Treatment of the helicobacter pylori Infection : a critical appraisal of the literature

Introducción: la infección por Helicobacter pylori es un problema de salud pública, dada su relación con cáncer gástrico. El incremento de la resistencia bacteriana limita la erradicación efectiva, a pesar del empleo de diferentes esquemas de tratamiento. Métodos: revisión de la literatura en la base de datos Pubmed/Medline entre el 1 de enero de 2015 y el 31 de diciembre de 2016 sobre el manejo del Helicobacter pylori . Resultados: se incluyeron 26 artículos. La terapia secuencial sobresale como opción de tratamiento de primera línea para escenarios como Colombia. La implementación de coadyuvantes puede influir en las tasas de erradicación. Los estudios de epidemiología local y costo- efectividad son escasos. Conclusiones: el uso y conocimiento adecuado de los esquemas de manejo puede disminuir los costos para el sistema, la resistencia antimicrobiana y favorecer la erradicación de patógenos. Se requieren estudios para generar recomendaciones localesIntroduction: Helicobacter pylori (H. pylori) infection is a public health problem due to its relationship with gastric cancer. The escalation of antibiotic resistance hampers an effective eradication, despite the availability of treatment options. Methods: A review of the literature was performed in the database PubMed between 01/01/2015 and 31/31/2016. Results: Twenty six articles were included. Sequential therapy stands out as a first line therapy for scenarios such as Colombia. The implementation of adjuvants may have a positive impact on eradication rates. Local epidemiology and cost-effectiveness studies are scarce. The results were analized by erradication therapies, coadyuvant treatment, guidelines and outcomes non mentioned in the guidelines. Conclusions: The correct use and knowledge of the different treatment options could reduce the costs for the health systems, the antibiotics resistance and could favor pathogen eradication. Further studies are required for establishing local recommendations.https://orcid.org/0000-0002-6186-7842Revista Nacional - No indexad

Manejo de la infección por Helicobacter pylori: apreciación crítica de la literatura

Introduction: Helicobacter pylori (H. pylori) infection is a public health problem due to its relationship with gastric cancer. The escalation of antibiotic resistance hampers an effective eradication, despite the availability of treatment options. Methods: A review of the literature was performed in the database PubMed between 01/01/2015 and 31/31/2016. Results: Twenty six articles were included. Sequential therapy stands outas a first line therapy for scenarios such as Colombia. The implementation of adjuvants may have a positive impact on eradication rates. Local epidemiology and cost-effectiveness studies are scarce. The results were analized by erradication therapies, coadyuvant treatment, guidelines and outcomes non mentioned in the guidelines. Conclusions: The correct use and knowledge of the different treatment options could reduce the costs for the health systems, the antibiotics resistance and could favor pathogen eradication. Further studies are required for establishing local recommendations.Introducción: la infección por Helicobacter pylori es un problema de salud pública, dada su relación con cáncer gástrico. El incremento de la resistencia bacteriana limita la erradicación efectiva, a pesar del empleo de diferentes esquemas de tratamiento. Métodos: revisión de la literatura en la base de datos Pubmed/Medline entre el 1 de enero de 2015 y el 31 de diciembre de 2016 sobre el manejo del Helicobacter pylori. Resultados: se incluyeron 26 artículos. La terapia secuencial sobresale como opción de tratamiento de primera línea para escenarios como Colombia. La implementación de coadyuvantes puede influir en las tasas de erradicación. Los estudios de epidemiología local y costoefectividad son escasos. Conclusiones: el uso y conocimiento adecuado de los esquemas de manejo puede disminuir los costos para el sistema, la resistencia antimicrobiana y favorecer la erradicación de patógenos. Se requieren estudios para generar recomendaciones locales

Extrapulmonary Tuberculosis: A Current Clinical Challenge

Los dos tipos de manifestación clínica de la tuberculosis (TB) son la pulmonar y la extrapulmonar, de las cuales la primera es la más frecuente. No obstante, si bien se ha logrado disminuir la prevalencia de la TB en general, las cifras de TB extrapulmonar se mantienen estables; se notificaron aproximadamente 1’050.000 casos nuevos en el mundo en 2018. Por lo general, se presenta por diseminación hematógena o linfática del bacilo del complejo Mycobacterium tuberculosis a otros órganos. Los sitios afectados más frecuentes son pleural, ganglionar, tubo digestivo y osteoarticular. Otros menos habituales son el sistema nervioso central, las vías genitourinarias, las vías aéreas superiores, el pericardio y la piel. Las manifestaciones clínicas de la TB extrapulmonar son variables por su naturaleza paucibacilar y constituye un verdadero reto para los clínicos. La aproximación diagnóstica depende del sitio de afectación, la facilidad de toma de la muestra, la sensibilidad de las pruebas y la distribución de la micobacteria en el tejido. La enfermedad usualmente responde al tratamiento estándar para TB y el tiempo ideal del régimen varía según el sitio afectado. El propósito de esta revisión es describir la presentación clínica y el proceso diagnóstico de la TB extrapulmonar.The two types of clinical presentation of tuberculosis (TB) are pulmonary, which is the most frequent, and extrapulmonary. Although TB prevalence has been coming down, extrapulmonary TB numbers remain stable; with approximately 1’050.000 new cases reported in the world in 2018. It usually presents by hematogenous or lymphatic dissemination of the Mycobacterium tuberculosis complex to other organs. The more often affected organs are pleura, lymph nodes, gastrointestinal tract, bone and joints. Rarely it can affect the central nervous system, urinary tract, upper respiratory airway, pericardium and skin. Clinical manifestations of extrapulmonary TB are heterogeneous due to its paucibacillary nature representing a clinical challenge for clinicians. Diagnostic work up depends on the affected organ, the quality and accessibility of the sample, the sensitivity of the test and the distribution of the mycobacteria in the tissue. EPTB usually respond to standard TB treatment and optimal time duration depends on the organ involved. The purpose of this review is to describe the clinical presentation and diagnosis workup of extrapulmonary TB.https://orcid.org/0000-0002-7756-1805https://orcid.org/0000-0002-4033-9987https://orcid.org/0000-0001-5363-5729https://orcid.org/0000-0002-3061-5212https://orcid.org/0000-0002-2071-3142Revista Nacional - IndexadaS

Biblioteca para pacientes del Hospital Universitario San Ignacio: ejemplo de liderazgo estudiantil

Fortalecer las habilidades de liderazgo desde el pregrado genera profesionalesmás integrales y propositivos. Participar en investigación desarrolla unamentalidad más independiente y fortalece la confianza en sí mismos [1,2].Este empoderamiento promueve la inquietud intelectual y el pensamiento divergente, lo que genera habilidades de liderazgo [3], comunicación y colaboración [4]. Desde este precepto, el Grupo Científico Estudiantil MAJIIS [5] lideró el proyecto Libros de cabecera, con el apoyo de la Carrera de Ciencias de Información-Bibliotecología, la Biblioteca General y el Hospital Universitario San Ignacio (HUSI). El objetivo es implementaruna biblioteca para pacientes con fines sociales e investigativos.Las actividades estructuradas de lectura han disminuido la ansiedad y ladepresión en pacientes hospitalizados [6-8], posiblemente asociado con el mejoramiento de la estancia hospitalaria y la humanización de los servicios. Sin embargo, sus efectos no han sido estudiados con profundidad. En Colombia, existen pocas instituciones que presten este servicio [9].Libros de cabecera demuestra el potencial de las actividades lideradaspor estudiantes. Inicialmente, funcionará para pacientes hospitalizados,pero se planea alcanzar otros servicios del HUSI (por ejemplo, oncología onefrología). Se busca favorecer la recuperación de los pacientes, mejorar la percepción de estancia hospitalaria, optimizar los hábitos de lectura y apoyarla política de humanización de nuestro Hospital. Se espera aportar a la evidencia de la efectividad de la biblioterapia en el manejo integral de los enfermos y sus familias

Biblioteca para pacientes del Hospital Universitario San Ignacio: ejemplo de liderazgo estudiantil

Fortalecer las habilidades de liderazgo desde el pregrado genera profesionalesmás integrales y propositivos. Participar en investigación desarrolla unamentalidad más independiente y fortalece la confianza en sí mismos [1,2].Este empoderamiento promueve la inquietud intelectual y el pensamiento divergente, lo que genera habilidades de liderazgo [3], comunicación y colaboración [4]. Desde este precepto, el Grupo Científico Estudiantil MAJIIS [5] lideró el proyecto Libros de cabecera, con el apoyo de la Carrera de Ciencias de Información-Bibliotecología, la Biblioteca General y el Hospital Universitario San Ignacio (HUSI). El objetivo es implementaruna biblioteca para pacientes con fines sociales e investigativos.Las actividades estructuradas de lectura han disminuido la ansiedad y ladepresión en pacientes hospitalizados [6-8], posiblemente asociado con el mejoramiento de la estancia hospitalaria y la humanización de los servicios. Sin embargo, sus efectos no han sido estudiados con profundidad. En Colombia, existen pocas instituciones que presten este servicio [9].Libros de cabecera demuestra el potencial de las actividades lideradaspor estudiantes. Inicialmente, funcionará para pacientes hospitalizados,pero se planea alcanzar otros servicios del HUSI (por ejemplo, oncología onefrología). Se busca favorecer la recuperación de los pacientes, mejorar la percepción de estancia hospitalaria, optimizar los hábitos de lectura y apoyarla política de humanización de nuestro Hospital. Se espera aportar a la evidencia de la efectividad de la biblioterapia en el manejo integral de los enfermos y sus familias

