Secuenciación del ITS-1 del ADN ribosomal de Galba truncatula (Gastropoda, Lymnaeidae) y su impacto potencial en la transmisión de la fascioliasis en Mendoza, Argentina

Sequencing of the rDNA ITS–1 proved that the lymnaeid snail species Galba truncatula is present in Argentina and that it belongs to the haplotype HC, the same as that responsible for the fascioliasis transmission in the human hyperendemic area with the highest human prevalences and intensities known, the Northern Bolivian Altiplano.La secuenciación del ITS–1 del ADNr demostró que la especie de gasterópodo lymnaeido Galba truncatula se encuentra en Argentina y que pertenece al haplotipo HC, el mismo responsable de la transmisión de la fascioliasis en el área de hiperendemia humana con las mayores prevalencias e intensidades de fascioliasis conocidas, el Altiplano Norte Boliviano

The deep inferior epigastric artery perforator flap: a review

Breast cancer is recognized worldwide as a major health problem among women due to its high incidence and high mortality and morbidity rates. Breast reconstruction is an approach of great value for those patients who underwent mastectomy, impacting their quality of life and psychological stress. The deep inferior epigastric artery perforator (DIEP) flap was described as the preferred graft for breast reconstruction with an autologous flap by surgeons because it represented a decrease in complications for the time and obtained better results. DIEP flap reconstruction requires microsurgical skills as well as continuous monitoring of the patient to identify and resolve possible associated complications.

Interregionalism's impact on regional integration in developing countries: the case of Mercosur

This article examines the impact of interregionalism on deepening regional integration processes in non-European Union (EU) regions, specifically the Southern Common Market (Mercosur). It considers whether ‘capacity-building’ functions of interregionalism are present in EU–Mercosur relations. It argues that although negotiations for an association agreement might have helped Mercosur survive periods of severe crisis in the past, the terms of the agreement under negotiation were not sufficiently attractive to encourage deeper integration in Mercosur. Moreover, interregionalism cannot be expected to compensate for low institutionalization, nor substitute for weak political willingness to deepen integration. Ultimately, Mercosur alone can decide how far it wants to take its regional integration

Stevens-Johnson syndrome and toxic epidermal necrolysis: a review

Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are considered a single entity with variability in the extent of the lesions, characterized by erythema multiforme that may involve mucosa. Severe cutaneous reactions secondary to medications are classified according to the area of epidermal detachment. The activation of cytotoxic T cells and macrophages is mediated mainly by IL-2 and interferon gamma secreted by Th1 lymphocytes, and the activation of eosinophils and B lymphocytes in IgE is mediated by secreted IL-4, IL-5, IL-10 and IL13 by B lymphocytes. The topography of SJS is predominantly central, affecting the trunk and sometimes a generalized dissemination is shown that affects a body surface area of less than 10%, characterized by irregular violaceous erythematous macules of target shooting, which can form confluent blisters. TEN is characterized by a skin detachment greater than 30% of the body surface, whose predominant lesion is diffuse erythema with individual macules, which give rise to detachment surfaces greater than 5 cm. The treatment is symptomatic, nonspecific, and aimed at avoiding complications, carried out in specialized intensive care units, due to ignorance of the pathogenesis. Integral management with different therapeutic alternatives can represent a crucial part in the multisystemic management of SJS and TEN

Antebrachial microvascular flap for reconstruction of the pelvic limb: case report

Complex defects in the soft tissues of the foot and ankle caused by high-energy trauma, infection, cancer or diabetes require rapid and effective treatment which decreases the risk of infection, bone healing time, hospital stay and number total of surgical approaches. Authors report a clinical case of a 23-year-old female patient who suffers high-energy trauma due to a motorcycle accident which causes exposure of the distal third of the tibia, loss of the tibial joint face, and loss of tissue throughout the region of the malleolus medial of the right pelvic extremity. Tissue transfer to the pelvic limb is performed using left contralateral radial antebrachial free flap as donor area. This case report aims to emphasize the key aspects of the high energy trauma approach by using microvascular flaps, as well as the satisfactory evolution of the patient that directly affects the prognosis for life and function

Regional actorness and interregional relations:ASEAN, the EU and Mercosur

The European Union (EU) has a long tradition of interregional dialogue mechanisms with other regional organisations and is using these relations to project its own model of institutionalised actorness. This is partly motivated by the emerging actorness of the EU itself, which benefits from fostering capable regional counterparts in other parts of the world. This article advances the argument that actorness, which we conceptualise in terms of institutions, recognition and identity, is a relational concept, dependent on context and perception. Taking the Association of Southeast Asian Nations (ASEAN) and the Common Market of the South (Mercosur) and their relations with the EU as case studies, this article demonstrates that the actorness capabilities of all three organisations have been enhanced as result of ASEAN-EU and Mercosur-EU relations. However, there are clear limits to the development of the three components of regional actorness and to the interregional relations themselves. These limits stem both from the type of interregionalism at play and from the different regional models the actors incorporate. While there is evidence of institutional enhancement in ASEAN and Mercosur, these formal changes have been grafted on top of firmly entrenched normative underpinnings. Within the regional organisations, interactions with the EU generate centrifugal forces concerning the model to pursue, thus limiting their institutional cohesion and capacity. In addition, group-to-group relations have reinforced ASEAN and Mercosur identities in contrast to the EU. The formation of such differences has narrowed the scope of EU interregionalism despite the initial success of improved regional actorness

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

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

Análisis y rediseño del sistema de distribución de la subestación centro industrial cnel los ríos, basado en la calidad del servicio

Nowadays the Electric Distribution Systems presents constant interruption problems in the energy service that go from brief seconds until hours of interruption, causing economic losses so much in the users as those Distributor companies. In order to obtain a reliable and secure system, according to the standards and Regulations of power Quality, it is necessary to carry out a study that identify the factors that deteriorate the quality providing the necessary tools to choose the correct and economically acceptable alternative

Ribosomal DNA ITS-1 sequencing of Galba truncatula (Gastropoda, Lymnaeidae) and its potential impact on fascioliasis transmission in Mendoza, Argentina

Sequencing of the rDNA ITS–1 proved that the lymnaeid snail species Galba truncatula is present in Argentina and that it belongs to the haplotype HC, the same as that responsible for the fascioliasis transmission in the human hyperendemic area with the highest human prevalences and intensities known, the Northern Bolivian Altiplano