Streptococcus pyogenes Pneumonia in Adults: Clinical Presentation and Molecular Characterization of Isolates 2006-2015

Introduction In the preantibiotic era Streptococcus pyogenes was a common cause of severe pneumonia but currently, except for postinfluenza complications, it is not considered a common cause of community-acquired pneumonia in adults. Aim and Material and Methods This study aimed to identify current clinical episodes of S. pyogenes pneumonia, its relationship with influenza virus circulation and the genotypes of the involved isolates during a decade in a Southern European region (Gipuzkoa, northern Spain). Molecular analysis of isolates included emm, multilocus-sequence typing, and superantigen profile determination. Results Forty episodes were detected (annual incidence 1.1 x 100,000 inhabitants, range 0.29-2.29). Thirty-seven episodes were community-acquired, 21 involved an invasive infection and 10 developed STSS. The associated mortality rate was 20%, with half of the patients dying within 24 hours after admission. Influenza coinfection was confirmed in four patients and suspected in another. The 52.5% of episodes occurred outside the influenza seasonal epidemic. The 67.5% of affected persons were elderly individuals and adults with severe comorbidities, although 13 patients had no comorbidities, 2 of them had a fatal outcome. Eleven clones were identified, the most prevalent being emm1/ST28 (43.6%) causing the most severe cases. Conclusions S. pyogenes pneumonia had a continuous presence frequently unrelated to influenza infection, being rapidly fatal even in previously healthy individuals.This work was supported in part by the Education Department of the Basque Country Government, UPV/EHU [grant number IT656-13] and Fondo de Investigacion Sanitaria, Ministerio de Sanidad y Politica Social [grant PI08/0808]

Earthen Architecture in childhood awareness for sustainable development

The work presented has been developed within the framework of the educational and diffusion activities promoted by the UNESCO Chair of Earthen Architecture, constructive cultures and sustainable development at its headquarters in the UPV (directed by F. Vegas and C. Mileto) in collaboration with the UPV Nursery School and UPV Summer School. Within this framework, we structured some activities focused on knowledge, promotion and development of earth as material associated with a wide range of constructive, sustainable and ecological techniques, being a former resort yet contemporary, linked to different cultures. The proposed workshops are an educational resource based on active methodologies ("learning by doing") because the students are who learn to build the various earthen techniques their own hands, actively and collaboratively to achieve a common goal, a small building which all participants are encouraging teamwork and collective participation.El trabajo presentado se ha desarrollado en el marco de las actividades didácticas y de difusión fomentadas por la Cátedra UNESCO de Arquitectura de tierra, culturas constructivas y desarrollo sostenible en su sede de la UPV (dirigida por F. Vegas y C. Mileto) y en colaboración con la Escuela Infantil UPV y la Escuela de Verano UPV. En este marco se han estructurado una serie de actividades centradas en el conocimiento, fomento y desarrollo de la tierra como material asociado a un amplio abanico de técnicas constructivas, sostenibles, ecológicas, tratándose de un recurso antiguo y a la vez contemporáneo, vinculado a diversas culturas. Los talleres propuestos constituyen un recurso pedagógico basado en las metodologías activas (“learning by doing”) ya que son los alumnos los que aprenden a construir las diversas técnicas de tierra con sus propias manos, de forma activa y colaborativa para conseguir un objetivo común, una pequeña construcción de la que todos sean partícipes, fomentando el trabajo en equipo y la participación colectiva

Bibliometric analysis of communications presented at Congreso Nacional Bioquímico, between 1997 and 2005

Un congreso es una reunión científica multitudinaria, con cientos o miles de participantes, dirigida a profesionales de una disciplina o campo del conocimiento, para difundir, discutir e intercambiar información sobre avances recientes. El programa incluye tres subprogramas: actualización, educación y comunicaciones libres. La Bibliometría se ocupa de analizar estadísticamente la información registrada en publicaciones científicas, habiéndose propuesto tres tipos de indicadores bibliométricos para congresos: cuantitativos, cualitativos y de evidencia científica. El propósito del presente trabajo ha sido analizar, según indicadores cuantitativos, las comunicaciones del Congreso Nacional Bioquímico de la Confederación Unificada Bioquímica de la República Argentina (CUBRA). Se analizaron las comunicaciones presentadas en los congresos de Tucumán 1997, Huerta Grande 1999, Bariloche 2001, Posadas 2003 y San Juan 2005. El total de comunicaciones fue 388, todas en formato poster. La mediana fue de 4 autores por comunicación. Las principales áreas temáticas fueron Química Clínica, (incluyendo Endocrinología y Medio Interno, 45,4%) y Microbiología (incluyendo Bacteriología, Parasitología, Micología y Virología, 21,1%). El 34,3% provenía de universidades, 27,1% de hospitales y 23,7% por colaboración entre 2 instituciones, siendo el principal aporte de: Universidad de Buenos Aires (n=35, 9,0%), Fundación Bioquímica Argentina (n=30, 7,7%) y Universidad Nacional de Tucumán (n=26, 6,7%).A congress is a multitudinous scientific meeting, with hundreds or thousands of participantes, wich is addressed to professionals of a discipline or knowledge field, to disseminate, discuss and exchange information about recent advances. It includes three subprograms: updating, education and free communications. Bibliometrics sta- tistically analyzes the information recorded in scientific publications. Three bibliometric indica- tors have been proposed for congressess: quantitative, qualitative and scientific evidence ones. The aim of this work has been to analyze, through quantitative bibliometric indicators, the communications submitted at the Congreso Nacional Bioquímico of Confederación Unificada Bioquímica de la República Argentina (CUBRA). The analysis was done on the communications submitted at congresses held in Tucumán 1997, Huerta Grande 1999, Bariloche 2001, Posadas 2003 and San Juan 2005. A total of388 communications were presented, all of them as posters. Median was 4 authors per communication. The main topical areas were Clinical Chemistry (including Endocrinology and Acid Base/Blood Gases, 45.4%) and Microbiology (including Bacteriology Parasitology Mycology and Virology 21.1%). A total of 34.3% came from universities, 27.1% of hospitals and 23.7% in collaboration from 2 institutions, being the main participation of Universidad de Buenos Aires (n=35, 9.0%), Fundación Bioquímica Argentina (n=30, 7.7%) and Universidad Nacional de Tucumán (n=26, 6.7%).Facultad de Ciencias ExactasFacultad de Humanidades y Ciencias de la Educació

Síndrome de Cohen. Presentación de un caso

El síndrome de Cohen es una rara enfermedad de origen genético que se transmite con un patrón autosómico recesivo. Se caracteriza por la asociación de obesidad, hipotonía, retraso mental, microcefalia, dismorfia cráneofacial típica, así como incisivos centrales grandes y salientes, con dedos finos en forma de huso. Se ha localizado el locus para el síndrome de Cohen en el cromosoma 8q 22 (COH 1). Desde su descripción se reportan pocos casos, su diagnóstico es clínico a través de una delineación correcta del fenotipo. Se presenta una paciente de 14 años de edad afectada con este síndrome, en la que hasta ahora no se había podido llegar al diagnóstico clínico. A esta edad fue que se logró una delineación correcta del fenotipo y por consiguiente el correcto diagnóstico, lo que es de vital importancia para poder brindar un mejor asesoramiento genético a la familia

Vascular Endothelial Growth Factor-Delivery Systems for Cardiac Repair: An Overview

Since the discovery of the Vascular Endothelial Growth Factor (VEGF) and its leading role in the angiogenic process, this has been seen as a promising molecule for promoting neovascularization in the infarcted heart. However, even though several clinical trials were initiated, no therapeutic effects were observed, due in part to the short half life of this factor when administered directly to the tissue. In this context, drug delivery systems appear to offer a promising strategy to overcome limitations in clinical trials of VEGF

Profilaxis antibiótica en cirugía

Existe una abundantísima documentación en la literatura acerca de la eficacia de los antibióticos utilizados profilácticamente en cirugía (1-10). Probablemente lo más útil para el trabajo diario de un hospital sea la adopción de pautas concretas que permitan ser evaluadas periódicamente a través de la colaboración, entre otros, de anestesistas, cirujanos y microbiólogos (11,12). En esta línea hemos revisado, de una manera intencionadamente esquemática, diversas facetas relativas a la profilaxis antibiótica en cirugía. Para ello comentaremos algunos aspectos generales de profilaxis de la infección postquirúrgica, unas breves normas para la utilización profiláctica de antibióticos y resumiremos determinadas indicaciones en función del tipo de intervención

Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients

Producción CientíficaBackground: Sepsis is strongly associated with an increased risk of postoperative mortality, longer length of hospital stay, and elevated health care costs. Early clinical symptoms overlap with those of systemic inflammatory response syndrome, a response that commonly occurs after cardiac surgery with cardiopulmonary bypass. Since a combination of biomarkers has been demonstrated to improve the prediction of postoperative infection, the objective of the present study was to test whether the combination of C-reactive protein (CRP), white blood cells (WBC), and procalcitonin (PCT) is able to predict postoperative infection in a large cohort of cardiac surgery patients. Material and methods: Case-control study involving 423 patients who underwent cardiac surgery with cardiopulmonary bypass. Patients were retrospectively classified into two groups based on whether they developed severe sepsis or septic shock during the postoperative period. Blood samples for biological measurements (PCT, CRP, and WBC) were drawn on the first day in the intensive care unit, then once daily in the morning until the 10th postoperative day. Results: CRP median values were similar in both groups. WBC and PCT median values were significantly higher in patients with infection than without during the first 10 postoperative days. With elevation cutoffs ≤3 times (OR: 4.058; 95% CI: 2.206-7.463; P = 0.001) and ≥4 times (OR: 10.274, 95% CI: 3.690-28.604; P < 0.001), the median value for PCT (1.7 ng/mL) and/or WBC (13,000 cells/mm3) on the second postoperative day was significantly associated with the development of infection. Conclusions: The goal of this study was to use a large cohort of cardiac surgery patients to ensure that the results were representative of this population. The combination of PCT and WBC levels over the first three postoperative days was able to predict postoperative infection within the 30 d following cardiac surgery.Instituto de Salud Carlos III (grant PI15/01451)Junta de Castilla y León (grant GRS1270/A/16

Epidural analgesia and its implications in the maternal health in a low parity comunity

Producción CientíficaBackground: In regard to obstetrical analgesia management there are different results related to the use of epidural analgesia versus mechanical adverse outcomes at delivery. Methods: Cohort study of 23,183 consecutive, term, singleton vaginal deliveries, including spontaneous and induced labours, at a single institution from January 2004 to June 2016 to determine the association between epidural analgesia and different mechanical complications affecting maternal health such as severe perineal tears (SPT), abnormal foetal head position at delivery, instrumental delivery and caesarean section (CS). Multivariate logistic regression models were constructed to evaluate the risk factors of these mechanical complications with respect to possible cofounders. Results: Epidural analgesia was used in 15,821 (68.24%) women. The logistic regression model showed a non-significant association between the use of epidural analgesia and SPT (odds ratio [OR], 078; 95% confidence interval [CI], 0.48–1.26; p = 0.310). Instrumental delivery and CSs were more frequently performed in cases than controls (p = < 0.001), with OR of 1.19 (95% CI: 1.10–1.29) for CS and with OR of 3.27 (95% CI: 2.93–4.61) for instrumental delivery. The abnormal foetal position head at delivery were significantly lower in the neonates delivered without epidural analgesia compared with those in which epidural analgesia was used (p < 0.001) with OR of 1.43 (95% CI:1.27–1.72). Conclusions: Epidural analgesia is not associated with an increase of SPT, but it was an independent risk factor for instrumental delivery, CS and abnormal foetal head position at delivery