Absceso epidural cervical por peptostreptococcus anaerobius

Se presenta 1 caso de infección con absceso epidural a nivel cervical producido por un Peplostreptococcus anaerobius en 1 paciente en el que se realizó previamente una artrodesis C6-C7 por una hernia discal cervical. En la literatura no se han encontrado referencias bibliográficas de casos similares, por la etiología y la localización. Se discute la importancia de las infecciones por bacterias anaerobias en patología osteoarticular, métodos diagnósticos, así como su abordaje terapéutico.A case of postsurgical infection with cervical epidural abscess produced by Peptostreptococcus anaerobius is presented. The patient underwent previously a cervical arthrodesis (levels C6-C7) due to a discal herniation. A similar case has not been found in the review of the literature, taking into account its etiology and localization. It is discussed the importance of anerobic bacterial infections in osteoarticular pathology, and diagnostic and therapeutic means

Application-infrastructure co-programming: managing the entire complex application lifecycle

With an estimated 20 billion connected devices by 2020 generating enormous amounts of data, more data-centric ways of working are needed to cope with the dynamic load and reconfigurability of on-demand computing. There is a growing range of complex, specialised means by which this flexibility can be achieved, e.g. Software-defined networking (SDN). Specification of Quality of Service (QoS) constraints for time-critical characteristics, such as network availability and bandwidth, will be needed, in the same way that compute requirements can be specified in today's infrastructures. This is the motivation for SWITCH -- an EU-funded H2020 project addressing the entire lifecycle of time-critical, self-adaptive cloud applications by developing new middleware and tools for interactive specification of such applications. This paper presents a user-facing perspective on SWITCH by discussing the SWITCH Interactive Development Environment (SIDE) Workbench. SIDE provides a programmable and dynamic graphical modeling environment for cloud applications that ensures efficient use of compute and network resources while satisfying time-critical QoS requirements. SIDE enables a user to specify the software components, properties and requirements, QoS parameters, machine requirements and their composition into a fully operational, multi-tier cloud application. In order to enable SIDE to represent the software and infrastructure constraints and to communicate them to other SWITCH components, we have defined a co-programming model using TOSCA that is capable of representing the application's state during the entire lifecycle of the application. We show how the SIDE Web GUI, along with TOSCA and the other subsystems, can support three use cases and provide a walk-through of one of these use cases to illustrate the power of such an approach

Application-infrastructure co-programming: managing the entire complex application lifecycle

With an estimated 20 billion connected devices by 2020 generating enormous amounts of data, more data-centric ways of working are needed to cope with the dynamic load and reconfigurability of on-demand computing. There is a growing range of complex, specialised means by which this flexibility can be achieved, e.g. Software-defined networking (SDN). Specification of Quality of Service (QoS) constraints for time-critical characteristics, such as network availability and bandwidth, will be needed, in the same way that compute requirements can be specified in today's infrastructures. This is the motivation for SWITCH -- an EU-funded H2020 project addressing the entire lifecycle of time-critical, self-adaptive cloud applications by developing new middleware and tools for interactive specification of such applications. This paper presents a user-facing perspective on SWITCH by discussing the SWITCH Interactive Development Environment (SIDE) Workbench. SIDE provides a programmable and dynamic graphical modeling environment for cloud applications that ensures efficient use of compute and network resources while satisfying time-critical QoS requirements. SIDE enables a user to specify the software components, properties and requirements, QoS parameters, machine requirements and their composition into a fully operational, multi-tier cloud application. In order to enable SIDE to represent the software and infrastructure constraints and to communicate them to other SWITCH components, we have defined a co-programming model using TOSCA that is capable of representing the application's state during the entire lifecycle of the application. We show how the SIDE Web GUI, along with TOSCA and the other subsystems, can support three use cases and provide a walk-through of one of these use cases to illustrate the power of such an approach

Staphylococcus aureus nasal colonization in Spanish children. The COSACO nationwide surveillance study

Objective: To assess the prevalence and risk factors for S. aureus and methicillin-resistant S. aureus (MRSA) nasal colonization in Spanish children. Methods: Cross-sectional study of patients <14 years from primary care centers all over Spain. Clinical data and nasal aspirates were collected from March to July 2018. Results: A total of 1876 patients were enrolled. Prevalence of S. aureus and MRSA colonization were 33% (95% CI 30.9–35.1) and 1.44% (95% CI 0.9–2), respectively. Thirtythree percent of the children (633/1876) presented chronic conditions, mainly atopic dermatitis, asthma and/or allergy (524/633). Factors associated with S. aureus colonization were age =5 years (OR 1.10, 95% CI 1.07–1.12), male sex (OR 1.43, 95% CI 1.17–1.76), urban setting (OR 1.46, 95% CI 1.08–1.97) and the presence of asthma, atopic dermatitis or allergies (OR 1.25; 95% CI: 1.093–1.43). Rural residence was the only factor associated with MRSA colonization (OR 3.62, 95% CI 1.57–8.36). MRSA was more frequently resistant than methicillin-susceptible S. aureus to ciprofloxacin [41.2% vs 2.6%; p<0.0001], clindamycin [26% vs 16.9%; p=0.39], and mupirocin [14.3% vs 6.7%; p=0.18]. None of the MRSA strains was resistant to tetracycline, fosfomycin, vancomycin or daptomycin. Conclusions: The main risk factors for S. aureus colonization in Spanish children are being above five years of age, male gender, atopic dermatitis, asthma or allergy, and residence in urban areas. MRSA colonization is low, but higher than in other European countries and is associated with rural settings

Vessel Shrinkage as a Sign of Atherosclerosis Progression in Type 2 Diabetes : A Serial Intravascular Ultrasound Analysis

OBJECTIVE—The aim of this study was to determine the natural history of vascular remodeling of atherosclerotic plaques in patients with type 2 diabetes and the predictors of vessel shrinkage

Characterization of deuterium clusters mixed with helium gas for an application in beam-target-fusion experiments

We measured the average deuterium cluster size within a mixture of deuterium clusters and helium gas by detecting Rayleigh scattering signals. The average cluster size from the gas mixture was comparable to that from a pure deuterium gas when the total backing pressure and temperature of the gas mixture were the same as those of the pure deuterium gas. According to these measurements, the average size of deuterium clusters depends on the total pressure and not the partial pressure of deuterium in the gas mixture. To characterize the cluster source size further, a Faraday cup was used to measure the average kinetic energy of the ions resulting from Coulomb explosion of deuterium clusters upon irradiation by an intense ultrashort pulse. The deuterium ions indeed acquired a similar amount of energy from the mixture target, corroborating our measurements of the average cluster size. As the addition of helium atoms did not reduce the resulting ion kinetic energies, the reported results confirm the utility of using a known cluster source for beam-target-fusion experiments by introducing a secondary target gas.NNSA DE-FC52-08NA28512DOE Office of Basic Energy SciencesU.S. Department of Energy, Office of Science, Office of Nuclear Physics DE-FG03-93ER40773Robert A. Welch Foundation A0330LANS, LLC, Los Alamos National Laboratory (LANL) DE-AC52-06NA25396LANL LDRD programPhysic

Signaling Mechanisms of Vav3, a Guanine Nucleotide Exchange Factor and Androgen Receptor Coactivator, in Physiology and Prostate Cancer Progression

The Rho GTPase guanine nucleotide exchange factor (GEF) Vav3 is the third member of the Vavfamily of GEFS and is activated by tyrosine phosphorylation. Through stimulation of Rho GTPaseactivity, Vav3 promotes cell migration, invasion, and other cellular processes. Work from our laboratory first established that Vav3 is upregulated in models of castration-resistant prostate cancer progression and enhances androgen receptor as well as androgen receptor splice variant activity. Recent analysis of clinical specimens supports Vav3 as a potential biomarker of aggressive prostate cancer. Consistent with a role in promoting castration-­resistant disease, Vav3 is a versatile enhancer of androgen receptor by both ligand-dependent and ligand-independent mechanisms and as such impacts established pathways of androgen receptor reactivation in advanced prostate cancer. Distinct Vav3 domains and mechanisms participate in ligand-dependent and -independent androgen receptor coactivation. To provide a physiologic context, we review Vav3 actions elucidated by gene knockout studies. This chapter describes the pervasive role of Vav3 in progression of prostate cancer to castration resistance. We discuss the mechanisms by which prostate cancer cells exploit Vav3 signaling to promote androgen receptor activity under different hormonal milieus, which are relevant to clinical prostate cancer. Lastly, we review the data on the emerging role for Vav3 in other cancers ranging from leukemias to gliomas.https://nsuworks.nova.edu/hpd_medsci_faculty_books/1002/thumbnail.jp

Biology of moderately halophilic aerobic bacteria

The moderately halophilic heterotrophic aerobic bacteria form a diverse group of microorganisms. The property of halophilism is widespread within the bacterial domain. Bacterial halophiles are abundant in environments such as salt lakes, saline soils, and salted food products. Most species keep their intracellular ionic concentrations at low levels while synthesizing or accumulating organic solutes to provide osmotic equilibrium of the cytoplasm with the surrounding medium. Complex mechanisms of adjustment of the intracellular environments and the properties of the cytoplasmic membrane enable rapid adaptation to changes in the salt concentration of the environment. Approaches to the study of genetic processes have recently been developed for several moderate halophiles, opening the way toward an understanding of haloadaptation at the molecular level. The new information obtained is also expected to contribute to the development of novel biotechnological uses for these organisms

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks