Stenocarpella maydis and Sporisorium reilianum: Two Pathogenic Fungi of Maize

Stenocarpella maydis and Sporisorium reilianum are phytopathogenic fungi that cause white rot in corn cob and head smut in maize (Zea mays L.) respectively, diseases that are spread worldwide and cause many economic losses. In this chapter the characteristics of the above diseases, such as their life cycle, pathogenicity factors, control methods, as well as the biotechnological potential of the fungi involved in this processes are described, specifically in connection to their extracellular enzymes

Current model systems for the study of preeclampsia

Preeclampsia (PE) is a pregnancy complex disease, distinguished by high blood pressure and proteinuria, diagnosed after the 20th gestation week. Depending on the values of blood pressure, urine protein concentrations, symptomatology, and onset of disease there is a wide range of phenotypes, from mild forms developing predominantly at the end of pregnancy to severe forms developing in the early stage of pregnancy. In the worst cases severe forms of PE could lead to systemic endothelial dysfunction, eclampsia, and maternal and/or fetal death. Worldwide the fetal morbidity and mortality related to PE is calculated to be around 8% of the total pregnancies. PE still being an enigma regarding its etiology and pathophysiology, in general a deficient trophoblast invasion during placentation at first stage of pregnancy, in combination with maternal conditions are accepted as a cause of endothelial dysfunction, inflammatory alterations and appearance of symptoms. Depending on the PE multifactorial origin, several in vitro, in vivo,andin silico models have been used to evaluate the PE pathophysiology as well as to identify or test biomarkers predicting, diagnosing or prognosing the syndrome. This review focuses on the most common models used for the study of PE, including those related to placental development, abnormal trophoblast invasion, uteroplacental ischemia, angiogenesis, oxygen deregulation, and immune response to maternal–fetal interactions. The advances in mathematical and computational modeling of metabolic network behavior, gene prioritization, the protein–protein interaction network, the genetics of PE, and the PE prediction/classification are discussed. Finally, the potential of these models to enable understanding of PE pathogenesis and to evaluate new preventative and therapeutic approaches in the management of PE are also highlighted

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

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

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad

Acta de congresoLa conmemoración de los cien años de la Reforma Universitaria de 1918 se presentó como una ocasión propicia para debatir el rol de la historia, la teoría y la crítica en la formación y en la práctica profesional de diseñadores, arquitectos y urbanistas. En ese marco el VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad constituyó un espacio de intercambio y reflexión cuya realización ha sido posible gracias a la colaboración entre Facultades de Arquitectura, Urbanismo y Diseño de la Universidad Nacional y la Facultad de Arquitectura de la Universidad Católica de Córdoba, contando además con la activa participación de mayoría de las Facultades, Centros e Institutos de Historia de la Arquitectura del país y la región. Orientado en su convocatoria tanto a docentes como a estudiantes de Arquitectura y Diseño Industrial de todos los niveles de la FAUD-UNC promovió el debate de ideas a partir de experiencias concretas en instancias tales como mesas temáticas de carácter interdisciplinario, que adoptaron la modalidad de presentación de ponencias, entre otras actividades. En el ámbito de VIII Encuentro, desarrollado en la sede Ciudad Universitaria de Córdoba, se desplegaron numerosas posiciones sobre la enseñanza, la investigación y la formación en historia, teoría y crítica del diseño, la arquitectura y la ciudad; sumándose el aporte realizado a través de sus respectivas conferencias de Ana Clarisa Agüero, Bibiana Cicutti, Fernando Aliata y Alberto Petrina. El conjunto de ponencias que se publican en este Repositorio de la UNC son el resultado de dos intensas jornadas de exposiciones, cuyos contenidos han posibilitado actualizar viejos dilemas y promover nuevos debates. El evento recibió el apoyo de las autoridades de la FAUD-UNC, en especial de la Secretaría de Investigación y de la Biblioteca de nuestra casa, como así también de la Facultad de Arquitectura de la UCC; va para todos ellos un especial agradecimiento

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Disposición de medicamentos caducos

Material electrónicoMéxico enfrenta uno de los retos más importantes en materia ambiental: el tratamiento y disposición adecuada de los residuos peligrosos, esto se debe a que un manejo inadecuado de los mismos puede alterar las características del ambiente, y también a la escaza difusión de la legislación para la adecuada disposición de éstos. Mediante la exposición, se busca fomentar la aplicación de las medidas necesarias para la disposición de medicamentos caducos en la comunidad universitaria, hacer extensiva la información a la sociedad, y fomentar la divulgación de la ciencia de manera que se logre la apropiación social de ésta. La industria farmacéutica representa un pequeño sector que tiene un papel importante en la investigación y procuración de la salud humana; aun cuando la generación de residuos es baja, algunos de éstos presentan características de toxicidad, requiriendo un tratamiento y disposición acorde a su composición química particular. Como una parte importante de estos residuos están los medicamentos caducos que provienen tanto de la industria como de los distribuidores de medicamentos, de hospitales y de casas habitación, considerados como residuos peligrosos por su toxicidad ambiental (SEMARNAT, 2006a). Los medicamentos caducos entran en las dos últimas categorías de residuos tóxico y se sabe al menos en México la forma más común de disposición de este tipo de residuos son los rellenos sanitarios, lo cual es realmente grave ya que el efecto además de ser tóxico, se puede mantener por un periodo de tiempo muy largo. A través de carteles se describe la problemática alrededor de la inadecuada disposición de medicamentos caducos, información en materia de legislación en México por la Secretaría de Salud, Secretaría del Medio Ambiente y Pesca (SEMARNAT), Procuraduría Federal de Protección al Ambiente (PROFEPA) y del Instituto Nacional de Ecología (INE) instancias encargadas de la regulación correspondiente; y las medidas que siguen otros países en el contexto internacional; las afecciones que se provoca al medio ambiente y las acciones a seguir por cualquier persona que desee desecharlos, ya sea consumidores, industrias, farmacias, con el fin de reducir los efectos tóxicos al ambiente.Cuatro carteles de la exposición fueron patrocinados por la Imprenta San Buenaventura. Toluca Estado de México

Hospital Juárez de México. Plan para el auto-cuidado de la seguridad del paciente

In response to government policies to improve quality of care and patient safety, we intend to implement strategies to identify risks and prevent adverse events. One of the most important adverse events in terms of their frequency and severity are nosocomial infections. Results achieved so far have been poor mainly as a result of resistance to report adverse events by medical staff, which has resulted in underreporting, lack of effective means for prevention, and lack of follow up in agreements from the Infections Committee. The need to identify and prevent adverse events requires the use of different strategies to those used to date. Such is the co-participation of patients and their relatives in safety issues and adverse event prevention. This worldwide trend has led to the integration of the World Alliance for Patient Safety and the creation of the Patient Safety Organization. Based on the document: �Self-Care Plan for Patient Safety� 112 surveys were applied to patients and relatives; 55 to staff, including doctors, nurses, orderlies and resident physicians; and 17 managers; resources were evaluated by the same 51 staff members. We studied the knowledge that patients have in relation to medical care received during their stay at the hospital and degree of communication with health personnel. Reasons for patient�s discomfort with received health care were identified. Results identified areas of opportunity in relation to inadequate knowledge of staff and managers on the availability of resources directed at patient safety, the magnitude of nosocomial infections, adverse events and the current standards for prevention; insufficient resources for patient safety in terms of bed rails, stretchers and wheelchairs, non-skid floors and grab bars in bathrooms, resources and supplies for handwashing and for patient identification; insufficient knowledge of patients on treating physician, current condition, required care and prescription. Actions were initiated to address identified areas of opportunity. Progress will be evaluated as a second stage of this work after the first six months from implementation. Besides focusing on areas of opportunity, awareness on the need to identify, report and prevent adverse events in the Hospital has been encouraged as part of a cultural change towards improving quality of care and patient safety.En atención a las políticas gubernamentales para mejorar la calidad de la atención médica y la seguridad del paciente, se pretende poner en operación estrategias que permitan identificar los riesgos y prevenir los eventos adversos. Uno de los eventos adversos de mayor relevancia en función de su frecuencia y de la gravedad que desarrollan algunos casos, son las infecciones adquiridas en el hospital. No obstante, los resultados alcanzados hasta la fecha han sido pobres, como consecuencia de la resistencia para reportarlos por el personal médico, con el consiguiente subregistro, falta de acciones efectivas para su prevención y falta de seguimiento a los acuerdos del Comité de Infecciones. La necesidad de identificar y prevenir los eventos adversos obliga a emplear estrategias diferentes a las empleadas hasta la fecha, tal como la coparticipación del paciente y sus familiares en el cuidado de la seguridad y la prevención de eventos adversos. Esta tendencia a nivel mundial ha propiciado la integración de la Alianza Mundial por la Seguridad del Paciente y la formación de la Organización de Pacientes por la Seguridad de los Pacientes. Tomando como base el documento: �Plan para el Auto- cuidado de la Seguridad del Paciente� en el Hospital Juárez de México se practicaron encuestas a 112 pacientes y familiares, a 51 trabajadores que incluían: médicos, enfermeras, camilleros y médicos residentes y 17 directivos; se evaluaron los recursos mediante encuestas a 55 trabajadores. Se estudiaron los conocimientos con que cuentan los pacientes, con relación a la atención médica que reciben durante su estancia en el Hospital y la comunicación con el personal de salud se identificaron los motivos por los que los pacientes tenían alguna inconformidad durante su atención médica. En los resultados se identificaron áreas de oportunidad en relación a conocimiento insuficiente del personal y directivos en cuanto a la disponibilidad de recursos para la seguridad de los pacientes, de la magnitud de las infecciones hospitalarias, de los eventos adversos y de las normas vigentes para su prevención; recursos insuficientes para la seguridad en cuanto a barandales de camas, camillas y sillas de ruedas, pisos antiderrapantes y barandales para sujetarse en los baños, recursos e insumos para el lavado de manos y para la identificación del paciente, conocimiento insuficiente de los pacientes sobre quién era su médico, su padecimiento, los cuidados requeridos y la prescripción. Se iniciaron acciones para enfrentar las áreas de oportunidad identificadas, cuyos avances serán evaluados en una segunda etapa de este trabajo a seis meses de la primera. Además de la atención a las áreas de oportunidad se ha creado conciencia en la necesidad de identificar, informar y prevenir los eventos adversos en el Hospital como parte de un cambio cultural hacia la mejora de la calidad de la atención y la seguridad del paciente. Rev. CONAMED.2010:15(2):75-91