Risk factors for mortality caused by pseudomonas aeruginosa infection in hospitalized patients with oncologic diagnosis in three cities of Colombia

Pseudomonas aeruginosa es una bacteria oportunista Gram negativa particularmente eficiente en la adquisición de mecanismos de resistencia y de alta prevalencia en infecciones nosocomiales en pacientes oncológicos. Objetivo: identificar los factores de riesgo para mortalidad en pacientes oncológicos con aislamiento de P. aeruginosa. Metodología: estudio descriptivo, la población de estudio fueron los casos reportados con aislamiento de P. aeruginosa en el servicio de hospitalización de Oncólogos de Occidente en Pereira, Armenia y Manizales durante el año 2015. Se realizaron análisis univariados y multivariados; la supervivencia se estableció según el método de Kaplan-Meier. Se estableció un valor de p <0.05. Se usó el software STATA. Se tuvo aval de bioética de la Universidad Tecnológica de Pereira. Resultados: se estudió 41 casos confirmados de cultivos positivos de P. aeruginosa. El sexo masculino (46.3%), anemia (46.3%), neutropenia febril (41%), trombocitopenia (29.3%) y haber sido hospitalizado en la unidad de cuidados intensivos (29.3%) fueron asociados estadísticamente con mayor mortalidad (p=0.019); con estos resultados se diseñó una escala de riesgo (alfa de Cronbach =0.72). Los pacientes con cuatro de estas exposiciones mostraron mayor riesgo de mortalidad al egreso hospitalario con una sensibilidad del 68% y especificidad del 90%. La P. aeruginosa presentó resistencia a cefepime (36.6%) y a aztreonam (34.1%), mientras que la letalidad global fue del 26.8%. Conclusión: El sexo masculino, la coexistencia de anemia, trombocitopenia, y neutropenia febril, así como la estancia en la unidad de cuidados intensivos aumentan la mortalidad en los pacientes oncológicos infectados con P. aeruginosa.Pseudomonas aeruginosa is a Gram-negative and rod-shape opportunistic bacterium that is particularly efficient in the acquisition of resistance mechanisms and its high prevalence in nosocomial infections in cancer patients. Objective: To identify risk factors for mortality in cancer patients with P. aeruginosa infection. Methodology: A descriptive study was carried out in patients with P. aeruginosa infection during the hospitalization service of “Oncólogos de Occidente” in Pereira, Armenia and Manizales during 2015. Univariate and multivariate analyzes were performed. The survival analysis was established according to the Kaplan-Meier method. A value of p<0.05 was established for it. The analyses were examined with the STATA software. This study was endorsed by the bioethics committee of the “Universidad Tecnológica de Pereira”. Results: Fourty-one patients with positive culture for P. aeruginosa were studied. Males (46.3%), anemia (46.3%), febrile neutropenia (41%), thrombocytopenia (29.3%) and previous hospitalization in an intensive care unit (29.3%) were associated with higher mortality risk (p = 0.019); a risk scale was designed with these factors (Cronbach´s alpha = 0.72). Patients who presented four of these exposures were at higher risk of mortality with a sensitivity of 68% and specificity of 90% at the moment of discharge. P. aeruginosa showed 36.6% of resistance to cefepime, 34.1% to aztreonam, the mortality rate was 26.8%. Conclusion: Male sex, anemia, thrombocytopenia, febrile neutropenia and previous hospitalization in an intensive care unit increase the mortality rate in patients with cancer who were infected by P. aeruginosa.

Factores de riesgo para mortalidad en la infección por Pseudomonas aeruginosa en pacientes oncológicos hospitalizados en tres ciudades de Colombia

Introduction: Pseudomonas aeruginosa is a Gram-negative and rod-shape opportunistic bacterium that is particularly efficient in the acquisition of resistance mechanisms and its high prevalence in nosocomial infections in cancer patients. Objective: To identify risk factors for mortality in cancer patients with P. aeruginosa infection. Methodology: A descriptive study was carried out in patients with P. aeruginosa infection during the hospitalization service of “Oncólogos de Occidente” in Pereira, Armenia and Manizales during 2015. Univariate and multivariate analyzes were performed. The survival analysis was established according to the Kaplan-Meier method. A value of p<0.05 was established for it. The analyses were examined with the STATA software. This study was endorsed by the bioethics committee of the “Universidad Tecnológica de Pereira”. Results: Fourty-one patients with positive culture for P. aeruginosa were studied. Males (46.3%), anemia (46.3%), febrile neutropenia (41%), thrombocytopenia (29.3%) and previous hospitalization in an intensive care unit (29.3%) were associated with higher mortality risk (p = 0.019); a risk scale was designed with these factors (Cronbach´s alpha = 0.72). Patients who presented four of these exposures were at higher risk of mortality with a sensitivity of 68% and specificity of 90% at the moment of discharge. P. aeruginosa showed 36.6% of resistance to cefepime, 34.1% to aztreonam, the mortality rate was 26.8%. Conclusion: Male sex, anemia, thrombocytopenia, febrile neutropenia and previous hospitalization in an intensive care unit increase the mortality rate in patients with cancer who were infected by P. aeruginosa. Introducción: Pseudomonas aeruginosa es una bacteria oportunista Gram negativa particularmente eficiente en la adquisición de mecanismos de resistencia y de alta prevalencia en infecciones nosocomiales en pacientes oncológicos. Objetivo: identificar los factores de riesgo para mortalidad en pacientes oncológicos con aislamiento de P. aeruginosa. Metodología: estudio descriptivo, la población de estudio fueron los casos reportados con aislamiento de P. aeruginosa en el servicio de hospitalización de Oncólogos de Occidente en Pereira, Armenia y Manizales durante el año 2015. Se realizaron análisis univariados y multivariados; la supervivencia se estableció según el método de Kaplan-Meier. Se estableció un valor de p <0.05. Se usó el software STATA. Se tuvo aval de bioética de la Universidad Tecnológica de Pereira. Resultados: se estudió 41 casos confirmados de cultivos positivos de P. aeruginosa. El sexo masculino (46.3%), anemia (46.3%), neutropenia febril (41%), trombocitopenia (29.3%) y haber sido hospitalizado en la unidad de cuidados intensivos (29.3%) fueron asociados estadísticamente con mayor mortalidad (p=0.019); con estos resultados se diseñó una escala de riesgo (alfa de Cronbach =0.72). Los pacientes con cuatro de estas exposiciones mostraron mayor riesgo de mortalidad al egreso hospitalario con una sensibilidad del 68% y especificidad del 90%. La P. aeruginosa presentó resistencia a cefepime (36.6%) y a aztreonam (34.1%), mientras que la letalidad global fue del 26.8%. Conclusión: El sexo masculino, la coexistencia de anemia, trombocitopenia, y neutropenia febril, así como la estancia en la unidad de cuidados intensivos aumentan la mortalidad en los pacientes oncológicos infectados con P. aeruginosa

Terapia con pregabalina versus bloqueos intervencionistas en dolor neuropático: Un estudio de cohorte

Objective: tcompare the decrease in pain in patients with pregabalin therapy versus interventional blocks. Materials and methods: retrospective cohort study that included patients older than 18 years diagnosed with neuropathic pain from a reference center in Pereira, Colombia, between the years 2010-2016. The outcome was assessed at three months in each cohort and was defined as the change in pain intensity according to the visual analog pain scale. The comparison between cohorts and the effectiveness of the intervention was evaluated through repeated measures analysis with the generalized estimating equation. Results: a total of 1451 patients with pain were selected, of these, only 94 met the inclusion criteria. Sixty-two (66%) patients received a pharmacological scheme with pregabalin, and 32 patients (34%) underwent blockages. The pain intensity prior to pregabalin treatment was 7.3 ± 1.8 and 8.9 ± 1.2 in the group with blocks, p = 0.005. The intensity of posterior pain in the group with pregabalin was 3.5 ± 2.4, with an average improvement of 53.9%, while in the group with blocks, it was 2.5 ± 2 with an average improvement of 70.7%. Interventional management reduces pain 2.09 times more compared to pregabalin therapy (p <0.001). Conclusions: the use of interventional blocks in the treatment of neuropathic pain should be considered in patients with moderate to severe neuropathic pain.Objetivo: comparar la disminución en el dolor en pacientes con terapia con pregabalina frente a bloqueos intervencionistas. Materiales y métodos: estudio de cohorte retrospectiva, se reclutó pacientes mayores de 18 años diagnosticados con dolor de tipo neuropático de centro de referencia de la ciudad de Pereira, Colombia, entre los años 2010 a 2016. Se evaluó la variación en la intensidad del dolor. La comparación entre cohortes y la efectividad de la intervención se evaluó a través del análisis de medias repetidas con la ecuación de estimación generalizada. Resultados: se incluyeron 94 pacientes con dolor neuropático. A 62 (66%) pacientes se les formuló un esquema farmacológico con pregabalina y a 32 (34%) pacientes se les realizó bloqueos. La intensidad del dolor previa al tratamiento con pregabalina fue de 7,3 ± 1,8 y de 8,9 ± 1,2 en el grupo con bloqueos, p=0,005. La intensidad del dolor posterior en el grupo con pregabalina fue de 3,5 ± 2,4, con una mejoría media de 53,9%, mientras que en el grupo con bloqueos fue del 2,5 ± 2 con una mejoría media de 70,7%. El manejo intervencionista logró una reducción 2,09 veces mayor comparada con la pregabalina (p<0,001). Conclusiones: el empleo de bloqueos intervencionistas en el tratamiento del dolor neuropático debe ser considerado en pacientes con dolor neuropático moderado a severo

Terapia con pregabalina versus bloqueos intervencionistas en dolor neuropático: Un estudio de cohorte

Objetivo: comparar la disminución en el dolor en pacientes con terapia con pregabalina frente a bloqueos intervencionistas. Materiales y métodos: estudio de cohorte retrospectiva, se reclutó pacientes mayores de 18 años diagnosticados con dolor de tipo neuropático de centro de referencia de la ciudad de Pereira, Colombia, entre los años 2010 a 2016. Se evaluó la variación en la intensidad del dolor. La comparación entre cohortes y la efectividad de la intervención se evaluó a través del análisis de medias repetidas con la ecuación de estimación generalizada. Resultados: se incluyeron 94 pacientes con dolor neuropático. A 62 (66%) pacientes se les formuló un esquema farmacológico con pregabalina y a 32 (34%) pacientes se les realizó bloqueos. La intensidad del dolor previa al tratamiento con pregabalina fue de 7,3 ± 1,8 y de 8,9 ± 1,2 en el grupo con bloqueos, p=0,005. La intensidad del dolor posterior en el grupo con pregabalina fue de 3,5 ± 2,4, con una mejoría media de 53,9%, mientras que en el grupo con bloqueos fue del 2,5 ± 2 con una mejoría media de 70,7%. El manejo intervencionista logró una reducción 2,09 veces mayor comparada con la pregabalina (p<0,001). Conclusiones: el empleo de bloqueos intervencionistas en el tratamiento del dolor neuropático debe ser considerado en pacientes con dolor neuropático moderado a severo

Falla cardíaca avanzada en pacientes tratados con dispositivos electrofisiológicos en una unidad de electrofisología, Pereira (Colombia)

Introduction: advanced heart failure it's a disease with a high prevalence in the world wide,with an increasing mortality and hospitalization rates, due to his severity and clinical profile. Which costs to the health system is up to 20% of the resources devoted to the management of cardiovascular disease in North Amerca. A cross-sectional study was made with 70 patients on pharmacological treatment and Cardiac Resynchronization Therapy with or without Implantable Cardioverter (CDI) or Implantable Cardioverter (CDI) among 2010 and 2012.Methods: a cross-sectional study.Results: we found 71% with hypertension, 65,75% ischemic cardiopathy , 58.3% with resynchronizator with or without CDI, 90% had two or more drugs for heart failure, 77% had beta blocker, 90% ACE inhibitor or ARB, 85.7% diuretics.Conclusion: patients with advanced heart failure who underwent electrophysiological therapy, were clinically characterized in Pereira, Colombia.Resumen: la falla cardíaca avanzada es una enfermedad prevalente, con una tasa alta de mortalidad y hospitalización con relación a su estadio y perfil clínico, que cuesta en Norteamérica hasta el 20% de los recursos destinados para el manejo de la enfermedad cardiovascular. Se realizó un análisis transversal a una cohorte de 70 pacientes en tratamiento farmacológico y cardioresincronizador con o sin cardiodesfibirlador, o solo cardiodesfibrilador automático (ICD) implantado entre los años 2010 y 2012.Métodos: el presente es un estudio transversal.Resultados: 71% presentaron hipertensión arterial HTA; 65,75% cardiopatía isquémica, siendo el 58.3% portadores de resincronizador con o sin cardiodesfibrilador. El 90% de los pacientes tiene 2 o más medicamentos, 77% betabloqueador, 90% iECA o ARA II, 85.7% algún diurético.Conclusión: se caracterizaron los pacientes que recibieron terapia electrofisiológica para manejo avanzado de falla cardíaca.ardíaca

Falla cardíaca avanzada en pacientes tratados con dispositivos electrofisiológicos en una unidad de electrofisiología, Pereira (Colombia)

Revista Indexada en categoría A2 por ColcienciasLa falla cardíaca avanzada es una enfermedad prevalente con una taza alta de mortalidad y hospitalización con relación a su estadio y perfil clínico, que cuesta en Norteamérica hasta 20% de los recursos destinados para el manejo de la enfermedad cardiovascular. Se realizó un análisis transversal a una cohorte de 70 pacientes en tratamiento farmacológico y cardioresincronizador con o sin cardiodesfibirlador, o solo cardiodesfibirlador automático (ICD) implantado entre los años 2010 y 2012

Genome-wide association analysis of dementia and its clinical endophenotypes reveal novel loci associated with Alzheimer's disease and three causality networks : The GR@ACE project

Introduction: Large variability among Alzheimer's disease (AD) cases might impact genetic discoveries and complicate dissection of underlying biological pathways. Methods: Genome Research at Fundacio ACE (GR@ACE) is a genome-wide study of dementia and its clinical endophenotypes, defined based on AD's clinical certainty and vascular burden. We assessed the impact of known AD loci across endophenotypes to generate loci categories. We incorporated gene coexpression data and conducted pathway analysis per category. Finally, to evaluate the effect of heterogeneity in genetic studies, GR@ACE series were meta-analyzed with additional genome-wide association study data sets. Results: We classified known AD loci into three categories, which might reflect the disease clinical heterogeneity. Vascular processes were only detected as a causal mechanism in probable AD. The meta-analysis strategy revealed the ANKRD31-rs4704171 and NDUFAF6-rs10098778 and confirmed SCIMP-rs7225151 and CD33-rs3865444. Discussion: The regulation of vasculature is a prominent causal component of probable AD. GR@ACE meta-analysis revealed novel AD genetic signals, strongly driven by the presence of clinical heterogeneity in the AD series

Black list and Alert list of the Aquatic Invasive Alien Species in the Iberian Peninsula: an action of the LIFE INVASAQUA

Resumen del trabajo presentado en VI Congreso Nacional sobre Especies Exóticas Invasoras y I Congreso Ibérico sobre EEI (EEI 2022) celebrado en Navarra del 20 al 23 de abril de 2022.One of the objectives of LIFE INVASQUA project is to develop tools that will be more efficient the Early Warning and Rapid Response (EWRR) framework for Invasive Alien Species in the Iberian Peninsula. Horizon scanning for high-risk IAS is basic in implementing measures to reduce new invasions, developing Alert lists, and to focus effort in the species already established, for instance making a Black list. We developed a trans national horizon scanning exercise focused on inland waters of Spain and Portugal in order to provide a prioritized lists (Black list and Alert list) of aquatic IAS that may pose a threat to aquatic ecosystems and socio economic sectors in the future. We followed a step approach of existing information about IAS (Plants, Freshwater Invertebrates, Estuarine Invertebrates and Vertebrates; 127 established taxa in Black list; 90 non established taxa in Alert list) combining with an expert scoring of prioritized taxa. IAS established in the Iberian aquatic system consistently highlighted as the worst included vertebrates (e.g. Cyprinus carpio, Gambusia holbrooki, Silurus glanis), freshwater and estuarine invertebrates (e.g. Procambarus clarkii, Dreissena polymorpha, Pacifastacus leniusculus, Ficopomatus enigmaticus, Callinectes sapidus, Corbicula fluminea) and plants (e.g. Eichhornia crassipes, Azolla filiculoides, Ludwigia grandiflora). Amongst taxa not yet established (Alert list), expert pointed to Perna viridis, Hydroides dirampha, Dreissena bugensis, Procambarus fallax f. virginallis, Perccottus glenii with higher risk of invasion, ecological and socioeconomic impacts. Over 20.6% of the taxa in the preliminary black list received no votes (no prioritization) by experts, 17.8% in the innitial alert list. Our horizon scanning approach is inclusive of all-taxa, prioritizes both established and emerging biological threats across trans-national scales, and considers not only the ecological impact, but also potential direct economic consequences as well as the manageability of invasive species.This work received funds from the LIFE Programme (LIFE17 GIE/ES/000515)

Sloan Digital Sky Survey IV: Mapping the Milky Way, Nearby Galaxies, and the Distant Universe

We describe the Sloan Digital Sky Survey IV (SDSS-IV), a project encompassing three major spectroscopic programs. The Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2) is observing hundreds of thousands of Milky Way stars at high resolution and high signal-to-noise ratios in the near-infrared. The Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey is obtaining spatially resolved spectroscopy for thousands of nearby galaxies (median $z\sim 0.03$). The extended Baryon Oscillation Spectroscopic Survey (eBOSS) is mapping the galaxy, quasar, and neutral gas distributions between $z\sim 0.6$ and 3.5 to constrain cosmology using baryon acoustic oscillations, redshift space distortions, and the shape of the power spectrum. Within eBOSS, we are conducting two major subprograms: the SPectroscopic IDentification of eROSITA Sources (SPIDERS), investigating X-ray AGNs and galaxies in X-ray clusters, and the Time Domain Spectroscopic Survey (TDSS), obtaining spectra of variable sources. All programs use the 2.5 m Sloan Foundation Telescope at the Apache Point Observatory; observations there began in Summer 2014. APOGEE-2 also operates a second near-infrared spectrograph at the 2.5 m du Pont Telescope at Las Campanas Observatory, with observations beginning in early 2017. Observations at both facilities are scheduled to continue through 2020. In keeping with previous SDSS policy, SDSS-IV provides regularly scheduled public data releases; the first one, Data Release 13, was made available in 2016 July

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele