Characteristics of cholecystectomized patients at Abel Santamaría Cuadrado General Teaching Hospital

Introducción: la alta frecuencia de presentación de la colelitiasis y sus complicaciones en consulta de cirugía general, determina una elevada práctica de la colecistectomía cada año.Objetivo: caracterizar a los pacientes colecistectomizados en el Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río en el período julio-diciembre de 2018.Métodos: se realizó un estudio observacional descriptivo, longitudinal, retrospectivo. El universo estuvo constituido por 86 pacientes colecistectomizados en el período julio-diciembre de 2018 y la muestra, seleccionada de forma intencional, fue de 69 que cumplieron los criterios de inclusión y exclusión. Las variables estudiadas (edad, sexo, color de la piel, antecedentes de Diabetes Mellitus, tipo de intervención, tiempo transoperatorio, estadía hospitalaria, uso de antibióticos, complicaciones, alteraciones ultrasonográficas) se analizaron mediante estadística descriptiva.Resultados: la mayoría de los pacientes se encontraban en el rango de edad de 40 a 59 años (46,4 %); predominando el sexo femenino con el 81,2 % e igual número de ellos fueron intervenidos por vía laparoscópica. La cirugía duró menos de una hora en el 60,2 % de los casos y en el 46,4 % se realizó de urgencia.Conclusiones: los pacientes colecistectomizados debido a afecciones propias de la vesícula biliar causadas por colelitiasis son en su mayoría adultos jóvenes de sexo femenino y piel blanca.Introduction: the high frequency of presentation of cholelithiasis and its complications in general surgery consultation, determines a high cholecystectomy practice every year. Objective: to characterize cholecystectomized patients in the General Teaching Hospital Abel Santamaría Cuadrado of Pinar del Río in the period July-December 2018.Methods: a descriptive, longitudinal, retrospective observational study was carried out. The universe was constituted by 86 cholecystectomized patients in the period July-December 2018 and the sample, selected intentionally, was 69 who met the inclusion and exclusion criteria. The variables studied (age, sex, skin color, history of Diabetes Mellitus, type of intervention, transoperative time, hospital stay, antibiotic use, complications, ultrasonographic alterations) were analyzed by descriptive statistics.Results: most of the patients were between 40 and 59 years of age (46,4 %); 81,2 % were female and the same number of them underwent laparoscopic surgery. Surgery lasted less than one hour in 60,2 % of the cases and in 46,4 % it was performed urgently.Conclusions: patients who underwent cholecystectomy due to gallbladder disorders caused by cholelithiasis are mostly young white-skinned female adults

Steady Decline of Corals and Other Benthic Organisms in the SeaFlower Biosphere Reserve (Southwestern Caribbean)

Coral reef decline persists as a global issue with ties to climate change and human footprint. The SeaFlower Biosphere reserve includes some of the most isolated oceanic coral reefs in the Southwestern Caribbean, which provide natural experiments to test global and/or basin-wide factors affecting coral reefs. In this study, we compared coral and other substrate cover (algae, cyanobacteria, and octocorals), along population densities of keystone urchin species from two atolls (Serrana and Roncador Banks), during 1995, 2003, and 2015/2016. We also surveyed benthic foraminifera as a water quality proxy for coral growth in the last period. A steady reduction in coral cover was clearly observed at Roncador’s lagoon, but not at Serrana’s reefs, with significant differences between 1995 and 2015/2016. Percent cover of fleshy algae decreased significantly also at Roncador between 1995 and 2003 but did not change notably from 1995 to 2016 at Serrana. However, both Banks exhibited a loss in crustose coralline algae from 2003 to 2015/2016. Likewise, a reduction in bottom complexity, measured as bottom rugosity, was evident between 1995 and 2003. Roncador Bank had unprecedented high octocoral densities, which increased almost threefold from 2003 to 2015. In contrast, urchin densities were low in Roncador; only Diadema antillarum increased from 2003 to 2016 in Serrana Bank. The Foraminifera in Reef Assessment and Monitoring (FORAM) Index (FI) in the two Banks was below the range expected for healthy coral reefs. Although both Banks follow a reduction in CCA and CA cover, Roncador Bank also faces an alarming decline in coral cover, urchins and bottom complexity (rugosity) in contrast to increases in octocoral densities and potential loss of resilience and eutrophication suggested by the FI index. These unexpected findings led us to consider and discuss potential outcomes, where these reefs deteriorate (i.e., erode and drown) providing ideal conditions for octocoral growth. Hence, it is of utmost urgency to start monitoring reef budgets, octocorals and nutrient sources

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

Centrality evolution of the charged-particle pseudorapidity density over a broad pseudorapidity range in Pb-Pb collisions at root s(NN)=2.76TeV

Peer reviewe

Initial dysnatremia and clinical outcomes in pediatric traumatic brain injury: A multicenter observational study

Purpose: We aimed to investigate the association between initial dysnatremia (hyponatremia and hypernatremia) and in-hospital mortality, as well as between initial dysnatremia and functional outcomes, among children with traumatic brain injury (TBI).Method: We performed a multicenter observational study among 26 pediatric intensive care units from January 2014 to August 2022. We recruited children with TBI under 18 years of age who presented to participating sites within 24 h of injury. We compared demographics and clinical characteristics between children with initial hyponatremia and eu-natremia and between those with initial hypernatremia and eu-natremia. We defined poor functional outcome as a discharge Pediatric Cerebral Performance Category (PCPC) score of moderate, severe disability, coma, and death, or an increase of at least 2 categories from baseline. We performed multivariable logistic regression for mortality and poor PCPC outcome.Results: Among 648 children, 84 (13.0%) and 42 (6.5%) presented with hyponatremia and hypernatremia, respectively. We observed fewer 14-day ventilation-free days between those with initial hyponatremia [7.0 (interquartile range (IQR) = 0.0-11.0)] and initial hypernatremia [0.0 (IQR = 0.0-10.0)], compared to eu-natremia [9.0 (IQR = 4.0-12.0); p = 0.006 and p \u3c 0.001]. We observed fewer 14-day ICU-free days between those with initial hyponatremia [3.0 (IQR = 0.0-9.0)] and initial hypernatremia [0.0 (IQR = 0.0-3.0)], compared to eu-natremia [7.0 (IQR = 0.0-11.0); p = 0.006 and p \u3c 0.001]. After adjusting for age, severity, and sex, presenting hyponatremia was associated with in-hospital mortality [adjusted odds ratio (aOR) = 2.47, 95% confidence interval (CI) = 1.31-4.66, p = 0.005] and poor outcome (aOR = 1.67, 95% CI = 1.01-2.76, p = 0.045). After adjustment, initial hypernatremia was associated with mortality (aOR = 5.91, 95% CI = 2.85-12.25, p \u3c 0.001) and poor outcome (aOR = 3.00, 95% CI = 1.50-5.98, p = 0.002).Conclusion: Among children with TBI, presenting dysnatremia was associated with in-hospital mortality and poor functional outcome, particularly hypernatremia. Future research should investigate longitudinal sodium measurements in pediatric TBI and their association with clinical outcomes

A multicenter observational study on outcomes of moderate and severe pediatric traumatic brain injuries-time to reappraise thresholds for treatment

Purpose: Children with moderate traumatic brain injury (modTBI) (Glasgow Coma Scale (GCS) 9-13) may benefit from better stratification. We aimed to compare neurocritical care utilization and functional outcomes between children with high GCS modTBI (hmodTBI, GCS 11-13), low GCS modTBI (lmodTBI, GCS 9-10), and severe TBI (sTBI, GCS ≤ 8). We hypothesized that patients with lmodTBI have higher neurocritical care needs and worse outcomes than patients with hmodTBI and are similar to patients with sTBI. Methods: Prospective observational study from June 2018 to October 2022 in 28 pediatric intensive care units (PICU) in Asia, South America, and Europe. We included children (age \u3c 18 years) with modTBI and sTBI admitted to PICU and measured functional outcomes at 3 months using the Glasgow Outcome Scale-Extended Pediatric Revision (GOS-E Peds, scale 1-8, 1 = upper good recovery, 8 = death). Results: We analyzed 409 patients: 98 (24%) and 311 (76%) with modTBI and sTBI, respectively. Patients with lmodTBI (vs. hmodTBI) were more likely to have invasive ICP monitoring (32.3% vs. 4.5%, p \u3c 0.001), longer PICU stay (days, median [IQR]; 5.00 [4.00, 9.75] vs 4.00 [2.00, 5.00], p = 0.007), and longer hospital stay (days, median [IQR]: 13.00 [8.00, 17.00] vs. 8.00 [5.00, 12, 25], p = 0.015). Median GOS-E Peds scores were significantly different (hmodTBI (1.00 [1.00, 3.00]), lmodTBI (3.00 [IQR 2.00, 5.75]), and sTBI (5.00 [IQR 1.00, 6.00]) (p \u3c 0.001)). After adjusting for age, sex, presence of polytrauma and cerebral edema, lmodTBI, and sTBI remained significantly associated with higher GOS-E scores (adjusted coefficient (standard error): 1.24 (0.52), p = 0.018, and 1.27 (0.33), p \u3c 0.001, respectively) compared with hmodTBI. Conclusions: Children with lmodTBI have higher rates of neurocritical care utilization and worse functional outcomes than those with hmodTBI but better than those with sTBI. Children with lmodTBI may benefit from guideline-based management similar to what is implemented in children with sTBI. This work was performed in hospitals within the PACCMAN and LARed networks. No reprints will be ordere

Enzyme-Catalyzed Production of Potato Galactan-Oligosaccharides and Its Optimization by Response Surface Methodology

This work shows an optimized enzymatic hydrolysis of high molecular weight potato galactan yielding pectic galactan-oligosaccharides (PGOs), where endo-β-1,4-galactanase (galactanase) from Cellvibrio japonicus and Clostridium thermocellum was used. For this, response surface methodology (RSM) by central composite design (CCD) was applied. The parameters varied were temperature (°C), pH, incubation time (min), and enzyme/substrate ratio (U/mg). The optimized conditions for the production of low degree of polymerization (DP) PGOs were obtained for each enzyme by spectrophotometric assay and confirmed by chromatography. The optimal conditions predicted for the use of C. japonicus galactanase to obtain PGOs of DP = 2 were T = 51.8 °C, pH 5, E/S = 0.508 U/mg, and t = 77.5 min. For DP = 3, they were T = 21 °C, pH 9, E/S = 0.484 U/mg, and t = 12.5 min; and for DP = 4, they were T = 21 °C, pH 5, E/S = 0.462 U/mg, and t = 12.5 min. The efficiency results were 51.3% for substrate hydrolysis. C. thermocellum galactanase had a lower yield (35.7%) and optimized conditions predicted for PGOs of DP = 2 were T = 60 °C, pH 5, E/S = 0.525 U/mg, and time = 148 min; DP = 3 were T = 59.7 °C, pH 5, E/S = 0.506 U/mg, and time = 12.5 min; and DP = 4, were T = 34.5 °C, pH 11, E/S = 0.525 U/mg, and time = 222.5 min. Fourier transformed infrared (FT-IR) and nuclear magnetic resonance (NMR) characterizations of PGOs are presented

Proteogenomic analysis of the Clostridium difficile exoproteome reveals a correlation between phylogenetic distribution and virulence potential

C. difficile induces antibiotic-associated diarrhea due to the action of two secreted toxins, TcdA and TcdB. A considerable range of virulence among C. difficile strains has been widely reported. During a hospital outbreak, 46 isolates were collected that belonged to different genotypes. Of those, the majority corresponded to two virulent strains, the globally distributed Sequence Type 1 (ST1)_North American Pulsotype 1 (NAP1) and the endemic ST54_NAPCR1 genotypes, respectively. Whereas the virulence of the latter has been attributed to increased secretion of toxins and production of a highly cytotoxic TcdB, these characteristics do not explain the increased lethality of the former. We undertook a proteomic comparative approach of the isolates participating in the outbreak to look for proteins present in the exoproteome of the ST1_NAP1and ST54_NAPCR1 strains. We used a low virulent ST2_NAP4 strain isolated also in the outbreak as control. Dendrograms constructed using the exoproteomes of the strains were very similar to those created using genomic information, suggesting an association between secreted proteins and relative virulence of the strains. By 2D electrophoresis and mass spectrometry it was found that approximately half of the proteins are shared among strains of different genotypes. From the identified proteins, the surface-located SlpA draw our attention due to its detection in ST54_NAPCR1 exoproteomes. Biochemical analysis indicated that the processing of SlpA is different in the ST54_NAPCR1 strain and confirmed that this strain secretes more SlpA than its counterparts. Furthermore, SlpA from the ST54_NAPCR1 strain exerted an increased proinflammatory activity. Altogether, these results indicate that the exoproteome composition correlates with the C. difficile genotype and suggest that particular proteins secreted by some strains could synergize with the effects of TcdA and TcdB increasing their virulence.Universidad de Costa Rica/[803-B6-657]/UCR/Costa RicaUniversidad de Costa Rica/[803-B5-112]/UCR/Costa RicaUniversidad de Costa Rica/[803-B5-108]/UCR/Costa RicaUniversidad de Costa Rica/[803-B5-600]/UCR/Costa RicaConsejo Nacional de Rectores/[]/CONARE/Costa RicaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Centro de Investigación en Enfermedades Tropicales (CIET)UCR::Vicerrectoría de Docencia::Salud::Facultad de MicrobiologíaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Laboratorio de Ensayos Biológicos (LEBI)UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP

Pedagogía universitaria: Convergencias interdisciplinarias

La presente edición “Pedagogía Universitaria: Convergencias Interdisciplinarias” contiene una recopilación de ensayos redactados por egresadas y egresados de la Maestría en Educación con Énfasis en Docencia Universitaria de la Universidad Nacional de Costa Rica. En ella, convergen pensamientos divergentes y prospectivos sobre el camino para darle continuidad y perseverancia al acto educativo que transcurre en las aulas universitarias y en todas las modalidades conocidas antes, en, durante y post pandemia COVID-19. Estos docentes nos presentan sus preocupaciones, dudas, pensamientos, inquietudes y proposiciones plasmadas en las líneas de cada de uno de estos ensayos, en diversos temas y conectados con el quehacer pedagógico universitario en una gama de disciplinas como: arte, medicina, matemáticas, psiquiatría, química, administración, docencia, lenguas, diseño ambiental, diseño gráfico, o en temas específicos como el fraude académico, la pedagogía saludable, el Diseño Universal de Aprendizaje (DUA) y los cursos de capacitación para el profesorado en materia pedagógica, entre otros. Es un libro lleno de experiencias pedagógicas y planteamientos conceptuales y metodológicos para compartir entre colegas, y hace una llamada a la reflexión permanente de nuestro ejercicio profesional. Los y las invito a disfrutar de esta lectura.Universidad Nacional, Costa RicaDivisión de Educologí