Evaluation and optimization of the Sysmex UF1000i system for the screening of urinary tract infection in primary health care elderly patients

Objective Urinary tract infections (UTIs) are a common problem in the elderly population. Urine culture is still considered the "gold standard" to diagnose infection in this population. However, urine cultures are laborious and costly, and most samples will yield no growth. Methods An evaluation was made of the Sysmex UF-1000i flow cytometer as a screening tool for UTI in an elderly population older than 65 years who lived in the community, using 346 urine samples submitted for culture. Results The Receiver Operating Characteristic (ROC) analysis showed a significant difference (P < 0.01) between 0.98 bacteria area under the curve value and 0.82 of white blood cells (WBC). The combination of both counts for screening did not show any improvement in specificity or sensitivity. According to our data, the use of a single cut-off point of 200 bacteria/μL is suggested, in which the sensitivity and specificity were 99.11% and 91.59%, respectively, with a NPV of 99.49%. Moreover, this cut-off value could avoid 60.24% of the samples to be cultured, with a minimal false negative results rate of 0.87%. Conclusions The stratification of age groups stratification helps in selecting a more adjusted Sysmex UF1000i cut-off limit, leading to an improvement in the screening parameters that would imply a better management of these infections, as well as a high reduction in the workload and cost savings

Quiste óseo aneurismático poliostótico

Se presenta un caso de quiste óseo aneurismático de localización bifocal, correspondiente a una niña de 12 años de edad. La primera lesión diagnosticada se localizó en la metáfisis proximal de la tibia izquierda y dos años más tarde, se descubrió una lesión similar en el calcáneo derecho. El estudio individualizado de estas lesiones no demuestra diferencias significativas respecto a las clásicamente descritas para los quistes óseos aneurismáticos genuinos, monostó- ticos. En una amplia revisión bibliográfica sólo hemos podido encontrar un caso de localización plurifocal.A bifocal aneurysmatic bone cyst presenting in a 12-year-old is reported. The first lesion detected was situated in the proximal metaphysis of the left tibia; the second lesion was diagnosed two years later in the right calcaneus. Individual evaluation of these lesions discovered no significant differences with respect to classical monostotic, true aneurysmatic bone cysts. An exhaustive review of the literature yielded only one case exhibiting plurifocal location

Las canteras de calizas de los interfluvios de los ríos Jarama-Tajuña-Tajo en la Comunidad de Madrid: Valoración de recursos.

Un conjunto de ca lizas situadas en los interfluvios de los ríos Jarama-Tajuña-Tajo en la Comunidad de Madrid, explotadas más intensamente en las últimas décadas, son estudiadas como recurso geológico. Estas cal izas pertenecen básicamente a la Unidad Superior del relleno neógeno de la Cuenca de Madrid y en menor proporción a la Unidad Terminal. Se analizan sus características para diferentes usos estableciéndose unas posibles reservas de mil millones de toneladas, que podríamos considerar prácticamente ilimitadas a efectos de la producción de cemento. Las propiedades químicas y mecánicas de estas calizas, así como la presencia de algunas fábricas tobáceas de notable belleza sugieren una explotación racional esca lonada de las ca lizas como: rocas ornamentales, áridos de machaqueo, cales, cargas , etc. Se aconseja una central ización de todas las expfotaciones existentes en dos o tres cortas diseñadas correctamente en cuanto a Ja minimización del impacto ambiental

CO19 168. Impacto de la hipertensión pulmonar en la evolución de los ancianos sometidos a sustitución valvular aórtica

ObjetivoEstudiar la influencia de la hipertensión pulmonar (HTP) en la evolución de los ancianos sometidos a sustitución valvular aórtica (SVA).Material y métodosDesde octubre de 1999 hasta noviembre de 2009, 517 ancianos (rango 70-87 años) fueron sometidos a SVA. Trescientos cincuenta y cinco (68,7%) enfermos (grupo I) tenían hipertensión pulmonar (ligera 157; moderada 149; grave 49) frente a 162 (31,3%) (grupo II) con presiones pulmonares normales. El seguimiento medio fue de 4,3 años.ResultadosLa edad media fue de 76,4±3,9 años. La fibrilación auricular (29,5 vs 5,6%; p=0,001) y la insuficiencia mitral moderada preoperatorias (13,7 vs 5,1%; p=0,003) fueron más frecuentes en el grupo I. La mortalidad hospitalaria fue 4,3%, siendo significativamente superior en los pacientes con HTP (I: 5,7% vs II: 0,8%; p=0,027). Los pacientes con HTP moderada (7,3%) o grave (13,9%) tuvieron una mortalidad significativamente superior a la de los pacientes con HTP ligera (1,7%) (p=0,016). La supervivencia actuarial a los 5 años, de los pacientes dados de alta, aunque superior en los pacientes sin HTP (I: 80,9% vs II: 90,6%; p=0,162), no alcanzó significación. La HTP moderada-grave se asoció de manera independiente a la mortalidad hospitalaria (odds ratio [OR]: 2,07; p=0,015), pero no a una menor supervivencia en el seguimiento.ConclusionesLa HTP moderada-grave es un factor de riesgo independiente de mortalidad hospitalaria en los ancianos sometidos a SVA. Su influencia en la supervivencia a medio plazo es menos clara

Geological factors of the Guadalajara landscapes (Central Spain) and their relevance to landscape studies

The landscapes of a territory are the consequence of its history; overlapped geological, vegetable and cultural histories usually exist on a landscape. At the Mediterranean domain, however, a translucent vegetation exists, and its history is closely related to the geologic and cultural histories, because low-technology agricultural uses on a different hardness rock background control vegetation. Thus, in areas like the Guadalajara province, the geologic composition and the human activities can be considered the primary conditions for landscape configuration. Both condition the typologies, distribution and relative importance of the geotic, biotic and anthropogenic components of landscapes. A complex network of interrelations among all them exists but, in the base of which lie the geology of the territory, included relief, because it has amore independent influence since man cannot modify the geologic factors; such as the colour of the rocks, the size and distribution of rock bodies, the palaeogeographic domains and the tectonic structure all which control landscape development and configuration. Moreover, geology influences conditions and even limit, the presence, typologies and development of the biotic and anthropogenic elements. These factors also have a major relevance for environmental management, educational and economic policy, and, in some cases, for environmental impact assessment.Depto. de Geodinámica, Estratigrafía y PaleontologíaFac. de Ciencias GeológicasTRUEpu

Geological factors of the Guadalajara landscapes (Central Spain) and their relevance to landscape studies

The landscapes of a territory are the consequence of its history; overlapped geological, vegetable and cultural histories usually exist on a landscape. At the Mediterranean domain, however, a translucent vegetation exists, and its history is closely related to the geologic and cultural histories, because low-technology agricultural uses on a different hardness rock background control vegetation. Thus, in areas like the Guadalajara province, the geologic composition and the human activities can be considered the primary conditions for landscape configuration. Both condition the typologies, distribution and relative importance of the geotic, biotic and anthropogenic components of landscapes. A complex network of interrelations among all them exists but, in the base of which lie the geology of the territory, included relief, because it has amore independent influence since man cannot modify the geologic factors; such as the colour of the rocks, the size and distribution of rock bodies, the palaeogeographic domains and the tectonic structure all which control landscape development and configuration. Moreover, geology influences conditions and even limit, the presence, typologies and development of the biotic and anthropogenic elements. These factors also have a major relevance for environmental management, educational and economic policy, and, in some cases, for environmental impact assessment

Proposals for environmental impact decreasing in a suburban zone of limestone quarries: Southem Madrid Community, Spain

Over 30 Mm3 of limestones are extracted at least 100 quarries in southem part ofMadrid, its environmental impact is described in this paper. Three main reclamation areas are distinguished: surrounding of quarries, faces or highwalls of quarries and the floor. For soil reclamation in the environs of quarries we suggest to sow it with forage of fast growth plants (Lupinus, Tripho/ium ... ), in the floor of quarries is possible a spontaneous revegetation or even may be reclaimed for agricultural uses. For quarried rocks faces previous blasting and/or wider benchs are proposed. In opinion of the authors it is necessary to concentrate the limestone extraction in two or three Iarge quarries that allows a best policy and reclamation

Necrosis aséptica de astrágalo: presentación de un caso en la infancia

Se presenta un caso de necrosis aséptica de astrágalo en la infancia de origen idiopático que, hasta donde sabemos, resulta único en la literatura mundial. Se trata de una niña con un síndrome de Klippel-Trenaunay que debuta a la edad de 8 años con un cuadro de dolor e inflamación intermitente en tobillo derecho. Se realiza estudio mediante radiografías simples, RNM y gammagrafía con "Tc, llegando al diagnóstico de necrosis avascular de astrágalo. Se trata mediante descarga del miembro durante 3 meses, realizando la paciente vida normal con mínimas molestias a los 3 años del diagnósticoWe present one case of idiopathic avascular necrosis of the talus in a child.To our knowledge, this is the first case reported in the literature. The patient is a girl diagnosed of Klippel-Trenaunay syndrome of the ipsilateral limb. When she was 8 years old began with pain and swelling in the right ankle. Simple X-ray, isotopic bone scan and MRI were done, and she was diagnosed of avascular necrosis of the talar dome. The treatment was no weight bearing for three months. She has no sympthoms three years after diagnosis

Application of a Microalgal Peptide-Enriched Extract as Media Component in E. coli Culture

This study evaluated the feasibility of applying a microalgal peptide-enriched extract, obtained through a sequential alkaline and enzymatic method, as a fundamental media component in Escherichia coli culture. The results demonstrated that the extract is viable as the primary nutrient source for E. coli cultures (wild type), even as a complete substitute for the widely used Luria-Bertani (LB) medium, using an extract dilution of 1:3. Its application in a proportion carbon limiting (dilution 1:7), with glycerol supplementation at the early stationary phase, improved the nutrient use efficiency and controlled the undesirable acetate production. Furthermore, this last strategy applied in an E. coli mutant (M4-Delta iclR) enhanced the production of succinate by 67.3% compared with the M9 medium. The innovative approach proposed in this study opens a wide range of applications and studies related to the production of bio-compounds through diverse microorganisms