30 research outputs found
Estudio comparativo sobre la capacidad de atrapamiento del catiónradical abts+. por los aceites esenciales de especies aromáticas con alto contenido de trans-anetol y estragol
Se determinó la composición química de aceites esenciales (AEs) y extractos de seis especies aromáticas con alto contenido de trans-anetol y estragol (estragón de invierno, estragón, anís estrellado, anisillo, hinojo y sígueme morado), obtenidos por hidrodestilación asistida por radiación de microondas (MWHD) y destilación-extracción simultánea con solvente (SDE). La separación e identificación de los compuestos se realizó por GC-MS en columna apolar DB-5MS, comparando sus espectros de masas con los de las bases de datos ADAMS, NIST02 y Wiley138 e índices de retención de kovàts. Para todos los AEs se evaluó su capacidad del atrapamiento del catión-radical ABTS+. (ácido 2,2’ -azino-bis -(3-etiltiazolina-bencenosulfónico-6))
The dynamic use of EGFR mutation analysis in cell-free DNA as a follow-up biomarker during different treatment lines in non-small-cell lung cancer patients
Epidermal growth factor receptor (EGFR) mutational testing in advanced non-small-cell lung cancer (NSCLC) is usually performed
in tumor tissue, although cfDNA (cell-free DNA) could be an alternative. We evaluated EGFR mutations in cfDNA as a
complementary tool in patients, who had already known EGFR mutations in tumor tissue and were treated with either
EGFR-tyrosine kinase inhibitors (TKIs) or chemotherapy. We obtained plasma samples from 21 advanced NSCLC patients with
known EGFR tumor mutations, before and during therapy with EGFR-TKIs and/or chemotherapy. cfDNA was isolated and
EGFR mutations were analyzed with the multiple targeted cobas EGFR Mutation Test v2. EGFR mutations were detected at
baseline in cfDNA from 57% of patients. The semiquantitative index (SQI) significantly decreased from the baseline
(median = 11, IQR = 9 5-13) to the best response (median = 0, IQR = 0-0, p < 0 01), followed by a significant increase at
progression (median = 11, IQR = 11-15, p < 0 01) in patients treated with either EGFR-TKIs or chemotherapy. The SQI obtained
with the cobas EGFR Mutation Test v2 did not correlate with the concentration in copies/mL determined by droplet digital
PCR. Resistance mutation p.T790M was observed at progression in patients with either type of treatment. In conclusion, cfDNA
multiple targeted EGFR mutation analysis is useful for treatment monitoring in tissue of EGFR-positive NSCLC patients
independently of the drug received
Genomic characterization of individuals presenting extreme phenotypes of high and low risk to develop tobacco-induced lung cancer
Single nucleotide polymorphisms (SNPs) may modulate individual susceptibility to carcinogens. We designed a genome-wide association study to characterize individuals presenting extreme phenotypes of high and low risk to develop tobacco-induced non-small cell lung cancer (NSCLC), and we validated our results. We hypothesized that this strategy would enrich the frequencies of the alleles that contribute to the observed traits. We genotyped 2.37 million SNPs in 95 extreme phenotype individuals, that is: heavy smokers that either developed NSCLC at an early age (extreme cases); or did not present NSCLC at an advanced age (extreme controls), selected from a discovery set (n=3631). We validated significant SNPs in 133 additional subjects with extreme phenotypes selected from databases including >39,000 individuals. Two SNPs were validated: rs12660420 (p(combined)=5.66x10(-5); ORcombined=2.80), mapping to a noncoding transcript exon of PDE10A; and rs6835978 (p(combined)=1.02x10(-4); ORcombined=2.57), an intronic variant in ATP10D. We assessed the relevance of both proteins in early-stage NSCLC. PDE10A and ATP10D mRNA expressions correlated with survival in 821 stage I-II NSCLC patients (p=0.01 and p<0.0001). PDE10A protein expression correlated with survival in 149 patients with stage I-II NSCLC (p=0.002). In conclusion, we validated two variants associated with extreme phenotypes of high and low risk of developing tobacco-induced NSCLC. Our findings may allow to identify individuals presenting high and low risk to develop tobacco-induced NSCLC and to characterize molecular mechanisms of carcinogenesis and resistance to develop NSCLC
Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence
La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar
recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son
dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia
Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure
Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Calidad del agua en el tramo bajo del río Negro (Chaco, Argentina)
Water quality in the lower stretch of the Negro River (Chaco, Argentine).
The main physical, chemical and biological characteristics of surface waters were measured between
November 1999 and May 2002 in four sampling sites located in the course of Negro River. At sites 1
and 2 wetlands and alluvial forest with low human occupation characterize the bordering landscape.
Sites 3 y 4 were affected by domestic and industrial discharges, although in the last years tannin production
was working at a reduce volume. The chemical composition of surface water was derived
primarily from the rain seasonality and the wash-out of salt rich wetlands soil into the river channel.
Conductivity was higher during the dry period than the rain period. Salinity varied between 82.7
mg.1-1 and 6500 mg.l-1. The mean concentration of total phosphorus was high (1053 µg.l-1) and pH
was neutral or slightly alkaline. At site 4, organic matter content (COD = 385 mg.l-l ) increased significantly
during the low water period. There were not found residues of 27 pesticides and organochlorine
compounds on bottom sediments at sampling sites. Cadmium (Cd) and lead (Pb) content
in bottom sediments fell below the detection limits. Chromium (Cr) content varied between 14
and 22 µg. g dry weight depending on study sites. Ten species of aquatic plants were collected at Site
1, which is characterized by low flow velocities. The macrophytes species richness decreased downstream.
The occurrence of some macrophytes species such as Hydrocotyle ranunculoides and Ceratophyllum
demersum was related to significant phosphorus availability. Chlorophyll a concentration,
as indicator of phytoplankton biomass, was low at all study sites (minor than 20 µg.l-1).Las principales características físicas, químicas y biológicas fueron medidas entre noviembre
de 1999 y mayo de 2002 en 4 sitios ubicados en el cauce principal del río Negro. En los sitios
1 y 2 los humedales y bosques con baja ocupación humana constituyen el paisaje característico
que bordea al curso principal. Los sitios 3 y 4 están afectados por descargas domésticas e industriales,
aunque la producción de tanino fue de menor volumen en los últimos años. La composición química
del agua superficial estuvo influenciada por la estacionalidad de las lluvias y el lavado de suelos ricos
en sales de los humedales hacia el canal del río. La conductividad eléctrica del agua durante las sequías
fue más alta que la registrada después de las lluvias. La salinidad fluctuó de manera semejante
entre 82,7 mg.l-1 y 6500 mg.l-1. La concentración promedio de fósforo total fue alta (1053 µg.l-1) y el
pH neutro o ligeramente alcalino. En el sitio 4, el contenido de materia orgánica (DQO=385 mg.l-1)
aumentó significativamente durante el periodo de aguas bajas. No se encontraron residuos de 27 plaguicidas
y compuestos organoclorados en los sedimentos del fondo de los sitios muestreados. El contenido
de Plomo y Cadmio de los sedimentos estuvo debajo del límite de detección. Los valores de
Cromo varió entre 14 y 22 µg.g de sedimento seco, dependiendo del sitio estudiado. Diez especies de
plantas acuáticas fueron recolectadas en el Sitio 1 que se caracterizó por baja velocidad de flujo. La
riqueza de macrófitas disminuyó aguas abajo. La ocurrencia de algunas especies, tales como Hydrocotyle
ranunculoides y Ceratophyllum demersum, estuvo relacionada con la buena disponibilidad de
fósforo. La biomasa de algas indicada por la concentración de clorofila a fue baja en todos los sitios
estudiados (inferior a 20 µg.l-1).Fil: Poi, Alicia Susana G.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; Argentina. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Neiff, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; ArgentinaFil: Patiño, Carlos Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; ArgentinaFil: Ramos, Abel Oscar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; Argentina. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentin