Abordaje diagnóstico del gato con enfermedad del tracto urinario

ABORDAJE DIAGNÓSTICO DEL GATO CON ENFERMEDAD DEL TRACTO URINARIOLas enfermedades del tracto urinario caudal de los gatos (ETUCG) son un grupo de patologías que afectan a la vejiga y/o uretra, manifestándose por la presencia de signos clínicos del tracto urinario caudal; estas se pueden mostrar con cuadros obstructivos o no obstructivos. Su abordaje diagnóstico implica un proceso sistemático basado en los hallazgos de los estudios epidemiológicos

Efecto de la temperatura y tiempo de almacenamiento en la concentración de algunas fitohormonas y germinación de las semillas del chile piquín Capsicum annuum var. glabriusculum (Dunal) Heiser & Pickersgill

The genus Capsicum is an economically important plant around the world. In Mexico, chili cropping is a profitable agricultural business due to its demand in the national and international market. A species of interest is the bird pepper, Capsicum annuum var. glabriusculum (Dunal) Heiser & Pickersgill, whose exploitation is limited only to wild populations. There have been many unsuccessful attempts to cultivate it intensively because of its low germination percentage, since the seed shows non-deep physiological dormancy, a frequent feature in undomesticated wild species. In this study, the effect of temperature and age of bird pepper seed on the concentration of auxins (tryptophan), cytokinins (kinetin) and gibberellins (GA3) and their germinative capacity were analyzed. For this, the germinative capacity of pepper seeds stored at two temperatures (4 and 24°C) and five ages (0, 3, 6, 9 and 12 months) was evaluated. Also, quantification of the phytohormones auxins, cytokinins and gibberellins was performed using high performance liquid chromatography (HPLC). The results show that the content of the three phytohormones had increased through time according to the time of storage (p≤0.05). The highest germination percentage was at 9 months of storage (p≤0.05) and this was the highest content of the three phytohormones; therefore at this age, the seed reached its maturation point; however, at 12 months of storage, germination started diminishing as well as the phytohormone content, indicating that the seed quality and viability was starting to decrease.El género Capsicum es una hortaliza de importancia económica a nivel mundial. En México es una importante actividad económica en el sector agrícola, por ello la importancia del cultivo de variedades que permitan abrir nuevas áreas de oportunidad comercial tanto a nivel nacional como internacional. Una de estas variedades es el chile piquín Capsicum annuum var. glabriusculum (Dunal) Heiser & Pickersgill, cuyo aprovechamiento se reduce únicamente a poblaciones silvestres, ya que se han hecho varios intentos de cultivarla de manera intensiva teniendo como resultado bajos porcentajes de germinación, debido a que la semilla presenta latencia fisiológica no profunda, rasgo característico de especies que aún no han sido domesticadas. En este estudio se propuso conocer el efecto de la temperatura y el tiempo de almacenamiento, sobre el contenido de triptófano (aminoácido precursor de auxinas), citocininas (kinetina) y giberelinas (GA3) presentes en la semilla y su relación en el proceso de germinación. Para evaluar la capacidad de germinación de las semillas de chile piquín, estas se almacenaron a dos temperaturas (4 °C y 24 °C) y cinco tiempos de almacenamiento (0, 3, 6, 9 y 12 meses). Además, se cuantificó el contenido de fitohormonas, auxinas, citicininas y giberelinas utilizándose la técnica de Cromatografía Líquida de Alta Resolución (HPLC). Los resultados muestran que el contenido de las tres fitohormonas se incrementó con respecto al tiempo de almacenamiento. El más alto porcentaje de germinación y concentración de fitohormonas se presentó a los 9 meses de almacenamiento; mientras que, a los 12 meses, la germinación empieza a disminuir, así como el contenido de fitohormonas, indicando que la calidad y viabilidad de la semilla ha empezado a decrecer

Hitos Demográficos del Siglo XXI: Migración Internacional

La migración ha sido una constante en la historia mundial. Sin embargo, las migraciones que han tenido lugar desde principios del siglo XXI no tienen precedentes, ya que recientemente éstas han alcanzado su mayor volumen en la historia y presentan características que las diferencian de las observadas en periodos anteriores, lo que ha propiciado una nueva conceptualización del fenómeno, enmarcada en lo que algunos estudiosos llaman “la nueva era” de las migraciones internacionales (Arango, 2003, mencionado por Fernández, 2005). Este nuevo ciclo se caracteriza por una profusa re-configuración del mapa migratorio mundial, el cual parece dar cuenta hoy, de una auténtica mundialización migratoria, con una fuerte tendencia a la diversificación de rutas y conexiones origen-destino. El nuevo mapa es el correlato de un escenario de globalización económica, cultural e informacional, que estimula que segmentos amplios de la población respondan cada vez más rápidamente a informaciones y oportunidades que se originan más allá de las fronteras nacionales (CONAPO, 2009). De esta forma la nueva era de la globalización, se ha convertido en un asunto de especial trascendencia. Por un lado, la mejora y expansión de los sistemas de comunicación y transporte y la significativa reducción del tiempo y coste de desplazamiento, así como las disparidades económicas y la existencia de situaciones sociales y políticas extremas han propiciado el crecimiento de los movimientos transnacionales de personas y la intensificación de las presiones migratorias. En este sentido, España nunca ha sido ajena al fenómeno de las corrientes migratorias. Así por ejemplo, en los últimos años y durante la primera mitad del siglo XX y parte de la segunda, grandes contingentes de españoles emigraron hacia diferentes puntos de América Latina y Europa en busca de un empleo y mejor calidad de vida. Pero fue a finales del siglo pasado cuando España, impulsada por el acelerado ritmo de crecimiento económico adoptado en parte gracias a su integración económica en Europa, pasó de ser una economía emisora de emigrantes a una receptora de inmigrantes. Sin embargo, el fenómeno de la inmigración en España cobró verdadera importancia hasta principios del siglo XXI, cuando las fuertes oleadas masivas de personas provenientes de países en vías de desarrollo se dejaron sentir en su estructura poblacional y actividad laboral; de ésta manera, durante el primer quinquenio de este siglo si al 1 de enero del año 2000 los residentes extranjeros en España eran 0.9 millones (que representaban 2.3 por ciento de las personas empadronadas) al 1 de enero de 2005 ya eran 3.7 millones, es decir, 8.5 por ciento de la población residente en el país, habiéndose por tanto cuadriplicado el efectivo de extranjeros en tan sólo cinco años (González, 2006: 2-3; Gil, 2007: 1). Con base en lo anterior, el objetivo del presente trabajo consistió en analizar las características de los flujos de inmigración actuales en España procedentes de países latinoamericanos, enmarcados en la nueva re-configuración del mapa migratorio mundial

Reconstructing Native American Population History

The peopling of the Americas has been the subject of extensive genetic, archaeological and linguistic research; however, central questions remain unresolved1–5. One contentious issue is whether the settlement occurred via a single6–8 or multiple streams of migration from Siberia9–15. The pattern of dispersals within the Americas is also poorly understood. To address these questions at higher resolution than was previously possible, we assembled data from 52 Native American and 17 Siberian groups genotyped at 364,470 single nucleotide polymorphisms. We show that Native Americans descend from at least three streams of Asian gene flow. Most descend entirely from a single ancestral population that we call “First American”. However, speakers of Eskimo-Aleut languages from the Arctic inherit almost half their ancestry from a second stream of Asian gene flow, and the Na-Dene-speaking Chipewyan from Canada inherit roughly one-tenth of their ancestry from a third stream. We show that the initial peopling followed a southward expansion facilitated by the coast, with sequential population splits and little gene flow after divergence, especially in South America. A major exception is in Chibchan-speakers on both sides of the Panama Isthmus, who have ancestry from both North and South America

Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic

[EN] Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May–September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October–December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0–4; odds ratio [OR] range = 1.23–1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0–4; OR range 1.30–1.32), and the perceived lack of healthcare center preparedness (scaled 0–4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3–57.6%. Other significant risk factors were financial stressors (OR range 1.26–1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.S

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Ciencias Sociales: Economía y Humanidades HANDBOOK T-I

Se presenta un breve examen de la producción y comercialización de rosa en México; un estudio en México sobre el ingreso mínimo de las familias que identifica la línea de pobreza alimentaria en el área rural del sur de México, 2012; un pequeño estudio donde hablará sobre el análisis comparado del Sector Gubernamental y la Economía Mexicana desde la perspectiva de los eslabonamientos productivos Hirshman-Rasmuss; un estudio sobre los canales de comercialización de limón persa en el municipio de Martínez de la Torre, Veracruz; una análisis del comercio estratégico en el TLCAN: El Estado en la política agrícola de biocombustibles; también se expresan acerca de la importancia de la comercialización del café en México; un diagnóstico, retos del comercio electrónico en el Sector Agroindustrial Mexicano; trabajo nos muestra y habla sobre la inversión extranjera directa y su impacto en crecimiento de México, un análisis en prospectiva: 1999-2010; un estudio acerca sobre la importancia de la Banca en México; un trabajo acerca de la competitividad de la producción agrícola en México, un análisis regional; se analizan todo acerca de el SIAL productor de quesos en Poxtla, competividad y territorio; se habla acerca de la intermediación financiera al servicio de la comunidad indígena: el fondo regional indígena Tarhiata Keri; ademas un estudio acerca de la demanda de Importaciones de durazno (Prunus pérsica L. Batsch) en México procedentes de Estados Unidos de América (1982-2011); Loera y Sepúlveda analizan los parámetros de la productividad forestal en la producción de madera en rollo; un análisis de factores sociales, ambientales y económicos del territorio rural cercano a la ciudad de México; un estudio acerca de la crisis económica mundial y su efecto sobre los flujos migratorios de América Latina; Magadán, Hernández y Escalona presentan la tipología de los sujetos sociales que intervienen en el mercado campesino de Ocotlán Oaxaca; la normalización del proceso de compostaje: una opción para desarrollar el mercado de la composta; acerca de la reestructuración del capitalismo y crisis política en México; la rentabilidad de la producción de miel en el municipio de León, Guanjuato; la economía del maíz en la región metropolitana, Chiapas, 2014; análisis de los centros de educación y cultura ambiental, necesidad de profesionalización Pedagógica de facilitadores ambientales; los Costos y competitividad de la producción del limón persa en el municipio de Martínez de la Torre, Veracruz

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat