Correlación clínica entre tratamiento antibiótico inicial vs. resultado cultivo de aspirado bronquial de neumonía asociada a ventilación mecánica en la UCI del Hospital Nacional Dos de Mayo : periodo octubre 2013-marzo 2014

El documento digital no refiere asesorObjetivo: Este estudio estuvo dirigido para conocer el grado de correlación clínica entre tratamiento antibiótico inicial y el resultado cultivos de aspiración bronquial en pacientes con neumonía asociada a ventilación mecánica en la Unidad de Cuidados Intensivos del Hospital Nacional Dos de Mayo. Periodo 2013-2014. Diseño: Se realizó un estudio clínico prospectivo, longitudinal y diseño transversal en pacientes del Hospital 2 de Mayo en el periodo de Octubre 2013 - Marzo 2014. Materiales y métodos: Se seleccionaron a todos los pacientes que tuvieron Neumonía asociado a ventilación durante el periodo de estudio. Resultados: Se estudiaron 23 pacientes con una edad media de 64,87 +/- 18.319 años, que varía de 20 a 91 años. El diagnóstico de ingreso más frecuente fue shock séptico con 30.4% y la mortalidad por NAV fue de 17.4 %, el 100% inicio tratamiento con ceftazidima +amikacina, la NAV precoz fue evidenciada solo en 11 (47,8%), NAV tardía en 12 (52,2%), El germen más frecuente aislado fue Staphylococo aureus con 47,8%, y acinotebacter baumm con 21,7%, se cambio de terapéutica en 4 pacientes por Carbapenem el 17,4%, y en uno de ellos se cambio por colistina 4,3%, Se presento disfunción multiorgánica en 3 pacientes 13%, y falla multiorgánica en 1 4,3%. Conclusión: Al iniciar una terapéutica antibiótica eficaz fue del 75% en el periodo de estudio en el Hospital 2 de Mayo, la mortalidad fue del 17,4%.Trabajo académic

Partial Root-Zone Drying of Olive (Olea europaea var. "Chetoui") Induces Reduced Yield under Field Conditions

The productivity of olive trees in arid and semi-arid environments is closely linked to irrigation. It is necessary to improve the efficiency of irrigation techniques to optimise the amount of olive fruit produced in relation to the volume of water used. Partial root-zone drying (PRD) is a water saving irrigation technique that theoretically allows the production of a root-to-shoot signal that modifies the physiology of the above-ground parts of the plant; specifically reducing stomatal conductance (gs) and improving water use efficiency (WUE). Partial root-zone drying has been successfully applied under field conditions to woody and non-woody crops; yet the few previous trials with olive trees have produced contrasting results. Thirty year-old olive trees (Olea europaea ‘var. Chetoui’) in a Tunisian grove were exposed to four treatments from May to October for three-years: ‘control’ plants received 100% of the potential evapotranspirative demand (ETc) applied to the whole root-zone; ‘PRD100’ were supplied with an identical volume of water to the control plants alternated between halves of the root-zone every ten-days; ‘PRD50’ were given 50% of ETc to half of the root-system, and; ‘rain-fed’ plants received no supplementary irrigation. Allowing part of the root-zone to dry resulted in reduced vegetative growth and lower yield: PRD100 decreased yield by ~47% during productive years. During the less productive years of the alternate bearing cycle, irrigation had no effect on yield; this suggests that withholding of water during ‘off-years’ may enhance the effectiveness of irrigation over a two-year cycle. The amount and quality of oil within the olive fruit was unaffected by the irrigation treatment. Photosynthesis declined in the PRD50 and rain-fed trees due to greater diffusive limitations and reduced biochemical uptake of CO2. Stomatal conductance and the foliar concentration of abscisic acid (ABA) were not altered by PRD100 irrigation, which may indicate the absence of a hormonal root-to-shoot signal. Rain-fed and PRD50 treatments induced increased stem water potential and increased foliar concentrations of ABA, proline and soluble sugars. The stomata of the olive trees were relatively insensitive to super-ambient increases in [CO2] and higher [ABA]. These characteristics of ‘hydro-passive’ stomatal behaviour indicate that the ‘Chetoui’ variety of olive tree used in this study lacks the physiological responses required for the successful exploitation of PRD techniques to increase yield and water productivity. Alternative irrigation techniques such as partial deficit irrigation may be more suitable for ‘Chetoui’ olive production.This work was supported by the Ministero dell’Istruzione, dell’Università e della Ricerca of Italy: PRIN 2010–2011 “PRO-ROOT” and Progetto Premiale 2012 “Aqua”. MH acknowledges funding from a Marie Curie IEF (2010–275626). We are grateful to Dr Mohamed Ghrab (Olive Tree Institute) for technical assistance and scientific discussion. The comments of Georgios Koubouris (Hellenic Agricultural Organization) and two anonymous reviewers significantly improved this manuscript

User-centered design to develop clinical applications. Literature review

User-centered design is mentioned by Norman as 'the need for a design that uses the natural properties of the individuals, exploiting the relationships and constraints and focusing on the needs and interests of the user, in order to make the final products usable and understandable'. This is also important in health developments. The objective of this paper is to search and analyze articles in the healthcare field where user-centered design principles have been applied. We describe findings in this topic from articles published between January 1995 and September 2014.Fil: Luna, Daniel Roberto. Hospital Italiano. Departamento de Informática En Salud.; Argentina. Instituto Tecnológico de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Quispe, María. Hospital Italiano. Departamento de Informática En Salud.; ArgentinaFil: Gonzalez, Zulma. Hospital Italiano. Departamento de Informática En Salud.; ArgentinaFil: Alemrares, Alfredo. Hospital Italiano. Departamento de Informática En Salud.; ArgentinaFil: Risk, Marcelo. Hospital Italiano. Departamento de Informática En Salud.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Garcia Aurelio, Mauro. Hospital Italiano. Departamento de Informática En Salud.; ArgentinaFil: Otero, Carlos Martin. Hospital Italiano. Departamento de Informática En Salud.; Argentin

Candidate HIV-1 Tat vaccine development: From basic science to clinical trials

No abstract available

Esophageal chemical clearance and baseline impedance values in patients with chronic autoimmune atrophic gastritis and gastro-esophageal reflux disease

Background: The factors influencing new markers of gastro-esophageal reflux disease detected by impedance-pH monitoring - mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave (PSPW) index - need to be evaluated. Aim: To compare endoscopy-negative heartburn with chronic autoimmune atrophic gastritis (CAAG). Materials and methods: 24 patients with CAAG, 25 with non-erosive reflux disease (NERD) and 25 with functional heartburn (FH) were included. In all patients the main impedance-pH monitoring parameters were calculated. Results: CAAG and NERD patients had a number of reflux events (non-acid ones being more common among the former group) which was higher than that found in FH (p 3000 Ohm), CAAG (> 2000 Ohm) and NERD (<1000 Ohm) patients (p = 0.0046). The PSPW index was similar between CAAG and NERD patients but significantly lower in comparison to FH (p <0.0001). Conclusion: Patients with CAAG have evidence of non-acid reflux based on the high number of reflux events and confirmed by low values of MNBI and PSPW index. MNBI is a strong marker of acid/non-acid reflux-induced mucosal damage, whereas the PSPW index can reliably discriminate patients with reflux from those with FH, independently of the acidity of refluxate. (C) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Real-world evidence of health outcomes and medication use 24 months after bariatric surgery in the public healthcare system in Brazil: a retrospective, single-center study

OBJECTIVES: The number of bariatric procedures has significantly increased in Brazil, especially in the public Unified Health System. The present study describes health outcomes and medication use in obese patients treated in a major hospital that performs publicly funded surgery in Brazil. METHODS: A retrospective, single center study was conducted to collect real-world evidence of health outcomes and medication use in 247 obese patients (female, 82.2%) who underwent open Roux-en-Y gastric bypass. Changes in weight and body mass index (BMI), presence of apnea, hypertension, and type 2 diabetes (T2D), and medication use (hypertension, diabetes, and dyslipidemia) were assessed preoperatively and up to 24 months postoperatively. The mean cost of medications was calculated for the 12-month preoperative and 24-month postoperative periods. RESULTS: During the surgery, the mean age of patients was 43.42 years (standard deviation [SD], 10.9 years), and mean BMI was 46.7 kg/m2 (SD, 6.7 kg/m2 ). At 24 months, significant declines were noted in weight (mean, -37.6 kg), BMI (mean, -14.3 kg/m2 ); presence of T2D, hypertension, and apnea (-29.6%, -50.6%, and -20.9%, respectively); and number of patients using medications (-66.67% for diabetes, -41.86% for hypertension, and -55.26% for dyslipidemia). The mean cost of medications (total costs for all medications) decreased by 450% in 12–24 postoperative months compared to that in 12 preoperative months. CONCLUSION: Roux-en-Y gastric bypass successfully reduced weight, BMI, and comorbidities and medication use and cost at 24 months in Brazilian patients treated in the public Unified Health System

HIV-1 tat addresses dendritic cells to induce a predominant th1-type adaptive immune response that appears prevalent in the asymptomatic stage of infection

Tat is an early regulatory protein that plays a major role in human HIV-1 replication and AIDS pathogenesis, and therefore, it represents a key target for the host immune response. In natural infection, however, Abs against Tat are produced only by a small fraction (∼20%) of asymptomatic individuals and are rarely seen in progressors, suggesting that Tat may possess properties diverting the adaptive immunity from generating humoral responses. Here we show that a Th1-type T cell response against Tat is predominant over a Th2-type B cell response in natural HIV-1 infection. This is likely due to the capability of Tat to selectively target and very efficiently enter CD1a-expressing monocyte-derived dendritic cells (MDDC), which represent a primary target for the recognition and response to virus Ag. Upon cellular uptake, Tat induces MDDC maturation and Th1-associated cytokines and β-chemokines production and polarizes the immune response in vitro to the Th1 pattern through the transcriptional activation of TNF-αgene expression. This requires the full conservation of Tat transactivation activity since neither MDDC maturation nor TNF-α production are found with either an oxidized Tat, which does not enter MDDC, or with a Tat protein mutated in the cysteine-rich region (cys22 Tat), which enters MDDC as the wild-type Tat but is transactivation silent. Consistently with these data, inoculation of monkeys with the native wild-type Tat induced a predominant Th1 response, whereas cys22 Tat generated mostly Th2 responses, therefore providing evidence that Tat induces a predominant Th1 polarized adaptive immune response in the host. Copyright © 2009 by The American Association of Immunologists, Inc

Dye-sensitized solar cells and solar module using polymer electrolytes: Stability and performance investigations

We present recent results on solid-state dye-sensitized solar cell research using a polymer electrolyte based on a poly(ethylene oxide) derivative. The stability and performance of the devices have been improved by a modification in the method of assembly of the cells and by the addition of plasticizers in the electrolyte. After 30 days of solar irradiation (100 mW cm-2) no changes in the cell's efficiency were observed using this new method. The effect of the active area size on cell performance and the first results obtained for the first solar module composed of 4.5 cm2 solid-state solar cells are also presented

In vitro effects of different levels of quebracho and chestnut tannins on rumen methane production, fermentation parameters, and microbiota

Both condensed and hydrolysable tannins (CTs and HTs, respectively) have the ability to reduce enteric CH4 production in ruminants. However, the precise mechanism of action is not fully understood. Among the proposed hypotheses are the reduction of ruminal digestibility, direct control action on protozoa, reduction of archaea, and a hydrogen sink mechanism. In this in vitro study, which simulated rumen fermentation, two additives, one containing CTs (70% based on DM) from quebracho and one with HTs (75% based on DM) from chestnut, at four levels of inclusion (2, 4, 6, 8% on an as-fed basis) were added to the fermentation substrate and tested against a negative control. Both types of tannins significantly reduced total gas (GP) and CH4 (ml/g DM) production during the 48 h of incubation. The lower GP and CH4 production levels were linked to the reduction in dry matter digestibility caused by CTs and HTs. Conversely, no significant differences were observed for the protozoan and archaeal populations, suggesting a low direct effect of tannins on these rumen microorganisms in vitro. However, both types of tannins had negative correlations for the families Bacteroidales_BS11 and F082 and positive correlations for the genera Prevotella and Succinivibrio. Regarding the fermentation parameters, no differences were observed for pH and total volatile fatty acid production, while both CTs and HTs linearly reduced the NH3 content. CTs from quebracho were more effective in reducing CH4 production than HTs from chestnut. However, for both types of tannins, the reduction in CH4 production was always associated with a lower digestibility without any changes in archaea or protozoa. Due to the high variability of tannins, further studies investigating the chemical structure of the compounds and their mechanisms of action are needed to understand the different results reported in the literature