Frontotemporal dementia presentation in patients with heterozygous p.H157Y variant of TREM2

Q2Q1Pacientes con Demencia frontotemporalBackground: The triggering receptor expressed on myeloid cell 2 (TREM2) is a major regulator of neuroinflammatory processes in neurodegeneration. To date, the p.H157Y variant of TREM2 has been reported only in patients with Alzheimer’s disease. Here, we report three patients with frontotemporal dementia (FTD) from three unrelated families with heterozygous p.H157Y variant of TREM2: two patients from Colombian families (study 1) and a third Mexican origin case from the USA (study 2). Methods: To determine if the p.H157Y variant might be associated with a specific FTD presentation, we compared in each study the cases with age-matched, sex-matched and education-matched groups—a healthy control group (HC) and a group with FTD with neither TREM2 mutations nor family antecedents (Ng-FTD and Ng-FTD-MND). Results: The two Colombian cases presented with early behavioural changes, greater impairments in general cognition and executive function compared with both HC and Ng-FTD groups. These patients also exhibited brain atrophy in areas characteristic of FTD. Furthermore, TREM2 cases showed increased atrophy compared with Ng-FTD in frontal, temporal, parietal, precuneus, basal ganglia, parahippocampal/hippocampal and cerebellar regions. The Mexican case presented with FTD and motor neuron disease (MND), showing grey matter reduction in basal ganglia and thalamus, and extensive TDP-43 type B pathology. Conclusion: In all TREM2 cases, multiple atrophy peaks overlapped with the maximum peaks of TREM2 gene expression in crucial brain regions including frontal, temporal, thalamic and basal ganglia areas. These results provide the first report of an FTD presentation potentially associated with the p.H157Y variant with exacerbated neurocognitive impairments.https://orcid.org/0000-0001-9422-3579https://orcid.org/0000-0002-2071-3142https://orcid.org/0000-0003-4214-0266https://orcid.org/0000-0002-0141-1149https://orcid.org/0000-0002-0729-6866https://orcid.org/0000-0001-6336-5347https://orcid.org/0000-0001-6705-7157https://orcid.org/0000-0001-6529-7077Revista Internacional - IndexadaA1S

The SuperCam Instrument Suite on the NASA Mars 2020 Rover: Body Unit and Combined System Tests

TheSuperCaminstrumentsuiteprovidestheMars2020rover,Perseverance,with a number of versatile remote-sensing techniques that can be used at long distance as well as within the robotic-arm workspace. These include laser-induced breakdown spectroscopy (LIBS), remote time-resolved Raman and luminescence spectroscopies, and visible and in- frared (VISIR; separately referred to as VIS and IR) reflectance spectroscopy. A remote micro-imager (RMI) provides high-resolution color context imaging, and a microphone can be used as a stand-alone tool for environmental studies or to determine physical properties of rocks and soils from shock waves of laser-produced plasmas. SuperCam is built in three parts: The mast unit (MU), consisting of the laser, telescope, RMI, IR spectrometer, and associated electronics, is described in a companion paper. The on-board calibration targets are described in another companion paper. Here we describe SuperCam’s body unit (BU) and testing of the integrated instrument.The BU, mounted inside the rover body, receives light from the MU via a 5.8 m opti- cal fiber. The light is split into three wavelength bands by a demultiplexer, and is routed via fiber bundles to three optical spectrometers, two of which (UV and violet; 245–340 and 385–465 nm) are crossed Czerny-Turner reflection spectrometers, nearly identical to their counterparts on ChemCam. The third is a high-efficiency transmission spectrometer contain- ing an optical intensifier capable of gating exposures to 100 ns or longer, with variable delay times relative to the laser pulse. This spectrometer covers 535–853 nm (105–7070 cm−1 Ra- man shift relative to the 532 nm green laser beam) with 12 cm−1 full-width at half-maximum peak resolution in the Raman fingerprint region. The BU electronics boards interface with the rover and control the instrument, returning data to the rover. Thermal systems maintain a warm temperature during cruise to Mars to avoid contamination on the optics, and cool the detectors during operations on Mars.Results obtained with the integrated instrument demonstrate its capabilities for LIBS, for which a library of 332 standards was developed. Examples of Raman and VISIR spec- troscopy are shown, demonstrating clear mineral identification with both techniques. Lumi- nescence spectra demonstrate the utility of having both spectral and temporal dimensions. Finally, RMI and microphone tests on the rover demonstrate the capabilities of these sub- systems as well

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.info:eu-repo/semantics/publishedVersio