Acute gastric dilatation in a bulimic patient: Systemic effects

Objetivos: Mostrar mediante un caso clínico, la repercusión sistémica y las complicaciones orgánicas, que pueden darse tras una dilatación gástrica aguda, ocasionada por un atracón bulímico. Caso clínico: Mujer joven, diagnosticada de bulimia nerviosa, acude a urgencias tras un atracón. A su llegada, presenta gran distensión abdominal y refiere dificultad para provocarse el vómito. Con el paso de unas horas, comienza a presentar signos de inestabilidad hemodinámica y oliguria. Se realiza un TC urgente, en el que se aprecian infartos renales bilaterales por compresión de la aorta abdominal y algunas de sus ramas viscerales. Intervenciones: El proceso de evaluación incluyó la medida del volumen gástrico mediante TC. Se realizó una gastrostomía de descarga, que permitió la evacuación de gran contenido alimenticio y la restauración de la vascularización intraabdominal, que mejoró la perfusión renal. Conclusiones: El TC es una herramienta diagnóstica fundamental que, no sólo permite cuantificar la dilatación gástrica aguda, sino que también permite valorar la integridad de los órganos adyacentes que pudieran estar sufriendo hipoperfusión por compresión.Objectives: To demonstrate through a clinical case the systemic effetcss and complications that can arise after an acute gastric dilatation caused by an eating binge. Clinical case: A young woman diagnosed of bulimia nervosa presents to the emergency room after a massive food intake. She shows important abdominal distention and refers inability to self-induce vomit. A few hours later she commences to show signs of hemodynamic instability and oliguria. A CT scan is performed; it shows bilateral renal infarctions due to compression of the abdominal aorta and some of its visceral branches. Interventions: The evaluation procedures included quantification of the gastric volume by CT. A decompression gastrostomy was performed; it allowed the evacuation of a large amount of gastric content and restored blood supply to the abdomen, which improved renal perfusion. Conclusions: CT is a basic diagnostic tool that not only allows us to quantify the degree of acute gastric dilatation but can also evaluate the integrity of the adjacent organs which may be suffering compression hypoperfusio

INFLUENCE OF THE MINERAL COMPOSITION OF CLAY ROCKS IN THEWELLBORE STABILITY

En la industria petrolera, durante la operación de perforación de un pozo, los costos pueden aumentar entre el 10 y 15% del presupuesto inicial, si la composición de las formaciones perforadas es arcillosa. Para disminuir este problema, la industria ha invertido mucho dinero en investigación, para desarrollar mecanismos que brinden mayor control y estabilidad en estas formaciones durante la perforación. Estudios realizados y publicados por la Society Petroleum Engineer (SPE), muestran que los principales efectos químicos que están involucrados en la interacción fluido de perforación - formación arcillosa son: 1) ósmosis química; y 2) esfuerzos de hidratación. Aunque, existen otros como: efectos capilares, deshidratación, desbalance de presiones e intercambio catiónico. Estos factores generalmente no se presentan de forma independiente. En el piedemonte llanero el problema deinestabilidad de pozos representa un gran costo para las compañías petroleras, debido a que en este sector del país intervienen no sólo los factores químicos generados entre la interacción fluido/roca, también factores mecánicos como resultado del régimen de esfuerzos. Se realizaron pruebas de Metil Blue Testing (MBT) y Difracción de Rayos X (DR-X), en muestras de lodos tomados de ripios extraídos de pozos perforados en algunos sectores del piedemonte y los llanos orientales colombianos. Se encontró en estas muestras un moderado contenido de minerales arcillosos reactivos y bajo contenido de minerales propensos a sufrir hinchamiento. El componente principal en las muestras es caolinita, lo cual hace que la roca sea poco hidratable, pero este tipo de mineral genera dispersión de las paredes del pozo y por lo tanto derrumbes. Sin embargo, se deben realizar más pruebas de laboratorio para cuantificar los daños y evaluar su influencia dentro de los posibles cambios dentro del régimen de esfuerzos durante la perforación. Palabras Clave: Pozos petroleros, Inestabilidad, Minerales arcillosos, Piedemonte llanero.    In the oil companies, the operation of drilling wellbore could be more expensive if the composition of the rocks is clay, the cost could increase between 10 and 15% from the starting budget. In order to decrease this problem, the oil industry has spent too much money for developing mechanisms that can provide better controland stability in clay formations during the drilling. The Society Petroleum Engineers (SPE) in some researches have published that the main chemical effects that are involved in the interaction of perforation fluids and the clay formation are: 1) chemical osmosis; and 2) hydration stresses, although, there are others like: Capillary effects, dehydration, differences in pressure and cationic exchange. These factors are not present generally in independent form. At “Piedemonte Llanero” the problem of the wellbore stability represents a high spending of money for oil companies, caused in this region by chemical factors between fluid/rock and mechanical factors as resulted of the stresses in the area. Metil Blue Testing (MBT) and X-ray Difraction (DR-X) were made in samples of clay; these were taken from cuts extracted of boreholes drilled in some places of the Colombian Llanos. It was found that these samples had a moderate content of reactive and low content of swell minerals.The samples main component was kaolinite, this mineral does not let the rock get swell, but it produces cavingin the hole. However, it is necessary to do other tests to quantify the damages and evaluate the influence of there gime of the stress during the perforation of wellbore. Keywords: Wellbore, Instability, Clay minerals, “Piedemonte Llanero”

