Utilidad de la relación aclaramiento de creatinina - índice de resistencia de la ecografía Doppler renal como predictor de rechazo agudo en riñones trasplantados

ResumenObjetivoAnalizar la utilidad de la asociación del índice de resistencia (IR) en las arterias arcuatas renales con el aclaramiento de creatinina (Cl Cr) para predecir el rechazo agudo del riñón trasplantado.Materiales y métodosSe realizó un estudio prospectivo de una cohorte de 87 pacientes que fueron sometidos a una biopsia renal por alteraciones clínicas de la función renal. Se les midió el IR junto con el Cl Cr mediante el método de modificación de la dieta en la enfermedad renal.ResultadosLa sensibilidad de la asociación IR mayor de 0,7 y Cl Cr 0-30 fue del 53,3% (intervalo de confianza [IC] de 95%: 34,3-71,7%) y la especificidad del 98,2% (95% IC: 90,4-100%). El área bajo la curva fue de 0,758 (95% IC: 0,665-0,85), el likelihood ratio positivo de 22,9 (95% IC: 4,16-214), el likelihood ratio negativo de 0,475 (95% IC: 0,324- 0,685), el odds ratio de 62,9, el valor predictivo positivo de 94,1% (95% IC: 71,3- 99,9%) y el valor predictivo negativo de 79,1% (95% IC: 68,3-88,4%).ConclusiónLa asociación IR mayor de 0,7 y Cl Cr 0-30 demostró ser útil para confirmar la posibilidad de rechazo renal agudo, al tener una buena especificidad (98,2%) a pesar de su baja sensibilidad (53%).AbstractObjectiveTo determine the usefulness of the association between the resistance index (RI) values in renal arcuate arteries and creatinine clearance (Cr Cl) levels in order to predict or detect acute rejection in a kidney transplant patient.Materials and methodsA prospective study was conducted on a cohort of 87 patients who were subjected to a kidney biopsy due to clinical changes in renal function. The RI was measured, and Cr Cl levels determined using the modification of diet in renal disease formula.ResultsThe sensitivity of an RI association higher than 0.7 and a Cr Cl 0-30 was 53.3% (95% confidence interval [CI]: 34.3-71.7%), with a specificity of 98.2% (95% CI: 90.4-100%). The area under the curve was 0.758 (95% CI: 0.665-0.85), the positive and negative likelihood ratio was 22.9 (95% CI: 4.16-214) and 0.475 (95% CI: 0.324-0.685), respectively. The odds ratio was 62.9, and the positive and negative predicted value was 94.1% (95% CI: 71.3-99.9%) and 79.1% (95% CI: 68.3-88.4%), respectively.ConclusionThe RI association higher than 0.7- Cr Cl 0-30 showed to be useful to detect the possibility of acute renal rejection, with its good specificity (98.2%), although with a low sensitivity (53%)

(M, N)-coherent pairs of order (m, k) and Sobolev orthogonal polynomials

A pair of regular linear functionals (U,V)(U,V) is said to be a (M,N)(M,N)-coherent pair of order (m,k)(m,k) if their corresponding sequences of monic orthogonal polynomials...We thank the referees for the careful revision of the manuscript. Their comments and suggestions have contributed to improve substantially the presentation. The work of F. Marcellán, J. Petronilho, and N.C. Pinzón-Cortés has been supported by Dirección General de Investigación Científica y Técnica, Ministerio de Economía y Competitividad of Spain, under grants MTM2012-36732-C03-01 (FM and NCP-C) and MTM2012-36732-C03-02 (JP). The work of J. Petronilho was also supported by the Centro de Matemática da Universidade de Coimbra (CMUC), funded by the European Regional Development Fund through the program COMPETE and by the Portuguese Government through the FCT—Fundação para a Ciência e a Tecnologia under the project PEst-C/MAT/UI0324/2011, and the research project PTDC/MAT/098060/2008 (FCT)

Prevalencia de parásitos intestinales en niños preescolares de barrios vulnerables de Bogotá

