Uso de técnicas cromatográficas en la identificación de residuos de antibióticos veterinarios

Diversos organismos nacionales e internacionales han establecido los límites máximos de residuos (LMRs); con el fin de realizar un adecuado monitoreo de fármacos veterinarios en alimentos de origen animal. Las metodologías elegidas para el monitoreo deben caracterizarse por ser sensibles e identificar volúmenes en partes por billón (ppb). De todas las metodologías existentes la cromatografía acoplada a espectrómetro de masas es la mejor alternativa ya que responde a las exigencias de las normas. Este trabajo presenta diversos protocolos cromatográficos desarrollados y propuestos para la identificación de los residuos de antibióticos veterinarios en matrices alimentarias de origen animal.Trabajo de suficiencia profesiona

Determinación de residuos de antibióticos veterinarios en productos de origen animal mediante cromatografía líquida

TITLE: Determination of veterinary antibiotic residues in foods of animal origin by liquid chromatographyIntroduction: The presence of certain infectious agents makes necessary the use of antibiotics to ensure the welfare of animals destined for human consumption; however, the withdrawal time must be considered and respected since there is the possibility of finding residues above the permitted levels, which could constitute a risk to public health. Objective: Present a collection of information based on how is performed the detection and quantification of antibiotic residues in various products of animal origin using chromatography methods. Method: Review of databases in Elsevier, SciELO, Springer, Hindawi, FAO, EFSA, Senasa and Sanipes, using keywords such as “liquid chromatography”, “mass spectrometry”, “antibiotic residues” and “products of animal origin” in Spanish and English. Results: They were selected 71 references among articles, book chapters, norms and regulations published between 2000 and 2017, which it is emphasized that chromatographic methodologies for antibiotic residues monitoring must be sensitive, reproducible, reliable and identify volumes in mg/kg; likewise, they must follow the requirements of international standards for the maximum residue limits detecction. Conclusions: Liquid chromatography coupled to a mass spectrometer is the most used technique to allow the separation of complex matrices based on the molecular weight of the compound (antibiotic) or its fragments; however, It is complex, expensive and requires highly trained personnel.Introducción: La presencia de ciertos agentes infecciosos hace necesario el uso de antibióticos para asegurar el bienestar de los animales destinados a consumo humano; sin embargo, hay que considerar y respetar el tiempo de retiro ya que existe la posibilidad de encontrar residuos por encima de los niveles permitidos, hecho que podría constituir un riesgo para la salud pública. Objetivo: Presentar una recopilación de información basada en cómo se realiza la detección y cuantificación de residuos de antibióticos en diversos productos de origen animal mediante métodos cromatográficos. Método: Revisión de bases de datos en Elsevier, SciELO, Springer, Hindawi, FAO, EFSA, Senasa y Sanipes, utilizando palabras clave como “cromatografía líquida”, “espectrometría de masas”, “residuos de antibióticos” y “productos de origen animal” en idioma español e inglés. Resultados: Se seleccionaron 71 referencias entre artículos, capítulos de libros, normas y reglamentos publicados entre el 2000 al 2017, de las cuales se destaca que las metodologías cromatográficas para el monitoreo de residuos de antibióticos deben ser sensibles, reproducibles, confiables e identificar volúmenes en mg/kg; asimismo, deben cumplir con las exigencias de las normas internacionales para la detección de límites máximos de residuos. Conclusiones: La cromatografía líquida acoplada a espectrómetro de masas es la técnica más utilizada ya permite la separación de matrices complejas en base del peso molecular del compuesto (antibiótico) o sus fragmentos; sin embargo, es compleja, costosa y requiere personal altamente entrenado

TX - Taller de Tesis - AR304 - 202102

Descripción: En este curso se desarrollará, mediante una propuesta arquitectónica, un proyecto escogido por el estudiante, en el que pueda acreditar que está en capacidad de hacer frente a los principales aspectos comprendidos en el desarrollo de un proyecto arquitectónico. En la primera etapa se establecen los criterios básicos de diseño de un pre-anteproyecto arquitectónico sustentado a partir de las condiciones: conceptuales, programáticas y de usuario, aspectos medio ambientales, urbano y paisajistas. En la segunda etapa se desarrolla un anteproyecto arquitectónico incluyendo además los criterios de las especialidades de estructuras, instalaciones eléctricas y sanitarias, y sistemas de evacuación. Propósito: El curso tiene como propósito la aprobación del anteproyecto con el cual el estudiante puede iniciar su Proyecto de Titulación Profesional. Busca contribuir al desarrollo de las competencias generales UPC: Comunicación Escrita, Comunicación Oral, 3Pensamiento Crítico, Razonamiento Cuantitativo, Manejo de la Información, Ciudadanía, Pensamiento Innovador y de las competencias específicas de la carrera: Diseño Fundamentado (que corresponde a los criterios NAAB PC2, PC3,PC5, PC8, SC5), Cultura Arquitectónica (que corresponde a los criterios NAAB1 PC4), Técnica y Construcción (que corresponde a los criterios NAAB1 SC1, SC4,SC6) y Gestión Profesional (que corresponde a los criterios NAAB1 PC6, SC2), todas en el nivel 3. Tiene como requisitos AR248 Gestión Inmobiliaria y HU61 inglés 5 y AR271 Lineamientos para el Proyecto Profesional y AR272 Seminario de Urbanismo y AR250 TIX - Taller de Ejercicio Profesional y aprobación por el director de la Carrera

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used