Estudio Epidémico-etiológico y de costes de la infección viral respiratoria aguda en la época epidémica 2010-2011 en la edad pediátrica.

212 p.Las infecciones respiratorias agudas de etiología viral son, en conjunto, los procesos infecciosos más frecuentes en los humanos. Algunas de ellas, como la infección por virus influenza y Virus respiratorio sincitial están entre las principales causas de hospitalización pediátrica en los meses de invierno. Se llevó a cabo un estudio en el Hospital Universitario de Basurto (HUB) para estimar la carga de la enfermedad de la gripe confirmada por el laboratorio en niños <15 años. Los niños que acudieron al HUB con síntomas de infección respiratoria aguda y/o fiebre aislada entre noviembre de 2010 y mayo 2011 fueron incluidos en el estudio. Se tomaron 2 muestras de secreción nasofaríngea para test de diagnóstico rápido de gripe y otra para análisis en el laboratorio mediante RT-PCR y cultivo viral.Se seleccionó un total de 501 niños, de los que 91 fueron hospitalizados. El diagnóstico de gripe se confirmó en 131 (26%); 120 fueron tratados ambulatoriamente y 11 hospitalizados. La proporción de otros virus respiratorios detectados fue 145/501 niños (28,9%), siendo el VRS (n=52), el Rinovirus (n=40) y el Adenovirus (n=30) los virus más aislados. La coinfección con otro virus respiratorio además de gripe se observó en 7/501 (1,4%) niños. Los tipos de gripe fueron: A (H1N1 y H3N2) 53,6% (67/125); B (Victoria y Yamagata) 46,4% (58/125). El coste médico directo medio asociado con cada caso de gripe confirmada fue de 177 € (n=131). No se observaron diferencias estadísticamente significativas entre el coste asociado con gripe A o B

Estudio Epidémico-etiológico y de costes de la infección viral respiratoria aguda en la época epidémica 2010-2011 en la edad pediátrica.

212 p.Las infecciones respiratorias agudas de etiología viral son, en conjunto, los procesos infecciosos más frecuentes en los humanos. Algunas de ellas, como la infección por virus influenza y Virus respiratorio sincitial están entre las principales causas de hospitalización pediátrica en los meses de invierno. Se llevó a cabo un estudio en el Hospital Universitario de Basurto (HUB) para estimar la carga de la enfermedad de la gripe confirmada por el laboratorio en niños <15 años. Los niños que acudieron al HUB con síntomas de infección respiratoria aguda y/o fiebre aislada entre noviembre de 2010 y mayo 2011 fueron incluidos en el estudio. Se tomaron 2 muestras de secreción nasofaríngea para test de diagnóstico rápido de gripe y otra para análisis en el laboratorio mediante RT-PCR y cultivo viral.Se seleccionó un total de 501 niños, de los que 91 fueron hospitalizados. El diagnóstico de gripe se confirmó en 131 (26%); 120 fueron tratados ambulatoriamente y 11 hospitalizados. La proporción de otros virus respiratorios detectados fue 145/501 niños (28,9%), siendo el VRS (n=52), el Rinovirus (n=40) y el Adenovirus (n=30) los virus más aislados. La coinfección con otro virus respiratorio además de gripe se observó en 7/501 (1,4%) niños. Los tipos de gripe fueron: A (H1N1 y H3N2) 53,6% (67/125); B (Victoria y Yamagata) 46,4% (58/125). El coste médico directo medio asociado con cada caso de gripe confirmada fue de 177 € (n=131). No se observaron diferencias estadísticamente significativas entre el coste asociado con gripe A o B

Dielectric and mechanical assessment of cellulosic insulation during transformer manufacturing

Due to the impact of cellulose of paper insulation on transformer life, it is imperatire to remove moisture from the oil and the solid insulation. Several techniques have been implemented during manufacturing of power transformers to reduce water content in transformers. These drying processes can involve different costs and time, and they can damage the insulation paper. In this work, a drying process has been implemented in the laboratory trying to simulate the most aggressive conditions that can be suffered by the paper in transformer manufacturing in a real industry. Once the moisture content of papers was lower than 0.5%, the effect of the drying process on paper degradation was evaluated using the analysis of mechanical and dielectric properties and the degree of polymerization. Different commercial papers were studied to quantify the possible degradation induced by the drying process. The results of the mechanical strength study showed a reduction on the degree of polymerization from 1100 to 850 after 4 days of drying. The dielectric analysis of the samples showed different behavior in one of the solids evaluated and it was also found a decreased hygroscopic capacity of degraded samples in comparison with new samples.This research is under the National Research Project “Gestión del Ciclo de Vida de Transformadores Aislados con Fluidos Biodegradables” (PID2019-107126RB-C22/ AEI /10.13039/501100011033). The authors also wish to thank “Fundación Iberdrola” for its financial support for the research project: “Análisis de las Propiedades Dieléctricas de Aislamientos Sólidos Impregnados con Líquidos Dieléctricos”. C. Méndez would like to acknowledge the Spanish Ministry of Science, Innovation and Universities for the financial support for the FPU grant (FPU19/01849)

Study of the impregnation of power-transformer cellulosic materials with dielectric ester oils

The application of alternative dielectric oils as esters in power transformers is hindered by the lack of knowledge regarding their properties and respecting which are the best techniques to ensure their proper performance. In this sense one of the fields needing an impulse is the impregnation processes of transformers cellulosic materials with these alternative oils, currently impregnated in most of the cases with mineral oils. This paper studies the impregnation behavior of eight usual dielectric solids, with two esters and a traditional mineral oil. Empirical equations of the impregnation evolution with time have been obtained, from these the rigid cellulosic materials present in the transformers and the viscosity of the dielectric oils have been identified as the key materials and properties to consider during impregnation. An adaptation of the current impregnation processes to the alternative oils have been proposed by increasing their temperature from ambient temperature up to 61-74°C, depending on the viscosity of the oil used.This work was supported in part by the Spanish Ministry of Science and Innovation by the National Research Project Asset Management of Biodegradable-Fluid-Based Transformers under Grant PID2019-107126RB-C22/AEI/ 10.13039/501100011033, in part by the Universities and Research Council of the Government of Cantabria by the Grant ‘‘Biodegradable Fluids in Electrical Power Transformers: Solid Dielectric Impregnation and Thermal Modeling with Thermal Hydraulic Network Models (THNM)’’ under Grant VP32, 2019-2, and in part by the University of Cantabria through the Industrial Doctoral Program 2016, Scholarship DI13

Caries en dentición decidua y riesgo de pérdida del primer molar permanente joven: reporte de caso

Risk assessment of dental caries can provide the dental clinician with important information that leads to the correct approach for taking care of the pediatric patient, especially when performed at an early age. Tooth decay is one of the most common chronic diseases in infants. The contemporary approach promotes management of dental caries based on biological and clinical evidence seeking to maintain health, preserve tooth structure, prevent appearance of new lesions and prevent progression of existing ones., In addition, this approach emphasizes non-operative management in the initial stages and a conservative operative one in more severe cases. All this in parallel with the control of risk factors. The objective of this work is to highlight the risk factors that influence early development of caries of the first permanent molar, to the point of considering invasive interventions as endodontic treatments, even in immature stages of its formation. This case report is about a seven years and one month of age female patient, who attended the School of Dentistry of the University of El Salvador, with multiple carious lesions in the deciduous dentition and a reported pain in teeth 2-6 and 3 -6 with a presumptive diagnosis of reversible and irreversible pulpitis, respectively. It is concluded that identifying risk factors for dental caries at an early age and educating children and their caregivers about oral health in the child’s first dental consultations is essential to prevent the installation of caries in the deciduous dentition, as well as in the permanent oneLa evaluación de riesgo a caries dental puede proveer al clínico dentista información importante que conduzca al correcto abordaje del paciente pediátrico, especialmente cuando se ejecuta a temprana edad. La caries dental es una de las enfermedades crónicas más comunes en infantes, el enfoque contemporáneo promueve el manejo basado en evidencia biológica y clínica, que busca mantener la salud, preservar la estructura dental, prevenir la aparición de nuevas lesiones y evitar que progresen las ya existentes; con énfasis en el manejo no operatorio en estadios iniciales y operatorio conservador en los casos más severos. Todo ello paralelo con el control de factores de riesgo. El objetivo del presente trabajo es resaltar los factores de riesgo a caries que influyeron en la exposición temprana a caries del primer molar permanente, comprometiéndolo hasta considerar intervenciones invasivas como tratamientos endodónticos aun en etapas inmaduras de su formación. El presente reporte de caso es sobre una paciente femenina de 7 años 1 mes de edad, que acude a la Facultad de Odontología de la Universidad de El Salvador, con múltiples lesiones cariosas en dentición decidua y relato de dolor en dientes 26 y 36 con diagnóstico presuntivo de pulpitis reversible e irreversible respectivamente. Se concluye que identificar los factores de riesgo a caries dental a temprana edad y educar sobre salud bucal al paciente infantil y sus cuidadores en las primeras consultas dentales del niño, es primordial para prevenir la instalación de caries en la dentición decidua, así como en la permanente

Functional benefits of PLGA particulates carrying VEGF and CoQ10 in an animal of myocardial ischemia

Myocardial ischemia (MI) remains one of the leading causes of death worldwide. Angiogenic therapy with the vascular endothelial growth factor (VEGF) is a promising strategy to overcome hypoxia and its consequences. However, from the clinical data it is clear that fulfillment of the potential of VEGF warrants a better delivery strategy. On the other hand, the compelling evidences of the role of oxidative stress in diseases like MI encourage the use of antioxidant agents. Coenzyme Q10 (CoQ10) due to its role in the electron transport chain in the mitochondria seems to be a good candidate to manage MI but is associated with poor biopharmaceutical properties seeking better delivery approaches. The female Sprague Dawley rats were induced MI and were followed up with VEGF microparticles intramyocardially and CoQ10 nanoparticles orally or their combination with appropriate controls. Cardiac function was assessed by measuring ejection fraction before and after three months of therapy. Results demonstrate significant improvement in the ejection fraction after three months with both treatment forms individually; however the combination therapy failed to offer any synergism. In conclusion, VEGF microparticles and CoQ10 nanoparticles can be considered as promising strategies for managing MI

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Brain structural changes in schizoaffective disorder, and how far they resemble those seen in schizophrenia and bipolar disorder, have only been studied to a limited extent. Forty-five patients meeting - and criteria for schizoaffective disorder, groups of patients with 45 matched schizophrenia and bipolar disorder, and 45 matched healthy controls were examined using voxel-based morphometry (). Analyses comparing each patient group with the healthy control subjects found that the patients with schizoaffective disorder and the patients with schizophrenia showed widespread and overlapping areas of significant volume reduction, but the patients with bipolar disorder did not. A subsequent analysis compared the combined group of patients with the controls followed by extraction of clusters. In regions where the patients differed significantly from the controls, no significant differences in mean volume between patients with schizoaffective disorder and patients with schizophrenia in any of five regions of volume reduction were found, but mean volumes in the patients with bipolar disorder were significantly smaller in three of five. The findings provide evidence that, in terms of structural gray matter brain abnormality, schizoaffective disorder resembles schizophrenia more than bipolar disorder

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication