Virus respiratorios identificados de pacientes hospitalizados en una institución de alta complejidad

Introduction: Acute Respiratory Infections (ARI) are a group of diseases with respiratory symptoms similar caused by bacteria or viruses that are acquired by direct contact or through the air. Objective: To determine the prevalence of detected respiratory viruses by using the test CLART PneumoVir in Fundación Valle del Lili since June 2013 to December 2014. Methods: A cross sectional study was conducted, in patients admitted to a general hospital between June 2013 to December 2014. Samples were analysed through multiplex RT- PCR and detection by microarrays. Descripitve statitics were used. Results: Of 161 samples, 96 (60%) were positive. Isolation of viruses was higher in ICU patients (56%). 32 % of positive yields came from patients 60 years of age and older. The viruses most frequently detected were Rhinovirus (30%), Influenza (H1N1/2009) (12%) and Bocavirus (12%). Influenza A (H1N1/2009) was the most commonly isolated strain among Influenza viruses (12%), followed by 11% (17 cases) with viral coinfection. No seasonal pattern was identified. All patients received antibiotics. Conclusion: The multiplex RT-PCR and detection by microarray are a tool useful, sensitive and faster for identification of virus circulation mayor in the world. Unlike what was reported in the scientific literature, this study mayor percentage of positive tests in adults was observed seasonality was observed and no para none evaluated the virus.Introducción: Las Infecciones Respiratorias Agudas (IRA) son un grupo de enfermedades con sintomatología respiratoria similar, causadas por bacterias o virus que se adquieren por contacto directo o a través del aire. Objetivo: Determinar la prevalencia de virus respiratorios identificados por RT-PCR múltiplex y detección por microarreglos,  en la Fundación Valle del Lili entre junio de 2013 y diciembre de 2014. Métodos: Realizamos un estudio observacional descriptivo de corte transversal, se evaluaron registros de pacientes hospitalizados en la FVL entre junio de 2013 y diciembre de 2014. Las muestras fueron evaluadas por RT-PCR múltiplex y detección por microarreglos (CLART PneumoVir), se aplicó estadística descriptiva. Resultados: De 161 muestras, 96 (60 %) fueron positivas. El servicio con la mayor proporción de pacientes positivos fue la Unidad de Cuidados Intensivos-UCI (56%). El 32 % de los aislamientos positivos se identificaron en pacientes mayores de 60 años. Los virus más frecuentemente detectados fueron: Rinovirus (30%), Influenza (H1N1/ 2009) (12 %) y Bocavirus (12 %). Influenza A (H1N1/2009) fue la cepa más comúnmente aislada entre los virus de la gripe (12%), seguido de un 11% (17 casos) con coinfección viral. No se identificó el patrón estacional. Conclusión: La RT-PCR múltiplex y la detección por microarreglos para la identificación de los virus de mayor circulación en el mundo, son herramientas útiles, sensibles y rápidas. A diferencia de lo reportado por la literatura científica, en este estudio se observó mayor porcentaje de pruebas positivas en adultos y no se observó estacionalidad para ninguno de los virus evaluado

Pilot study of hemoglobinopathies in newborns of the Rafael Calvo maternity clinic of Cartagena, Colombia

Introduction: The hemoglobinopathies are a heterogeneous group of congenital anemias from Africa, Asia and the Medi- terranean. Due to the migration of this population have spread worldwide, especially in Latin America and the Caribbean region, which Cartagena de Indias is included, with a large proportion of people of African descent. The lack of routine programs that include an appropriate methodology for precise identification of those affected and carriers, impossible to know the real behavior of this disease in our country and an early and appropriate to the patients before the disease mani- fests itself and produce its serious consequences. Objective: To estimate the incidence and describe the epidemiological profile of hemoglobinopathies in newborns Rafael Calvo Maternity Clinic of Cartagena, in the period from January to June 2010. Methods: Prospective descriptive study of a population of 1729 newborns. Samples were collected cord blood on filter paper. Isoelectric focusing electrophoresis (IEF )was used to separate the haemoglobins. Results: 94.4% (1633samples) were normal (hemoglobinFA), 4.5% (78samples) were heterozygous for haemoglobin S (HbFAS), 1% (17samples) were heterozygous for haemoglobin C (hemoglobinFAC) and 0.1% (1 sample) was double hete- rozygous SC (hemoglobinFSC). Conclusion: Due to the high incidence of hemoglobinopathies found in this pilot study highlights the importance and necessity of establishing an obligatory neonatal screening in the city of Cartagena, in order to make a timely diagnosis and monitoring of affected and carrier

Estudio piloto de hemoglobinopatías en recién nacidos de la Clínica Maternidad Rafael Calvo de Cartagena, Colombia

Introduction: The hemoglobinopathies are a heterogeneous group of congenital anemias from Africa, Asia and the Mediterranean. Due to the migration of this population have spread worldwide, especially in Latin America and the Caribbean region, which Cartagena de Indias is included, with a large proportion of people of African descent. The lack of routine programs that include an appropriate methodology for precise identification of those affected and carriers, impossible to know the real behavior of this disease in our country and an early and appropriate to the patients before the disease manifests itself and produce its serious consequences. Objective: To estimate the incidence and describe the epidemiological profile of hemoglobinopathies in newborns Rafael Calvo Maternity Clinic of Cartagena, in the period from January to June 2010. Methods: Prospective descriptive study of a population of 1729 newborns. Samples were collected cord blood on filter paper. Isoelectric focusing electrophoresis (IEF )was used to separate the haemoglobins. Results: 94.4% (1633samples) were normal (hemoglobinFA), 4.5% (78samples) were heterozygous for haemoglobin S (HbFAS), 1% (17samples) were heterozygous for haemoglobin C (hemoglobinFAC) and 0.1% (1 sample) was double heterozygous SC (hemoglobinFSC). Conclusion: Due to the high incidence of hemoglobinopathies found in this pilot study highlights the importance and necessity of establishing an obligatory neonatal screening in the city of Cartagena, in order to make a timely diagnosis and monitoring of affected and carrier. Introducción:Las hemoglobinopatías comprenden un grupo heterogéneo de anemias congénitas originarias de África, Asia y la cuenca mediterránea. Debido a las migraciones de este grupo poblacional se han esparcido en todo el mundo, especialmente en América Latina y la región Caribe, en la cual está incluida Cartagena de Indias, con una gran proporción de población afrodescendiente.La inexistencia de programas rutinarios para la identificación precisa de los afectados y portadores, imposibilita conocer el comportamiento real de esta enfermedad en nuestro medio, el manejo temprano y adecuado a los pacientes, antes que la enfermedad se manifieste y produzca sus graves secuelas. Objetivo: Estimar la incidencia y describir el perfil epidemiológico de las hemoglobinopatías, en recién nacidos de la Clínica Maternidad Rafael Calvo de Cartagena, en el período de enero a junio del año 2010. Método: Estudio descriptivo prospectivo. Se tomó muestra de cordón umbilical recolectada en papel de filtro, a una población de 1729 recién nacidos, empleando la técnica de electroforesis de punto isoeléctrico. Resultados: El 94.4 % (1633 muestras) fueron normales (hemoglobina FA), el 4.5% (78 muestras) fueron heterocigotos para hemoglobina S (hemoglobina FAS), el 1% (17 muestras) fueron heterocigotos para hemoglobina C (hemoglobina FAC) y el 0.1% (1 muestra) fue doble heterocigoto SC (hemoglobina FSC). Conclusión: debido a la alta incidencia de hemoglobinopatías encontrada en este estudio piloto, se resalta la importancia de establecer un programa de tamizaje neonatal en la población de Cartagena, a fin de realizar un oportuno diagnóstico y seguimiento de los afectados y portadores

Aspectos técnicos y clínicos de la prueba cruzada de histocompatibilidad en el trasplante de órganos sólidos

The presence of antibodies directed against human leukocyte antigens (HLA) expressed on donor cells is a significant risk factor for serious clinical complications after transplantation.The crossmatch assay is one of the most important tests available for the detection of donor-specific antibodies in potential allograft recipients. Early crossmatch methods utilized complement-dependent cytotoxicity, which is useful for detecting the donor-specific anti-HLA antibodies responsible for hyperacute allograft rejection but lacks adequate sensitivity.Consequently, more sensitive crossmatch methods have been developed, ultimately leading to the flow cytometry crossmatch as the currently preferred methodology.Herein, we review the evolution of the crossmatch assay and the most important factors to consider when performing and interpreting the results of this fundamental assay for ensuring the long-term survival of the transplanted organ.La presencia de anticuerpos dirigidos contra los antígenos leucocitarios humanos (Human Leukocyte Antigens, HLA) que se expresan en las células del donante, es uno de los factores de riesgo más importantes asociados con las complicaciones clínicas después del trasplante. La prueba cruzada es una de las pruebas de histocompatibilidad más eficaces para la detección de anticuerpos específicos contra el donante en los receptores de injertos. En los primeros métodos de la prueba cruzada, se utilizaba la citotoxicidad dependiente del complemento, que es útil para detectar dichos anticuerpos responsables del rechazo hiperagudo del injerto, pero carece de la sensibilidad adecuada. Por ello, se desarrollaron métodos de pruebas cruzadas más sensibles, entre ellas, la prueba cruzada por citometría de flujo que hoy se considera el método preferido.En este artículo se revisa la evolución de la prueba cruzada y los factores más importantes que deben tenerse en cuenta al realizarla y al interpretar los resultados de esta prueba fundamental para la supervivencia a largo plazo del injerto

Zika virus damages the human placental barrier and presents marked fetal neurotropism

Submitted by Claudete Queiroz ([email protected]) on 2016-05-10T13:36:21Z No. of bitstreams: 1 Zika virus damages the human placental barrier and presents marked fetal neurotropism.pdf: 1105746 bytes, checksum: b1d12ab552d6ba6aa4d3f65652e5dd73 (MD5)Approved for entry into archive by Claudete Queiroz ([email protected]) on 2016-05-10T13:47:39Z (GMT) No. of bitstreams: 1 Zika virus damages the human placental barrier and presents marked fetal neurotropism.pdf: 1105746 bytes, checksum: b1d12ab552d6ba6aa4d3f65652e5dd73 (MD5)Made available in DSpace on 2016-05-10T13:47:39Z (GMT). No. of bitstreams: 1 Zika virus damages the human placental barrier and presents marked fetal neurotropism.pdf: 1105746 bytes, checksum: b1d12ab552d6ba6aa4d3f65652e5dd73 (MD5) Previous issue date: 2016Pontifícia Universidade Católica do Paraná. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Virologia Molecular. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Virologia Molecular. Curitiba, PR, Brasil.Universidade Federal do Rio Grande do Norte. Instituto de Medicina Tropical. Natal, RN, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Virologia Molecular. Curitiba, PR, Brasil.An unusually high incidence of microcephaly in newborns has recently been observed in Brazil. There is a temporal association between the increase in cases of microcephaly and the Zika virus (ZIKV) epidemic. Viral RNA has been detected in amniotic fluid samples, placental tissues and newborn and fetal brain tissues. However, much remains to be determined concerning the association between ZIKV infection and fetal malformations. In this study, we provide evidence of the transplacental transmission of ZIKV through the detection of viral proteins and viral RNA in placental tissue samples from expectant mothers infected at different stages of gestation. We observed chronic placentitis (TORCH type) with viral protein detection by immunohistochemistry in Hofbauer cells and some histiocytes in the intervillous spaces. We also demonstrated the neurotropism of the virus via the detection of viral proteins in glial cells and in some endothelial cells and the observation of scattered foci of microcalcifications in the brain tissues. Lesions were mainly located in the white matter. ZIKV RNA was also detected in these tissues by real-time-polymerase chain reaction. We believe that these findings will contribute to the body of knowledge of the mechanisms of ZIKV transmission, interactions between the virus and host cells and viral tropism

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Supernova Pointing Capabilities of DUNE

International audienceThe determination of the direction of a stellar core collapse via its neutrino emission is crucial for the identification of the progenitor for a multimessenger follow-up. A highly effective method of reconstructing supernova directions within the Deep Underground Neutrino Experiment (DUNE) is introduced. The supernova neutrino pointing resolution is studied by simulating and reconstructing electron-neutrino charged-current absorption on $^{40}$Ar and elastic scattering of neutrinos on electrons. Procedures to reconstruct individual interactions, including a newly developed technique called ``brems flipping'', as well as the burst direction from an ensemble of interactions are described. Performance of the burst direction reconstruction is evaluated for supernovae happening at a distance of 10 kpc for a specific supernova burst flux model. The pointing resolution is found to be 3.4 degrees at 68% coverage for a perfect interaction-channel classification and a fiducial mass of 40 kton, and 6.6 degrees for a 10 kton fiducial mass respectively. Assuming a 4% rate of charged-current interactions being misidentified as elastic scattering, DUNE's burst pointing resolution is found to be 4.3 degrees (8.7 degrees) at 68% coverage

Supernova Pointing Capabilities of DUNE

International audienceThe determination of the direction of a stellar core collapse via its neutrino emission is crucial for the identification of the progenitor for a multimessenger follow-up. A highly effective method of reconstructing supernova directions within the Deep Underground Neutrino Experiment (DUNE) is introduced. The supernova neutrino pointing resolution is studied by simulating and reconstructing electron-neutrino charged-current absorption on $^{40}$Ar and elastic scattering of neutrinos on electrons. Procedures to reconstruct individual interactions, including a newly developed technique called ``brems flipping'', as well as the burst direction from an ensemble of interactions are described. Performance of the burst direction reconstruction is evaluated for supernovae happening at a distance of 10 kpc for a specific supernova burst flux model. The pointing resolution is found to be 3.4 degrees at 68% coverage for a perfect interaction-channel classification and a fiducial mass of 40 kton, and 6.6 degrees for a 10 kton fiducial mass respectively. Assuming a 4% rate of charged-current interactions being misidentified as elastic scattering, DUNE's burst pointing resolution is found to be 4.3 degrees (8.7 degrees) at 68% coverage