Situación epidemioloógica de la cirugía Laparoscóspica diagnóstica y terapéutica de las pacientes ingresadas en el Hospital Bertha Calderón de Enero a Noviembre del 2014

Se realizó un estudio de tipo descriptivo, retrospectivo de corte transversal en el Hospital Bertha Calderón Roque (HBCR), en el período de Enero del 2014 a Noviembre del 2014 en muestra de 38 pacientes. En este estudio el universo estuvo conformado por 38 pacientes a las que se le realizó cirugía por vía laparoscópica en el HBCR en el tiempo estudiado y la muestra fue igual al universo. La edad más frecuente de la pacientes estudiadas fue las mayores de 35 años un total de 21 pacientes para 55.3%. La escolaridad encontrada en las pacientes estudiadas fue principalmente secundaria 21 pacientes para un 55.3%. Los factores de riesgo encontrados fueron la obesidad que la presentó el % de las pacientes, las enfermedades crónicas como Diabetes, Hipertensión, EPOC, etc se encontró en % de las pacientes; El antecedente de cirugías abdominopelvicas lo tuvieron 17 pacientes para 44.7% lo cual no generó complicaciones postquirúrgicas. La indicación quirúrgica en las pacientes estudiadas fue principalmente la patologías de ovario 26 pacientes para 68.4%, luego la patología biliar con 9 pacientes para 23.7%, patología apendicular 1 paciente para 2.6%. No hubo ninguna complicación quirúrgica Inmediata ni Mediata en 100% de las pacientes estudiadas. Tampoco hubo Reingresos. En las pacientes estudiadas, las horas postquirúrgicas al egreso de las pacientes a estudio fue: menor de 24 horas 33 pacientes para 86.8%, de 25-72 horas fue 5 pacientes para 13.2% y no hubo pacientes que permaneciera más de 72 horas; el tiempo quirúrgico más frecuente encontrado fue para % de las pacientes. El tiempo anestésico durante la cirugía fue principalmente de minutos para % de las pacientes. Por lo que se puede concluir, que con pacientes bien seleccionadas la técnica laparoscópica es segura en cirugía general, ginecológica y obstétrica. Por tanto se recomienda en el presente estudio, que se cree mecanismos, por parte del Ministerio de Salud, para capacitar, entrenar y acreditar a ginecoobstetras para la realizar las cirugías ginecológicas y obstétricas con la técnica de laparoscopía, ofreciendo más alternativas a la mujer nicaragüense, a quienes les beneficiaríamos en gran maner

A new species of Epicauta from Venezuela with comments on the Epicauta (E.) vittata species group(Coleoptera: Meloidae)

[EN] The study of specimens of Epicauta held at the collection of the Museo del Instituto de Zoología Aplicada (MIZA, Venezuela) allowed us to discover specimens with singular morphological traits from the states of Lara and Falcón. The characters shown by these specimens do not permit to assign them to any of the known species of the genus, and thus we consider that they represent a new species: Epicauta falcolarandina sp. nov. The new species is included in the Epicauta vittata species group. E. falcolarandina differs at first glance from all other Venezuelan species of the E. vittata species group (Epicauta aragua and Epicauta apure) because it presents the ventral blade of the tarsal claws curved and of similar width and length than the dorsal one. The characteristic coloration pattern of E. falcolarandina, which vaguely resembles the pattern displayed by Epicauta leopardina, differs from all other species of the E. vittata species group. A particular trait of E. falcolarandina, shared with Epicauta abadona, is that the coloration of the pilosity does not match the color of the tegument. Most of the surface of the elytra of E. falcolarandina, including almost all dark zones, is covered by a whitish-yellow pilosity.[ES] El examen de ejemplares del género Epicauta de la colección del Museo del Instituto de Zoología Aplicada (MIZA, Venezuela) nos permitiódetectar la presencia de ejemplares procedentes de los estados de Lara y Falcón, con características morfológicas singulares. Estos rasgos nopermiten su asignación a ninguna de las especies conocidas del género por lo que se describe como una especie nueva: Epicauta falcolarandinasp. nov., que se incluye en el grupo de especies de Epicauta vittata. E. falcolarandina se diferencia de las demás especies venezolanas del grupode E. vittata (Epicauta aragua y Epicauta apure) por presentar la lámina inferior de las u˜nas de los tarsos curvada y casi de la misma anchura ylongitud que la lámina superior. El patrón característico de coloración de E. falcolarandina, que recuerda al de Epicauta leopardina, la diferenciade las restantes especies del grupo de E. vittata. Una característica peculiar de esta especie, que comparte con Epicauta abadona, es que el colorde la pilosidad no coincide con el de la coloración tegumentaria; así, en la mayor parte de los élitros, incluidas casi todas las zonas oscuras, lapilosidad es amarillo-blanquecina.Este estudio ha contado con el apoyodel Proyecto CGL2015-66571-P (MINECO/FEDER).Peer Reviewe

Desarrollo de un sistema web y móvil para la gestión logística en la disciplina PowerLifting Levantamiento de potencia de la Federación Nicaragüense de Potencia FENIPO.

El presente trabajo desarrollo de un sistema web y móvil para la gestión logística en la disciplina Powerlifting (Levantamiento de potencia) de la Federación Nicaragüense de Potencia (FENIPO) tiene como objetivo desarrollar un prototipo de sistema de gestión logística para la disciplina Powerlifting en la Federación Nicaragüense de Potencia

Efficacy and Safety of Oral Fosfomycin for Asymptomatic Bacteriuria in Kidney Transplant Recipients: Results from a Spanish Multicenter Cohort

Current guidelines recommend against systematic screening for or treating asymptomatic bacteriuria (AB) among kidney transplant (KT) recipients, although the evidence regarding episodes occurring early after transplantation or in the presence of anatomical abnormalities is inconclusive. Oral fosfomycin may constitute a good option for the treatment of posttransplant AB, particularly due to the emergence of multidrug-resistant (MDR) uropathogens. Available clinical evidence supporting its use in this specific setting, however, remains scarce. We performed a retrospective study in 14 Spanish institutions from January 2005 to December 2017. Overall, 137 episodes of AB diagnosed in 133 KT recipients treated with oral fosfomycin (calcium and trometamol salts) with a test-of-cure urine culture within the first 30 days were included. Median time from transplantation to diagnosis was 3.1 months (interquartile range [IQR], 1.1 to 10.5). Most episodes (96.4% [132/137]) were caused by Gram-negative bacteria (GNB), and 56.9% (78/137) were categorized as MDR (extended‐spectrum β‐lactamase‐producing Enterobacterales [20.4%] and carbapenem‐resistant GNB [2.9%]). Rate of microbiological failure at month 1 was 40.1% (95% confidence interval [CI], 31.9% to 48.9%) for the whole cohort and 42.3% (95% CI, 31.2% to 54.0%) for episodes due to MDR pathogens. Previous urinary tract infection (odds ratio [OR], 2.42; 95% CI, 1.11 to 5.29; P value = 0.027) and use of fosfomycin as salvage therapy (OR, 8.31; 95% CI, 1.67 to 41.35; P value = 0.010) were predictors of microbiological failure. No severe treatment-related adverse events were detected. Oral fosfomycin appears to be a suitable and safe alternative for the treatment (if indicated) of AB after KT, including those episodes due to MDR uropathogens

An exploratory analysis of C-X-C motif chemokine ligand 10 as a new biomarker of asymptomatic Leishmania infantum infection in solid-organ transplant recipients

Objective: Sensitive and less laborious assays are needed to detect asymptomatic Leishmania among solid organ transplant (SOT) recipients. Using SLA-stimulated plasma from SOT recipients living where an outbreak of Leishmania infantum occurred, we examined potential biomarkers to identify asymptomatic Leishmania infections. Methods: Concentrations of cytokines/chemokines in plasma from whole blood stimulated with specific Leishmania antigen (SLA) were compared against infection status as determined by a currently used cell proliferation assay. Results: Twenty-six percent (13/50) of the SOT recipients had a cell proliferation assay (CPA) indicating asymptomatic infection, and showed higher processed plasma C-X-C motif chemokine ligand 10 (CXCL10 or IP-10) concentrations than did non-infected subjects (median 2272.0 pg/ml [IQR 1570-2772] vs. 18.2 pg/ml [IQR 1-150.1]; p<0.0001). CXCL10 showed a sensitivity of 93% and a specificity of 95% compared to CPA. In addition, we demonstrated that the number of asymptomatic infections detected using CXCL10, decreased with distance from a park at the center of the mentioned outbreak. Conclusion: CXCL10 in plasma from SLA-stimulated blood could be a robust biomarker of asymptomatic L. infantum infection in solid organ transplant recipients.This study was co-funded by the World Health Organization (APW-2012/271093-O), and the Spanish Ministry of Science and Universities (via Proyecto Integrado de Excelencia [PIE] 13/00045). Additional funding was provided by the Instituto de Salud Carlos III via project PI18CIII/00028 and DTS16CIII/00010, and via the Red de Enfermedades Tropicales, Subprograma RETICS del Plan Estatal de I+D+I 2013–2016, which is co-supported by FEDER “Una Manera de Hacer Europa” funds via project RD16CIII/0003/0002. M.F.R. holds a “Miguel Servet” (CP18/00073) research contract from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III. The funders had no role in the design of the study, data collection, or the interpretation of the results.S

Influence of single-nucleotide polymorphisms in TLR3 (rs3775291) and TLR9 (rs352139) on the risk of CMV infection in kidney transplant recipients

Risk stratification for cytomegalovirus (CMV) infection after kidney transplantation (KT) remains to be determined. Since endosomal toll-like receptors (TLRs) are involved in viral sensing, we investigated the impact of common single-nucleotide polymorphisms (SNPs) located within TLR3 and TLR9 genes on the occurrence of overall and high-level (≥1,000 IU/ml) CMV infection in a cohort of 197 KT recipients. Homozygous carriers of the minor allele of TLR3 (rs3775291) had higher infection-free survival compared with reference allele carriers (60.0% for TT versus 42.3% for CC/CT genotypes; P-value = 0.050). Decreased infection-free survival was observed with the minor allele of TLR9 (rs352139) (38.2% for TC/CC versus 59.3% for TT genotypes; P-value = 0.004). After multivariable adjustment, the recessive protective effect of the TLR3 (rs3775291) TT genotype was confirmed (adjusted hazard ratio [aHR]: 0.327; 95% CI: 0.167–0.642; P-value = 0.001), as was the dominant risk-conferring effect of TLR9 (rs352139) TC/CC genotypes (aHR: 1.865; 95% CI: 1.170–2.972; P-value = 0.009). Carriers of the TLR9 (rs352139) TC/CC genotypes showed lower CMV-specific interferon-γ-producing CD4+ T-cell counts measured by intracellular cytokine staining compared with the TT genotype (median of 0.2 versus 0.7 cells/μl; P-value = 0.003). In conclusion, TLR3/TLR9 genotyping may inform CMV infection risk after KT

CA 15-3 prognostic biomarker in SARS-CoV-2 pneumonia.

The severity of lung involvement is the main prognostic factor in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Carbohydrate antigen 15-3 (CA 15-3), a marker of lung damage and fibrosis, could help predict the prognosis of SARS-CoV-2 pneumonia. This was a retrospective and observational study. CA 15-3 was analyzed in the blood samples of patients consecutively admitted for SARS-CoV-2 pneumonia and whose blood samples were available in the biobank. Other prognostic markers were also measured (interleukin 6 [IL6], C-reactive protein [CRP], D-dimer, troponin T, and NT-ProBNP). The occurrence of in-hospital complications was registered, including death, the need for medical intensive care, and oxygen therapy at discharge. In this study, 539 patients were recruited (54.9% men, mean age: 59.6 ± 16.4 years). At admission, the mean concentrations of CA 15-3 was 20.5 ± 15.8 U/mL, and the concentration was correlated with male sex, older age, and other severity markers of coronavirus disease of 2019 (COVID-19) (IL6, CRP, D-dimer, troponine T, and NT-ProBNP). CA 15-3 levels were higher in patients who died (n = 56, 10.4%) (35.33 ± 30.45 vs. 18.8 ± 12.11, p < 0.001), who required intensive medical support (n = 78, 14.4%; 31.17 ± 27.83 vs. 18.68 ± 11.83; p < 0.001), and who were discharged with supplemental oxygen (n = 64, 13.3%; 22.65 ± 14.41 vs. 18.2 ± 11.7; p = 0.011). Elevated CA 15-3 levels (above 34.5 U/mL) were a strong predictor of a complicated in-hospital course, in terms of a higher risk of death (adjusted odds ratio [OR] 3.74, 95% confidence interval [CI]: 1.22-11.9, p = 0.022) and need for intensive care (adjusted OR 4.56, 95% CI: 1.37-15.8) after adjusting for all other risk factors. The degree of lung damage and fibrosis evaluated in terms of CA 15-3 concentrations may allow early identification of the increased risk of complications in patients with SARS-CoV-2 pneumonia.S

Discordance Between SARS-CoV-2-specific Cell-mediated and Antibody Responses Elicited by mRNA-1273 Vaccine in Kidney and Liver Transplant Recipients

Background: Severe acute respiratory syndrome coronavirus 2-specific cell-mediated immunity (SARS-CoV-2-CMI) elicited by mRNA-based vaccines in solid organ transplant (SOT) recipients and its correlation with antibody responses remain poorly characterized. Methods: We included 44 (28 kidney, 14 liver, and 2 double organ) recipients who received the full series of the mRNA-1273 vaccine. SARS-CoV-2-CMI was evaluated at baseline, before the second dose, and at 2 wk after completion of vaccination by an ELISpot-based interferon-γ FluoroSpot assay using overlapping peptides covering the S1 domain. SARS-CoV-2 immunoglobulin G seroconversion and serum neutralizing activity against the spike protein were assessed at the same points by commercial ELISA and an angiotensin-converting enzyme-2/spike antibody inhibition method, respectively. Postvaccination SARS-CoV-2-CMI was compared with 28 healthcare workers who received the BNT162b2 vaccine. Results: Positive SARS-CoV-2-CMI increased from 6.8% at baseline to 23.3% after the first mRNA-1273 dose and 59.5% after the completion of vaccination (P < 0.0001). Lower rates were observed for immunoglobulin G seroconversion (2.3%, 18.6%, and 57.1%, respectively) and neutralizing activity (2.3%, 11.6%, and 31.0%). There was a modest correlation between neutralizing titers and the magnitude of SARS-CoV-2-CMI (Spearman's rho: 0.375; P = 0.015). Fifteen recipients (35.7%) mounted SARS-CoV-2-CMI without detectable neutralizing activity, whereas 3 (7.1%) did the opposite, yielding poor categorical agreement (Kappa statistic: 0.201). Rates of positive SARS-CoV-2-CMI among SOT recipients were significantly decreased compared with nontransplant controls (82.1% and 100.0% after the first dose and completion of vaccination, respectively; P < 0.0001). Kidney transplantation, the use of tacrolimus and prednisone, and the number of immunosuppressive agents were associated with lower cell-mediated responses. Results remained unchanged when 3 recipients with prevaccination SARS-CoV-2-CMI were excluded. Conclusions: Two-thirds of SOT recipients mounted SARS-CoV-2-CMI following vaccination with mRNA-1273. Notable discordance was observed between vaccine-induced cell-mediated and neutralizing humoral immunities. Future studies should determine whether these patients with incomplete responses are effectively protected.This work was supported by the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (COVID-19 Research Call COV20/00181) and cofinanced by the European Development Regional Fund “A way to achieve Europe.” M.F.R. holds a research contract “Miguel Servet” (CP18/00073) and R.L.G. a research contract “Rio Hortega” (CM19/00120), both from the Instituto de Salud Carlos III, Spanish Ministry of Science and InnovationS

DNA polymerase lambda (Pol λ), a novel eukaryotic DNA polymerase with a potential role in meiosis

A new gene (POLL) encoding a novel DNA polymerase (Pol λ) has been identified at mouse chromosome 19. Murine Pol λ, consisting of 573 amino acid residues, has a 32 % identity to Pol β, involved in nuclear DNA repair in eukaryotic cells. It is interesting that Pol λ contains all the critical residues involved in DNA binding, nucleotide binding and selection, and catalysis of DNA polymerization, that are conserved in Pol β and other DNA polymerases belonging to family X. Murine Pol λ, overproduced in Escherichia coli, displayed intrinsic DNA polymerase activity when assessed by in situ gel analysis. Pol λ also conserves the critical residues of Pol β required for its intrinsic deoxyribose phosphate lyase (dRPase) activity. The first 230 amino acid residues of Pol λ, that have no counterpart in Pol β, contain a BRCT domain, present in a variety of cell-cycle check-point control proteins responsive to DNA damage and proteins involved in DNA repair. Northern blotting, in situ hybridization analysis and immunostaining showed high levels of Pol λ specifically expressed in testis, being developmentally regulated and mainly associated to pachytene spermatocytes. These first evidences, although indirect, suggest a potential role of Pol λ in DNA repair synthesis associated with meiosis.This work has been granted by DGES (PB97-1192) and CAM (08.1/0044/98) to LB; CAM(08.1/0044.2/98) to AB; DGICYT (PB 95-0119), EC PL96-0183 and CAM (07/0022) to JM, and by an institutional grant from Fundación Ramón Areces

Galernas: A history of coastally trapped disturbances (2003−2020) with hidden frontogenesis in the Bay of Biscay

Galerna is the term accepted for an abrupt westerly change that affects the north coast of Spain. The wind surge travels from the mid-north coast of Spain to France, generally reaching their maximum intensity at the Basque Coast, and cuts off a period of hot weather, clear skies, and calm conditions at sea. The galernas have a large history of shipwrecks and fishermen deaths. They have been characterized as coastally trapped disturbances (CTD) and their propagation, enhanced with the local formation of a micro-front, was documented to behave like a density current. Alternatively, synoptic fronts have also been reported to cause galernas, considered to be more intense than those generated by a local micro-front. In this article we have generated the first climatology (2003–2020) of these events based on an objective identification methodology. The developed Event Identification Software (EIS), based on both 10-min surface station data and hourly ERA5 reanalysis fields, together with a new Front Identification Scheme (FIS) have enabled a deeper study into the origin and development of these micro-fronts, and a more comprehensive exploration of the interaction of the oceanic fronts entering the Bay of Biscay. Our results show that the area receives an average of four to five relatively intense galernas (Vmax > 50 km h−1) per year. Their number shows a great interannual variability (from one to seven) and a marked seasonality: May and June concentrate the largest fraction (almost one episode each year) and practically no episodes in winter. They occur more frequently between noon and the late afternoon, where the most intense wind records concentrate. Very strong galernas (Vmax > 72 km h−1) have occurred in all 18 years, can happen in any month from February to November, and their monthly distribution does not show the mentioned seasonality. On the contrary, the highest rates of temperature decrease across the galerna front in the coastal stations (−∆T/0.5 h > 4 °C) do have a stronger seasonality, with May and June concentrating a relatively large number of cases with a more abrupt temperature drop. The FIS shows that most of the galernas (83.5%) have a local origin inside the Bay of Biscay, and only a few ones (16.5%) are caused by oceanic fronts initiated out of the region. The local frontogenesis is more frequently initiated by the relatively cold marine southwesterly pre-frontals preceding a parent oceanic front and blowing against the warm continentals inside the Bay of Biscay, after being ducted along the north and northwestern coast of Spain. This hidden local frontogenesis, first revealed by the FIS, seems to be enhanced by the observed lee troughing, which could have both a thermal and dynamic origin, acting simultaneously after the intense Foehn at the coastal strip, preceding the formation of the galerna front. The local front enhancement appears to be the reason for the apparent jump of the primary front, which may eventually weaken, and even disappear, as the galerna front sharpens. Even during the more occasional frontal galernas, directly caused by the westerlies or north-westerlies behind the oceanic front, their eastward propagation is more rapid over the coastal area. The front deforms in shape and may cause its characteristic unexpected/abrupt irruption. All the EIS detected galernas, even the frontal ones, are wind reversals caused by a coastally trapped marine boundary layer. The upper-level ridge over Europe, observed in all of them, seems to be a synoptic ingredient for their development, preventing the eastward propagation of Atlantic depressions and enhancing at the same time the temperature and pressure gradients between the marine and continental air masses.The authors wish to thank the Basque Government and the University of the Basque Country UPV/EHU as the source of our main financial support: GIA consolidated Research Groups (https://www.ehu.eus/es/web/gia) IT1057-16 (GIC15/152) and GIU13/03. These financing bodies have played an exclusively economic role in the study