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The aim of the study was to investigate the epidemiology and clinical features of bloodstream infections due to Escherichia coli producing AmpC beta-lactamases (AmpC-Ec-BSI). In a multi-centre case-control study, all third-generation-cephalosporin-resistant Escherichia coli BSI (3GC-Ec-BSI) isolates were analysed. Acquired bla (AmpC) (bla (ac-AmpC)) detection was done by polymerase chain reaction (PCR) and sequencing. Chromosomal bla (AmpC) (bla (c-AmpC)) expression was quantified by real-time PCR. Cases were patients with AmpC-Ec-BSI. Controls were patients with cephalosporin-susceptible E. coli BSI, matched 1:1 by sex and age. Demographics, comorbidities, intrinsic and extrinsic risk factors for antimicrobial resistance, clinical presentation and outcomes were investigated. Among 841 E. coli BSI, 17 were caused by AmpC-Ec (2 %). Eleven isolates (58.8 %) had bla (ac-AmpC) and six were bla (c-AmpC) overproducers. The mean age of cases was 66.2 years and 71 % were men. Cases were more frequently healthcare-related (82 vs. 52 % controls, p < 0.05) and presented more intrinsic and extrinsic risk factors. At least one risk factor was present in 94.1 % of cases vs. 41.7 % of controls (p = 0.002). Severity and length of stay (LOS) were higher among cases (mean Pitt Score 2.6 vs. 0.38 in controls, p = 0.03; LOS 17.5 days vs. 6 in controls, p = 0.02). Inappropriate empirical therapy (IET) was administered to 70.6 % of cases and 23.5 % of controls (p < 0.003). No differences were found in terms of cure rate at the 14th day and mortality. Bloodstream infections due to AmpC-Ec (mostly plasmid-mediated) are infrequent in our area. AmpC-Ec-BSI affects mainly patients with intrinsic risk factors and those with previous antibiotic exposure. A high proportion received IET.

Background: Cholellthiasis is one of the registered causes within maternal deaths in an indirect way, with a reported up to 20% prevalence, it is considered within the main reasons for surgery in the postnatal period. Objective: To determine the frequency of asymptomatic cholellthiasis in pregnant successors of the Family Medicine Unit no. 53 (FMU 53). Material and methods: Observational, perspective, and descriptive study was conducted in the FMU 53 pregnant women who attended the service of ultrasound, size of sample was estimated taking 10% of anticipated ratio, significance of 95% and 3% of Alfa error corresponding to 348 patients. Excluding patients with diagnosis of biliary ducts pathology, biliary tract surgery patient carrier, and the ones who did not want to participate, ultrasound of biliary tract exploration took place; descriptive statistics was used for analysis and the results were presented in figures. Results: 348 Ultrasonographic studies were performed to pregnant patients, 16% (54) with presence of sonographic data of asymptomatic cholellthiasis, 66% (36) with age of 20 to 29 years, 26.5 as middle age, predominating the primigravid 41% (22) and the third trimester with 66% (33), in 74% multiple gallstones, polyps 7%, 39% thin complexion, 31% overweight and obesity and 33% with work activity. Conclusion: The incidence of asymptomatic Cholellthiasis in pregnant women of the FMU 53 is high, it predominates in primigravid patients of thin complexion , between 20 to 29 years of age, with multiple gallstones, size>5 mm and they are economically active women.