INFLUENCE OF THE MINERAL COMPOSITION OF CLAY ROCKS IN THEWELLBORE STABILITY

En la industria petrolera, durante la operación de perforación de un pozo, los costos pueden aumentar entre el 10 y 15% del presupuesto inicial, si la composición de las formaciones perforadas es arcillosa. Para disminuir este problema, la industria ha invertido mucho dinero en investigación, para desarrollar mecanismos que brinden mayor control y estabilidad en estas formaciones durante la perforación. Estudios realizados y publicados por la Society Petroleum Engineer (SPE), muestran que los principales efectos químicos que están involucrados en la interacción fluido de perforación - formación arcillosa son: 1) ósmosis química; y 2) esfuerzos de hidratación. Aunque, existen otros como: efectos capilares, deshidratación, desbalance de presiones e intercambio catiónico. Estos factores generalmente no se presentan de forma independiente. En el piedemonte llanero el problema deinestabilidad de pozos representa un gran costo para las compañías petroleras, debido a que en este sector del país intervienen no sólo los factores químicos generados entre la interacción fluido/roca, también factores mecánicos como resultado del régimen de esfuerzos. Se realizaron pruebas de Metil Blue Testing (MBT) y Difracción de Rayos X (DR-X), en muestras de lodos tomados de ripios extraídos de pozos perforados en algunos sectores del piedemonte y los llanos orientales colombianos. Se encontró en estas muestras un moderado contenido de minerales arcillosos reactivos y bajo contenido de minerales propensos a sufrir hinchamiento. El componente principal en las muestras es caolinita, lo cual hace que la roca sea poco hidratable, pero este tipo de mineral genera dispersión de las paredes del pozo y por lo tanto derrumbes. Sin embargo, se deben realizar más pruebas de laboratorio para cuantificar los daños y evaluar su influencia dentro de los posibles cambios dentro del régimen de esfuerzos durante la perforación. Palabras Clave: Pozos petroleros, Inestabilidad, Minerales arcillosos, Piedemonte llanero.    In the oil companies, the operation of drilling wellbore could be more expensive if the composition of the rocks is clay, the cost could increase between 10 and 15% from the starting budget. In order to decrease this problem, the oil industry has spent too much money for developing mechanisms that can provide better controland stability in clay formations during the drilling. The Society Petroleum Engineers (SPE) in some researches have published that the main chemical effects that are involved in the interaction of perforation fluids and the clay formation are: 1) chemical osmosis; and 2) hydration stresses, although, there are others like: Capillary effects, dehydration, differences in pressure and cationic exchange. These factors are not present generally in independent form. At “Piedemonte Llanero” the problem of the wellbore stability represents a high spending of money for oil companies, caused in this region by chemical factors between fluid/rock and mechanical factors as resulted of the stresses in the area. Metil Blue Testing (MBT) and X-ray Difraction (DR-X) were made in samples of clay; these were taken from cuts extracted of boreholes drilled in some places of the Colombian Llanos. It was found that these samples had a moderate content of reactive and low content of swell minerals.The samples main component was kaolinite, this mineral does not let the rock get swell, but it produces cavingin the hole. However, it is necessary to do other tests to quantify the damages and evaluate the influence of there gime of the stress during the perforation of wellbore. Keywords: Wellbore, Instability, Clay minerals, “Piedemonte Llanero”

Del modelo cinético molecular de los gases en la formación inicial de profesores de química

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Differential expression of dnaA and dosR genes among members of the Mycobacterium tuberculosis complex under oxic and hypoxic conditions

Major differences regarding the pathology and host immune response of the Beijing and Canettii genotypes of Mycobacterium tuberculosis have been reported; however, studies on the genetic expression of these genotypes during in vitro dormancy are scarce. This study examined the expression of five cell-cycle-related genes and two dormancy-related genes in M. canettii, M. tuberculosis H37Rv, and M. tuberculosis Beijing during the Wayne model of dormancy. The results showed that under hypoxic conditions the three tuberculosis genotypes were able to transcribe genes involved in DNA replication and cellular division. In addition, dosR was found to be up-regulated in M. tuberculosis Beijing during the exponential growth phase but down-regulated under hypoxic conditions. In this genotype, the replication-related gene dnaA was also strongly down-regulated. These latter two findings suggest that, compared to M. tuberculosis H37Rv and M. canettii, the Beijing genotype has a lower capacity to synthesize dosR, hspX, and dnaA mRNAs during in vitro dormancy. [Int Microbiol 2010;13(1):9-13

