Herida antebraquial infectada por Aeromonas hydrophila

Se presenta un caso de celulitis por Aeromonas hydrophila, en un paciente de 23 años, tras una herida antebraquial producida en el medio acuático. La celulitis se resolvió mediante desbridamiento agresivo y quimioterapia. En los controles posteriores no se han apreciado déficits funcionales tras la infección.A case of Aeromonas hidrophila cellulitis developped in a 23-year-old patient, after aquatic environment forearm wound is presented. His cellulitis was effectively resolved with aggressive debridement and chemotherapy. Follow-up examinations have shown no residual functional deficits from the infection

Parent-child relationship in student with and without difficulties of development

La forma de responder de los padres ante un niño con necesidades específicas de apoyo educativo, cuyas características son diferentes al resto, puede diferir de unos padres a otros. Este proceso de afrontamiento de la dificultad del niño es importante ya que la relación que los padres establezcan con sus hijos va a estar influenciada en parte por las reacciones y sentimientos que éstos desarrollen ante la dificultad de sus hijos pudiéndose producir tendencia al rechazo, indiferencia, percepciones alteradas de las cualidades y capacidades del hijo, problemas matrimoniales o injustificadas reacciones hacia la comunidad, sin olvidar el sentimiento de culpa (Nazir y Naz, 2012). Desde esta perspectiva, los objetivos que se plantean en el presente estudio son conocer las actitudes más frecuentes de los padres hacia sus hijos en términos de aceptación-rechazo y estilo educativo en función de las diferentes tipologías de sus hijos siendo estas: necesidades educativas especiales, otras necesidades específicas de apoyo educativo y sin dificultades de aprendizaje ni desarrollo y establecer una comparación entre ellas. Para ello, 75 familillas de alumnos de las diferentes tipologías han respondido al cuestionario Parental Acceptance-Rejection/Control Questionnaire (Rohner y Khaleque, 2005). Los resultados muestran diferencias en los sentimientos de aceptación-rechazo de los padres y sus estilos de control en función de las características tipológicas de sus hijos.How to respond to parent a child with special educational needs whose characteristics are different from the rest, you may differ from other parents. This process of coping with the difficulty of the child is important because the relationship that parents establish with their children will be influenced in part by the reactions and feelings they develop given the difficulty of their children being able to produce trend of rejection, indifference, altered perceptions of the qualities and abilities of the child, marital problems or unjustified reactions to the community, not to mention the guilt (Nazir and Naz, 2012). From this perspective, the objectives proposed in this study are to know the most common attitudes of parents towards their children in terms of acceptance-rejection and educational style based on the different types of children which are: special educational needs, other specific educational support and without learning and development and make a comparison between them. To do this, 75 students familiars of different types have responded to the questionnaire Parental Acceptance-Rejection / Control Questionnaire (Rohner and Khaleque, 2005). The results show differences in feelings of acceptance and rejection of parents and their styles of control depending on the typological characteristics of their children

Resident macrophages of pancreatic islets have a seminal role in the initiation of autoimmune diabetes of NOD mice

Significance Our studies indicate that the resident macrophages of the pancreatic islets of Langerhans have a seminal role in the initiation and progression of autoimmune diabetes in NOD mice. In this study, islet macrophages were depleted by administration of a monoclonal antibody to the CSF-1 receptor. Macrophage depletion, either at the start of the autoimmune process or when diabetogenesis is active, leads to a significant reduction in diabetes incidence. Depletion of the islet macrophages reduces the entrance of T cells into islets and results in the absence of antigen presentation. Concordantly, a regulatory pathway develops that controls diabetes progression. We conclude that treatments that target the islet macrophages may have important clinical relevance for the control of autoimmune type 1 diabetes.</jats:p

Clinical study of cervicogenic headache

The cervicogenic headache was studied to get a deeper insight into the pathogenetic mechanisms, and clinical presentation forms. Material and Methods. Eleven female patients, ranging from 34 to 81 years-old, with cervicogenic headaches, were studied and correlated with NMR images of the cervical spine. Results. Intense neck pain irradiated to parietal, occipital, temporal regions, and shoulders were correlated with NMR images of the degenerated cervical spine. Also, lumbar spine pathology, osteoporosis, gallstones, and cholecystitis were found. The following associated neurological, neurobehavioral, and metabolic diseases comorbidities were observed, such as blood hypertension, diabetes, obesity, hypothyroidism, partial epilepsy, tremor, familial stress, memory, sleep disorders, and dizziness. Also, we found mixed cervicogenic headaches and migraines in 50% of cases studied. Conclusion. The headache and the associated images of cervical pathology have been clinically interpreted as cardinal signs of cervicogenic headache. A mixed cervicogenic mixed type was observed

Clinical Study of Memory Disorders in Aging Patients with Associated Cardiovascular, Neurological, Neurobehavioral and Metabolic Diseases”. A Review

We have observed semantic memory and episodic memory disorders (100%) in patients ranging from 40 to 92 years-old, associated to cardiovascular diseases and blood hypertension (82%), sleep disorders (50%), neurobehavioral disorders (44%), such as depression, anxiety, aggression, and vascular demencia, disorders of language (36%), neurosensory disorders (28%), as diminution of visual and hearing acuity, dizziness (26%), Parkinson disease (34%), Alzheimer disease (21%), gait disturbances (10%), vertigo (10%), cervicalgia and cervicogenic headache (10%) trigeminal neuralgia (2%,), We observed as comorbidities the following non-nervous diseases: metabolic diseases as diabetes (21%) and hypothyroidism (5%), gastrointestinal pathology (21%), such as constipation, loss of sphincter control, and gastritis, arthritis (13%), prostatic hypertrophy (1%) and loss of weight (1%). We consider that according to their high frequency the most risk factors associated to memory disorders are cardiovascular diseases and blood hypertension (82%), sleep disorders (50%), neurobehavioral disorders (44%), such as depression, anxiety, aggression, and vascular demencia, disorders of language (36%), neurosensory disorders (28%), as diminution of visual and hearing acuity, dizziness (26%), and Parkinson disease (34%)

A fully automated flow injection atomic absorption system for the determination of copper traces in waters with on-line pre-concentration in an ion-exchange column

The paper describes the development of an automatic on-line column pre-concentration technique using a time based-flow injection atomic absorption spectrometry system. A manifold incorporating a micro-column containing 25 mg of Dowex 50W-X8 was used with a time-based injector for the pre-concentration and determination of copper in natural and drinking waters. The system features depend on the alternate positions of a solenoid valve. The 3σ detection limits, enrichment factors, sampling frequency, relative standard deviations and linear calibration graphs were, respectively, in the range 0.6-1.5 μg/l, 25-60, 15-30 measurements/h, 1.0-3.1% and 1-65 μg/ml for pre-concentration times of 1 min. The procedure was successfully applied to a range of water samples and the accuracy was assessed through recovery experiments, the analysis of certified reference water samples and by independent analysis by atomic absorption spectrometry with electrothermal atomization

Listeriolysin O Is Strongly Immunogenic Independently of Its Cytotoxic Activity

The presentation of microbial protein antigens by Major Histocompatibility Complex (MHC) molecules is essential for the development of acquired immunity to infections. However, most biochemical studies of antigen processing and presentation deal with a few relatively inert non-microbial model antigens. The bacterial pore-forming toxin listeriolysin O (LLO) is paradoxical in that it is cytotoxic at nanomolar concentrations as well as being the source of dominant CD4 and CD8 T cell epitopes following infection with Listeria monocytogenes. Here, we examined the relationship of LLO toxicity to its antigenicity and immunogenicity. LLO offered to antigen presenting cells (APC) as a soluble protein, was presented to CD4 T cells at picomolar to femtomolar concentrations- doses 3000–7000-fold lower than free peptide. This presentation required a dose of LLO below the cytotoxic level. Mutations of two key tryptophan residues reduced LLO toxicity by 10–100-fold but had no effect on its presentation to CD4 T cells. Thus there was a clear dissociation between the cytotoxic properties of LLO and its very high antigenicity. Presentation of LLO to CD8 T cells was not as robust as that seen in CD4 T cells, but still occurred in the nanomolar range. APC rapidly bound and internalized LLO, then disrupted endosomal compartments within 4 hours of treatment, allowing endosomal contents to access the cytosol. LLO was also immunogenic after in vivo administration into mice. Our results demonstrate the strength of LLO as an immunogen to both CD4 and CD8 T cells

Ertapenem susceptibility of extended spectrum beta-lactamase-producing organisms

<p>Abstract</p> <p>Background</p> <p>Infections caused by multiply drug resistant organisms such as extended spectrum <it>beta</it>-lactamase (ESBL)-producing <it>Escherichia coli </it>and <it>Klebsiella pneumoniae </it>are increasing. Carbapenems (imipenem and meropenem) are the antibiotics commonly used to treat these agents. There is limited clinical data regarding the efficacy of the newest carbapenem, ertapenem, against these organisms. Ertapenem susceptibility of ESBL-producing <it>E. coli </it>and <it>K. pneumoniae </it>clinical isolates were evaluated and compared to imipenem to determine if imipenem susceptibility could be used as a surrogate for ertapenem susceptibility.</p> <p>Methods</p> <p>100 ESBL isolates (n = 34 <it>E. coli </it>and n = 66 <it>K. pneumoniae</it>) collected from 2005–2006 clinical specimens at WRAMC were identified and tested for susceptibility by Vitek Legacy [bioMerieux, Durham, NC]. Ertapenem susceptibility was performed via epsilometer test (E-test) [AB Biodisk, Solna, Sweden].</p> <p>Results</p> <p>100% of ESBL isolates tested were susceptible to ertapenem. 100% of the same isolates were also susceptible to imipenem.</p> <p>Conclusion</p> <p>These results, based on 100% susceptibility, suggest that ertapenem may be an alternative to other carbapenems for the treatment of infections caused by ESBL-producing <it>E. coli </it>and <it>K. pneumoniae</it>. Clinical outcomes studies are needed to determine if ertapenem is effective for the treatment of infection caused by these organisms. However, due to lack of resistant isolates, we are unable to conclude whether imipenem susceptibility accurately predicts ertapenem susceptibility.</p

Dietary intake in adults on hemodialysis compared with guideline recommendations

Background: Clinical practice guidelines of dietary management are designed to promote a balanced diet and maintain health in patients undergoing haemodialysis but they may not reflect patients’ preferences. We aimed to investigate the consistency between the dietary intake of patients on maintenance haemodialysis and guideline recommendations. Methods: Cross-sectional analysis of the DIET-HD study, which included 6,906 adults undergoing haemodialysis in 10 European countries. Dietary intake was determined using the Global Allergy and Asthma European Network (GA2LEN) Food Frequency Questionnaire (FFQ), and compared with the European Best Practice Guidelines. Consistency with guidelines was defined as achieving the minimum daily recommended intake for energy (≥ 30&nbsp;kcal/kg) and protein (≥ 1.1&nbsp;g/kg), and not exceeding the maximum recommended daily intake for phosphate (≤ 1000&nbsp;mg), potassium (≤ 2730&nbsp;mg), sodium (≤ 2300&nbsp;mg) and calcium (≤ 800&nbsp;mg). Results: Overall, patients’ dietary intakes of phosphate and potassium were infrequently consistent with guidelines (consistent in 25% and 25% of patients, respectively). Almost half of the patients reported that energy (45%) and calcium intake (53%) was consistent with the guidelines, while the recommended intake of sodium and protein was consistent in 85% and 67% of patients, respectively. Results were similar across all participating countries. Intake was consistent with all six guideline recommendations in only 1% of patients. Conclusion: Patients on maintenance haemodialysis usually have a dietary intake which is inconsistent with current recommendations, especially for phosphate and potassium

Circulating proteins as predictors of cardiovascular mortality in endstage renal disease

Introduction: Proteomic profiling of end-stage renal disease (ESRD) patients could lead to improved risk prediction and novel insights into cardiovascular disease mechanisms. Plasma levels of 92 cardiovascular disease-associated proteins were assessed by proximity extension assay (Proseek Multiplex CVD-1, Olink Bioscience, Uppsala, Sweden) in a discovery cohort of dialysis patients, the Mapping of Inflammatory Markers in Chronic Kidney disease cohort [MIMICK; n = 183, 55% women, mean age 63 years, 46 cardiovascular deaths during follow-up (mean 43 months)]. Significant results were replicated in the incident and prevalent hemodialysis arm of the Salford Kidney Study [SKS dialysis study, n = 186, 73% women, mean age 62 years, 45 cardiovascular deaths during follow-up (mean 12 months)], and in the CKD5-LD-RTxcohort with assessments of coronary artery calcium (CAC)-score by cardiac computed tomography (n = 89, 37% women, mean age 46 years). Results: In age and sex-adjusted Cox regression in MIMICK, 11 plasma proteins were nominally associated with cardiovascular mortality (in order of significance: Kidney injury molecule-1 (KIM-1), Matrix metalloproteinase-7, Tumour necrosis factor receptor 2, Interleukin-6, Matrix metalloproteinase-1, Brain-natriuretic peptide, ST2 protein, Hepatocyte growth factor, TNF-related apoptosis inducing ligand receptor-2, Spondin-1, and Fibroblast growth factor 25). Only plasma KIM-1 was associated with cardiovascular mortality after correction for multiple testing, but also after adjustment for dialysis vintage, cardiovascular risk factors and inflammation (hazard ratio) per standard deviation (SD) increase 1.84, 95% CI 1.26–2.69, p = 0.002. Addition of KIM-1, or nine of the most informative proteins to an established risk-score (modified AROii CVM-score) improved discrimination of cardiovascular mortality risk from C = 0.777 to C = 0.799 and C = 0.823, respectively. In the SKS dialysis study, KIM-1 predicted cardiovascular mortality in age and sex adjusted models (hazard ratio per SD increase 1.45, 95% CI 1.03–2.05, p = 0.034) and higher KIM-1 was associated with higher CACscores in the CKD5-LD-RTx-cohort. Conclusions Our proteomics approach identified plasma KIM-1 as a risk marker for cardiovascular mortality and coronary artery calcification in three independent ESRD-cohorts. The improved risk prediction for cardiovascular mortality by plasma proteomics merit further studies.Swedish Research CouncilSwedish Heart–Lung foundationEuropean Union Horizon 2020 (Grant number 634869)Dalarna UniversityUppsala UniversitySwedish Medical Research CouncilNjurfondenEuropean Union’s Horizon 2020 research and innovation programme, Marie Sklodowska-Curie Grant Agreement no. 722609Publishe