Emerging fungal infections : Sporobolomyces salmonicolor fungemia. Case Report

En los últimos años, la emergencia de infecciones por hongos se ha dado en parte por el aumento en las infecciones por microrganismos que normalmente no son patógenos. El siguiente reporte describe la fungemia y meningoencefalitis por Sporobolomyces salmonicolor, una levadura frecuente en el medio ambiente y las plantas, en un paciente sin factores de riesgo conocidos, con desenlace fatal a pesar del manejo con antifúngicos. Este caso nos recuerda que dentro de las infecciones micóticas emergentes se encuentra el S. salmonicolor y se debe tener en cuenta dentro del diagnóstico diferencial de levaduras en sangre, como causa infrecuente, potencialmente mortal.Q3Reporte de casoS193-S196The emergence of pathogens, mainly fungi, in recent years has been partly due to over-appearance of organisms that normally are not pathogenic in humans. The following report describes Sporobolomyces salmonicolor fungaemia and proven meningoencephalitis in a patient not showing risk factors who suffers a fatal outcome despite management with antifungal agents. The said yeast lives mainly in tree environments and plants.This case reminds us that there is S. salmonicolor within the emerging fungal infections, and this fact should be taken into account in the differential diagnosis of yeasts in blood as a rare and life-threatening cause

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamento Boyacá y Antioquia

Se determinaron las afectaciones e impactos psicosociales del relato denominado como Modesto Pacaya, teniendo en cuenta la identificación del posicionamiento subjetivo desde el lugar de víctimas o sobreviviente con sus aspectos dominantes de la violencia y sus impactos naturalizados en el contexto del conflicto armando que revelaron una emancipación discursiva, frente a los hallazgos de los eventos de violencia que se han desencadenado en las desmovilizaciones de algunos integrantes de los grupos ilegales. Para el caso denominado como Cacarica se analizaron y se describieron los impactos que ha generado la estigmatizada sobre el presunto cómplice de un actor armado y sus consecuencias en el contexto del conflicto. Para este caso se propusieron acciones de apoyo en los hechos de crisis por violencia, causa por punibles como la tortura y el homicidio de pobladores y sus líderes comunitarios con el propósito de resolver la problemática identificada con la premisa de la propuesta de tres estrategias para la comunidad de Cacarica, para potencializar sus habilidades y los recursos disponibles para facilitar el afrontamiento, mediante acciones de resiliencia y estrategias psicosociales. Como parte final se presenta un informe analítico sobre la experiencia de la foto voz realizada en diferentes contextos evocando la memoria y la descripción metafórica como una estrategia de reflexión psicosocial, bajo la óptica de la imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia de los departamentos de Boyacá y Antioquia.The effects and psychosocial impacts of the story called Modesto Pacaya were determined by taking into account the identification of the subjective position from the place of victims or survivors. It focused on the dominant aspect of violence and its naturalized impacts in the context of the armed conflict. It revealed emancipation discourse against the findings of the events of violence that have been unleashed in the demobilizations of some members of the illegal groups. For the case known as Cacarica, the impacts of the stigma on the alleged accomplice of an armed actor and their consequences in the context of the conflict were analyzed and described. In this case, support actions were proposed in the events of crises due to violence, caused by punishable persons such as torture and homicide of residents and their community leaders in order to solve the problem identified with the premise of the proposal of three strategies for community of Cacaricas. These strategies were to potentiate their skills and the resources available to facilitate coping, through actions of resilience and psychosocial strategies. As a final part, an analytical report on the experience of the photo voice carried out in different contexts is presented which evoke memory and metaphorical description as a strategy of psychosocial reflection under the optics of image and narrative as tools for the psychosocial approach in scenarios of violence of the Departments of Boyacá and Antioquia

Miocarditis fulminante en adultos por el virus de la influenza B: reporte de dos casos y revisión de la literatura