Introducción: Infecciones parasitarias intestinales (IPI) son enfermedades tropicales desatendidas, a pesar de que su prevalencia es alta en muchos países en desarrollo. El impacto en la salud pública de los IPI es importante, especialmente para los niños debido al efecto negativo sobre el crecimiento y el desarrollo. Objectivos: Este estudio examina la prevalencia y factores de riesgo de IPI en niños preescolares de barrios en riesgo, incluidos los de las familias desplazadas. Materiales y Métodos: estudio transversal entre 239 niños preescolares de dos barrios vulnerables de Bogotá. Se recogieron muestras fecales y se examinaron microscópicamente utilizando dos técnicas (directa y Ritchie). Se aplicó cuestionario para indagar factores relacionados con el parasitismo intestinal. Resultados: Se encontró una prevalencia de 26,4% de parásitos intestinales patógenos (Giardia duodenalis, Blastocystis spp, Trichuris trichiura, Ascaris lumbricoides y Hymenolepis nana). La regresión logística resultó en cuatro factores de riesgo: hermanos ?5 años (OR 2.33 [1.077-5.021]), los perros callejeros (OR 2.91 [0.867-9.767]), los ocupantes de la casa (OR 2.57 [1.155-5.706]) y el sexo del niño/a (OR 2.17 [1.022-4.615]). Discusión: La presencia del IPI en los niños preescolar es un problema de salud importante en Bogotá y que debe abordarse. Una alta prevalencia de protozoos se encontró comparado con helmintos. La implementación de políticas que aborden los factores de riesgo podría ser un primer paso en la disminución de la prevalencia del IPI. El antecedente de desplazamiento no cambio ni el tipo de parásito ni la prevalencia de parasitismo.Introduction: Intestinal parasitic infections (IPIs) are neglected tropical diseases, even though their prevalence is high in many developing countries. The public health impact of IPIs is substantial, in particular for children due to the negative effect on growth and development. Objectives: This study examines the prevalence and risk factors of IPIs in preschool-children from at-risk neighborhoods, including those from internally displaced families. Materials and Methods: A cross-sectional study among 239 preschool-children from two vulnerable neighborhoods in Bogotá. Fecal samples were collected and microscopically examined (direct and Ritchie technique) and data regarding related factors was obtained through a questionnaire. Results: A prevalence of 26.4% for pathogenic parasites (Giardia duodenalis, Blastocystis spp, Trichuris trichiura, Ascaris lumbricoides, and Hymenolepis nana) was found. Logistic regression resulted in four risk factors: siblings ?5 years (OR 2.33 [1.077-5.021]), stray dogs (OR 2.91 [0.867-9.767]), household members (OR 2.57 [1.155-5.706]) and child's sex (OR 2.17 [1.022-4.615]). Discussion: IPI presence in preschool children is an important health issue in Bogotá which should be addressed. A high protozoan prevalence was found compared to helminthes. Implementing policies addressing risk factors could be a first step in decreasing IPI prevalenc

Adipocinas y síndrome metabólico: múltiples facetas de un proceso fisiopatológico complejo

Debido a la alta morbimortalidad de las enfermedades cardiovasculares y a su relación con trastornos de base como la obesidad y el síndrome metabólico, es crucial entender cuáles son los mecanismos y procesos que desencadenan la alteración del metabolismo y a su vez la generación de dichas enfermedades. En tal sentido, el tejido adiposo y el adipocito tienen un papel fundamental en este proceso, mediante la producción de múltiples adipocinas, algunas clásicas y otras de reciente descripción, pero que hasta ahora empieza a dilucidarse en medio del complejo panorama de interacciones fisiopatológicas conducentes al desarrollo de resistencia a la insulina y del complejo desequilibrio metabólico que conlleva un sinnúmero de complicaciones clínicas. Un grupo de estas adipocinas tiene claros efectos proinflamatorios, mientras que otras pueden clasificarse como anti-inflamatorias, las cuales contrarrestan en cierta medida y hasta cierto punto las acciones de las otras. Cuando esta homeostasis se rompe, la cascada de inflamación crónica allí originada desencadena resistencia a la insulina y se inicia el desarrollo del síndrome metabólico a partir de la obesidad, que a su vez genera alteraciones de la respuesta del adipocito a diferentes estímulos. Esto, sumado a los efectos de otros elementos, configura un complejo cuadro de factores que es necesario tener en cuenta para el abordaje correcto de la obesidad y sus patologías asociadas.Due to the high morbidity and mortality of cardiovascular diseases and their relationship with basic disorders such as obesity and metabolic syndrome, the understanding of the mechanisms and processes that trigger metabolic alterations and generate such diseases, is a crucial matter. In this regard, adipose tissue and adipocytes have a crucial role in this process through the production of multiple adipokines, some of them classical and others recently described; however, until now their role is beginning to be elucidated in the middle of the complex picture of pathophysiological interactions leading to insulin resistance and the metabolic imbalance that leads to a large number of clinic complications. A group of these adipokines has clear pro-inflammatory effects, while others can be classified as anti-inflammatory, which counteract in some extent the effects of the others. When this homeostasis is broken, the originated cascade of chronic inflammation triggers insulin resistance and the metabolic syndrome is developed from obesity, which in turn generates changes in adipocyte response to different stimuli. This, together with the effects of other elements, forms a complex picture of factors that need to be considered for the correct management of obesity and its comorbidities

Vicente Yáñez Pinzón : sus viajes y descubrimientos

72 p. ; 8º mlla. (20 cm).El autor es capitán de infantería y licenciado en derecho. Incluye (p. 6) autógrafo dedicado al presidente de la Sociedad Colombina de Huelva (Madrid, oct. 1920)

Factors contributing to morning rain in the upper Río Chagres Basin, Panamá

The Upper Chagres River Basin plays an important role in the stable operation of the Panama Canal. Previous studies have shown that there is a salient regional difference in the diurnal variation of precipitation in the basin. Precipitation during the rainy season peaks in the early afternoon throughout the basin, but precipitation is also observed in the morning at sites in the northern part of the basin. However, the cause of this is not clear due to limited ground observation. To address this issue, we conducted dynamical downscaling experiments with a horizontal grid spacing of 5 and 2 km and nested in a global atmospheric model with horizontal grid spacing of approximately 20 km. The results showed that the 2 km convection-permitting model successfully reproduced regional differences in observed diurnal variations. The downscaled results indicated that intensified low-level northeasterly winds over the southern Caribbean Sea triggered favorable conditions for morning rain with an orographic effect under the seaside coastal regime in the western Caribbean Sea. This is in contrast to precipitation peaks in the early afternoon under a landside coastal regime

Emergence and spread of a new community-genotype methicillin-resistant Staphylococcus aureus clone in Colombia

© 2017 The Author(s). Background: Community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) clones are a global concern due to their resistance and increased virulence and their ability to cause infections both hospitalized patients and healthy people in the community. Here, we characterize 32 isolates of a new CG-MRSA clone. These isolates were identified in four cities in Colombia, South America. Methods: The isolates were recovered from four different epidemiological and prospective studies that were conducted in several regions of Colombia. Molecular characterizations included multilocus sequence typing; pulsed-field gel electrophoresis; SCCmec, agr and spa typing; and whole-genome sequencing. Results: All isolates belonged to ST923 (clonal complex 8), harbouring SCCmec IVa and a spa type t1635 and lacking an arginine catabolism mobile element. The isolates were classified as COL923, were resistant to at least one non-beta-lactam antibiotic, and exhibited high frequencies (>60%) of resistance to macrolides and tetracycline. Using whole-genome sequencing, we found that this new clone harbours novel prophage 3 and beta-island structures and a slightly different pathogenicity island 5. Moreover, isolates belonging to the COL923 clone are grouped in a different clade than USA300 and USA300-LV. Conclusion: Our results show the emergence and spread of the COL923 clone in different cities in Colombia. This clone is resistant to several antibiotics and possesses new structures in its mobile genetic elements

Accounting for the male domination through legislative empowerment of upper-middle class women in the early nineteenth century Spain

Purpose The purpose of this paper is to address both the neglect of non-Anglo-centric accounting gendered practices beyond the predominant professional setting and the controversial roles of women and accounting in power relationships inside the household. Analyzing a Spanish upper-middle class Catholic family in the early nineteenth century, the research focuses on the reciprocal interaction of accounting with practices and processes of daily life in a rigid patriarchal socio-cultural and juridical context. Design/methodology/approach This microhistory draws upon several archives, including in Spain the Archivo Histórico Provincial de Cádiz. In England, the Bath Record Office has preserved documents and correspondence, both personal and business related, and the Worcester Record Office preserved notarial documents concerning the family. The large number of letters which have survived has facilitated an in-depth study of the people who were affected by accounting calculations. Findings In a juridical context where women were conceived as merely the means for the circulation of property between two families, the evidence shows that accounting provided the proof of women’s patrimony value and the means to facilitate their recovery in this cosification process. Although women had a little involvement in the household’s accounting and management, they demonstrated confidence in accounting, fulfilling a stewardship function for the resources received. Also, evidence shows that by using accounting practices to shield supposedly defenseless women, this reinforced male domination over women and promoted the view that the role of women was as an ornament and in need of a good husband. Originality/value Contrasting with the Anglo-Saxon contemporary context, the Spanish law preserved a woman’s property rights, guaranteeing recovery of properties owned by her before marriage should the marriage be legally annulled or be dissolved because one of the spouses’ death. This required a detailed accounting of the wife’s properties brought to her marriage, most especially regarding the dowry provided by her family

Coping Strategies Used by Female Victims of the Colombian Armed Conflict: The Women in the Colombian Conflict (MUCOCO) Program

The effects of armed conflict on women in post-conflict situations are an area of analysis for social disciplines. This study will analyze the situation in Colombia, currently involved in a peace restoration process. The aim is to verify the efficacy of a coping and emotion regulation program analyzing victimization as well as the coping strategies employed in response to these violent acts. The program focuses on 62 women contacted through the Ruta Pacífica de las Mujeres, a nongovernmental organization. The program had a positive effect on women, reporting lower levels of posttraumatic stress, more functional coping strategies, and less use of dysfunctional strategies. All emotional cognitive and social indicators improved. Women felt emotionally better, perceiving greater social support and more trust in institutions. Survivors had more self-confidence to achieve their goals and solve their problems. The implications in a context of peace reconstruction and search for social cohesion are discussed.project (Proyectos CUD 2017) funded by the Oficina de Cooperación al Desarrollo (Development Cooperation Office) of the Universidad del País Vasco/Euskal Herriko Unibertsitatea (University of the Basque Country, Spain) and the University of Burgos funding for the research group SIQoL (Y133GI)

Differences in aquatic respiration in two contrasting streams: forested vs. agricultural

Land cover changes alter hydrologic (e.g., infiltration-runoff), biochemical (e.g., nutrient loads), and ecological processes (e.g., stream metabolism). We quantified differences in aquatic ecosystem respiration in two contrasting stream reaches from a forested watershed in Colorado (1st-order reach) and an agricultural watershed in Iowa (3rd-order reach). We conducted two rounds of experiments in each of these reaches, featuring four sets of continuous injections of Cl− as a conservative tracer, resazurin as a proxy for aerobic respiration, and one of the following nutrient treatments: (a) N, (b) N + C, (c) N + P, and (d) C + N + P. With those methods providing consistent information about solute transport, stream respiration, and nutrient processing at the same spatiotemporal scales, we sought to address: (1) Are respiration rates correlated with conservative transport metrics in forested or agricultural streams? and (2) Can short-term modifications of stoichiometric conditions (C:N:P ratios) override respiration patterns, or do long-term physicochemical conditions control those patterns? We found greater respiration in the reach located in the forested watershed but no correlations between respiration, discharge, and advective or transient storage timescales. All the experiments conducted in the agricultural stream featured a reaction-limited transformation of resazurin, suggesting the existence of nutrient or carbon limitations on respiration that our short-term nutrient treatments did not remove. In contrast, the forested stream was characterized by nearly balanced transformation and transient storage timescales. We also found that our short-lived nutrient treatments had minimal influence on the significantly different respiration patterns observed between reaches, which are most likely driven by the longer-term and highly contrasting ambient nutrient concentrations at each site. Our experimental results agree with large-scale analyses suggesting greater microbial respiration in headwater streams in the U.S. Western Mountains region than in second-to-third-order streams in the U.S. Temperate Plains region