Bacterial Contamination of Clothes and Environmental Items in a Third-Level Hospital in Colombia

Objective. This study evaluates the bacterial contamination rate of items in the hospital setting that are in frequent contact with patients and/or physicians. By determining the bacterial species and the associated antibiotic resistance that patients are exposed to. Methods. Hospital-based cross-sectional surveillance study of potential bacterial reservoirs. Cultures from 30 computer keyboards, 32 curtains, 40 cell phones, 35 white coats, and 22 ties were obtained. Setting. The study was conducted an urban academic 650-bed teaching hospital providing tertiary care to the city of Medellin, Colombia. Results. In total, 235 bacterial isolates were obtained from 159 surfaces sampled. 98.7% of the surfaces grew positive bacterial cultures with some interesting resistance profiles. Conclusion. There are significant opportunities to reduce patient exposure to frequently pathogenic bacteria in the hospital setting; patients are likely exposed to many bacteria through direct contact with white coats, curtains, and ties. They may be exposed to additional bacterial reservoirs indirectly through the hands of clinicians, using computer keyboards and cell phones

Utility of c-reactive protein in early neonatal sepsis

Introducción: La baja sensibilidad y especificidad de las ayudas diagnósticas y el bajo aislamiento en los cultivos dificulta el reconocimiento de la sepsis bacteriana de inicio temprano en neonatos. Objetivo: Determinar la validez diagnóstica de la de la proteína C reactiva (PCR) en la sepsis en la sepsis neonatal temprana. Método: Se evaluó el papel de la PCR en el diagnóstico de sepsis neonatal temprana. Las concentraciones se midieron a las 12 y 48 h de vida en pacientes con sospecha de sepsis. Al evaluar la sensibilidad y especificidad de la PCR, se utilizó el resultado de manera cuantitativa y mediante una curva ROC no paramétrica se estimó sensibilidad y especificidad, razones de verosimilitud y porcentaje de clasificación correcta para cada punto de corte posible. Resultados: El estudio incluyó 198 pacientes. La sensibilidad, especificidad, valor predictor positivo (VPP), valor predictor negativo (VPN), índice de probabilidad positiva e índice de probabilidad negativa de la PCR fue de 72,2 - 82,4 - 45,2 - 93,7 - 4,1 y 0,3, respectivamente con área bajo la curva de 0,78. Conclusiones: La PCR es particularmente útil para descartar una infección. Dos PCR seriadas negativas en ausencia de expresión clínica y de hemocultivos positivos tienen un alto VPN y un índice de probabilidad negativa a favor de excluir la infección con una alta certeza y/o de descontinuar la terapia antibiótica.Background: The low sensitivity and specificity of diagnostic aids and the low isolation in cultures make it difficult to recognize early-onset bacterial sepsis in neonates. Aim: Determine the diagnostic validity of C reactive protein (CRP) in early neonatal sepsis. Method: The role of CRP in the diagnosis of early-onset neonatal sepsis was evaluated. Levels were measured at 12 and 48 hours of life in patients with suspected sepsis. When evaluating the sensitivity and specificity of the CRP, the result was used quantitatively, using a non-parametric ROC curve to estimate sensitivity and specificity, likelihood ratios and percentage of correct classification for each possible cut-off point. Results: The study included 198 patients. The sensitivity, specificity, positive predictive value, negative predictive value, positive probability index and negative probability index of CRP, were 72.2 - 82.4 - 45.2 - 93.7 - 4.1, and 0.3, respectively with area under the curve of 0.78. Conclusions: CRP is particularly useful to rule out infection. Two negative serial CRP in the absence of clinical symptoms and positive blood cultures have a high negative predictive value and a negative probability index in favor of excluding infection with high certainty and/or discontinuing antibiotic therapy

Local extinctions of birds in forest fragments in the Santa Elena region, Central Andes, Colombia

Los registros históricos de la avifauna de la región de Santa Elena (Andes centrales colombianos), realizados entre 1879 y 1952, fueron comparados con los de las aves presentes actualmente en tres fragmentos remanentes de bosque de 41, 129 y 136 ha. De las 132 especies presentes originalmente solo se conservan 64 en los tres fragmentos. En los tres fragmentos han desaparecido el 78%, el 66% y el 63% de sus especies. Las especies con alta especificidad de hábitat, con peso corporal de 51–100 g, las que se alimentan en el estrato arbóreo y las que lo hacen en troncos tendieron a presentar una proporción de extinción mayor a lo esperado. Sin embargo, no hubo diferencias estadísticamente significativas entre la proporción de especies extintas observada y esperada para ninguna de las categorías (gremio trófico, estrato de alimentación, tamaño corporal y especificidad de hábitat), lo que indica que todos los grupos presentaron la misma vulnerabilidad a la extinción. El peso promedio de las aves extintas fue similar al de las aves aún presentes en los tres fragmentos. Las especies de las familias Grallaridae, Cotingidae, Thraupidae, Trogonidae y de la subfamilia Dendrocolaptinae fueron las más afectadas. Se discute por qué las características ecológicas evaluadas pueden no estar relacionadas con la extinción local de aves en estos fragmentos de bosque.We compared historic records from 1879 until 1952 of birds of Santa Elena region (Colombian central Andes) with those from a recent survey in three forest fragments of 41, 129 and 136 ha. Only 64 out of the 132 original species still remain in the three fragments; 78%, 66% and 63% of the original species have disappeared from the fragments. Species with high habitat specificity, those with body mass of 51–100 g, those which forage in the arboreal stratum, and those which forage on trunks showed a tendency to suffer more extinctions than expected. However, there were no statistical differences between observed and expected proportions of extinctions in any of the categories (trophic guild, foraging stratum, body mass and habitat specificity), indicating that all the bird groups presented the same vulnerability to extinction. Mean body mass of extinct birds was similar to that of the birds still remaining in the fragments. Species from the families Grallaridae, Cotingidae, Thraupidae, Trogonidae and from the subfamily Dendrocolaptinae were the most affected. We discuss why the evaluated ecological features could not be related with local extinction of bird species in these forest fragments

Efficacy of robotic-assisted prostatectomy in localized prostate cancer : a systematic review of clinical trials

Q2Artículo de revisión1-7Background. Radical prostatectomy is an effective treatment for clinically localized prostate cancer. The three approaches in current use have been extensively compared in observational studies, which have methodological limitations. Objective. To compare the efficacy and safety of three radical prostatectomy approaches in patients with localized prostate cancer: open, laparoscopic, and robotic-assisted laparoscopic surgery. Materials and Methods. A systematic review of the literature was carried out. Databases MEDLINE, EMBASE, LILACS, and CENTRAL were searched for randomized clinical trials that directly compared two or more radical prostatectomy approaches. Selection criteria, methodological rigor, and risk of bias were evaluated by two independent researchers using Cochrane Collaboration’s tools. Results. Three trials were included. In one study, laparoscopic surgery was associated with fewer blood loss and transfusion rates than the open procedure, in spite of longer operating time. The other two trials compared laparoscopic and robotic-assisted surgery in which no differences in perioperative outcomes were detected. Nevertheless, robotic-assisted prostatectomy showed more favorable erectile function and urinary continence recovery. Conclusion. At the present time, no clear advantage can be attributed to any of the existing prostatectomy approaches in terms of oncologic outcomes. However, some differences in patient-related outcomes favor the newer methods. Larger trials are required

Transmission-dominated mid-infrared supermirrors with finesse exceeding 200 000

We fabricate and characterize substrate-transferred single-crystal mirror coatings with 9.33 $\pm$ 0.17 ppm of transmittance and 4.27 $\pm$ 0.52 ppm of excess optical loss, corresponding to a transmission-loss dominated reflectance of 99.9986% at 4.45 $\mu$m. For the first time, a cavity finesse > 200 000 is achieved in the mid-infrared.Comment: Sept 21: Minor revisions to conform to 2-page length requirement including abbr. refs.; Figure font sizes increase

Composición y riqueza íctica en quebradas y ríos del piedemonte de la cuenca del río Cusiana, Orinoquia colombiana

In order to provide information on the composition and richness of fish in the Colombian Orinoco piedmont (Tauramena - Casanare), collections were made every two months (June 2012 - February 2013), and standardized (arts-length-time), for six streams and three rivers from de Cusiana River piedmont, Orinoco River Basin, Colombia. 88 species where registered, 33 found on streams and 78 on rivers, there all grouped into six orders, 24 families and 56 genera. Two orders: Characiformes (43 sp.) and Siluriformes (34 sp.) and two families: Characidae (27 sp.) and Loricariidae (15 sp.) had the highest species richness. The results obtained increase the number of species to from the Cusiana River drainage by 26 species, for a new total of 141 species; nine of these had been considered endemic to other sub-drainages. There was also a record of a new order and family (Synbranchiformes: Synbranchidae) and a new genus Ceratobranchia. Eight of the reported species of the reported species require further confirmation because they are new records. The importance of fish diversity and human intervention that the Cusiana River drainage is suffering makes this research a tool for the conservation of this aquatic ecosystems and its fish species.Con el objeto de proporcionar información sobre la composición y riqueza de los peces del piedemonte de la Orinoquia colombiana (Tauramena - Casanare), se realizaron colectas bimestralmente (junio 2012- febrero 2013) y estandarizadas (artes-longitud-tiempo), para seis quebradas y tres ríos del piedemonte de la cuenca del río Cusiana, cuenca del Orinoco, Colombia. Se registraron 88 especies, 33 en quebradas y 78 para los ríos, agrupadas en seis órdenes, 24 familias y 56 géneros. La mayor riqueza la presentaron los órdenes Characiformes (43 sp.) y Siluriformes (34 sp.) y las familias Characidae (27 sp.) y Loricariidae (15 sp.). Los resultados obtenidos incrementan el número de especies para la cuenca media del río Cusiana en 26, para un total de 141. Nueve de estas habían sido consideradas como endémicas para otras subcuencas, registrándose un nuevo orden y familia (Synbranchiformes: Synbranchidae) y un género Ceratobranchia. Ocho especies de las reportadas necesitan ser confirmadas pues se trata de nuevos reportes. La importancia de la diversidad íctica y la intervención antrópica que sufre la cuenca del río Cusiana, hacen de esta investigación una herramienta para la conservación de estos ecosistemas acuáticos y sus especies de peces

Composition and fish species richness in piedmont streams and rivers of the Cusiana River drainage in the Colombian Orinoco River Basin

In order to provide information on the composition and richness of fish in the Colombian Orinoco piedmont (Tauramena - Casanare), collections were made every two months (June 2012 - February 2013), and standardized (arts-length-time), for six streams and three rivers from de Cusiana River piedmont, Orinoco River Basin, Colombia. 88 species where registered, 33 found on streams and 78 on rivers, there all grouped into six orders, 24 families and 56 genera. Two orders: Characiformes (43 sp.) and Siluriformes (34 sp.) and two families: Characidae (27 sp.) and Loricariidae (15 sp.) had the highest species richness. The results obtained increase the number of species to from the Cusiana River drainage by 26 species, for a new total of 141 species; nine of these had been considered endemic to other sub-drainages. There was also a record of a new order and family (Synbranchiformes: Synbranchidae) and a new genus Ceratobranchia. Eight of the reported species of the reported species require further confirmation because they are new records. The importance of fish diversity and human intervention that the Cusiana River drainage is suffering makes this research a tool for the conservation of this aquatic ecosystems and its fish species

Substrate-transferred GaAs/AlGaAs crystalline coatings for gravitational-wave detectors: A review of the state of the art

In this Perspective we summarize the status of technological development for large-area and low-noise substrate-transferred GaAs/AlGaAs (AlGaAs) crystalline coatings for interferometric gravitational-wave (GW) detectors. These topics were originally presented in a workshop{\dag} bringing together members of the GW community from the laser interferometer gravitational-wave observatory (LIGO), Virgo, and KAGRA collaborations, along with scientists from the precision optical metrology community, and industry partners with extensive expertise in the manufacturing of said coatings. AlGaAs-based crystalline coatings present the possibility of GW observatories having significantly greater range than current systems employing ion-beam sputtered mirrors. Given the low thermal noise of AlGaAs at room temperature, GW detectors could realize these significant sensitivity gains, while potentially avoiding cryogenic operation. However, the development of large-area AlGaAs coatings presents unique challenges. Herein, we describe recent research and development efforts relevant to crystalline coatings, covering characterization efforts on novel noise processes, as well as optical metrology on large-area (~10 cm diameter) mirrors. We further explore options to expand the maximum coating diameter to 20 cm and beyond, forging a path to produce low-noise AlGaAs mirrors amenable to future GW detector upgrades, while noting the unique requirements and prospective experimental testbeds for these novel materials.Comment: 13pages, 3 figure

Prevalence and possible etiology of erectile dysfunction in HIV positive patients from Hospital Universitario San Ignacio

32 ќѐіђёюёȱ ќљќњяіюћюȱёђȱ џќљќєҌюurol.colomb. Vol XXI, No. 1: pp. 32-39, 2012 џѡҌѐѢљќȱ џієіћюљRecibido: 05 de julio de 2011Aceptado: 10 de abril de 2012Premio Pablo Gómez MartínezXLVI Congreso Curso Internacional de Urología 2011Prevalencia y posible etiología de la disfunción eréctil en pacientes VIH positivos del Hospital Universitario San IgnacioAdriana Chaves Parra1, José Miguel Silva H.2, Natalia Estupiñán3, María Clara Castro4, Juan Guillermo Cataño C.5, Carlos Eduardo Hernández6, Jaime Pérez Niño7M.D., Residente IV Urología, Pontificia Universidad Javeriana, Bogotá, Colombia, [email protected]., Profesor Asociado Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Unidad de Urología, Bogotá, Colombia, [email protected]., Pontificia Universidad Javeriana, Bogotá, Colombia, [email protected] jefe, Unidad de Infectología, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia, [email protected]., Profesor Asistente, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Unidad de Urología, Bogotá, Colombia, [email protected]., Instructor, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Unidad de Urología, Bogotá, Colombia, [email protected]., Profesor Asociado, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Unidad de Urología, Bogotá, Colombia, [email protected]ño del estudio: Descriptivo, observacional de corte transversalNivel de evidencia: IIIEl autor declara que no tiene conflicto de interésResumenObjetivo: medir la prevalencia de disfunción eréctil en pacientes VIH positivos, en la población que asiste a la consulta externa de VIH/SIDA de infectología, en el Hospital Universitario San Ignacio, y re-conocer posibles orígenes de esta. Materiales y métodos: estudio descriptivo observacional de corte trans-versal, donde a una muestra de hombres VIH positivos que asisten a consulta de infectología en el Hospital Universitario San Ignacio se le aplicó la versión abreviada del Índice Internacional de Función Eréctil – SHIM (Sexual Health Inventory for Men), que evalúa seis elementos referentes a la erección con el fin de calificar los pacientes con criterios de disfunción eréctil y clasificarlos en tres categorías (leve, moderada y severa). A los pacientes clasificados con disfunción eréctil moderada a severa se les tamizó con biotesiome-tría para establecer un posible origen neurológico relacionado con la severidad. Resultados: se incluyeron 156 pacientes, de los cuales 55 (33%) no tenían disfunción eréctil, 39 (24%) tuvieron disfunción eréctil leve, 47 (28,3%) moderada y 10 (6%) severa, y 5 pacientes de los cuales no se obtuvieron los datos completos 33Prevalencia y posible etiología de la disfunción eréctil en pacientes V I H positivos del Hospital Universitario San Ignacio ђѣіѠѡюȱ џќљќєҌюȱ ќљќњяіюћюpero fueron incluidos en el estudio. En total, la prevalencia de algún grado de disfunción eréctil en este grupo fue de 61,5%. La edad promedio fue de 39,1 años —rango de edad entre 20 y 61 años— para el total de la población estudiada, con una edad promedio de 37 años para el grupo de disfunción eréctil moderada y 42 años para severa, con rangos de edad que variaban entre 20 y 60 años para moderada, y 26 y 50 años para severa. Se les realizó biotesiometría a 20 pacientes con disfunción eréctil moderada y a 6 con severa; según el análisis cualitativo, el resultado fue anormal en el 65% de pacientes con disfunción moderada, y en el 83% de los que calificaron en la forma severa. Según el análisis cuantitativo, el resultado fue anormal en el 25% de pacientes con disfunción moderada y en el 67% de severa. Ningún paciente presentó atrofia testicular, y se encontró hipotrofia testicular en el 20% del grupo de moderada, y en el 17% del grupo de se-vera. Conclusiones: con estos datos podemos afirmar que la prevalencia de disfunción eréctil en pacientes con VIH/SIDA es mayor que la de la población general. Se percibe un compromiso neurológico importante gracias a la prueba de tamizaje (biotesiometría), aunque esta modalidad de examen no permite definir la naturaleza ni la localización de la lesión.Q4Artículo original32-39Purpose: To measure the prevalence of erectile dysfunction of HIV patients, in the population atten-ding infectious disease group at Hospital Universitario San Ignacio, and identify potential origins of this situation. Methods: A descriptive, observational cross-sectional study was performed. A sample of HIV positive men attending infectious disease consultation at Hospital Universitario San Ignacio was included. The short version of International Index of Erectile Function – SHIM (Sexual Health Inventory for Men), which assesses six factors relating to erection was applied in order to qualify erectile dysfunction, and patient’s dysfunction was classified into three categories (mild, moderate and severe). Those with moderate to severe dysfunction were screened with biothesiometry looking for a neurological injury. Results: We included 156 patients, of whom 55 (33%) did not have erectile dysfunction, 39 (24%) had mild, 47 (28.3%) moderate and 10 (6%) severe; 5 patients with incomplete data, were also included in the study. Overall, the prevalence of some degree of erectile dysfunction in this group was 61.5%. The average age was 39.1 years - age range between 20 and 61 years - for the total study population, with an average age of 37 years for the moderate erectile dysfunction group and 42 years for severe, with age ranges between 20 and 60 years for moderate and 26 - 50 years for severe group. Biothesiometry was performed on 20 patients with moderate erectile dysfunction and 6 with severe. According to the qualitative analysis, the result was abnormal in 65% of patients with moderate dysfunction and 83% of those who scored in the severe form. According to quantitative analysis, the result was abnormal in 25% of patients with moderate dysfunction and 67% of the severe group. No patient had testicular atrophy, testicular hypotrophy was found in 20% of the moderate group and 17% of the severe group. Conclusions: With these data we can affirm that the prevalence of erectile dysfunction in patients with HIV / AIDS is higher than in general population. There is a perceived significant neurological compromise due to the screening test (biothesiometry), although this type of test does not define the nature or location of the lesion