El análisis se realizó en condiciones de campo, en dos localidades (Candelaria y Palmira), determinando los componentes de rendimiento (kg), altura (cm) y fenología (dds/floración). Se empleó un diseño completamente al azar con cinco repeticiones. El crecimiento de C. ensiformis no mostró diferencias entre las localidades evaluadas. El desempeño fisiológico en la acumulación de fotosintatos se concentró en mayor proporción en el órgano vertedero “frutoâ€?, que representa entre el 60 y 75% de MS total. La dinámica de acumulación de MS mostró correlación en los índices medidos (TCC, TCR, TAN, IAF). Abstract Analysis of growth of canavalia in the plane zone of Valle del Cauca. Under conditions of field, in two localities (Candelaria and palmira), determining the components of yield (Kg), height (cm) and fenology (d/flower). A design at random with five (5) repetitions was used completely. The growth of Canavalia ensiformis does not show differences enters the evaluated localities. The physiological performance in the accumulation of photosintates is it accumulated in greater proportion in the organ garbage dump “fruitâ€?, that represents between 60 and 75% of dry matter. The dynamics of accumulation of MS shows correlation in the measured indices (NAR, LAI, RGR). Key words: Canavalia ensiformis, biological analysis, phenology, yield components.

Pancreatitis in pregnancy has a prevalence of 1.5/1500-4500 cases, constituting one of the most common acute abdomen wedges, with biliary origin in 70% of cases, triglycerides in 20% and other causes in the remaining 10%, including choledochal cyst (CC) as a rare cause with three previous reports in literature, which may have a fatal outcome with fetal loss in some cases. We report the case of a 25-year-old patient with 30.4 weeks of gestation (WOG) that arrived to emergency room with right upper quadrant and epigastric pain for the last 8 hours, associated with nausea and vomiting. No pathological background referred. At physical examination with jaundice, gravidic abdomen for 30.4 WOG pregnant, fetal movements presents, Murphy (+) and epigastric pain on deep palpation. Laboratories report total bilirubin (TB) 3.9 mg/dl and direct bilirubin (DB) 3.69 mg/dl Alkaline phosphatase (AP) 2038 IU/L Amylase 280 IU/L Lipase 1938 IU/L. Pancreatitis is confirmed and abdominal ultrasound (US) is requested to determine biliar origin. USG reports gallbladder of 9×4 cm, thin walls without filling defects, dilated intrahepatic bile duct and common bile duct cyst. Cholangiopancreatography Resonance Imaging (CPMR) concludes Todani I choledochal cyst of 17×9 cm, with displacement of duodenum, colon and pancreas. Due to gestation ongoing appropriate medical management with fluids and analgesics was started until remission of pancreatitis 72 hours later. After delivery at 34 WOG, cholecystectomy was performed with hepatico-jejunum Roux-Y anastomosis successfully. Histopathologic analisis reports inespecific inflammation without displasia or metaplasia. At four months follow-up patient is asymptomatic. Pancreatitis in pregnancy is a common cause of acute abdomen, rarely associated with choledochal cysts as the cause. Surgical resolution once pregnancy is over must be done as soon as possible by the high risk of adenocarcinoma degeneration and recurrent pancreatitis.

"Some strains of Bacillus subtilis, B. clausii and B. coagulans are commercially used as probiotic bacteria and their proteolytic activity is well known. The aim of this work was to evaluate their capacity to produce calcium- and ironbinding peptides when grown in culture media with different nitrogen sources. The fermentation media included broths containing tryptic soy (TS), casein peptone (CP), soy peptone (SP), and a crude phycobiliprotein extract (CPE). Cell-free supernatants (CFS) were prepared from the fermented media after 24, 48 and 72 h of fermentation and, tested for degree of hydrolysis (DH). Calcium- and iron-binding activities were determined as well. When the inocula were prepared in a medium designed for the production of alkaline proteases (AP), the degree of hydrolysis and the mineral-binding activity in the CFS were higher. The best results for calcium-binding activity and DH were obtained when B. subtilis and B. coagulans grew in a CPE-containing medium. Analogous results were found for the iron-binding activity; nevertheless, this bioactivity was also high for B. clausii when grown in broths containing TS-, CP- and, SP."

