El G4 : Propuesta de Reforma del Consejo de Seguridad

En este trabajo de investigación se desarrolló la propuesta del llamado Grupo de los Cuatro (G4) para reformar el órgano de las Naciones Unidas, el considerado más importante que es el Consejo de Seguridad. La importancia de realizar esta tesis recalca entonces en la necesidad en pleno siglo XXI de encontrar una forma para poder reformar el CS y adaptarlo a las necesidades actuales que requieren los Estados para mantener la paz y la seguridad internacional. La propuesta del G4 es la más aceptada por los países miembros de las Naciones Unidas pero tiene sus ventajas y desventajas con los 5 miembros permanentes actuales, situación que deben negociar para poder llegar a un acuerdo y que no utilicen el derecho a veto con el que cuentan. Cuenta con cuatro capítulos y en ellos se trabajó sobre las variables de la cuestión de la representatividad geográfica, la inclusión de nuevos miembros al CS y la posición de los actuales 5 del órgano sobre la reforma en general y sobre la cuestión del G4 en particular que se trata en esta tesis.Fil: Romano Buryaile, Carolina. Universidad Católica de Salta. Facultad de Economía y Administración; Argentina.Fil: Batule, Eduardo Abraham. Universidad Católica de Salta. Facultad de Ciencias Jurídicas; Argentina

Development of HRPzyme-Integrated PCR Platform for Colorimetric Detection of Foodborne Pathogens

In recent years, foodborne illnesses have become the most significant public health issue in both developed and developing countries. The World Health Organization (WHO) reported that in 2010, around 1.8 million people died due to foodborne illness. Therefore, the development of a cost-effective, sensitive, and selective detection method for identifying and monitoring foodborne pathogens is necessary for improved public health. Here, we describe a simple and ultrasensitive colorimetric method for the detection of foodborne pathogens based on HRPzyme-integrated PCR using PC-based ImageJ software. We present insights into different aspects of this method such as the importance of 16S rRNA detection, the modification of traditional PCR primers with a unique functional sequence for generating a color signal, and the application of ImageJ in colorimetric image data acquisition. The performance of the proposed strategy in detecting various foodborne pathogens is comparable to that of the commercial UV-Vis spectrophotometer Tecan Infinite 200 Pro. This detection platform exhibits linearity over wide range, high sensitivity, and high selectivity. The diagnostic capability of this colorimetric system to detect foodborne pathogens was demonstrated with spiked fruit and vegetable samples. This low-cost and effective colorimetric method can be conveniently employed for the analysis of DNA sequences arising from pathogenic bacteria

High intensity focused ultrasound: alternative for functional surgery in movement disorders

Introducción: los trastornos del movimiento son enfermedades neurodegenerativas que incrementan su incidencia con la edad. El uso del ultrasonido focalizado de alta intensidad guiado mediante imagen por resonancia magnética es estudiado como opción novedosa para los casos refractarios a tratamiento médico. Objetivo: describir el uso del ultrasonido focalizado de alta intensidad guiado por imagen de resonancia magnética en los trastornos del movimiento. Métodos: se realizaron una revisión y una discusión de la literatura científica en las bases de datos Medical Key, Pubmed, Medline y Cochrane hasta el año 2017. Desarrollo: se describen la historia, los principios de funcionamiento y los usos clínicos de este método y se hace especial referencia a los trastornos del movimiento, así como a las ventajas y desventajas respecto a otros métodos de intervención quirúrgica funcional, ya sea ablativa por estereoataxia o por estimulación cerebral profunda, ambas más invasivas y que requieren craneotomía. Conclusión: el uso del ultrasonido focalizado de alta intensidad guiado por imagen de resonancia magnética es una alternativa mínimamente invasiva y limpia en el tratamiento ablativo del temblor esencial y la enfermedad de Parkinson; sin embargo, es necesaria la realización de estudios para confirmar sus efectos a largo plazo.Introduction: movement disorders are neurodegenerative diseases that increase their incidence with age. The use of the high intensity focused ultrasound guided by means of magnetic resonance imaging has been studied as a new option for medically treatment refractory cases. Objective: to describe the use of the high intensity focused ultrasound guided by magnetic resonance imaging in movement disorders. Methods: a review and discussion of the scientific literature were made in the Medical Key, Pubmed, Medline and Cochrane data bases until 2017. Development: the history, principles of functioning and clinical uses of this method are describe, with special reference in movement disorders, as well as advantages and disadvantages in comparison to other methods of functional surgery, as stereotactic ablative or deep brain stimulation, both more invasive and require a craniotomy. Conclusion: the high focused ultrasound guided with magnetic resonance imaging is a minimally invasive and clean alternative to ablative treatment in essential tremor and Parkinson disease; nevertheless, further studies are needed to confirm long term side effects

Influencia del retraso prehospitalario en la evolución del infarto cerebral aterotrombótico del adulto mayor

Se realizó un estudio descriptivo retrospectivo de 178 pacientes con 60 años ó más que sufrieron infarto cerebral aterotrombótico durante el período comprendido desde enero hasta diciembre de 2008 y que fueron admitidos en el Hospital Provincial Universitario “Arnaldo Milián Castro” con el objetivo de determinar la influencia del retraso prehospitalario en su evolución. Los datos se recogieron de las historias clínicas; la edad promedio es de 76.5 años y predominó el sexo femenino. La generalidad de los pacientes accedió al hospital en un plazo mayor de tres horas, los que accedieron tempranamente a la institución tuvieron una tendencia a presentar una menor estadía hospitalaria y una mejor evolución, de manera que el retraso prehospitalario influye desfavorablemente en la evolución de los adultos mayores con infarto cerebral aterotrombótico

Factors associated with critical care requirements in diabetic patients treated with dexamethasone for COVID-19 infection in the first wave of the pandemia

Diabetes mellitus (DM) and hyperglycemia are important risk factors for poor outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). The aim of the present study was to analyze the factors associated with the composite outcome of the necessity of invasive mechanical ventilation (IMV) or admission to the intensive care unit (ICU) in subjects with severe COVID-19 infection treated with dexamethasone comparing patients with DM vs. patients without DM. An observational retrospective cohort study was performed, including hospitalized subjects with a diagnosis of SARS-CoV-2 pneumonia. Inclusion criteria were: age ≥18 years old with severe COVID-19 disease requiring daily intravenous 6 mg dexamethasone treatment for 10 days. Exclusion criteria were: <18 years old, non-severe illness and/or patients in charge of ICU. Variables related to clinical and analytical parameters, glycemic control, acquired-hospital superinfections, mortality, IMV requirement, ICU admission and length of stay were included. Two hundred and nine individuals with COVID-19 disease treated with dexamethasone were included. One hundred twenty-five out of these subjects (59.8%) were patients with DM. Overall, from the 209 subjects, 66 (31.6%) required IMV or were admitted to the ICU, with significant differences between patients with DM (n=50) vs. patients without DM (n=16) (76% vs. 24%, p=0.002). Among the group of subjects with DM (n=125), those who required IMV or were admitted to the ICU showed higher serum concentrations of C-reactive protein, interleukin-6, D-dimer, ferritin and pro-calcitonin and significantly lower serum concentrations of albumin compared to those who did not require IMV or were not admitted to the ICU. Besides, between these two groups of patients with DM, we observed no differences in glycemic parameters, including median capillary blood glucose values, glycosylated hemoglobin, coefficient of variability and hypoglycemic episodes. In the multinomial analysis, factors independently associated with the composite outcome of IMV or admission to the ICU in the insulin-treated group were the National Early Warning Score (NEWS) 2 score (OR 1.55 [1.17-2.17], p=0.005) and the presence of hospital-acquired superinfections (OR 35.21 [5.11-386.99], p=0.001). In our study, parameters related to glycemic control were not associated with IMV requirement nor admission to the ICU in patients with DM and severe COVID-19 disease receiving daily 6 mg of dexamethasone for 10 days. However, hospital-acquired superinfections and disease severity at admission were independent factors associated with this composite outcome

Intervención educativa para mejorar la calidad de vida de diabéticos de debut con antecedentes de hipertensión arterial

The main cause of death of the person with type 2 diabetes mellitus is cardiovascular. Its prevention involves an integrated management of all risk factors. Objective: To evaluate the results of an intervention to improve the outcome of patients with type 2 diabetes debut and a history of hypertension that were treated with betablockers at the Chiqui Lubián Gomez University Polyclinic. Material and Method: prospective quasi-experimental study in an intentional sample of 22 patients with type 2 diabetes mellitus debut and a history of hypertension who attended the multidisciplinary consultation of diabetes mellitus in the period from January to December 2011. Results: there was a prevalence of female patients -16 patients (72.7%) - and the age group between 50 and 69 years - (77.2%). The hypertension control was achieved with a change to inhibitors of angiotensin converting enzyme (90.9%). Metabolic control, by quarter, improved significantly until reaching a 95.4% in the last one. Favorable changes in lifestyle, such as incorporating the practice of physical exercises (81.8%), were achieved. They ensure a better quality of life. With regard to body weight, at the start of the intervention there were 12 (54.5%) overweight patients and at the end they were reduced to seven (31.8%). It was possible that 100% of patients had a proper diet to control the disease, but only one patient (18.1%) stopped smoking, which is not significant. Better results could be achieved in the long term. Generally, the intervention was successful in 90.9% of patients. Conclusions: Patients presenting with type 2 diabetes mellitus and a history of hypertension evolve favorably with a treatment of angiotensin converting enzyme inhibitors as hypotensive and good metabolic control with lifestyle changes.La principal causa de muerte de la persona con diabetes mellitus tipo 2 es la cardiovascular; prevenirla implica un manejo integral de todos los factores de riesgo.  Objetivo: valorar los resultados de una intervención para mejorar la calidad de vida de los pacientes diabéticos tipo 2 de debut con antecedentes de hipertensión arterial tratados con betabloqueadores en el Policlínico Universitario “Chiqui Gómez Lubián”.  Material y Método: estudio cuasi experimental prospectivo a una muestra intencional de 22 pacientes con diabetes mellitus tipo 2 de debut que asistieron a la consulta multidisciplinaria y tenían antecedentes de hipertensión arterial en el período enero-diciembre de 2011. Resultados: predominaron el sexo femenino -16 (72.7%)- y el grupo de edad entre 50 y 69 años -(77.2%)-, se logró el control de la hipertensión con cambio a inhibidores de la enzima convertidora de la angiotensina (90.9%), el control metabólico por trimestre mejoró considerablemente hasta lograr en el último un 95.4%, se lograron cambios favorables en los estilos de vida como la incorporación a la práctica de ejercicios físicos (81.8%) que aseguran una mejor calidad de vida, relacionado con el peso corporal al inicio de la intervención había 12 (54.5%) pacientes con exceso de peso y al finalizar se redujeron a siete (31.8%), se logró que el 100% de los pacientes realizara una dieta adecuada para el control de la enfermedad pero solo un paciente (18.1%) abandonó el hábito de fumar, lo que no es significativo; pudieran lograrse mejores resultados a largo plazo. De forma general la intervención resultó satisfactoria en el 90.9% de los pacientes.Conclusiones: los pacientes que debutan con diabetes mellitus tipo 2 y tienen antecedentes de hipertensión evolucionaron favorablemente con tratamiento de inhibidores de la enzima convertidora de la angiotensina como hipotensor y buen control metabólico con cambios de estilo de vida

Uterine adenosarcoma with overgrowth of the sarcomatous component

Se trata de una paciente de 68 años con historia de sangrado vaginal postmenopáusico de ocho meses de evolución que se acompañaba de dolor en bajo vientre; al examen físico se le constató útero ligeramente aumentado de tamaño. Se le realizó un legrado diagnóstico que informó la presencia de un tumor mesenquimatoso en el útero y se decidió realizar histerectomía. En el estudio histopatológico se diagnosticó un adenosarcoma uterino con sobrecrecimento del componente sarcomatoso. Los adenosarcomas son tumores raros que tienen un componente epitelial glandular benigno y uno mesenquimal maligno. Los adenosarcomas mullerianos con sobrecrecimiento del componente sarcomatoso se comportan de modo agresivo y están frecuentemente asociados con recurrencia postoperatoria o metástasis.A female patient with 68 years old with a history of postmenopausal vaginal bleeding of 8 months of evolution accompanied by pain in the lower abdomen that the physical examination revealed a slightly enlarged uterus. Diagnostic curettage was performed, which reported the presence of a mesenchymal tumor in the uterus and deciding to perform hysterectomy. In the histopathological study, a uterine adenosarcoma was diagnosed with overgrowth of the sarcomatous component. The adenosarcomas are rare tumors in which there is a benign glandular epithelial component and a malignant mesenchymal component. Mullerian adenosarcomas with overgrowth of the sarcomatous component behave aggressively and are frequently associated with postoperative recurrence or metastasis

Syringocistadenocarcinoma papilliferum

Se trata de una paciente de 54 años que comenzó con una lesión en la vulva a nivel de la cicatriz de la rafia desde hace cuatro años aproximadamente que evolucionó a un absceso, para lo que llevó tratamiento en varias ocasiones, sin mejoría, por lo que continuó con sangrado y dolor en la región de la vulva. Decidió acudir a la Consulta ginecológica del Hospital “Mariana Grajales” de Santa Clara y se le diagnosticó lesión en horquilla vulvar de 3cm, sobreelevada, de bordes indurados y ulcerada. Por las características clínicas de la lesión se decidió su ingreso en la Sala de Ginecología y se le realizó una vulvectomía con linfadenectomía inguinal bilateral. El diagnóstico histológico consistió en un siringocistadenocarcinoma papilífero ulcerado infiltrante de la vulva. El siringocistadenocarcinoma papilífero es un tumor anexial maligno derivado de las glándulas sudoríparas extremadamente infrecuente. Se localiza, predominantemente, en la cabeza y el cuello y puede desarrollarse de un siringocistadenoma papilífero o de un nevo sebáceo de Jadassohn; su localización en la vulva es infrecuente.This is a 54-year-old patient who started with an injury to the vulva at the level of the scar of the raffia for about four years, which evolves and abscess, what has been treated several times, without improvement, so it continued with bleeding and pain in the region of the vulva. He decided to go to the Gynecological Consultation of the Mariana Grajales Hospital of Santa Clara, and she was diagnosed with a lesion in the vulvar fork of 3 cm, raised, with indurated and ulcerated edges. The clinical characteristics of the lesion are resolved in the Gynecology Room and a vulvectomy is performed with bilateral inguinal lymphadenectomy. The histological diagnosis consisted of a syringocistadenocarcinoma of the ulcerated infiltrating papillary vulva. Syringocistadenocarcinoma papilliferum is a malignant tumor derived from the sweat glands extremely infrequent. It is located, predominantly, in the head and neck and may develop a papilliferous syringocistadenoma or a sebaceous neva of Jadassohn; Its location in the vulva is uncommon

Low-grade endometrial stromal sarcoma

Se trata de una paciente de 25 años con historia de salud anterior e historia obstétrica de un embarazo y un parto. En esta ocasión acudió a consulta por presentar dolor bajo vientre desde hacía tres meses y expulsión por la vagina de un material muy fétido desde hacía quince días. Al examen físico se observó una tumoración de color blanquecino grisáceo que salía por el orificio cervical externo, con superficie reblandecida, de la que se tomó una muestra para estudio histológico, pero no fue útil para diagnóstico, por lo que se impuso tratamiento antibiótico; luego de otra toma de muestra para biopsia, que no fue concluyente para diagnóstico, se decidió realizar histerectomía con doble anexectomía y omentectomía. El diagnóstico histopatológico resultó ser un sarcoma del estroma endometrial de bajo grado. El sarcoma del estroma endometrial es un tumor infrecuente que contabiliza menos del 10% de los sarcomas uterinos. Dentro de los tumores mesenquimales uterinos se encuentran los tumores del estroma endometrial, que a su vez se dividen en nódulo estromal endometrial (benigno, bien circunscrito y sin invasión vascular) y el sarcoma del estroma endometrial, antes denominado miosis estromal endolinfática, que representa el 0,25% de los tumores malignos uterinos.She is a 25-year-old patient with a previous health history, an obstetric history of pregnancy and childbirth. On this occasion she went to the clinic for presenting pain in the abdomen for three months and expulsion from the vagina of a very fetid material for fifteen days. On physical examination, a gray-white tumor was seen that exited through the external cervical orifice, with a softened area, from which a sample was taken for histological study, but it was not useful for diagnosis, for which antibiotic treatment was applied; after another biopsy sample, which was not conclusive for diagnosis, it was decided to perform a hysterectomy with double adnexectomy and omentectomy. The histopathological diagnosis was found to be a low-grade endometrial stromal sarcoma. Endometrial stromal sarcoma is an infrequent tumor that accounts for less than 10% of uterine sarcomas. Within the uterine mesenchymal tumors are tumors of the endometrial stroma, which in turn are divided into endometrial stromal nodules (benign, well circumscribed and without vascular invasion) and endometrial stromal sarcoma, formerly called stromal miosis endolymphatic, which represents 0.25% of uterine malignancies

바이오 센싱을 위한 유기-무기 혼성 나노 물질 개발

학위논문(박사) - 한국과학기술원 : 생명화학공학과, 2016.8 ,[ix, 114 p. :]In recent years, an intense interest has grown in the synthesis of functional hybrid organic-inorganic nanostructured materials. Several research groups have reported different hybrid organic-inorganic nanomaterials by employing organic materials (such as proteins, amino acids, and organic acids) and inorganic materials (such as metal ion and metal nanoparticles). Based on the aforementioned unique combinations of organic-inorganic hybrid nanomaterials, we have developed a novel nanostrucuted materials employed in sensing different biomolecules such $H_2O_2$, glucose, choline, and acetyl choline. In chapter 2, we developed a simple but efficient method to synthesize protein-inorganic hybrid nanostructures with a flower-like shape (nanoflowers), which relies on sonication to facilitate the synthesis of the nanoflowers. With this technique, we synthesized nanoflowers containing laccase as a model enzyme and copper phosphate within 5 minutes at room temperature. The resulting laccase nanoflowers yielded greatly enhanced activity, stability, and reusability, and their usefulness was successfully demonstrated by applying them in the colorimetric detection of epinephrine. In chapter 3, we reported sonicated bovine serum albumin (BSA)-incorporated $Cu_3(PO_4)_2.3H_2O$ nanoflowers (SBSA-NFs) possess an intrinsic peroxidase-mimicking activity and also demonstrate that glucose oxidase (GOx) incorporated in nanoflowers showed enhanced activity compared with free GOx for the detection of target glucose in the cascade reaction, due to the synergistic effect arises from improved spatial coupling between enzymes and peroxidase-mimicking copper(II). In chapter 4, we synthesized different amine grafted MIL-100(Fe) metal organic frameworks (MOFs) and found that N,N,N&amp;apos;,N&amp;apos; Tetramethyl- 1, 4- butanediamine (TMBDA)-MIL-100(Fe) showed excellent peroxidase-mimicking activity. Further, we developed detection strategy by employing TMBDA-MIL-100(Fe) for the detection of biomolecules and obtained excellent limit of detection for $H_2O_2$, choline, and acetylcholine with $0.329 \mu M$ , $0.027 \mu M$, and $0.036 \mu M$ respectively. The diagnostic capability of this method is also demonstrated by detecting choline and acetyl choline in serum, showing its great potential in practical application.한국과학기술원 :생명화학공학과