Semen quality in Peruvian pesticide applicators: association between urinary organophosphate metabolites and semen parameters

<p>Abstract</p> <p>Background</p> <p>Organophosphates are broad class of chemicals widely used as pesticides throughout the world. We performed a cross-sectional study of associations between dialkylphosphate metabolites of organophosphates and semen quality among pesticide applicators in Majes (Arequipa), Peru.</p> <p>Methods</p> <p>Thirty-one men exposed to organophosphate (OP) pesticides and 31 non-exposed were recruited (age, 20–60 years). In exposed subjects, semen and a blood sample were obtained one day after the last pesticide application. Subjects were grouped according to levels of OP metabolites in urine. Semen samples were analyzed for sperm concentration, percentage of sperm motility, percentage of normal morphology, semen leucocytes and concentrations of fructose and zinc. Exposure to OP was assessed by measuring six urinary OP metabolites (dimethyl and diethyl phosphates and thiophosphates) by gas chromatography using a single flame photometric detector.</p> <p>Results</p> <p>Diethyldithiophosphate (p = 0.04) and diethylthiophosphate (p = 0.02) better reflected occupational pesticide exposure than other OP metabolites. Semen analysis revealed a significant reduction of semen volume and an increase in semen pH in men with OP metabolites. Multiple regression analysis showed that both occupational exposure to pesticides and the time of exposure to pesticides were more closely related to alterations in semen quality parameters than the single measurement of OP metabolites in urine.</p> <p>Conclusion</p> <p>The study demonstrated that occupational exposure to OP pesticides was more closely related to alterations in semen quality than a single measurement of urine OP metabolites. Current measurement of OP metabolites in urine may not reflect the full risk.</p