Implantación de un programa de optimización del uso de antibióticos y análisis de su impacto en un servicio de cirugía general y digestiva

La introducción de los antimicrobianos en la práctica clínica marcó el comienzo de la medicina moderna, pero con el tiempo los microorganismos pierden su sensibilidad natural a estos agentes. Entre los factores implicados destaca la relación estrecha entre antimicrobianos y desarrollo de resistencia (McGowan, 1987; Owens, 2008; Martínez-Martínez, 2010). La problemática actual se centra en el aumento del uso de antibióticos, especialmente significativo en carbapenémicos y polimixinas (van Boeckel, 2014), y en su uso no óptimo, marcador del impacto evitable sobre la resistencia (Dellit, 2007). Se ha comprobado en distintas zonas geográficas que el uso es inapropiado hasta en un 30-50% en el ámbito hospitalario (Cizman 2003). Así, la resistencia es una alarma mundial, independientemente del país y la sofisticación de su sistema sanitario. El Centro para la Prevención y Control de Enfermedades ha estimado que la resistencia es responsable de más de 2.000.000 de infecciones y 23.000 muertes anuales en EEUU (Gelband, 2015). Este hecho y sus consecuencias ocupan un lugar destacado en las políticas mundiales (TATFAR, 2014; WHO, 2015; ONU, 2016), estadounidenses (White House, 2015), europeas (Comunicación de la Comisión Europea al Parlamento Europeo y al Consejo Europeo, 2011) y españolas (Plan estratégico nacional, 2014)..

Total replacement of recycled aggregate and treated wastewater: concrete recycling in extremis

Million tons of construction and demolition waste (CDW) are generated every year around the world, and most of them are not adequately disposed, generating significant pollution on water, soil and air. Additionally, the use of freshwater in industrial processes, such as the production of cement, concrete manufacturing and curing for newly-built structures; has damaged the health of our freshwater ecosystems, reducing their volume and hindering their natural cycle of renovation. Therefore, the incorporation of recycled aggregate (RA) and treated wastewater (TW) as substitutes for the usual aggregates (UA) and freshwater, could generate significant environmental benefits. In this research, a comparative analysis of the experimental results of the properties of fresh and hardened concrete with different replacement percentage of UA for RA, is presented; and as an innovation the use TW. The results show that, regardless of the replacement percentage and use of treated wastewater, a concrete with RA and TW (recycled concrete in extremis, CRiE) had a satisfactory and acceptable or equivalent performance, not differing significantly from the performance of conventional concrete (CC), confirming that the use of RA for concrete building is feasible.Peer ReviewedPostprint (published version

Changing feeding habits and ontogenetic dimorphism in juveniles and adults Aplysia punctata (Cuvier, 1803) (Mollusca, Gastropoda, Heterobranchia) in the Mediterranean Sea

Specimens of Aplysia punctata inhabiting the Catalonian coast (NE Spain, Western Mediterranean Sea) display two different color patterns, which have been thought to represent two distinct species. However, molecular analyses conducted by other authors and confirmed herein show that there are no genetic differences between individuals of the two color morphs. At the same time these color morphs display distinct life history traits, including different size, mating behavior, and egg mass and larvae coloration. In this paper, it is hypothesized that distinct diets are responsible of these differences. The results of this study confirm that small red specimens of A. punctata feed on red algae and primarily Sphaerococcus coronopifolius and Plocamium cartilagineum; pigments from these algae give small specimens of A. punctata a very similar morphological appearance to adults of the Aplysia parvula species complex. In contrast, adult specimens of A. punctata feed preferentially on green algae of the species Ulva lactuca. This change in feeding behavior is probably related to defensive strategies involving camouflage. In addition, the egg masses take on a pink to reddish color that is retained in the larval stage of A. punctata juveniles

Gentrificación rural y turismo en El Triunfo, Baja California Sur (México)

Gentrification is not an exclusively urban phenomenon but occurs in rural settings as well. In the rural town of El Triunfo, Baja California Sur, Mexico, the remodeling process of old buildings, the growth of real estate and of commercial and cultural activities indicate an initial process of gentrification. This dynamic suggests incipient elements of transformation of space and social relations that coincide with the most notable -though not direct and immediate- element of gentrification: the displacement of one social group by another.La gentrificación no es un fenómeno exclusivamente urbano, sino también se presenta en ámbitos rurales. En la localidad rural de El Triunfo, Baja California Sur, México, el proceso de remodelación de los edificios antiguos del lugar, el crecimiento de actividades inmobiliarias, comerciales y culturales expresan un proceso inicial de gentrificación. Dicha dinámica sugiere elementos iniciales de transformación del espacio y de las relaciones sociales que coinciden con el elemento más destacable de la gentrificación, aunque no directo e inmediato: el desplazamiento de un grupo social por otro

A new morphologic classification of the alveolar ridge after distraction osteogenesis in human patients. A 17 years retrospective case series study

To perform a morphologic classification based on the results of bone augmentation after a distraction osteogenesis. Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range, 23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dental implants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis and ANOVA one-way test were used. Category I (30.95%): consisted of wide alveolar rim and no bone defects Category II (28.57%): wide alveolar rim, lateral bone surface concavity. Category III (23.81%): narrow alveolar rim, lateral bone surface concavity. Category IV (2.38 %): distraction transport segment forming a bridge, without bone formed beneath and requiring guided bone regeneration. Category V (9.52%): return of the transport segment to its initial position due to the reverse rotation of the distractor screw. Category VI (4.76 %): distraction transport segment completely lost. Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories I to IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone height achieved decreases as the category increases, due to the accompanying osteogenic limitations (p<0.001). The implants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in category III with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035). The alveolar ridge after distraction osteogenesis could be divided into six morphologic categories which provide a useful basis for decision-making regarding implant placement

Ascomicetos hipogeos de la región occidental del Sistema Volcánico Transversal, México

Background and Aims: In Mexico, 42 species of ascomycetes have been reported with hypogeous habit, which are few considering the knowledge of other groups of fungi. The purpose of this paper is to increase the knowledge about the diversion and distribution of hypogeous fungi species for Mexico.Methods: Specimens were collected from different types of vegetation in the western portion of the transverse volcanic system, located in the state of Michoacán. The specimens collected were pictured and described following the protocols for the group.Key results: We present the description and discussion of six species of ascomycetes with hypogeous habit, Elaphomyces appalachiensis, Genea mexicana, Genabea cerebriformis, Hydnobolites cerebriformis, Tuber pseudoseparans and T. tequilanum.Conclusions: The records of these species represent new collection sites for Mexico and first records for the mycobiota of the state of Michoacán. It increases the distribution of Elaphomyces appalachiensis, Genabea cerebriformis and Hydnobolites cerebriformis, known from the United States of America and northern Mexico, to the Transversal Volcanic System, while Genea mexicana, Tuber pseudoseparans and T. tequilanum only are known in this mountainous system.Antecedentes y Objetivos: En México se han reportado 42 especies de ascomicetos con hábito hipogeo; son pocas considerando el conocimiento de otros grupos de hongos. El objetivo de este trabajo fue incrementar el conocimiento sobre la diversidad y distribución de especies de hongos hipogeos para México.Métodos: Se realizaron recolectas en diversos tipos de vegetación del Sistema Volcánico Transversal en la porción occidental perteneciente al estado de Michoacán. El material se fotografió y describió siguiendo los protocolos para el grupo.Resultados clave: Se presentan la descripción y discusión de seis especies de ascomicetos con hábito hipogeo, Elaphomyces appalachiensis, Genea mexicana, Genabea cerebriformis, Hydnobolites cerebriformis, Tuber pseudoseparans y T. tequilanum.Conclusiones: Los registros representan nuevas localidades para el país y primeras citas para la micobiota del estado de Michoacán. Se incrementa la distribución de Elaphomyces appalachiensis, Genabea cerebriformis e Hydnobolites cerebriformis, conocidos de los Estados Unidos de América y el Norte de México, hasta el Sistema Volcánico Transversal, mientras que Genea mexicana, Tuber pseudoseparans y T. tequilanum solo se conocen en este sistema montañoso

The RstAB System Impacts Virulence, Motility, Cell Morphology, Penicillin Tolerance and Production of Type II Secretion System-Dependent Factors in the Fish and Human Pathogen Photobacterium damselae subsp. damselae

The RstB histidine kinase of the two component system RstAB positively regulates the expression of damselysin (Dly), phobalysin P (PhlyP) and phobalysin C (PhlyC) cytotoxins in the fish and human pathogen Photobacterium damselae subsp. damselae, a marine bacterium of the family Vibrionaceae. However, the function of the predicted cognate response regulator RstA has not been studied so far, and the role of the RstAB system in other cell functions and phenotypes remain uninvestigated. Here, we analyzed the effect of rstA and rstB mutations in cell fitness and in diverse virulence-related features. Both rstA and rstB mutants were severely impaired in virulence for sea bream and sea bass fish. Mutants in rstA and rstB genes were impaired in hemolysis and in Dly-dependent phospholipase activity but had intact PlpV-dependent phospholipase and ColP-dependent gelatinase activities. rstA and rstB mutants grown at 0.5% NaCl exhibited impaired swimming motility, enlarged cell size and impaired ability to eparate after cell division, whereas at 1% NaCl the mutants exhibited normal henotypes. Mutation of any of the two genes also impacted tolerance to benzylpenicillin. Notably, rstA and rstB mutants showed impaired secretion of a number of type II secretion system (T2SS)-dependent proteins, which included the three major cytotoxins Dly, PhlyP and PhlyC, as well as a putative delta-endotoxin and three additional uncharacterized proteins which might constitute novel virulence factors of this pathogenic bacterium. The analysis of the T2SS-dependent secretome of P. damselae subsp. damselae also led to the identification of RstAB-independent potential virulence factors as lipoproteins, Frontiers in sialidases and proteases. The RstAB regulon included plasmid, chromosome I and chromosome II-encoded genes that showed a differential distribution among isolates of this subspecies. This study establishes RstAB as a major regulator of virulence and diverse cellular functions in P. damselae subsp. damselaeThis work has been supported by grant AGL2016-79738-R (AEI/FEDER, EU) from the State Agency for Research (AEI) of Spain, and co-funded by the FEDER Programme from the European Union. The support of Xunta de Galicia (Spain) with grant ED431C 2018/18 is also acknowledged. MT thanks the Brazilian Ministry of Education and CAPES (Coordenaçao de Aperfeiçoamento de Pessoal de Nível Superior) for a predoctoral fellowship. XM thanks Xunta de Galicia for a predoctoral fellowship. AdV was supported by the FCT fellowship SFRH/BPD/95777/2013. The mass spectrometry technique was performed at the Proteomics i3S Scientific Platform with the assistance of Hugo Osório. This work had support from the Portuguese Mass Spectrometry Network, integrated in the National Roadmap of Research Infrastructures of Strategic Relevance (ROTEIRO/0028/2013; LISBOA-01-0145-FEDER-022125)S

Visual Magreb

Memoria ID-130. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2019-2020.[ES]Los alumnos adquirirán conocimientos sobre la geografía, historia, diversidad religiosa y social del Magreb, y competencias tecnológicas mediante el montaje de videos sencillos y el uso de bancos de imágenes, sonidos y contenido multimedia, para desarrollar la comprensión y expresión oral en otros idiomas, especialmente el árab

Gamificación de las competencias comunicativa y sociocultural por medio de la tecnología y la participación activa del alumnado

Memoria ID-087 Ayudas de la Universidad de Salamanca para la innovación docente, curso 2020-2021

Executive summary of the Consensus Document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and of the Spanish Association of Surgeons (AEC) in antibiotic prophylaxis in surgery

[ES] La profilaxis antibiótica en cirugía es una de las medidas más eficaces para la prevención de la infección de localización quirúrgica, aunque su uso es con frecuencia inadecuado, pudiendo incrementar el riesgo de infección, toxicidades y resistencias bacterianas. Debido al avance en las técnicas quirúrgicas y la emergencia de microorganismos multirresistentes las actuales pautas de profilaxis precisan ser revisadas. La Sociedad Española de Enfermedades Infecciosas (SEIMC), conjuntamente con la Asociación Española de Cirujanos (AEC) ha revisado y actualizado las recomendaciones de profilaxis antimicrobiana para adaptarlas a cada tipo de intervención quirúrgica y a la epidemiología actual. En este documento se recogen las recomendaciones de los antimicrobianos utilizados en profilaxis en los diferentes procedimientos, las dosis, la duración, la profilaxis en huéspedes especiales, y en situación epidemiológica de multirresistencia, de tal forma que permitan un manejo estandarizado, un uso racional, seguro y efectivo de los mismos en la cirugía electiva.[EN] Antibiotic prophylaxis in surgery is one of the most effective measures for preventing surgical site infection, although its use is frequently inadequate and may even increase the risk of infection, toxicities and antimicrobial resistance. As a result of advances in surgical techniques and the emergence of multidrug-resistant organisms, the current guidelines for prophylaxis need to be revised. The Sociedad Española de Enfermedades Infecciosas (Spanish Society of Infectious Diseases and Clinical Microbiology) (SEIMC) together with the Asociación Española de Cirujanos (Spanish Association of Surgeons) (AEC) have revised and updated the recommendations for antibiotic prophylaxis in surgery to adapt them to any type of surgical intervention and to current epidemiology. This document gathers together the recommendations on antimicrobial prophylaxis in the various procedures, with doses, duration, prophylaxis in special patient groups, and in epidemiological settings of multidrug resistance to facilitate standardized management and the safe, effective and rational use of antibiotics in elective surgery