A DNA Microarray-Based Assay to Detect Dual Infection with Two Dengue Virus Serotypes

Here; we have described and tested a microarray based-method for the screening of dengue virus (DENV) serotypes. This DNA microarray assay is specific and sensitive and can detect dual infections with two dengue virus serotypes and single-serotype infections. Other methodologies may underestimate samples containing more than one serotype. This technology can be used to discriminate between the four DENV serotypes. Single-stranded DNA targets were covalently attached to glass slides and hybridised with specific labelled probes. DENV isolates and dengue samples were used to evaluate microarray performance. Our results demonstrate that the probes hybridized specifically to DENV serotypes; with no detection of unspecific signals. This finding provides evidence that specific probes can effectively identify single and double infections in DENV samples

The Influence of Sonographer Experience on Skeletal Muscle Image Acquisition and Analysis

The amount of experience with ultrasonography may influence measurement outcomes while images are acquired or analyzed. The purpose of this study was to identify the interrater reliability of ultrasound image acquisition and image analysis between experienced and novice sonographers and image analysts, respectively. Following a brief hands-on training session (2 h), the experienced and novice sonographers and analysts independently performed image acquisition and analyses on the biceps brachii, vastus lateralis, and medial gastrocnemius in a sample of healthy participants (n = 17). Test–retest reliability statistics were computed for muscle thickness (transverse and sagittal planes), muscle cross-sectional area, echo intensity and subcutaneous adipose tissue thickness. The results show that image analysis experience generally has a greater impact on measurement outcomes than image acquisition experience. Interrater reliability for measurements of muscle size during image acquisition was generally good–excellent (ICC2,1: 0.82–0.98), but poor–moderate for echo intensity (ICC2,1: 0.43–0.77). For image analyses, interrater reliability for measurements of muscle size for the vastus lateralis and biceps brachii was poor–moderate (ICC2,1: 0.48–0.70), but excellent for echo intensity (ICC2,1: 0.90–0.98). Our findings have important implications for laboratories and clinics where members possess varying levels of ultrasound experience

The distribution of potential West Nile virus vectors, Culex pipiens pipiens and Culex pipiens quinquefasciatus (Diptera: Culicidae), in Mexico City

<p>Abstract</p> <p>Background</p> <p><it>Culex </it>spp. mosquitoes are considered to be the most important vectors of West Nile virus (WNV) detected in at least 34 species of mosquitoes in the United States. In North America, <it>Culex pipiens pipiens, Culex pipiens quinquefasciatus</it>, and <it>Culex tarsalis </it>are all competent vectors of WNV, which is considered to be enzootic in the United States and has also been detected in equines and birds in many states of Mexico and in humans in Nuevo Leon. There is potential for WNV to be introduced into Mexico City by various means including infected mosquitoes on airplanes, migrating birds, ground transportation and infected humans. Little is known of the geographic distribution of <it>Culex pipiens </it>complex mosquitoes and hybrids in Mexico City. <it>Culex pipiens pipiens </it>preferentially feed on avian hosts; <it>Culex pipiens quinquefasciatus </it>have historically been considered to prefer mammalian hosts; and hybrids of these two species could theoretically serve as bridge vectors to transmit WNV from avian hosts to humans and other mammalian hosts. In order to address the potential of WNV being introduced into Mexico City, we have determined the identity and spatial distribution of <it>Culex pipiens </it>complex mosquitoes and their hybrids.</p> <p>Results</p> <p>Mosquito larvae collected from 103 sites throughout Mexico City during 2004-2005 were identified as <it>Culex, Culiseta </it>or <it>Ochlerotatus </it>by morphological analysis. Within the genus <it>Culex</it>, specimens were further identified as <it>Culex tarsalis </it>or as belonging to the <it>Culex pipiens </it>complex. Members of the <it>Culex pipiens </it>complex were separated by measuring the ratio of the dorsal and ventral arms (DV/D ratio) of the male genitalia and also by using diagnostic primers designed for the <it>Ace.2 </it>gene. <it>Culex pipiens quinquefasciatus </it>was the most abundant form collected.</p> <p>Conclusions</p> <p>Important WNV vectors species, <it>Cx. p. pipiens</it>, <it>Cx. p. quinquefasciatus </it>and <it>Cx. tarsalis</it>, are all present in Mexico City. Hybrids of <it>Cx. p. pipiens </it>and <it>Cx. p. quinquefasciatus </it>were also collected and identified. The presence and abundance of these WNV competent vectors is a cause for concern. Understanding the distribution of these vectors can help improve viral surveillance activities and mosquito control efforts in Mexico City.</p

Association of HIV-1 Infection and Antiretroviral Therapy With Type 2 Diabetes in the Hispanic Population of the Rio Grande Valley, Texas, USA

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p \u3c 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens