Prognostic value of continuous EEG monitoring during therapeutic hypothermia after cardiac arrest

Introduction: Continuous EEG (cEEG) is increasingly used to monitor brain function in neuro-ICU patients. However, its value in patients with coma after cardiac arrest (CA), particularly in the setting of therapeutic hypothermia (TH), is only beginning to be elucidated. The aim of this study was to examine whether cEEG performed during TH may predict outcome. Methods: From April 2009 to April 2010, we prospectively studied 34 consecutive comatose patients treated with TH after CA who were monitored with cEEG, initiated during hypothermia and maintained after rewarming. EEG background reactivity to painful stimulation was tested. We analyzed the association between cEEG findings and neurologic outcome, assessed at 2 months with the Glasgow-Pittsburgh Cerebral Performance Categories (CPC). Results: Continuous EEG recording was started 12 ± 6 hours after CA and lasted 30 ± 11 hours. Nonreactive cEEG background (12 of 15 (75%) among nonsurvivors versus none of 19 (0) survivors; P < 0.001) and prolonged discontinuous "burst-suppression" activity (11 of 15 (73%) versus none of 19; P < 0.001) were significantly associated with mortality. EEG seizures with absent background reactivity also differed significantly (seven of 15 (47%) versus none of 12 (0); P = 0.001). In patients with nonreactive background or seizures/epileptiform discharges on cEEG, no improvement was seen after TH. Nonreactive cEEG background during TH had a positive predictive value of 100% (95% confidence interval (CI), 74 to 100%) and a false-positive rate of 0 (95% CI, 0 to 18%) for mortality. All survivors had cEEG background reactivity, and the majority of them (14 (74%) of 19) had a favorable outcome (CPC 1 or 2). Conclusions: Continuous EEG monitoring showing a nonreactive or discontinuous background during TH is strongly associated with unfavorable outcome in patients with coma after CA. These data warrant larger studies to confirm the value of continuous EEG monitoring in predicting prognosis after CA and TH

Pollen collection and honey bee forager distribution in cantaloupe

Honey bee (Apis mellifera, L.) pollen collection and forager distribution were examined during the 2002 summer in a cantaloupe (Cucumis melo, L., Cruiser cv ) field with plastic mulch and drip irrigated. The experimental site was located near the INIFAP Campo Experimental La Laguna, Matamoros, Coahuila within La Laguna region, Mexico. Two trials were conducted in the same location, but were separated by a 800 m wide pecan orchard. Both cantaloupe trials were planted the same date. Trial 1. Nine honey-bee hives were placed in a three hectare field at the start of bloom. Each hive was fitted with a modified-Ontario pollen trap. The pollen was collected one day a week from each colony every hour beginning from 8:30 hr to 14:30 hr during the first four blooming weeks of the crop. Trial 2. Three weeks after the start of bloom, in a ten-ha field 30 honey bee colonies were located. In four randomlyselected rows of 105 m long, 10 m transects at 25, 50, 75 and 100 m distances from the apiary were marked. The foraging bees were counted simultaneously at the transects every half hour from 7:30 hr until 20:30 hr at the same pollen collection-day during the third week of cantaloupe bloom. Pollen collection was higher early in the morning (22.6 g per colony), dropping to medium amount from 9:30 hr (13.7 g), 10:30 hr (12.5 g) to 11:30 hr (9.5 g) and remaining low from 12:30 through the afternoon (less than 2.6 g per colony; p< 0.05). The distribution pattern showed that bees were in the cantaloupe after 8:00 hr, reaching a maximum between 10:30 hr and 14:30 hr when the bees began to decrease, until foraging flights ceased completely at about 20:30 hr. No statistical differences were found in the number of foraging bees among the evaluated distances from the apiary.Durante el verano del 2002 la colecta de polen y la distribución de las abejas (Apis mellifera L.) pecoreadoras fueron estudiadas en el cultivo de melón (Cucumis melo L., cv Cruiser ) bajo condiciones de riego por goteo y acolchado plástico. El lote experimental estuvo localizado cerca del Campo Experimental La Laguna del INIFAP, en el municipio de Matamoros, Coahuila, México. Dos experimentos se realizaron en el mismo predio, en lotes separados 800 m por una huerta de nogal. Ambas superficies de melón fueron sembradas en la misma fecha. Experimento N° 1. Al inicio de la floración se colocaron nueve colmenas en tres hectáreas de cultivo. Cada colmena contó con una trampa de polen tipo Ontario modificada. El polen se colectó cada hora de cada colmena un día por semana de las 8:30 hr a las 14:30 hr durante las cuatro primeras semanas de floración del cultivo. Experimento N° 2. Tres semanas después del inicio de la floración se colocaron 30 colmenas en un campo de melón de diez hectáreas. En cuatro surcos de 105 m de longitud se marcaron transectos de diez metros a 25, 50, 75 y 100 metros de distancia del apiario. Las abejas pecoreadoras fueron contadas simultáneamente en cada transecto cada media hora de las 7:30 hr hasta las 20:30 horas, el mismo día en que fue colectado el polen de la tercera semana de floración. La colecta de polen fue mayor temprano por la mañana (22.6 g por colmena), disminuyendo a una cantidad media de las 9:30 hr (13.7 g), 10:30 hr (12.5 g) a las 11:30 hr (9.5 g) y permaneciendo baja desde las 12:30 hasta el mediodía (menos de 2.6 g por colmena; p<0.05). El patrón de distribución mostró que las abejas se presentaron en el cultivo de melón después de las 8:00 hr y alcanzaron su máximo entre las 10:30 hr y las 14:30 hr cuando las abejas iniciaron su disminución hasta el cese de los vuelos a las 20:30 hr. No se encontraron diferencias significativas en el número de abejas pecoreadoras a las diferentes distancias del apiario que fueron evaluadas

Especies de plantas visitadas por abejas pecoreadoras durante la inducción de polinización en melón.

The purpose of the research was to determine, by identifying pollen in corbicular pellets, the different plant species visited by honeybees (Apis mellifera L.) during cantaloupe (Cucumis melo L.) induced pollination. This work was carried out in La Laguna region, located in the states of Coahuila and Durango, Mexico in the spring of 2003. During the first 31 days of cantaloupe bloom, 18 honey bee colonies were placed in a six ha field, nine of which had a bottom pollen trap. Trapped pollen was collected twice per a week weighed and frozen. Through the year, anthers of wild and cultivated flowering plant species around the cantaloupe field and in La Laguna were collected, acetolyzed and preserved for pollen identified. Corbicular pollen from the 5th, 9th, 12th, 20th, 24th and 31st sample dates after start of staminate bloom was processed, identified and counted by microscopy. Pollen size was calculated with the formula: volume V=?a2b where a is the major axe and b the minor axis and multiplied by the number of pollen grains to get the total volume. Cantaloupe pollen made up 8.7 %, 9.8%, 17.6 %, 9.3 %, 28.1% and 83.5% of that collected (number of pollen grains) on respectively for the sample dates. The percentage of volume basis pollen for cantaloupe was: 51.6%, 85.0%, 66.6 %, 84.4 %, 68.9% and 95.0% respectively. It is concluded that the cantaloupe was the main species visited as a plant pollen source for pollinating honeybees and that the plants present in the sample like mesquite (Prosopis juliflora (Swartz) DC.), alfalfa (Medicago sativa L.), creosote bush (Larrea tridentata (DC) Cov.), cucumber (Cucumis sativus L.), London rocket (Sysimbrium irio L.) and sorghum (Sorghum vulgare L.) were species visited as supplementary pollen sources.El objetivo de la investigación fue determinar, a través de la identificación del polen corbicular, las diferentes especies de plantas que son visitadas por las abejas (Apis mellifera L.) durante la polinización inducida del melón (Cucumis melo L.). El trabajo se llevó a cabo en La Laguna ocalizada en los estados de Coahuila y Durango, México en la primavera del 2003. Durante los primeros 31 días de la floración del melón, un campo de seis hectáreas fue polinizada por 18 colmenas, nueve de las cuales tenía una trampa para captura de polen. El polen fue colectado dos veces por semana, pesado y congelado. Durante el año se colectaron anteras de plantas silvestres y cultivadas en floración alrededor del cultivo y en la región para preservarlas e identificar su polen usando la técnica de acetolisis. El polen corbicular, muestreado los días 5°, 9°, 12°, 20°, 24° y 31° contados a partir del inicio de la aparición de las flores estaminadas, fue procesado y contado en el microscopio óptico. El tamaño del polen fue calculado mediante la fórmula: volumen V=?a2b donde a es el eje mayor y b el eje menor y multiplicado por el número de granos de polen se obtuvo el volumen total. El polen de melón fue el 8.7 %, 9.8%, 17.6 %, 9.3 %, 28.1% y 83.5% del colectado (en base al número de granos) respectivamente en las fechas de muestreo. El porcentaje del polen de melón en base al volumen fue: 51.6%, 85.0%, 66.6 %, 84.4 %, 68.9% y 95.0% respectivamente. Se concluye que el melón fue la principal planta visitada por las abejas como fuente de polen y que las especies de plantas con mayor número de granos de polen presentes en las muestras como mezquite (Prosopis juliflora (Swartz) DC.), alfalfa (Medicago sativa L.), gobernadora (Larrea tridentata (DC) Cov.), pepino (Cucumis sativus L.), mostacilla (Sysimbrium irio L.) y sorgo (Sorghum vulgare L.) fueron especies visitadas como fuentes suplementarias de polen

Desenlaces clínicos de los pacientes con diabetes e hiperglucemia de estrés que presentaron infección por SARS-CoV-2

Introduction. Diabetes and stress hyperglycemia (SH) have been related with poorer clinical outcomes in patients infected by SARS-CoV-2 and at risk for severe disease.Objective. To evaluate clinical outcomes in three groups of patients (with diabetes, without diabetes and stress hyperglycemia [SH]) with SARS-CoV-2 infection.Materials and methods. A retrospective cohort study was conducted in Cali-Colombia. Patients aged ≥18 years with a diagnosis of SARS-CoV-2 infection managed in the emergency room, hospitalization or intensive care unit (ICU) between March 2020 and December 2021 were included. Immunocompromised patients and pregnant women were excluded. Patients were classified in three groups: without diabetes, with diabetes and SH. A comparison between the groups was performed. Results. A total of 945 patients were included (59.6% without diabetes, 27% with diabetes and 13.4% with SH). Fifty-five-point three percent required ICU management, with a higher need in patients with SH (89.8%) and diabetes (67.1%), with no difference between these groups (p=0.249). A higher chance of death was seen in SH vs. without diabetes (adjOR= 8.12, 95% CI 5.12-12.88, p<0.01). Frequency of acute respiratory distress syndrome, need for invasive mechanical ventilation, use of vasopressors and inotropes, the need for de novo renal replacement therapy and mortality was higher in patients with metabolic alterations (diabetes and SH). Conclusions. Diabetes and SH are associated to worse clinical outcomes and mortality in patients with COVID-19. These patients should be identified early and considered as high risk at moment of COVID-19 diagnosis that allow to mitigate adverse outcomes.Introducción. La diabetes y la hiperglucemia de estrés (HE) se han relacionado con peores desenlaces clínicos en pacientes infectados por SARS-CoV-2 y con riesgo de enfermedad grave. Objetivo. Evaluar los resultados clínicos en tres grupos de pacientes (con diabetes, sin diabetes e hiperglucemia de estrés [SH]) con infección por SARS-CoV-2.Materiales y métodos. Se realizó un estudio de cohorte retrospectivo en Cali-Colombia. Se incluyeron pacientes ≥18 años con diagnóstico de infección por SARS-CoV-2 atendidos en urgencias, hospitalización o unidad de cuidados intensivos (UCI) entre marzo de 2020 y diciembre de 2021. Se excluyeron pacientes inmunocomprometidos y mujeres embarazadas. Los pacientes fueron clasificados en tres grupos: sin diabetes, con diabetes e HE. Se realizó una comparación entre los grupos.Resultados. Se incluyeron un total de 945 pacientes (59,6% sin diabetes, 27% con diabetes y 13,4% con HE). El 55,3% requirió manejo en UCI, con mayor necesidad en pacientes con HE (89,8%) y diabetes (67,1%), sin diferencia entre estos grupos (p=0,249). Se observó una mayor probabilidad de muerte en HE vs. sin diabetes (adjOR= 8,12, 95% IC 5,12-12,88, p<0,01). La frecuencia de síndrome de distrés respiratorio agudo, necesidad de ventilación mecánica invasiva, uso de vasopresores e inotrópicos, necesidad de terapia de reemplazo renal de novo y la mortalidad fue mayor en pacientes con alteraciones metabólicas (diabetes e HE).Conclusiones. La diabetes y la HE se asociaron a peores resultados clínicos y mortalidad en pacientes con COVID-19. Estos pacientes deben ser identificados tempranamente y considerados de alto riesgo al momento del diagnóstico de COVID-19 que permitan mitigar los desenlaces adversos

Molecular detection and genotyping of intestinal protozoa from different biogeographical regions of Colombia

Background: Intestinal parasitic protozoa represent a serious problem of public health particularly in developing countries. Protozoa such as Blastocystis, Giardia intestinalis, Entamoeba histolytica and Cryptosporidium spp. are associated with diarrheal symptoms. In Colombia, there is little region-specific data on the frequency and circulating genotypes/species of these microorganisms. Therefore, the main objective of our study was to employ molecular detection and genotyping of G. intestinalis and Blastocystis, Cryptosporidium and Entamoeba spp. in samples from different biogeographical regions of Colombia. Methods: We collected 649 human fecal samples from five biogeographical regions of Colombia: the Amazon, Andean, Caribbean, Orinoco and Pacific regions. Blastocystis, G. intestinalis, Cryptosporidium spp. and Entamoeba complex were detected by microscopy and conventional PCR. Molecular genotyping was conducted to identify Blastocystis subtypes (STs) (18s), G. intestinalis assemblages (triose phosphate isomerase and glutamate dehydrogenase) and Cryptosporidium species (18s). Genetic diversity indices were determined using dnasp.5. Results: We detected G. intestinalis in 45.4% (n = 280) of samples, Blastocystis in 54.5% (n = 336) of samples, Cryptosporidium spp. in 7.3% (n = 45) of samples, Entamoeba dispar in 1.5% (n = 9) of samples, and Entamoeba moshkovskii in 0.32% (n = 2) of samples. Blastocystis STs 1-4, 8 and 9 and G. intestinalis assemblages AII, BIII, BIV, D and G were identified. The following Cryptosporidium species were identified: C. hominis, C. parvum, C. bovis, C. andersoni, C. muris, C. ubiquitum and C. felis. The Caribbean region had the highest frequency for each of the microorganisms evaluated (91.9% for G. duodenalis, 97.3% for Blastocystis, 10.8% for Cryptosporidium spp., 13.5% for E. dispar and 2.7% for E. moshkovskii). The Orinoco region had a high frequency of Blastocystis (97.2%) and the Andean region had a high frequency of G. intestinalis (69.4%). High and active transmission was apparent in several regions of the country, implying that mechanisms for prevention and control of intestinal parasitosis in different parts of the country must be improved. Copyright © 2020 Higuera et al

Global Gene Expression Characterization of Circulating Tumor Cells in Metastasic Castration-Resistant Prostate Cancer Patients

BACKGROUND: Current therapeutic options in the course of metastatic castration-resistant prostate cancers (mCRPC) reinforce the need for reliable tools to characterize the tumor in a dynamic way. Circulating tumor cells (CTCs) have emerged as a viable solution to the problem, whereby patients with a variety of solid tumors, including PC, often do not have recent tumor tissue available for analysis. The biomarker characterization in CTCs could provide insights into the current state of the disease and an overall picture of the intra-tumor heterogeneity. METHODS: in the present study, we applied a global gene expression characterization of the CTC population from mCRPC (n = 9), with the goal to better understand the biology of these cells and identify the relevant molecules favoring this tumor progression. RESULTS: This analysis allowed the identification of 50 genes specifically expressed in CTCs from patients. Six of these markers (HOXB13, QKI, MAOA, MOSPD1, SDK1, and FGD4), were validated in a cohort of 28 mCRPC, showing clinical interest for the management of these patients. Of note, the activity of this CTC signature was related to the regulation of MYC, a gene strongly implicated in the biology of mCRPC. CONCLUSIONS: Overall, our results represent new evidence on the great value of CTCs as a non-invasive biopsy to characterize PC

Aplastic anemia and severe pancytopenia during treatment with peg-interferon, ribavirin and telaprevir for chronic hepatitis C

Telaprevir and Boceprevir are the first direct acting antivirals approved for chronic hepatitis C in combination with peg-interferon alfa and ribavirin. Pancytopenia due to myelotoxicity caused by these drugs may occur, but severe hematological abnormalities or aplastic anemia (AA) have not been described. We collected all cases of severe pancytopenia observed during triple therapy with telaprevir in four Spanish centers since approval of the drug in 2011. Among 142 cirrhotic patients receiving treatment, 7 cases of severe pancytopenia (5%) were identified and three were consistent with the diagnosis of AA. Mean age was 59 years, five patients had compensated cirrhosis and two patients had severe hepatitis C recurrence after liver transplantation. Severe pancytopenia was diagnosed a median of 10 wk after the initiation of therapy. Three patients had pre-treatment hematological abnormalities related to splenomegaly. In six patients, antiviral treatment was interrupted at the onset of hematological abnormalities. Two patients died due to septic complications and one patient due to acute alveolar hemorrhage. The remaining patients recovered. Severe pancytopenia and especially AA, are not rare during triple therapy with telaprevir in patients with advanced liver disease. Close monitoring is imperative in this setting to promptly detect serious hematological disorders and to prevent further complications

Benthic Fauna of Littoral and Deep-Sea Habitats of the Alboran Sea: A Hotspot of Biodiversity

En prens

Intensity-modulated radiation therapy (IMRT) vs. 3D conformal radiotherapy (3DCRT) in locally advanced rectal cancer (LARC): dosimetric comparison and clinical implications

<p>Abstract</p> <p>Purpose</p> <p>To compare target dose distribution, comformality, normal tissue avoidance, and irradiated body volume (IBV) in 3DCRT using classic anatomical landmarks (c3DCRT), 3DCRT fitting the PTV (f3DCRT), and intensity-modulated radiation therapy (IMRT) in patients with locally advanced rectal cancer (LARC).</p> <p>Materials and methods</p> <p>Fifteen patients with LARC underwent c3DCRT, f3DCRT, and IMRT planning. Target definition followed the recommendations of the ICRU reports No. 50 and 62. OAR (SB and bladder) constraints were D5 ≤ 50 Gy and Dmax < 55 Gy. PTV dose prescription was defined as PTV95 ≥ 45 Gy and PTVmin ≥ 35 Gy. Target coverage was evaluated with the D95, Dmin, and Dmax. Target dose distribution and comformality was evaluated with the homogeneity indices (HI) and Conformity Index (CI). Normal tissue avoidance of OAR was evaluated with the D5 and V40. IBV at 5 Gy (V5), 10 Gy (V10), and 20 Gy (V20) were calculated.</p> <p>Results</p> <p>The mean GTV95, CTV95, and PTV95 doses were significantly lower for IMRT plans. Target dose distribution was more inhomogeneous after IMRT planning and 3DCRTplans had significantly lower CI. The V40 and D5 values for OAR were significantly reduced in the IMRT plans .V5 was greater for IMRT than for f3DCRT planning (p < 0.05) and V20 was smaller for IMRT plans(p < 0.05).</p> <p>Conclusions</p> <p>IMRT planning improves target conformity and decreases irradiation of the OAR at the expense of increased target heterogeneity. IMRT planning increases the IBV at 5 Gy or less but decreases the IBV at 20 Gy or more.</p

Evaluation of the Impact of Genetically Modified Cotton After 20 Years of Cultivation in Mexico

For more than 20 years cotton has been the most widely sown genetically modified (GM) crop in Mexico. Its cultivation has fulfilled all requirements and has gone through the different regulatory stages. During the last 20 years, both research-institutions and biotech-companies have generated scientific and technical information regarding GM cotton cultivation in Mexico. In this work, we collected data in order to analyze the environmental and agronomic effects of the use of GM cotton in Mexico. In 1996, the introduction of Bt cotton made it possible to reactivate this crop, which in previous years was greatly reduced due to pest problems, production costs and environmental concerns. Bt cotton is a widely accepted tool for cotton producers and has proven to be efficient for the control of lepidopteran pests. The economic benefits of its use are variable, and depend on factors such as the international cotton-prices and other costs associated with its inputs. So far, the management strategies used to prevent development of insect resistance to GM cotton has been successful, and there are no reports of insect resistance development to Bt cotton in Mexico. In addition, no effects have been observed on non-target organisms. For herbicide tolerant cotton, the prevention of herbicide resistance has also been successful since unlike other countries, the onset of resistance weeds is still slow, apparently due to cultural practices and rotation of different herbicides. Environmental benefits have been achieved with a reduction in chemical insecticide applications and the subsequent decrease in primary pest populations, so that the inclusion of other technologies—e.g., use of non-Bt cotton- can be explored. Nevertheless, control measures need to be implemented during transport of the bolls and fiber to prevent dispersal of volunteer plants and subsequent gene flow to wild relatives distributed outside the GM cotton growing areas. It is still necessary to implement national research programs, so that biotechnology and plant breeding advances can be used in the development of cotton varieties adapted to the Mexican particular environmental conditions and to control insect pests of regional importance