Tos Ferina en una lactante no inmunizada: a propósito de un caso

ResumenIntroducciónLas afecciones respiratorias son un problema de salud común entre los lactantes.Reporte de casoUna lactante de 75 días de edad fue llevada a urgencias por disnea y tos paroxística espasmódica, emetizante y cianosante. No estaba inmunizada contra tos ferina y tuvo contacto con su gemela, que tenía una infección por probable Bordetella pertussis. El diagnóstico de egreso fue bronquiolitis. Días después, reingresó por disnea.DiscusiónEn los lactantes, la tos ferina, el síndrome coqueluchoide y la bronquiolitis tienen manifestaciones clínicas comunes. Este caso resalta la importancia de seguir las guías de práctica clínica y los procedimientos de diagnóstico de B. pertussis, así como el análisis epidemiológico de los casos probables, debido a que de ello depende el tratamiento etiológico y, por lo tanto, el pronóstico de los pacientes.AbstractIntroductionRespiratory tract infections are a common cause of infant morbidity, and even mortality.Case reportA two-month old female was taken to the Emergency Department after she suddenly developed dyspnoea and a paroxysmal, spasmodic, cyanosing cough. Her vaccination scheme was incomplete and she had contact with her twin sister, who had an infection probably caused by Bordetella pertussis. The discharge diagnosis was bronchiolitis. She was re-admitted to hospital a few days later with an exacerbation of her dyspnoea.DiscussionThis case highlights the importance of following the clinical practice guidelines and the standard procedures for the diagnosis of B. pertussis, while the epidemiological context of patients should always be considered. It is important to correctly identify the aetiological agent, as the specific treatment is based on the aetiology, and both of them determine the prognosis of the patients

Experiencia en el tratamiento quirúrgico del angiofibroma nasal juvenil en Hospital de Especialidades No 2 Lic. Luis Donaldo Colosio Murrieta. Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora

Objective: To present our experience and assess the recurrence of juvenile nasopharyngeal angiofibroma after a surgical treatment (open versus endoscopic approach) in the country’s northwestern Department of Otorhinolaryngology. Materials and methods: An observational, retrospective, analytical study. The medical records of patients diagnosed with juvenile nasopharyngeal angiofibroma, who were treated at the Department of Otorhinolaryngology – Head and Neck Surgery of this institution from 2014 to 2017, were reviewed. Results: A total of 19 patients diagnosed with juvenile nasopharyngeal angiofibroma underwent a surgical procedure, out of which 14 had an open surgery and 5 an endoscopic one. Recurrence accounted for 50 % and 40 %, respectively, which was not statistically significant (p = 0.88). However, other variables were compared, such as the need for admission to the Intensive Care Unit (ICU), which was represented by 71 % in the case of the open approach and 20 % for the endoscopic approach, where a significant difference was found (p = 0.04). Conclusions: The study shows no statistically significant advantage of the endoscopic approach versus the open approach, but demonstrates less need for ICU admissions, which would reduce healthcare costs

Higth performance liquid chromatography technique design and validation for quantification of tolbutamide, acetamide and propianamide in solid dispersions

El estudio del tipo de interacción involucrada en la formación de dispersiones sólidas de tolbutamida con distintas proporciones de acetamida y propianamida, ha requerido del diseño y validación de un método analítico por cromatografía líquida de alta eficacia (CLAE) que permita cuantificar la proporción de los transportadores en mezclas físicas y en dispersión sólida. El método resultó ser lineal, preciso y exacto en el intervalo de concentración de 100-1,56 μg/mL para tolbutamida y 50-0,781 μg/mL para acetamida y propianamida.The interest to design and validate a high performance liquid chromatography method for quantification of tolbutamide, acetamide and propianamide in solid dispersions, was to find a relation among the amount of carriers and the active substance in solid dispersions, in order to further investigate the drug-carrier interaction pattern responsible of solid dispersion formation. The method was lineal, precise and accurate in the concentration range between 100.0 - 1.56 μg/ mL for tolbutamide and 50.0 - 0.78 μg/mL for acetamide and propianamide

Factors of the epidemiological triad that influence the persistence of human papilloma virus infection in women with systemic lupus erythematosus

We studied the epidemiologic triad-related factors influencing human papilloma virus (HPV) persistence in Mexican women with systemic lupus erythematosus (SLE). Patients aged ?18 years with SLE (American College of Rheumatology criteria), with and without HPV persistence, were selected. Groups were analyzed by (1) host: clinical disease characteristics; (2) agent: (I) infectious (prevalence, incidence, HPV genotype and co-infections (?2 HPV genotypes or mycoplasmas)), (II) chemical (contraceptives and immunosuppressive drugs) and (III) physical (vitamin D deficiency) and (3) environment. A total of 121 SLE patients were selected over a two-year period. (1) Host: mean age 45.8 years and disease duration 12.7 years. (2) Agent: (I) infectious. HPV infection prevalence in the second sample was 26.4%, high-risk HPV genotypes 21.5% and co-infections 7.4%. HPV infection incidence was 13.2%, persistence 13.2% and clearance 15.7%. (II) Chemical: use of oral hormonal contraceptives 5% and immunosuppressive treatment 97.5%. (III) Physical: Vitamin D levels were similar in both groups. (3) Environment: (I) natural. A total of 60.6% of patients were residents of Puebla City. (II) Social: The mean education level was 10.9. Poverty levels were: III degree 52.4%, IV degree 28% and II degree 17%. (III) Cultural behavioral: Onset of sexual life was 20.5 years, 10% had ?3 sexual partners and 51.2% were postmenopausal. In conclusion, no factor of the epidemiologic triad was associated with HPV infection prevalence. © The Author(s) 2018

Functional upgrading in China’s export processing sector

Functional upgrading occurs when a firm acquires more sophisticated functions within an existing value chain. In this paper, we analyze if there is evidence of this type of upgrading in China’s export processing regime by investigating dynamics in the relative prevalence of Import & Assembly (IA) versus Pure Assembly (PA) processing trade over the period 2000-2013. Firms in both regimes provide similar manufacturing services to foreign companies, but IA firms also conduct the sophisticated tasks of quality control, searching, financing and storing imported materials. Consistent with a trend of functional upgrading, we show that the share of IA trade in total processing trade has increased rapidly during the period 2000-2006, both overall and within product categories. Furthermore, we find that this trend has gone hand in hand with improvements in a sector’s labor productivity and unit values. Against expectations, we find that this process has slowed down notably during the period 2006-2013.status: publishe

Trail Marking by Caterpillars of the Silverspot Butterfly Dione Juno Huascuma

A pheromone is implicated in the trail marking behavior of caterpillars of the nymphalid silverspot butterfly, Dione juno huascuma (Reakirt) (Lepidoptera: Heliconiinae) that feed gregariously on Passiflora (Malpighiales: Passifloraceae) vines in Mexico. Although they mark pathways leading from one feeding site to another with silk, this study shows that the silk was neither adequate nor necessary to elicit trail following behavior. Caterpillars marked trails with a long-lived pheromone that was deposited when they brushed the ventral surfaces of the tips of their abdomens along branch pathways. The caterpillars distinguished between pathways deposited by different numbers of siblings and between trails of different ages. Caterpillars also preferentially followed the trails of conspecifics over those of another nymphalid, Nymphalis antiopa L., the mourning cloak butterfly

Ultrafast photochemistry produces superbright short-wave infrared dots for low-dose in vivo imaging

12 p.-5 fig.Optical probes operating in the second near-infrared window (NIR-II, 1,000-1,700 nm), where tissues are highly transparent, have expanded the applicability of fluorescence in the biomedical field. NIR-II fluorescence enables deep-tissue imaging with micrometric resolution in animal models, but is limited by the low brightness of NIR-II probes, which prevents imaging at low excitation intensities and fluorophore concentrations. Here, we present a new generation of probes (Ag2S superdots) derived from chemically synthesized Ag2S dots, on which a protective shell is grown by femtosecond laser irradiation. This shell reduces the structural defects, causing an 80-fold enhancement of the quantum yield. PEGylated Ag2S superdots enable deep-tissue in vivo imaging at low excitation intensities (<10 mW cm-2) and doses (<0.5 mg kg-1), emerging as unrivaled contrast agents for NIR-II preclinical bioimaging. These results establish an approach for developing superbright NIR-II contrast agents based on the synergy between chemical synthesis and ultrafast laser processing.Authors thank Dr A. Benayas (CICECO, U. Aveiro, Portugal), Prof G. Lifante and Prof J. García Sole (UAM) for helpful discussions. This work has been founded by Ministerio de Economı́a y Competitividad-MINECO (MAT2017-83111R and MAT2016-75362-C3-1-R) and the Comunidad de Madrid (B2017/BMD-3867 RENIM-CM) co-financed by European Structural and Investment Fund. D.M.-G. thanks UCM-Santander for a predoctoral contract (CT17/17-CT18/17). We thank the staff at the ICTS-National Centre for Electron Microscopy at the UCM for the help in the electron microscopy studies and C.M. at the beamline BL22-CLAESS of the Spanish synchrotron ALBA for his help in the XANES experiments. We also thank J.G.I at the Ultrafast Laser Laboratory at UCM for his help and fruitful discussion. Y.S. acknowledges the support from the China Scholarship Council (CSC File No. 201806870023). Additional funding was provided by the European Commission Horizon 2020 project NanoTBTech, the Fundación para la Investigación Biomédica del Hospital Universitario Ramón y Cajal project IMP18_38 (2018/0265). Ajoy K. Kar and Mark D. Mackenzie acknowledge support from the UK Engineering and Physical Sciences Research Council (Project CHAMP, EP/M015130/1). C. Jacinto thanks the financial support of the Brazilian agencies: CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico) through the grants: Projeto Universal Nr. 431736/2018-9 and Scholarship in Research Productivity 1C under the Nr. 304967/20181; FINEP (Financiadora de Estudos e Projetos) through the grants INFRAPESQ-11 and INFRAPESQ-12; FAPEAL (Fundação de Amparo à Pesquisa do Estado de Alagoas) grant Nr. 1209/2016. H. D. A. Santos was supported by a graduate studentship from CNPq and by a sandwich doctoral program (PDSE-CAPES) developed at Universidad Autonoma de Madrid, Spain, Project Nr. 88881/2016-01.Peer reviewe

Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry

Background: Venous thrombotic events (VTE) are frequent in COVID-19, and elevated plasma D-dimer (pDd) and dyspnea are common in both entities. Objective: To determine the admission pDd cut-off value associated with in-hospital VTE in patients with COVID-19. Methods: Multicenter, retrospective study analyzing the at-admission pDd cut-off value to predict VTE and anticoagulation intensity along hospitalization due to COVID-19. Results: Among 9386 patients, 2.2% had VTE: 1.6% pulmonary embolism (PE), 0.4% deep vein thrombosis (DVT), and 0.2% both. Those with VTE had a higher prevalence of tachypnea (42.9% vs. 31.1%; p = 0.0005), basal O2 saturation &lt;93% (45.4% vs. 33.1%; p = 0.0003), higher at admission pDd (median [IQR]: 1.4 [0.6–5.5] vs. 0.6 [0.4–1.2] µg/ml; p &lt; 0.0001) and platelet count (median [IQR]: 208 [158–289] vs. 189 [148–245] platelets × 109/L; p = 0.0013). A pDd cut-off of 1.1 µg/ml showed specificity 72%, sensitivity 49%, positive predictive value (PPV) 4%, and negative predictive value (NPV) 99% for in-hospital VTE. A cut-off value of 4.7 µg/ml showed specificity of 95%, sensitivity of 27%, PPV of 9%, and NPV of 98%. Overall mortality was proportional to pDd value, with the lowest incidence for each pDd category depending on anticoagulation intensity: 26.3% for those with pDd &gt;1.0 µg/ml treated with prophylactic dose (p &lt; 0.0001), 28.8% for pDd for patients with pDd &gt;2.0 µg/ml treated with intermediate dose (p = 0.0001), and 31.3% for those with pDd &gt;3.0 µg/ml and full anticoagulation (p = 0.0183). Conclusions: In hospitalized patients with COVID-19, a pDd value greater than 3.0 µg/ml can be considered to screen VTE and to consider full-dose anticoagulation. © 2021, Society of General Internal Medicine

Requisits higienicosanitaris en l’elaboració de formatges a partir de llet crua

Control oficial; Formatges; Llet crua; APPCCControl oficial; Quesos; Leche cruda; APPCCOfficial control; Cheeses; Raw milk; HACCPL’objectiu d’aquesta Comunitat de Pràctica (CoP ) és recollir uns criteris i elaborar un document de requisits sanitaris que cal seguir en la gestió del risc de l’elaboració dels formatges fets amb llet crua amb un període de maduració inferior a 60 dies. Els operadors econòmics han de garantir la seguretat dels seus productes i han d’aplicar programes d’autocontrol en matèria de seguretat alimentària, basats en l’anàlisi de perills i punts de control crític (APPCC), per garantir la innocuïtat dels seus productes. Les autoritats sanitàries són responsables de vetllar, mitjançant la vigilància i el control oficials, perquè aquests productes respectin les normes de seguretat alimentària. En el cas dels formatges elaborats amb llet crua, se’ns plantegen diversos problemes respecte a la seguretat alimentària, i comprovem que, cada cop més, els petits productors elaboren formatges amb llet crua amb períodes de maduració inferiors als 60 dies, que després són venuts en fires, mercats locals o altres establiments alimentaris i fins i tot exportats. El marc normatiu (Reglament (CE) 853/2004)1 recull l’elaboració d’aquests tipus de formatges sempre que es reuneixin uns requisits sanitaris específics, cosa que fins que no va entrar en vigor havia estat prohibida per la normativa espanyola (Reial decret 1679/1994). Atesa la complexitat i el risc que aquests productes poden suposar, tant els inspectors de l’ASPCAT com els inspectors de l’àmbit local es preocupen pels criteris tecnològics i d’autocontrols microbiològics que s’han de complir en aquests establiments per garantir la seguretat alimentària.El objetivo de esta Comunidad de Práctica (CoP) es recoger unos criterios y elaborar un documento de requisitos sanitarios a seguir en la gestión del riesgo de la elaboración de los quesos hechos con leche cruda con un período de maduración inferior a 60 días . Los operadores económicos deben garantizar la seguridad de sus productos y deben aplicar programas de autocontrol en materia de seguridad alimentaria, basados en el análisis de peligros y puntos de control crítico (APPCC), para garantizar la inocuidad de sus productos. Las autoridades sanitarias son responsables de velar, mediante la vigilancia y control oficiales, para que estos productos respeten las normas de seguridad alimentaria. En el caso de los quesos elaborados con leche cruda, se nos plantean varios problemas respecto a la seguridad alimentaria, y comprobamos que, cada vez más, los pequeños productores elaboran quesos con leche cruda con períodos de maduración inferiores a los 60 días, que después son vendidos en ferias, mercados locales u otros establecimientos alimenticios e incluso exportados. El marco normativo (Reglamento (CE) 853/2004)1 recoge la elaboración de este tipo de quesos siempre que se reúnan unos requisitos sanitarios específicos, algo que hasta que no entró en vigor había sido prohibido por la normativa española (Real decreto 1679/1994). Dada la complejidad y el riesgo que estos productos pueden suponer, tanto los inspectores de la ASPCAT como los inspectores del ámbito local se preocupan por los criterios tecnológicos y de autocontroles microbiológicos que deben cumplirse en estos establecimientos para garantizar la seguridad alimentaria.The objective of this Community of Practice (CoP) is to collect criteria and prepare a document of health requirements to be followed in the management of the risk of the production of cheeses made with raw milk with a maturation period of less than 60 days. Economic operators must guarantee the safety of their products and must apply self-control programs regarding food safety, based on hazard analysis and critical control points (HACCP), to guarantee the safety of their products. Health authorities are responsible for ensuring, through official surveillance and control, that these products respect food safety standards. In the case of cheeses made with raw milk, we face several problems regarding food safety, and we see that, increasingly, small producers make cheeses with raw milk with maturation periods of less than 60 days, which then They are sold at fairs, local markets or other food establishments and even exported. The regulatory framework (Regulation (EC) 853/2004)1 includes the production of this type of cheese as long as specific health requirements are met, something that until it came into force had been prohibited by Spanish regulations (RD 1679/1994). Given the complexity and risk that these products can pose, both ASPCAT inspectors and local inspectors are concerned about the technological and microbiological self-control criteria that must be met in these establishments to guarantee food safety