Myocarditis is an inflammatory disease of the myocardium. Viral infections are the most common cause, although it can also be due to hypersensitivity reactions and autoimmune etiology, among other causes.The clinical spectrum of the disease is varied, from an asymptomatic course, followed by chest pain, arrhythmias, and acute heart failure, to a fulminant episode. The term fulminant refers to the development of cardiogenic shock with a need for vasopressor support and inotropic or assisted circulation devices either extracorporeal membrane oxygenation (ECMO) or intra-aortic counterpulsation balloon.About 10% of cases of heart failure due to myocarditis correspond to fulminant myocarditis.Influenza myocarditis has been considered an infrequent condition. However, its incidence has increased since 2009 as a result of the AH1N1 pandemic; otherwise, myocarditis due to the Influenza type B virus remains an infrequent entity.We describe the experience in a cardiovascular center of two confirmed cases of fulminant myocarditis due to influenza B that required circulatory assistance devices.La miocarditis es una enfermedad inflamatoria del miocardio. Las infecciones virales son la causa más común, aunque también puede deberse a reacciones de hipersensibilidad y de etiología autoinmunitaria, entre otras.El espectro clínico de la enfermedad es variado y comprende desde un curso asintomático, seguido de dolor torácico, arritmias y falla cardiaca aguda, hasta un cuadro fulminante.El término ‘fulminante’ se refiere al desarrollo de un shock cardiogénico con necesidad de soporte vasopresor e inotrópico o dispositivos de asistencia circulatoria, ya sea oxigenación por membrana extracorpórea o balón de contrapulsación intraaórtico.Cerca del 10 % de los casos de falla cardiaca por miocarditis corresponde a miocarditis fulminante. La miocarditis por influenza se considera una condición infrecuente; no obstante, su incidencia ha aumentado desde el 2009 a raíz de la pandemia de influenza por el virus AH1N1.Por su parte, la miocarditis por influenza de tipo B sigue siendo una condición infrecuente.Se describen aquí dos casos confirmados de miocarditis fulminante por el virus de la influenza B atendidos en un centro cardiovascular, que requirieron dispositivos de asistencia circulatoria mecánica

Cryptic Oral Microbiota: What Is Its Role as Obstructive Sleep Apnea-Related Periodontal Pathogens?

Q2Q2Periodontitis has been commonly linked to periodontopathogens categorized in Socransky’s microbial complexes; however, there is a lack of knowledge regarding “other microorganisms” or “cryptic microorganisms”, which are rarely thought of as significant oral pathogens and have been neither previously categorized nor connected to illnesses in the oral cavity. This study hypothesized that these cryptic microorganisms could contribute to the modulation of oral microbiota present in health or disease (periodontitis and/or obstructive sleep apnea (OSA) patients). For this purpose, the presence and correlation among these cultivable cryptic oral microorganisms were identified, and their possible role in both conditions was determined. Data from oral samples of individuals with or without periodontitis and with or without OSA were obtained from a previous study. Demographic data, clinical oral characteristics, and genera and species of cultivable cryptic oral microorganisms identified by MALDI-TOF were recorded. The data from 75 participants were analyzed to determine the relative frequencies of cultivable cryptic microorganisms’ genera and species, and microbial clusters and correlations tests were performed. According to periodontal condition, dental-biofilminduced gingivitis in reduced periodontium and stage III periodontitis were found to have the highest diversity of cryptic microorganism species. Based on the experimental condition, these findings showed that there are genera related to disease conditions and others related to healthy conditions, with species that could be related to different chronic diseases being highlighted as periodontitis and OSA comorbidities. The cryptic microorganisms within the oral microbiota of patients with periodontitis and OSA are present as potential pathogens, promoting the development of dysbiotic microbiota and the occurrence of chronic diseases, which have been previously proposed to be common risk factors for periodontitis and OSA. Understanding the function of possible pathogens in the oral microbiota will require more research.https://orcid.org/0000-0003-0006-7822https://orcid.org/0000-0002-5841-3014https://orcid.org/0000-0002-8646-8725https://orcid.org/0000-0001-5576-9341https://orcid.org/0000-0002-9884-9242https://orcid.org/0000-0003-1803-9141https://orcid.org/0000-0003-1302-5429Revista Internacional - IndexadaA1N

Factors related to successful control of an outbreak by Klebsiella pneumonia-producing KPC-2 in an intensive care unit in Bogotá, Colombia

La resistencia a carbapenémicos en Klebsiella pneumoniae ha aumentado de manera considerable, incrementando las tasas de morbimortalidad. El objetivo de este trabajo fue describir las características epidemiológicas, microbiológicas y las medidas de intervención que permitieron el control exitoso de un brote de Klebsiella pneumoniae productora de KPC-2. Métodos El estudio se realizó en 2 periodos: el primero durante el brote, con instauración de un protocolo de medidas de intervención; y el segundo, de seguimiento posbrote. Se realizaron pruebas de identificación y susceptibilidad por sistema automatizado, tamización de carbapenemasas por test de Hodge modificado, PCR para detección de los genes blaKPC, blaKPC-2, NDM-1 y estudio de clonalidad por electroforesis de campos pulsados. Resultados Durante el brote, se identificaron 18 aislamientos de Klebsiella pneumoniae productora de KPC en 11 pacientes. Tres casos fueron confirmados como infección intrahospitalaria. La técnica de PCR reveló la presencia del gen blaKPC en 21 de 22 aislamientos (pacientes y medio ambiente) y se identificó la presencia de un clon con una similitud superior al 75%. En el periodo posbrote los cultivos ambientales y de búsqueda de colonizados fueron negativos. Discusión Se evidenció un control exitoso del brote producido por un clon. La implementación de un protocolo de intervención y la monitorización de su cumplimiento, la comunicación efectiva y el trabajo en equipo fueron indispensables para evitar su propagación y evitar un comportamiento endémico posbrote.Artículo original25-32The considerable increase in carbapenem-resistant Klebsiella pneumoniae has caused an increase in mortality and morbidity rates. The aim of this study was to describe its epidemiological and microbiological characteristics and the intervention measures that controlled an outbreak caused by K. pneumoniae-producing KPC-2 B-lactamase. Methods The study was divided into 2 periods: the first during the outbreak with the implementation of a bundle and the second a post-outbreak surveillance. We performed tests for identification and susceptibility by using an automated system, screening carbapenemases by the Modified-Hodge test, blaKPC, blaKPC-2 and NDM-1 identification by PCR and clonal relationship characterisation by PFGE. Results During the outbreak, there were 18 isolates of Klebsiella pneumoniae-producing KPC-2 in 11 patients. Three cases were confirmed as hospital-acquired infection. Of 22 isolates, 21 were positive to blaKPC by PCR (samples from patients and environment) and a clone was identified with a similarity of greater than 75%. During the post-outbreak surveillance, we did not find any new positive cultures from surfaces and there were no new colonisations. Discussion This was a successful control of an outbreak produced by a clone. The implementation of a bundle and a subsequent surveillance to monitor its fulfilment, effective communication and teamwork were crucial to inhibit propagation of the infection and to prevent an endemic behaviour post-outbreak

Experiencias en el aula: segundo encuentro de prácticas pedagógicas innovadoras

Experiencias de profesores en su quehacer en los distintos ambientes de aprendizaje presenciales y a distancia.La segunda entrega de Experiencias en el aula es una publicación anual que recoge las ponencias ganadoras presentadas en el Segundo Encuentro de Prácticas Pedagógicas Innovadoras, organizado por el Centro de Excelencia Docente aeiou, de la Vicerrectoría General Académica de la Corporación Universitaria Minuto de Dios – UNIMINUTO Todas las ponencias publicadas en la segunda entrega de Experiencias en el aula fueron seleccionadas por evaluadores externos durante la convocatoria al Segundo Encuentro de Prácticas Pedagógicas Innovadoras en el que fueron presentadas; este evento, organizado por el Centro de Excelencia Docente aeiou, y la Vicerrectoría General Académica de la Corporación Universitaria Minuto de Dios- UNIMINUTO, tuvo lugar los días 9 y 10 de octubre de 2017

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia