CSF neopterin level above the cut-off, whereas three and seven patients presented increased leukocyte and protein values, respectively. A significant association was found among CSF neopterin, proteins and leukocytes in the 606 patients. White matter disturbances were associated with high CSF neopterin concentrations.
Although children with inflammatory-immune mediated processes presented higher CSF neopterin values, patients with other neurological disorders also showed increased CSF neopterin concentrations. These results stress the importance of CSF neopterin analysis for the identification of inflammatory-immune mediated processes.
Performance of a full-scale wastewater treatment plant by rotating biological contactors (RBC) system was monitored during a year by physico-chemical and microbial characterisation. Six points along ...wastewater treatment were selected in the plant: three points along the water line (influent, sedimentation tank and effluent) and three points along RBC system (RBC1, RBC2 and RBC3). Although a large seasonal change in the values of physico-chemical parameters was observed, operation of the plant was optimal during all year (90% of removal in BOD
5 and SS influent content). Microbial characterisation was approached by determining the structure and dynamics of protozoan and metazoan communities. Protozoa were the most abundant in all stages in the plant, heterotrophic flagellates being the most representative group in the water line and ciliates in the RBC system. The same seasonal preference was only observed for heterotrophic flagellates in the water line and green flagellates in the RBC system, both groups having highest abundances in summer and spring, respectively.
Identification of ciliated protozoa populations rendered 58 species of ciliates in the plant. Most of these species are typical of aerobic wastewater treatment systems except three of them, which are cited for the first time in this type of ecosystems:
Chaenea stricta,
Holosticha mancoidea and
Oxytricha lanceolata. Along the water line 34 species were identified, and half of them only appeared occasionally (once in all the study), while along the RBC system biofilms 55 species were observed, and the majority appeared permanently in this system.
Our results indicate that the type of habitat, rather than the physico-chemical water parameters, was the primary factor in determining the different distribution of protozoan and metazoan communities in the plant. In RBC biofilms, the structure of ciliate protozoa community was found to be quite sensitive to changes in physico-chemical parameters, mainly to organic loading (BOD
5) variations.
Although pediatric inflammatory bowel disease (IBD) diagnosis has increased in the last decades in Spain, there are no consistent epidemiologic data. Our aim was to describe the changing pattern of ...pediatric IBD incidence in Spain in the last 14 years.
A retrospective survey of patients diagnosed below 18 years of age in the period 1996-2009 was performed. Patients' data were obtained from the hospitals' databases. To avoid reduced accrual of cases diagnosed by adult physicians, adult IBD units in referral centers were invited to participate. Seventy-eight centers participated in our survey. Rates of incidence were calculated using age-stratified population-based epidemiologic data. Incidence rates were compared for the last 14 years (1996-2009).
In total, data from 2107 patients were obtained: 1,165 Crohn's disease (CD, 55.3%), 788 ulcerative colitis (UC, 37.4%), and 154 IBD unclassified. The sex distribution was 56.4% male, with higher predominance for CD (59.3%) as compared to UC (52.8%) and IBD unclassified (53.2%) (P = 0.012). The median age at diagnosis was 12.3 years (p25-75 9.7-14.6) with significant differences between diseases. IBD incidence increased from 0.97 to 2.8/100,000 inhabitants <18 years/year in the study period. Although this increase is more evident for CD (from 0.53 to 1.7), UC has also risen considerably (0.39 to 0.88).
This is the first attempt to calculate the current incidence of pediatric IBD in Spain. A significant increase of incidence rates in the study period was observed. In the last 14 years pediatric IBD incidence has almost tripled, with a more important CD increase.
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