Glucosa sérica como predictor de mortalidad en unidad de cuidados intensivos

Objective: To establish the relationship between serum glucose and Scores of gravity: APACHE II / SAPS II as prognostic indicator of mortality in patients in intensive care unit. Materials and methods: Evaluation study of diagnostic and prognostic test that included 71 patients in critical clinical status of various etiologies; the probability of death was calculated using serum glucose levels regarding severity scores APACHE II and SAPS II. Data were obtained through interrogation and medical records subjected to statistical analysis. Results: 59% were male and 41% female. The highest frequency was 18 - 28 years old (25.31%). The cardiovascular and neurological liabilities were the most significant. Upon entering the critical care unit, glucose was higher than 180mg / dl in 33.73% of patients. The survival and mortality were 67.6% and 32.9%, respectively. The 60.8% of patients died had blood glucose > 180 mg / dl; while 39.13% had lower blood glucose. The glucose showed a sensitivity of 81% and specificity of 63.6% for identifying patients most and lower risk of death in ICU. Conclusion: Blood glucose> 180 mgs/dl was associated with increased mortality, although it was not specific to predict mortality. It can be a complementary testObjetivo: Establecer la relación entre glucosa sérica y Puntaje de gravedad APACHE II /SAPS II como indicador pronóstico de mortalidad en pacientes en unidad de cuidado intensivo. Materiales y Métodos: Estudio de evaluación de prueba diagnóstica y pronóstico que incluyó 71 pacientes en estado clínico crítico con diferentes etiologías; se calculó la probabilidad de muerte mediante los niveles de glucosa sérica en relación con Puntaje de Gravedad APACHE II y SAPS II. Los datos fueron obtenidos a través de interrogatorios e historias clínicas sometidos a análisis estadísticos. Resultados: 59% correspondió al sexo masculino y 41% al femenino. La mayor frecuencia estuvo entre 18 - 28 años de edad (25,31%). Los compromisos cardiovasculares y los neurológicos fueron los más significativos. La glucemia al ingreso a la unidad de cuidados críticos fue superior a 180mg/dl en 33,73% de los pacientes. La supervivencia y mortalidad fueron 67,6% y 32,9%, respectivamente. El 60,8% de los pacientes fallecidos presentaron glucemias > 180mg/dl; mientras que 39,13% presentó glucemias menores. La glucemia mostró sensibilidad de 81% y especificidad de 63,6% para identificar pacientes con mayor y menor riesgo de mortalidad en UCI. Conclusión: La glucemia > 180 mgs/dl se asoció con mayor mortalidad, aunque no resultó específica para predecir mortalidad, puede ser una prueba complementaria

Public Policy for the Poor? A Randomised Assessment of the Mexican Universal Health Insurance Programme

Background: We assessed aspects of Seguro Popular, a programme aimed to deliver health insurance, regular and preventive medical care, medicines, and health facilities to 50 million uninsured Mexicans. Methods: We randomly assigned treatment within 74 matched pairs of health clusters—ie, health facility catchment areas—representing 118 569 households in seven Mexican states, and measured outcomes in a 2005 baseline survey (August, 2005, to September, 2005) and follow-up survey 10 months later (July, 2006, to August, 2006) in 50 pairs (n=32 515). The treatment consisted of encouragement to enrol in a health-insurance programme and upgraded medical facilities. Participant states also received funds to improve health facilities and to provide medications for services in treated clusters. We estimated intention to treat and complier average causal effects non-parametrically. Findings: Intention-to-treat estimates indicated a 23% reduction from baseline in catastrophic expenditures (1·9% points; 95% CI 0·14–3·66). The effect in poor households was 3·0% points (0·46–5·54) and in experimental compliers was 6·5% points (1·65–11·28), 30% and 59% reductions, respectively. The intention-to-treat effect on health spending in poor households was 426 pesos (39–812), and the complier average causal effect was 915 pesos (147–1684). Contrary to expectations and previous observational research, we found no effects on medication spending, health outcomes, or utilisation. Interpretation: Programme resources reached the poor. However, the programme did not show some other effects, possibly due to the short duration of treatment (10 months). Although Seguro Popular seems to be successful at this early stage, further experiments and follow-up studies, with longer assessment periods, are needed to ascertain the long-term effects of the programme. Funding: Mexican Ministry of Health, the National Institute of Public Health of Mexico, and Harvard University Institute for Quantitative Social ScienceGovernmen

Expectativas de inflación en Colombia 2003-2019: un enfoque a través del Filtro de Kalman

28 páginasEn este documento se lleva a cabo la estimación de las expectativas de inflación mensuales en Colombia, para el período comprendido entre 2013 y 2019, a partir de una representación Estado-Espacio derivada de un proceso de vectores autorregresivos de la tasa de interés real ex ante y la inflación esperada. Para ello, se hace uso del Filtro de Kalman dentro de un optimizador no lineal, lo cual permite obtener los parámetros del modelo que describen la evolución de la tasa de interés nominal, la inflación y las expectativas de inflación. Se encontró evidencia que sugiere un comportamiento adaptativo de las expectativas junto con la subestimación de estas por parte de los agentes

Nanofotónica de OLEDs monocromáticos flexibles

Fabricación e implementación de una pantalla matriz 8x8 de diodos orgánicos emisores de luz (OLEDs) sobre sustrato flexible transparente de tereptalato de polietileno (PET) con emisión de fotones desde capas electroluminiscentes del orden de los nanómetros.Ingeniero (a) ElectrónicoPregrad

Endocarditis por entercoccus durans: Una causa poco frecuente. Reporte de caso

The infectious endocarditis is a disease that occurs in several clinical forms because of cardiac structural commitment established, involved microorganism and inherent situations to each patient. Among the most common causative agents are staphylococci group, followed by streptotococci and enterococci; in this last one, group the Enterococcus durans, is the lowest incidence. The case of a 54-year-old with a clinical picture characterized by worsening of chronic heart failure, who during hospitalization was handled as such, is presented; eight days later, due to the limited clinical improvement, the onset of fever quantified at 39°C, an echocardiogram revealed vegetations on mitral values and a positive blood culture for Enterococcus durans, the patient required antibiotic therapy and subsequent surgical management for valve replacement a biological mitral valve, with resolution of symptoms.La endocarditis infecciosa es una enfermedad que se presenta en diversas formas clínicas a causa del compromiso estructural cardiaco establecido, el microorganismo involucrado y las situaciones inherentes a cada paciente. En- tre los agentes causales los más frecuentes son del grupo de estafilococos, seguido por estreptococos y los entero- cocos; en este último grupo, el Enterococcus durans es el de menor incidencia. Se presenta el caso de una paciente de 54 años de edad, con cuadro clínico caracterizado por agudización de falla cardiaca crónica, quien durante el ingreso hospitalario fue manejada como tal; ocho días después, debido a la escasa mejoría clínica, la aparición de fiebre cuantificada en 39°C, un ecocardiograma que reveló vegetaciones en valvas mitrales y un hemocultivo po- sitivo para Enterococcus durans, la paciente requirió antibioticoterapia y posteriormente manejo quirúrgico para reemplazo de válvula mitral por una válvula biológica, con resolución del cuadro

Apex predators can structure ecosystems through trophic cascades: Linking the frugivorous behaviour and seed dispersal patterns of mesocarnivores

Current global change scenarios demand knowledge on how anthropogenic impacts affect ecosystem functioning through changes in food web structure. Frugivorous mesocarnivores are a key link in trophic cascades because, while their abundance and behaviour are usually controlled by apex predators, they can provide high-quality seed-dispersal services to plant communities. Thus, the recent rewilding of large carnivores worldwide can trigger cascading effects for plants. We investigated the top-down effects of an apex predator (Iberian lynx Lynx pardinus) on seed-dispersal services mediated by two mesocarnivore species (red fox Vulpes vulpes and stone marten Martes foina) at the plant community level by comparing areas with and without lynx in a Mediterranean mountain range in Southern Spain. We collected scats of mesocarnivores (n = 1575) to assess frugivory and seed dispersal of 15 plant species over two consecutive fruiting seasons and two habitat types (open and forest). Specifically, we assessed the effect of lynx presence on (i) seed occurrence and fleshy-fruit biomass per scat, (ii) number of scats containing seeds and (iii) diversity of dispersed seeds. The quantity and diversity of dispersed seeds drastically decreased under predation risk for both mesocarnivore's species. Seed dispersal by stone martens was negatively affected by the presence of lynx, with a marked reduction in the number of scats with seeds (93%) and the diversity of dispersed seeds (46%). Foxes dispersed 68% fewer seeds in open habitats when coexisting with lynx, probably leading to differential contributions to seed-dispersal effectiveness among habitats. Our study reveals a novel trophic cascade from apex predators to plant communities. The behavioural responses of frugivorous mesocarnivores to predation risk and the reduction in the intensity of their faecal deposition pattern are probably related to their lower abundance when co-occurring with apex predators. While rewilding apex predators is a successful conservation tool, attention should be paid to cascading effects across food webs, particularly where frugivore megafauna is missing and mesocarnivores provide unique services to plants. Read the free Plain Language Summary for this article on the Journal blog

Use of the System S2o3 (2-) -O2 for the Leaching of Precious Metals Contained in a Mineral From Molango in the State of Hidalgo, Mexico

The newer tendencies of research, related with the leaching of precious metals, involves the use of non toxic reagents that allows the leaching of a mineral of sedimentary origin using the system S2 - O3 2- - O2. Prior to thisprocess, the mineral was characterized by Scanning Electron Microscopy (SEM) in conjunction with Energy Dispersive Spectrometry of X – rays (EDS), X- ray mapping. Finally, the chemical composition was executed by Inductively Coupled Plasma Spectrometry (ICP). According to the results obtained, it was possible to determine that the mineral studied has adequate contents of gold, palladium, silver, and platinum. And after the leaching process, it could be possible to leach the gold and palladium that it contains, getting recoveries of 90% and 85 %, respectively. In the case of silver, a redissolution or precipitation could occur during the first minutes of reaction

Análisis de la competitividad del sistema extensivo de producción ovina de pequeña escala en el sureste hidalguense.

The objective of this study was to evaluate the comparative advantage of grazing in the competitiveness of the small-scale sheep production system in Singuilucan, Hidalgo, Mexico. For this purpose, data from 51 production units were analyzed, chosen from a simple random sampling. The information was obtained through an interview with 120 questions, organized into technical variables, economic aspects and social aspects of the producer. The Policy Analysis Matrix (PAM) was used to analyze the impact of grazing on competitiveness, in two scenarios: in the first, the low cost structure was studied under the traditional form of production, which uses grazing as feeding basis; while in the second, the cost was simulated by counting the purchase of feed, as well as hiring workforce. The results revealed that grazing as a feeding basis (real scenario), instead of commercial feed (simulated scenario), increases the profitability of the sheep system in 53%, which translates into a cost reduction (32%) and an increase in the utility of $10,830 (ten thousand eight hundred thirty pesos per farm) for each productive cycle of four months. The high dependency on grazing and family workforce observed in the simulated scenario indicate that the small-scale sheep production in Singuilucan could be vulnerable, if the micro-regional advantages that these factors contribute were to be lost, which would translate into a competitive reduction of approximately 62$10,830 (diez mil ochocientos treinta pesos promedio por granja) por cada ciclo productivo de cuatro meses. La alta dependencia del pastoreo y mano de obra familiar observada en el escenario simulado, indican que la producción ovina de pequeña escala en Singuilucan, podría ser vulnerable, si perdiera las ventajas microregionales que le aportan estos factores, lo cual, se traduciría en una reducción competitiva de aproximadamente 62%

Extracellular Monomeric Tau Is Internalized by Astrocytes

Tau is a microtubule-associated protein that is expressed in neurons. However, in a group of neurodegenerative diseases named tauopathies – characterized by an increase in aggregated and/or hyperphosphorylated Tau – the protein accumulates inside other cells, such as astrocytes and microglia. Given that these glial cells do not produce Tau, its presence can be explained by internalization from the extracellular medium and consequent formation of Tau aggregates. Among internalization mechanisms, heparan sulfate proteoglycans (HSPGs) have been proposed to be responsible for fibrillary Tau uptake in various cell types. Here we studied whether monomeric Tau, which has been observed to be internalized by glial cells such as microglia, was also taken up by astrocytes. Although this Tau form was internalized from the extracellular medium by these cells, the mechanism of uptake was found to be independent of HSPGsThis study was supported by the Spanish Ministry of Economy and Competitiveness [SAF-2014-53040-P (JÁ) and BFU2016- 77885-P (FH)] and the Centro de Investigación Biomédicaen Red sobre Enfermedades Neurodegenerativas (CIBERNED, Spain) (JÁ