Ribotipificación de aislamientos de Mannheimia haemolytica serotipo 1 obtenidos de exudado nasal de bovinos productores de leche en México

Se realizó la caracterización genética de 106 aislamientos de Mannheimia haemolytica serotipo 1 (S1) obtenidos de exudado nasal de bovinos clínicamente sanos (BCS) (n= 80) y enfermos (BCE) (n= 26) de neumonía de dos granjas lecheras del centro y norte de México, mediante la técnica de ribotipificación. De los cuales se extrajo el DNA para realizar el proceso de digestión con la endonucleasa de restricción HindIII y la posterior ribotipificación, que se realizó utilizando una sonda que contenía el operon rrnB rRNA. Se identificaron dos patrones de ribotipos: Rt1 y Rt2, en ambos casos, con bandas de hibridación con tamaños aproximados entre 0.78 y 19.70 kb. El Rt1 presentó 11 bandas de hibridación y el Rt2 13. El 96 % de los aislamientos (102/106) se agruparon en un cluster dentro del Rt1. Entre el Rt1 y el Rt2 se presentó un valor de similitud de 70 %. No se identificaron diferencias entre los Rt de los aislamientos de los animales BCS o BCE. Estos resultados indican que la mayoría de las cepas se agrupan dentro un mismo Rt (Rt1) conformando un solo cluster, independientemente del origen de las mismas y del estado de salu

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Global patterns and drivers of ecosystem functioning in rivers and riparian zones

River ecosystems receive and process vast quantities of terrestrial organic carbon, the fate of which depends strongly on microbial activity. Variation in and controls of processing rates, however, are poorly characterized at the global scale. In response, we used a peer-sourced research network and a highly standardized carbon processing assay to conduct a global-scale field experiment in greater than 1000 river and riparian sites. We found that Earth's biomes have distinct carbon processing signatures. Slow processing is evident across latitudes, whereas rapid rates are restricted to lower latitudes. Both the mean rate and variability decline with latitude, suggesting temperature constraints toward the poles and greater roles for other environmental drivers (e.g., nutrient loading) toward the equator. These results and data set the stage for unprecedented "next-generation biomonitoring" by establishing baselines to help quantify environmental impacts to the functioning of ecosystems at a global scale.peerReviewe

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Anales de la Academia de Medicina de Medellín, Año 1, No. 12. Enero. 1888. Primera época

Dime que comes y te dire quien eres. Pag.339-341 * Extracto del acta de la sesión del 3 de diciembre de 1888. Vermífugo Indígena. Tratamiento de la Blenorragia. Pag.341-346 * Observaciones sobre la etiología y el tratamiento de la disenteria. Pag.346-352 * Un caso de eczema cronico. Pag.352-354 * Medicina Legal. Pag. 354-358 * Folletin: Higiene Publica una reforma conveniente. Pag.355-363 * Algo sobre la cocaina. Pag.358-364 * Bibliografía tratado de terapeutica aplicada general y especial, escrito y publicado por el Sr. Dr. Manuel Plata Azuero. Pag.365-367 * Revista. Pag.367-370 * Correspondencia. Pag.370 * Correspondencia. Pag.37

Discurso, género y mujer

En este volumen, abordamos el estudio de la relación entre discurso y género desde dos perspectivas: en primer lugar sobre las formas en las cuales el discurso, el lenguaje en uso en todos los aspectos de nuestra vida social, construye el género, es decir, contribuye a la formación de nuestra identidad femenina o masculina. Desde esta perspectiva, partimos de la premisa de que cada individuo se convierte en mujer o en hombre mediante un proceso que incluye la interpelación con discursos, ideologías y prácticas sociales. Al considerar el discurso cotidiano tomamos en cuenta también las formas en las cuales el lenguaje nos da evidencia de concepciones ideológicas sobre los géneros, sobre el hombre pero sobre todo sobre la mujer, teniendo en cuenta siempre las diferencias de clase, de etnia, etc. En segundo lugar, exploramos brevemente cómo el concepto de género y la perspectiva de género transforman los discursos científicos de diversas disciplinas y saberes, tales como la sociología, la historia, la medicina social, la antropología, la educación y los estudios literarios. Se recogen además trabajos de investigación en las disciplinas mencionadas que incorporan la categoría de género como una concepción importante. Otros, aunque no incorporan explícitamente esta categoría, versan sobre la situación de la mujer vista desde una perspectiva histórica o antropológica, y, en un caso, sobre los movimientos feministas en Colombia y en otros paíse