6 research outputs found
LocalizaciĂłn in situ de inclusiones del virus tristeza de los cĂtricos con anticuerpos desarrollados contra la proteĂna recombinante no estructural p20
Se describe el desarrollo de un inmunoensayo para la localizaciĂłn in situ de inclusiones virales inducidas por el virus tristeza de los cĂtricos (Citrus tristeza virus =CTV) mediante microscopĂa de luz con anticuerpos preparados contra la proteĂna recombinante p20 no estructural del CTV. Se emplearon cortes manuales de aproximadamente 100 ìm de grosor a partir de corteza de varetas de plantas de cĂtricos sanas e infectadas por el CTV. Los cortes se fijaron en 70 % de etanol y se incubaron subsecuentemente con anticuerpos anti-p20 desarrollados ya sea en rata o conejo en diluciones de 1:5,000 y 1:10,000 y 1:1,000 y 1:3,000 respectivamente, y con conjugados comerciales IgG anti-especie en diluciones de 1:30,000 para cada uno de ellos, agregando al final la soluciĂłn cromogĂ©nica compuesta por NBT/BCIP. Las inclusiones
virales se visualizaron en un microscopio de luz a 10 y 40
aumentos en forma de áreas irregulares con coloración azul
obscura en el área del floema y fibras del floema en cortes
efectuados con plantas infectadas por el CTV; los tejidos
provenientes de plantas sanas no presentaron ningĂşn tipo de
coloraciĂłn, lo que permitiĂł discriminar plantas sanas e
infectadas por el CTV
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Reunión del Comité de Aplicaciones
Bienvenida a la Reunión de Aplicaciones por Elizabeth Velázquez (UANL); Convocatoria TICAL2014 a cargo de Cecilia Castañeda (CUDI); Presentación de Aplicaciones Internacionales por Salma Jalife y Presentación de la REDNIBA a cargo de Luis Gutierrez y Hans Reyes.Agenda Reunión del Comité de Aplicaciones y Asignación de Fondos.14_03_12_reuniondelcomitedeaplicaciones.fl