Objectives: To describe the prevalence and risk factors for infection due to AmpC ?-lactamase-producing Escherichia coli (AmpC-EC). Methods: For the prevalence study, all clinical isolates of E. coli with reduced susceptibility to third-generation cephalosporins were prospectively included from June 2010 to November 2011. For risk factor analysis, a case-control study was conducted. Cases were patients with an infection due to AmpC-EC. Controls were patients infected with cephalosporin-susceptible E. coli, matched 1:2. Detection of blaAmpC genes was done with a multiplex AmpC-PCR, and hyperproduction of E. coli chromosomal blaAmpC by quantitative RT-PCR. Alteration of the blaAmpC promoter was studied by PCR and sequencing. Results:We identified 243 (1.1%) AmpC-EC strains out of 21563 clinical isolates. Three cases with strains carrying ESBLs, 18 strains that were considered due to colonization and 8 cases lost to clinical follow-up were excluded. Finally, 214 cases were included in the analysis. Ninety-one cases (42.5%) and 269 (62.8%) controls were strictly community acquired (P,0.001). Thirty-five (16.3%) cases and 186 controls (43.5%) did not have any identifiable risk factor (P,0.001). Among cases, 158 (73.8%) were found to harbour an acquired AmpC (73.4% CMY-2). Previous use of fluoroquinolones [OR 2.6 (95% CI 1.12-3.36); P1/40.008] was independently associated with AmpC-EC in the multivariate analysis. Conclusions: Prevalence of AmpC in E. coli remains low in our area. Plasmid acquisition (CMY type) represents the main mechanism of AmpC production. A high proportion of community-acquired isolates and patients with no identifiable risk factors were found. Previous use of fluoroquinolones was identified as a risk factor. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

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Thin ferrocement walls are the structural elements that comprise the earthquake resistant system of housing built with this material. This article presents the results drawn from an experimental campaign carried out over full-scale precast ferrocement thin walls, which were assessed under cyclic loading conditions. The tests assessed the strength of the walls, their hysteretic behavior, ductility, energy dissipation, equivalent damping, their coefficient of energy dissipation and their characteristic failure mode when subjected to cyclic loading conditions. Finally, an analytical model that modeled the nonlinear dynamic behavior exhibited by ferrocement walls was implemented; its feasibility and potential use in earthquake resistant design of ferrocement walls was evaluated. RESUMEN Los muros de ferrocemento de pared delgada son los elementos estructurales, que conforman el sistema sismo resistente de viviendas construidas con este material. En este artículo se presentan los resultados obtenidos de una campaña experimental; llevada a cabo sobre muros prefabricados de pared delgada a escala real, los cuales fueron evaluados bajo ensayos de carga cíclica. Los ensayos permitieron evaluar: la resistencia, el comportamiento histerético, la ductilidad, la disipación de energía, el amortiguamiento equivalente, el coeficiente de disipación de energía y los modos de falla característicos de los muros de ferrocemento bajo carga cíclica. Al final, se implementó un modelo analítico que captura el comportamiento no lineal, exhibido por los muros de ferrocemento bajo carga cíclica y se evalúo la factibilidad y su potencial uso en el diseño sismo resistente de muros realizados en dicho material.

Las Organizaciones internacionales económicas son un actor clave en la creación, implementación y desarrollo de la normativa multilateral que regula los procesos de integración económica, pero ¿en qué forma e intensidad influyen normativamente esta clase de Organizaciones en dichos procesos? La subjeti- vidad internacional de la cual gozan y la soberanía cedida por parte de los Estados ¿han sido suficientes para cumplir con sus expectativas? Junto con lo anterior, es importante reconocer las principales vías de acción y analizar la situación actual, tanto de los procesos de integración económica como de las Organizaciones que los regulan, reconociendo sus características, principios, efectos y objetivos esperados por parte de la comunidad internacional, y en definitiva determinar cuánto hay de realidad y cuánto ha quedado solamente en expectativa. The international economic Organizations play a key role in the creation, implementation, and development of the multilateral normative that regulate the processes of economic integration. However, how much and what influence do these Organizations have in these processes? Has the international subjectivity, of which they enjoy, and the given sovereignty on the part of the States been sufficient to meet with their expectations? Along with the above, it is important to recognize the principal courses of action and the current situa- tion of the processes of economic integration as well as the regulating Organizations, taking into consideration their characteristics, principles, effects and goals that are expected from the international community. How much is real and how much are just expectations. Les Organisations internationales économiques sont un acteur clé dans la création, exécution, et développement de la règlementation multilatérale qui régule les processus d’intégration économique, mais; sous quelle forme et comment cette classe d’Organisations influence-t-elle, dans les normes, lesdits processus? La subjectivité internationale dont elles profitent, et la souveraineté de la part des Etats, ont elles été suffisantes pour atteindre ses attentes? Suite à ce qui a été énoncé précédemment, il est important de reconnaitre les principales voies d’actions et un panorama actuel, autant dans les processus d’intégration économique comme celles des Organi- sations qui les régulent, reconnaissant ces caractéristiques, principes, effets et objectifs attendus de la part de la communauté internationale. Combien est réel, que reste-t-il encore dans l’attente.

Con la finalidad de contar en Tabasco, México, con aislamientos nativos de Metarhizium anisopliae con potencial de control del salivazo de la caña de azúcar (Aeneolamia postica), cuatro aislamientos poliespóricos, 12 monospóricos y una cepa comercial se caracterizaron según variables fisiológicas y patogénicas. El desarrollo micelial, la velocidad de germinación y la producción conidial fueron las variables fisiológicas consideradas; las dos primeras se evaluaron a: 25, 30 y 35 oC. La temperatura favorable para el desarrollo micelial de las cepas nativas fue de 25-30 °C. El tiempo requerido para la germinación del 50% de los conidios (TG50) varió desde 6,3 h hasta 13.2 h donde los menores y mayores TG50se registraron a 30 y 35 oC, respectivamente. Los aislamientos nativos fueron menos sensibles a las temperaturas evaluadas que la cepa comercial. Respecto a producción conidial, los aislamientos poliespóricos superaron a los aislamientos monospóricos. La efectividad patogénica de M. anisopliae sobre A. postica varió de 31,9 a 53,6%. Las características fisiológicas y patogénicas con fines de selección de micoinsecticidas fueron superiores en los cultivos monospóricos. Los aislamientos con mayor potencial de biocontrol sobre A. postica fueron los monospóricos MaA3(1), MaA3(2), MaA2(7), MaA2(1), y la cepa poliespórica MaA4. In order to obtain native isolates of Metarhizium anisopliae with potential to control Aeneolamia postica, four polysporic strains, 12 monosporic and a commercial strain were characterized according to physiological and pathogenic variables. The mycelial development, germination rate and conidia production were considered physiological variables; the first two were evaluated at three temperatures: 25, 30 and 35 °C. The best temperature for mycelial growth of native strains ranged between 25 and 30 °C. The time required to 50% of conidial germination (TG50) ranged from 6.3 to 13.2 h, where the lowest and highest TG50were 30 °C and 35 °C, respectively. Native strains were less sensitive than the commercial strain at all temperatures tested. Regarding to conidial production, polysporic strains outperformed to the monosporic isolates. The pathogenic effectiveness of M. anisopliae to A. postica ranged from 31.9 to 53.6%. The physiological and pathogenic characteristics to select the best biocontrol strains were higher in monosporic strains. The strains with greatest potential for biocontrol of A. postica, were the monosporic MaA3 (1), MaA3 (2), MaA2 (7), MaA2 (1), and the polysporic MaA4 strain.

78-year-old man who entered twice at an interval of 8 months because of fever and recurrent meningeal involvement and remaining asymptomatic between episodes. Complementary examinations were consistent with meningoencephalitis with systemic inflammatory parameters significantly altered and adrenal mass, suggestive of myelolipoma in the first-admission and adrenal lymphoma in the second. Torpid course in the second and last entry, confirming the diagnosis. (C) 2013 Elsevier Espana, S.L. All rights reserved.