A mechanism synthesis and modeling for correction of hip dysplasia in medium and large dog breeds

Hip dysplasia is an incurable but treatable disease that affects medium and large dog breeds. It appears as a result of genetic disorders, overweight, and the care given to the dogs. Currently, there are no specialized mechanisms that provide comfort to the life of these pets, while adapting to the canine condition and promoting the use of their hind legs until mobility is completely lost. Therefore, in the present study, a versatile device was synthesized and modeled to help to improve the life quality of dogs, taking as a reference the "German Shepherd" breed. It was designed considering the health and welfare of these animals, taking into account the mobility and safety of their limbs. This device uses a linkage mechanism to provide structural support to the dogs, while allowing for mobility within an specified range of motion. It aims to incorporate a gear and spring system that controls the weight lifted by the device, so that dogs partially use their hind legs. The static and dynamic behavior of this mechanism were mathematically modeled, finding an optimal solution.La displasia de cadera es una enfermedad incurable pero tratable que afecta a razas de perros medianas y grandes. Aparece como resultado de trastornos genéticos, sobrepeso y la atención brindada a los perros. Actualmente, no existen mecanismos especializados que brinden comodidad a la vida de estas mascotas, al tiempo que se adaptan a la condición canina y promueven el uso de sus patas traseras hasta que se pierda por completo la movilidad. Por lo tanto, en el presente estudio, se sintetizó y modeló un dispositivo versátil para ayudar a mejorar la calidad de vida de los perros, tomando como referencia la raza "Pastor Alemán". Fue diseñado teniendo en cuenta la salud y el bienestar de estos animales, considerando la movilidad y la seguridad de sus extremidades. Este dispositivo utiliza un mecanismo de eslabones para proporcionar soporte estructural a los perros, al tiempo que permite la movilidad dentro de un rango de movimiento específico. Proyectando una posible incorporación de un sistema de engranaje y resorte que controla el peso levantado por el dispositivo, para que los perros utilicen parcialmente sus patas traseras. El comportamiento estático y dinámico de este mecanismo fue modelado matemáticamente, encontrando una solución óptima

Comparative In Vitro Activity of Ceftolozane/Tazobactam against Clinical Isolates of Pseudomonas aeruginosa and Enterobacterales from Five Latin American Countries

Background: Ceftolozane/tazobactam (C/T) is a combination of an antipseudomonal oxyiminoaminothiazolyl cephalosporin with potent in vitro activity against Pseudomonas aeruginosa and tazobactam, a known β-lactamase inhibitor. The aim of this study was to evaluate the activity of C/T against clinical isolates of P. aeruginosa and Enterobacterales collected from five Latin American countries between 2016 and 2017, before its clinical use in Latin America, and to compare it with the activity of other available broad-spectrum antimicrobial agents. Methods: a total of 2760 clinical isolates (508 P. aeruginosa and 2252 Enterobacterales) were consecutively collected from 20 hospitals and susceptibility to C/T and comparator agents was tested and interpreted following the current guidelines. Results: according to the CLSI breakpoints, 68.1% (346/508) of P. aeruginosa and 83.9% (1889/2252) of Enterobacterales isolates were susceptible to C/T. Overall, C/T demonstrated higher in vitro activity than currently available cephalosporins, piperacillin/tazobactam and carbapenems when tested against P. aeruginosa, and its performance in vitro was comparable to fosfomycin. When tested against Enterobacterales, it showed higher activity than cephalosporins and piperacillin/tazobactam, and similar activity to ertapenem. Conclusions: these results show that C/T is an active β-lactam agent against clinical isolates of P. aeruginosa and Enterobacterales.Fil: García Betancur, Juan Carlos. Universidad El Bosque;Fil: De La Cadena, Elsa. Universidad El Bosque;Fil: Mojica, María F.. Universidad El Bosque; . Case Western Reserve University; Estados UnidosFil: Hernández Gómez, Cristhian. Universidad El Bosque;Fil: Correa, Adriana. Universidad Santiago de Cali; ColombiaFil: Radice, Marcela Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); ArgentinaFil: Castañeda Méndez, Paulo. Fundacion Clinica Medica Sur; MéxicoFil: Jaime Villalon, Diego A.. Fundacion Clinica Medica Sur; MéxicoFil: Gales, Ana C.. Universidade Federal de Sao Paulo; BrasilFil: Munita, José M.. Universidad del Desarrollo; ChileFil: Villegas, María Virginia. Universidad El Bosque

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

A BAX/BAK and Cyclophilin D-Independent Intrinsic Apoptosis Pathway

Most intrinsic death signals converge into the activation of pro-apoptotic BCL-2 family members BAX and BAK at the mitochondria, resulting in the release of cytochrome c and apoptosome activation. Chronic endoplasmic reticulum (ER) stress leads to apoptosis through the upregulation of a subset of pro-apoptotic BH3-only proteins, activating BAX and BAK at the mitochondria. Here we provide evidence indicating that the full resistance of BAX and BAK double deficient (DKO) cells to ER stress is reverted by stimulation in combination with mild serum withdrawal. Cell death under these conditions was characterized by the appearance of classical apoptosis markers, caspase-9 activation, release of cytochrome c, and was inhibited by knocking down caspase-9, but insensitive to BCL-XL overexpression. Similarly, the resistance of BIM and PUMA double deficient cells to ER stress was reverted by mild serum withdrawal. Surprisingly, BAX/BAK-independent cell death did not require Cyclophilin D (CypD) expression, an important regulator of the mitochondrial permeability transition pore. Our results suggest the existence of an alternative intrinsic apoptosis pathway emerging from a cross talk between the ER and the mitochondria

Estudio comparativo del desarrollo de aleros en diferentes regiones climáticas y contextos geológicos de la Argentina: hacia una caracterización de patrones y procesos

Este estudio forma parte de un proyecto interdisciplinario en etapa de gestión cuyo objetivo consiste en realizar un análisis geoarqueológico comparativo de aleros ubicados en diferentes contextos geológicos y climáticos de Argentina, a fin de evaluar patrones recurrentes y peculiaridades en el desarrollo de sus morfologías y estratigrafías. El origen, evolución temporal, los tipos de rellenos y el eventual colapso de los aleros responde a factores de control cuyo análisis resulta clave para entender el uso humano de estos espacios en el pasado, su potencial cronológico, los procesos de sedimentación, las discontinuidades estratigráficas y las condiciones de preservación de materiales arqueológicos y tafonómicos. Entre aquellos factores que controlan el desarrollo de un alero pueden destacarse su litología y estructura (tipo de roca, composición mineralógica, textura, fracturas), las condiciones climático-ambientales (precipitación, temperatura, vientos, insolación), la biota (tipo de vegetación, fauna local), el marco tectónico (actividad sísmica) y el tiempo. Estos factores intervienen en los procesos de meteorización y erosión que inician y van modelando el crecimiento de un espacio u oquedad en la roca, que en determinada etapa de su evolución puede llegar a formar un refugio o reparo útil para ser ocupado por los seres humanos, transformándose en un abrigo rocoso o alero. Esta oquedad funciona como una trampa sedimentaria que no sólo contendrá los clastos derivados de la roca de caja, sino también los aportes sedimentarios clásticos (partículas) y químicos (sales, óxidos) acarreados hasta allí por el viento, el agua y/o una pendiente cercana. A este relleno se suman los materiales (clásticos, químicos y biológicos) que puedan generar la fauna y los seres humanos a partir del uso del reparo, produciéndose una suma de aportes autóctonos y alóctonos que van a configurar la estratigrafía del sitio que constituirá una evidencia, al menos parcial, de su historia de formación y ocupación. Finalmente, el alero puede degradarse o colapsar, perdiendo su relleno o quedando oculto. Este proyecto busca profundizar el conocimiento de estos aspectos a través de un abordaje comparativo intra e inter-regional, en función de determinadas preguntas básicas y metodologías analíticas similares aplicadas a estudios de casos en el sur, centro y norte de Argentina. Bajo esta perspectiva se evaluará la utilización y la modificación de estos loci puntuales por parte de los seres humanos y de la fauna que los ha ocupado en forma recurrente. Todo ello a fin de maximizar la contribución de los aleros a las investigaciones arqueológicas y paleoecológicas en las regiones donde éstos se desarrollan.Fil: Favier Dubois, Cristian Mario. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; ArgentinaFil: Mosquera, Bruno Hernan. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Ambrústulo, Pablo. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; ArgentinaFil: Herrera Villegas, Dalila Viviana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; ArgentinaFil: Scartascini, F.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Diversidad Cultural y Procesos de Cambio. Universidad Nacional de Río Negro. Instituto de Investigaciones en Diversidad Cultural y Procesos de Cambio; ArgentinaFil: Barberena, Ramiro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; ArgentinaFil: Zárate, M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Confluencia; ArgentinaFil: Martínez, G. A.. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Geología de Costas y del Cuaternario. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Geología de Costas y del Cuaternario; ArgentinaFil: Massigoge, Agustina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; ArgentinaFil: Durán, V.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; ArgentinaFil: Storchi Lobos, Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; ArgentinaFil: Carrera Aizpitarte, Manuel Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Museo Etnográfico "Juan B. Ambrosetti"; ArgentinaFil: Rivero, Diego Eduardo. Centro de Estudios Historicos "prof. Carlos S.a. Segreti". Instituto de Estudios Historicos. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Estudios Historicos.; ArgentinaFil: Carbonelli, Juan Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Museo Etnográfico "Juan B. Ambrosetti"; ArgentinaFil: Kligmann, Debora Myriam. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Hocsman, Salomón. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Estudios Sociales. Universidad Nacional de Tucumán. Instituto Superior de Estudios Sociales; ArgentinaFil: Babot, Maria del Pilar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Estudios Sociales. Universidad Nacional de Tucumán. Instituto Superior de Estudios Sociales; ArgentinaFil: Gomez Augier, Julian Patricio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto de Geociencias y Medio Ambiente; ArgentinaFil: Tchilinguirian, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Secretaría de Cultura de la Nación. Dirección Nacional de Cultura y Museos. Instituto Nacional de Antropología y Pensamiento Latinoamericano; ArgentinaVII Taller del Grupo de Estudios Geoarqueológicos de América Latina: Encuentro Latinoamericano de GeoarqueologíaLimaPerúPontificia Universidad Católica del Per

Guías colombianas de electrofisiología no invasiva

Los métodos diagnósticos no invasivos son el pilar inicial del estudio de cualquier paciente con una patología en particular, de ahí que sean los exámenes más solicitados y constituyan una importante carga en costos para un sistema de salud.Q4Guías1-12

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication