Significado de la anemia en las diferentes etapas de la vida

Overview: Anemia is very common in primary care consultations and pediatrics, and IDA is the cause of 50% of all cases of anemia. Methodology: Literature review and documentary descriptive analysis of the pathogenesis of iron-deficiency anemia, the basic diagnostic tests to study IDA and the significance of such using a specific time period in the documentary search and inclusion criteria that takes into account factors that are analyzed in the study: Ideas about the metabolism of iron. Ideas about hematopoiesis. Laboratory diagnosis and classification of anemia. Clinical features of iron deficiency anemia. Causes of iron deficiency. Results and conclusion: The staged documentary study covers the publications on the pathogenesis of iron deficiency anemia, the basic diagnostic tests to study the IDA and the significance of such, and it shows how important this data is for professional nursing in the area of primary care and pediatrics, to identify it and act accordingly.Resumen: La anemia presenta una elevada prevalencia en las consultas de atención primaria y pediatría, y la ADH representa el 50% de todos los casos de anemia. Metodología: Revisión bibliográfica y análisis descriptivo documental sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH  y su significado, utilizando una temporalidad determinada en la búsqueda documental y criterios de inclusión atendiendo a las dimensiones que se analizan en el estudio: Nociones acerca del metabolismo del hierro. Nociones acerca de la hematopoyesis. Diagnóstico por el laboratorio y clasificación de las anemias. Clínica de la anemia ferropénica. Causas de la deficiencia de hierro. Resultados y conclusión: EL estudio documental efectuado nos presenta la existencia de publicaciones con contenidos sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH  y su significado, evidenciando la importancia de este contenido para el profesional de enfermería en el área de la atención primaria y pediatría

Hypoglycemia and the Origin of Hypoxia-Induced Reduction in Human Fetal Growth

The most well known reproductive consequence of residence at high altitude (HA >2700 m) is reduction in fetal growth. Reduced fetoplacental oxygenation is an underlying cause of pregnancy pathologies, including intrauterine growth restriction and preeclampsia, which are more common at HA. Therefore, altitude is a natural experimental model to study the etiology of pregnancy pathophysiologies. We have shown that the proximate cause of decreased fetal growth is not reduced oxygen availability, delivery, or consumption. We therefore asked whether glucose, the primary substrate for fetal growth, might be decreased and/or whether altered fetoplacental glucose metabolism might account for reduced fetal growth at HA.Doppler and ultrasound were used to measure maternal uterine and fetal umbilical blood flows in 69 and 58 residents of 400 vs 3600 m. Arterial and venous blood samples from mother and fetus were collected at elective cesarean delivery and analyzed for glucose, lactate and insulin. Maternal delivery and fetal uptakes for oxygen and glucose were calculated.The maternal arterial – venous glucose concentration difference was greater at HA. However, umbilical venous and arterial glucose concentrations were markedly decreased, resulting in lower glucose delivery at 3600 m. Fetal glucose consumption was reduced by >28%, but strongly correlated with glucose delivery, highlighting the relevance of glucose concentration to fetal uptake. At altitude, fetal lactate levels were increased, insulin concentrations decreased, and the expression of GLUT1 glucose transporter protein in the placental basal membrane was reduced.Our results support that preferential anaerobic consumption of glucose by the placenta at high altitude spares oxygen for fetal use, but limits glucose availability for fetal growth. Thus reduced fetal growth at high altitude is associated with fetal hypoglycemia, hypoinsulinemia and a trend towards lactacidemia. Our data support that placentally-mediated reduction in glucose transport is an initiating factor for reduced fetal growth under conditions of chronic hypoxemia

Roles of Small GTPase Rac1 in the Regulation of Actin Cytoskeleton during Dengue Virus Infection

An important clinical characteristic of dengue hemorrhagic fever/dengue shock syndrome is increased vascular permeability. Actin cytoskeleton is a significant element of endothelial barrier function regulation. In vitro study showed that dengue virus infection could induce redistributions of actin cytoskeleton. It is not precisely clear the roles of actin and the mechanisms of its reorganization during the infection. Using immunochemical assays, drug inhibition assays and protein interaction profiling methods, we aimed to identify the ways in which dengue virus serotype 2 interacts with actin cytoskeleton. The study showed that dynamic treadmilling of actin is necessary for dengue virus entry, production and release, while small GTPase Rac1 also plays multiple roles during these processes. In addition, we demonstrated the association of viral E protein with actin, indicating a direct effect of viral protein on the structural modifications of actin cytoskeleton. Our results provide evidence for the participation of Rac1 signaling pathways in viral protein-induced actin reorganizations, which may be a mechanism involved in the etiology of dengue hemorrhagic fever

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics

Transversal clustering of phylogenetic relationships and genomic variation.

<p>Clustering was built using a ClonalFrame tree of MLST allele sequences of 67 <i>V. parahaemolyticus</i> strains, while the VGR data were grouped using a UPGMA algorithm, resulting in a data matrix ordered according to both phylogenetic relationship and the prevalence of VGRs. Solid boxes and open boxes in the appropriate column indicate VGR presence or absence, respectively. Peruvian subset names are shown in red.</p

Minimum spanning tree (MST) of <i>V.</i> parahaemolyticus.

<p>A) MST of 89 MLST allelic profiles of the whole dataset included in this study. The colors are based on the origin of isolation. B) MST of the Peruvian subset that includes 56 strains. The colors are based on the serotyping group. Each circle represents an MLST genotype, and its size is proportional to the number of strains. The numbers along the branch links of MLST genotypes denote the amount of allelic differences.</p