80 research outputs found
Utilización de los servicios de internamiento del hospital de la mujer "Bertha Calderón roque". Año 1995.
Tiene por objetivo determinar cuales de los problemas previamente identificados en el área no han sido superados y deben ser tomados en cuenta para la organización
An evaluation of food as a potential source for clostridium difficile acquisition in hospitalized patients
OBJECTIVETo determine whetherClostridium difficileis present in the food of hospitalized patients and to estimate the risk of subsequent colonization associated withC. difficilein food.METHODSThis was a prospective cohort study of inpatients at a university-affiliated tertiary care center, May 9, 2011–July 12, 2012. Enrolled patients submitted a portion of food from each meal. Patient stool specimens and/or rectal swabs were collected at enrollment, every 3 days thereafter, and at discharge, and were cultured forC. difficile. Clinical data were reviewed for evidence of infection due toC. difficile.A stochastic, discrete event model was developed to predict exposure toC. difficilefrom food, and the estimated number of new colonization events from food exposures per 1,000 admissions was determined.RESULTSA total of 149 patients were enrolled and 910 food specimens were obtained. Two food specimens from 2 patients were positive forC. difficile(0.2% of food samples; 1.3% of patients). Neither of the 2 patients was colonized at baseline withC. difficile. Discharge colonization status was available for 1 of the 2 patients and was negative. Neither was diagnosed withC. difficileinfection while hospitalized or during the year before or after study enrollment. Stochastic modeling indicated contaminated hospital food would be responsible for less than 1 newly colonized patient per 1,000 hospital admissions.CONCLUSIONSThe recovery ofC. difficilefrom the food of hospitalized patients was rare. Modeling suggests hospital food is unlikely to be a source ofC. difficileacquisition.Infect Control Hosp Epidemiol2016;1401–1407</jats:sec
Understanding toxin production during Clostridioides difficile infection using high dimensional data
Accurate prediction of major histocompatibility complex class II epitopes by sparse representation via â„“ 1-minimization
Mathematical modeling of the effects of nutrient competition and bile acid metabolism by the gut microbiota on colonization resistance against Clostridium difficile
Genome-wide profiling of non-smoking-related lung cancer cells reveals common RB1 rearrangements associated with histopathologic transformation in EGFR-mutant tumors.
The etiology and the molecular basis of lung adenocarcinomas (LuADs) in nonsmokers are currently unknown. Furthermore, the scarcity of available primary cultures continues to hamper our biological understanding of non-smoking-related lung adenocarcinomas (NSK-LuADs).
We established patient-derived cancer cell (PDC) cultures from metastatic NSK-LuADs, including two pairs of matched EGFR-mutant PDCs before and after resistance to tyrosine kinase inhibitors (TKIs), and then performed whole-exome and RNA sequencing to delineate their genomic architecture. For validation, we analyzed independent cohorts of primary LuADs.
In addition to known non-smoker-associated alterations (e.g. RET, ALK, EGFR, and ERBB2), we discovered novel fusions and recurrently mutated genes, including ATF7IP, a regulator of gene expression, that was inactivated in 5% of primary LuAD cases. We also found germline mutations at dominant familiar-cancer genes, highlighting the importance of genetic predisposition in the origin of a subset of NSK-LuADs. Furthermore, there was an over-representation of inactivating alterations at RB1, mostly through complex intragenic rearrangements, in treatment-naive EGFR-mutant LuADs. Three EGFR-mutant and one EGFR-wild-type tumors acquired resistance to EGFR-TKIs and chemotherapy, respectively, and histology on re-biopsies revealed the development of small-cell lung cancer/squamous cell carcinoma (SCLC/LuSCC) transformation. These features were consistent with RB1 inactivation and acquired EGFR-T790M mutation or FGFR3-TACC3 fusion in EGFR-mutant tumors.
We found recurrent alterations in LuADs that deserve further exploration. Our work also demonstrates that a subset of NSK-LuADs arises within cancer-predisposition syndromes. The preferential occurrence of RB1 inactivation, via complex rearrangements, found in EGFR-mutant tumors appears to favor SCLC/LuSCC transformation under growth-inhibition pressures. Thus RB1 inactivation may predict the risk of LuAD transformation to a more aggressive type of lung cancer, and may need to be considered as a part of the clinical management of NSK-LuADs patients.This work was supported by the Fundacion Cientifica Asociacion Española Contra el Cancer-AECC (grant number GCB14142170MONT) to LMM, MS-C, and EF; the Spanish Ministry of Economy and Competitivity-MINECO (grant number SAF-2017-82186R to MS-C; Rio Hortega-CM17/00180 to MS; PROYBAR17005NADA to EN); the Health Institute Carlos III-ISCIII, Fondo Europeo de Desarrollo Regional-FEDER (grant Number PT13/0001/0044, PT17/0009/0019, PI16 01821); the Government of Navarra (grant number DIANA project); and the Ramon Areces Foundation (no grant number is applicable) to LMM and RP.S
Mujer joven con poliadenopatÃas y anasarca. ¿Es siempre neoplásico?
PB-122
Introducción: La enfermedad de Castleman (EC) es una entidad linfoproliferativa, descrita por primera vez en 1954. Tiene dos formas de presentación: unicéntrica, con afectación de un único ganglio linfático y multicéntrica (ECM), con afectación de múltiples nódulos y presentación clÃnica en forma de linfadenopatÃas, fiebre, pérdida de peso, disnea, edemas, anemia e hipoalbuminemia. En la patogenia de la enfermedad hay una sobreproducción de IL6, que induce un sÃndrome proinflamatorio, responsable de los sÃntomas clÃnicos. ECM puede ser secundaria a infección por virus VIH y VHH8. En pacientes que no se demuestra causa etiológica se denomina ECM idiopática (ECMi), dentro de la cual se diferencian dos subtipos clÃnicos ECMi-TAFRO (trombocitopenia, anasarca, fiebre, fibrosis reticulÃnica/disfunción renal y organomegalia), o ECMi-NOS (not otherwise specified). ^
Métodos: se presenta el caso de una paciente con enfermedad de Castleman multicéntrica idiopática.
Resultados: El caso corresponde a una mujer de 53 años, sin antecedentes patológicos de interés, que en junio 2018, ingresa en el servicio de Medicina Interna de nuestro centro, por cuadro de fiebre, ascitis, derrame pleural y sÃndrome poliadenopático sin filiar. Durante ingreso presenta una evolución tórpida, objetivándose a la exploración esplenomegalia y cuadro de anasarca. AnalÃticamente destacan hipoalbuminemia (1, 1 g/dl), insuficiencia renal (creatinina 1, 88 mg/dl, FGE 36 mil/min), anemia (Hb 10, 3 g/dl), trombocitopenia (123000/mm3) y elevación de reactantes de fase aguda (PCR 36 mg/dl, ferritina 1063 ng/ml, fibrinógeno 1000 mg/dl). En PET/TC se observa un patron poliadenopático discretamente hipermetabólico supra e infradiafragmático, con incremento de captación difuso del radiotrazador en bazo (SUV máx ..
Mathematical modeling of the effects of nutrient competition and bile acid metabolism by the gut microbiota on colonization resistance against Clostridium difficile
Eficacia y seguridad del tratamiento con lenalidomida y dexametasona en pacientes con mieloma múltiple no candidatos a trasplante en recaÃda
PO-019
Introducción: En la actualidad existe una amplia diversidad de tratamientos en pacientes con Mieloma Múltiple (MM) refractarios a tratamiento en primera lÃnea y no candidatos a trasplante de progenitores hematopoyéticos. El tratamiento de estos pacientes con lenalidomida y dexametasona ha sido una de las opciones terapeúticas más utilizadas en los últimos años. El objetivo de este estudio es evaluar la eficacia y tolerabilidad de este tratamiento en un centro hospitalario de tercer nivel.
Material Y Métodos: Estudio descriptivo, observacional y retrospectivo en el que se incluyeron todos los pacientes no candidatos a TPH que iniciaron un esquema con lenalidomida entre Enero 2012 a Marzo 2019 y además recibieron al menos una lÃnea previa de quimioterapia. Fuentes: historia clÃnica electrónica, registro de dispensación de pacientes ambulatorios y externos (FarmaTools) del Servicio de Farmacia.
Resultados: En total 22 pacientes (50% mujeres) fueron incluidos en el estudio. La mediana de numero de lÃneas que recibieron previamente fue de 1(rango entre 1-2). 17 pacientes (77%) recibieron RD como 2º lÃnea y para 5 pacientes (33%) fue la 3ª lÃnea. Como tratamiento en 1ª lÃnea, solo 1 paciente recibió tratamiento con QT convencional (VAD), ..
Procesos de mejora de la calidad durante la recarga artificial de aguas regeneradas a través de una capa reactiva
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