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Calreticulin (CALR) is a multifunctional calcium-binding protein whose expression levels have been correlated with detection, clinical phase of disease, metastasis, and survival of various types of cancer. Therefore, the study of the regulation of the cellular levels of CALR may be important to understand the neoplastic process. Caenorhabditis elegans, which has a CALR ortholog (CRT-1), has been used as a model organism for the characterization of CALR, and several conditions promoting the upregulation of crt-1 have been studied and established to understand the molecular control of crt-1 transcription and assess the function of the protein. Here, we propose several modifications of previously published crt-1 upregulation strategies that improve the reproducibility of the assay and allow to achieve higher levels of overexpression. First, the manipulation of synchronized populations of worms instead of mixed-stage animals and the use of solid culture medium in all experimental conditions are proposed. Likewise, we evaluate four new experimental approaches that attempt to promote a higher crt-1 upregulation [short-term exposure to 30 µg/ml tunicamycin at 25°C, short-term exposure to 7% ethanol (EtOH) at 25°C, short-term exposure to 30°C of worms grown at 25°C, and a long-term exposure to 7% EtOH]. Our results not only validate previously published methods, but also point to a new experimental approach that increases previously achieved levels of crt-1 upregulation. More specifically, a 6-h exposure of synchronized worms grown at 25°C to 7% EtOH on solid medium promotes almost a 7-fold upregulation of crt-1.

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Objective. To assess changes in antibiotic resistance of eight of the World Health Organization priority bug-drug combinations and consumption of six antibiotics (ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, ciprofloxacin, vancomycin) before (March 2018 to July 2019) and during (March 2020 to July 2021) the COVID-19 pandemic in 31 hospitals in Valle del Cauca, Colombia. Methods. This was a before/after study using routinely collected data. For antibiotic consumption, daily defined doses (DDD) per 100 bed-days were compared. Results. There were 23 405 priority bacterial isolates with data on antibiotic resistance. The total number of isolates increased from 9 774 to 13 631 in the periods before and during the pandemic, respectively. While resistance significantly decreased for four selected bug-drug combinations (Klebsiella pneumoniae, extended spectrum beta lactamase [ESBL]-producing, 32% to 24%; K. pneumoniae, carbapenem-resistant, 4% to 2%; Pseudomonas aeruginosa, carbapenem-resistant, 12% to 8%; Acinetobacter baumannii, carbapenem-resistant, 23% to 9%), the level of resistance for Enterococcus faecium to vancomycin significantly increased (42% to 57%). There was no change in resistance for the remaining three combinations (Staphylococcus aureus, methicillin-resistant; Escherichia coli, ESBL-producing; E. coli, carbapenem-resistant). Consumption of all antibiotics increased. However, meropenem consumption decreased in intensive care unit settings (8.2 to 7.1 DDD per 100 bed-days). Conclusions. While the consumption of antibiotics increased, a decrease in antibiotic resistance of four bug-drug combinations was observed during the pandemic. This was possibly due to an increase in community-acquired infections. Increasing resistance of E. faecium to vancomycin must be monitored. The findings of this study are essential to inform stewardship programs in hospital settings of Colombia and similar contexts elsewhere.

Objetivo: describir la experiencia en la identificación y control de un brote por Ralstonia spp. en una unidad renal. Material y Método: investigación epidemiológica de brote hospitalario en 2 sedes y servicio extramural de una unidad renal. Se incluyeron pacientes que presentaron fiebre o escalofrío, durante o después de la terapia dialítica, y que tuvieran hemocultivo positivo para Ralstonia spp. Resultados: De los 709 pacientes para hemodiálisis, se identificaron 124 con bacteriemia por Ralstonia spp., 98,4% tenían acceso por catéter. La tasa de ataque global fue del 16,1% y la tasa de letalidad 0,8%. Se realizaron cultivos ambientales y trazabilidad de medicamentos y dispositivos, pero ante la presencia de casos extramurales la hipótesis fue redireccionada. La heparina prellenada había sido cultivada en varias oportunidades siguiendo la metodología de la farmacopea internacional. Sin embargo, la técnica de aislamiento microbiano recomendada por expertos fue la que permitió aislar el microorganismo y confirmar la fuente. Conclusiones: El brote que se describe excedió el número de pacientes documentados en la literatura y fue causado por un lote contaminado de heparina. Se aporta evidencia de una técnica recomendada por expertos utilizada para el aislamiento de Ralstonia spp. a fin de lograr el control de brotes de manera oportuna, minimizando el impacto clínico, económico y social.

Diffuse cognitive map was applied to analyse factors of vulnerability to climate variability in rural Andean micro-watershed. The iModeler software was used as a tool that allows the modelling of these maps. As input information, the results of the socioecological dynamics analysis previously implemented in the case study were taken, and weights were assigned to each input factor in relation to a central factor in a time scale. The model applied in the El Chocho micro-watershed - Department of Valle del Cauca in Colombia, can be validated in similar contexts of the Andean Colombian area. A high degree of water shortage and increased pressure on the associated ecosystems was evidenced, which puts at risk the resilience of the socio-ecosystem to face climate variability. The results of this type of models are tools for decision making in adaptation at rural level. Resumen Se aplicó mapa cognitivo difuso para analizar factores de vulnerabilidad a la variabilidad climática en microcuencas rurales andinas. Se utilizó el software iModeler como herramienta que permite el modelado de estos mapas. Como información de entrada se tomaron los resultados del análisis de dinámicas socioecológicas previamente implementado en el caso de estudio y se asignaron pesos a cada factor de entrada en relación con un factor central en una escala temporal. El modelo aplicado en la microcuenca El Chocho - Departamento del Valle del Cauca en Colombia, puede ser validado en contextos similares de la zona andina colombiana. Se evidenció un alto grado de desabastecimiento de agua e incrementos en la presión sobre los ecosistemas asociados, lo cual pone en riesgo la resiliencia del socioecosistema frente a la variabilidad climática. Los resultados de este tipo de modelos son herramientas para la toma de decisiones en adaptación a nivel rural.

IntroductionCOVID-19 pandemic is currently the most significant global public health challenge, with more than 31 million cases reported to date. Colombia first reported COVID-19 cases in the country by early March 2020, and six months later it has reached ∼750,471 clinical cases, with significant regional differences in morbidity, mortality, and hospitalization rates.AimsIdentify population characteristics and hospital capacity in the 13 municipalities with the highest disease notification and examine differences in cumulative reported cases, hospitalization, and mortality rates that may explain the regional differences.Materials and methodsA multi-group ecological study was performed based on the information available from public databases. Notification of cases, hospitalization, and crude mortality and age-adjusted rates were calculated.ResultsThe municipalities with the highest COVID-1 burden at different times during the study period displayed significant differences in population density and the proportion of elderly inhabitants, indigenous and afro descendants minorities; indices of unsatisfied basic needs and multidimensional poverty index, as well as the number of hospital beds. Likewise, essential variations in notification rates, hospitalization, and mortality were observed. The highest age-adjusted of reported cases (4,219 cases) and mortality (230.4 cases) rates were found in Leticia, the lowest general hospitalization rates in Buenaventura (37.5 cases) and the lowest ICU hospitalization rates (0) in Leticia and Tumaco due to a lack of these units in these municipalities.ConclusionThe probability of getting sick, hospitalized, and dying from COVID-19 appeared closely related to socio-economic, ethnic, and cultural characteristics, and also to hospital bed capacity.

The impact of multiple-stage filtration (MSF) was determined in two study systems. Water footprint (WF) was estimated with all its components and their results allowed the identification of those responsible for the environmental impact associated with drinking water production. Climatic conditions of high and low precipitation and socio-cultural context were considered. Results showed technical shortcomings, such as the presence of fissures that generate losses and the contribution of polluting substances in the effluent from filter washing. Socio-economic limitations increase the WF. Water management can be improved by studying the WF components and their relationships with the socio-cultural component. Resumen El impacto de la filtración en múltiples etapas (MSF) se determinó en dos sistemas de estudio. La huella hídrica (WF) se estimó con todos sus componentes y sus resultados permitieron identificar a los responsables del impacto ambiental asociado con la producción de agua potable. Se consideraron las condiciones climáticas de alta y baja precipitación y el contexto sociocultural. Los resultados mostraron deficiencias técnicas, como la presencia de fisuras que generan pérdidas y el aporte de sustancias contaminantes en el efluente del lavado del filtro. Las limitaciones socioeconómicas aumentan la WF. La gestión del agua se puede mejorar estudiando los componentes de WF y sus relaciones con el componente sociocultural.

Late gestational exposure to Zika increases the odds of delay in the Bayley-II mental developmental index (MDI) in children with normal baseline neurologic assessments; 9-fold when comparing third and first trimester exposure. Risk of MDI developmental delay increases by 8% for each week of gestational age at time of exposure.

Introduction: In coronavirus cases, reinfection has been associated with short-term immunity and genetic changes in viruses which allow them to escape from immune response, viral genotyping is required to make the precise diagnosis of reinfection, but the suspicion occurs in patients with more than 90 days between the tests and total improvement between them. We made a descriptive retrospective study with the cases of reinfection in Valle del Cauca, Colombia. Results: We found up to June 30, 3249 cases with suspected reinfection, 1.1% of all cases. During the first infection episode, 68% of the patients had symptoms, while at the moment of reinfection, the percentage was 73.4%. 55% of the analyzed cases had symptoms in both infection episodes, hospitalization of reinfection cases was 2% during the first episode and 2.2% in the second one. Conclusion: the reinfection percentage was low, as well as the hospitalization and ICU cases. These results allow to define that in terms of the provision of healthcare services, reinfection defined in this study, does not generate any differences in care required vs the first episode.

In previous studies, it was found that thymulin (thymic hormone), when prepared in homeopathic 5CH dilution, can modulate diseases progress and immune processes, such as virus infection in poultry and experimental tumor development. This project aims to study the immune modulatory mechanisms of thymulin 5CH in granulomatous experimental model induced by BCG in mice, with special focus on the phagocytes differentiation from peritoneal B1 stem cells and on the activity of these cells and lymphocyte cooperation at the injury site. Male adult Balb/c mice were inoculated with BCG into the footpad to induce granuloma and its cells were evaluated by histomorphometric methods (Ziehl-Neelsen staining of macrophages) and flow cytometry. The phenotypic characterization of phagocytes, T and B lymphocytes in the peritoneum and regional lymph node was done. Thus, CD11b (activated phagocytes and B1 cells), CD19 (B1 cells and B2), CD23 (B2 cells), CD5 (B1 cell subtypes and T cells), CD4, CD8 (effective T lymphocytes) and CD25 (regulatory lymphocytes) positive cells were quantified. After 21 days of infection, the differentiation of B1 peritoneal stem cells into phagocytes reached the peak, being higher in thymulin-treated mice (X2, p=0.0001). Simultaneously, the number of infected phagocytes in the lesion decreased (KW, p=0.001), indicating remission of the infection. The number of B1 derived phagocytes, CD4+ and CD8+ T lymphocytes in the local lymph node increased in thymulin-treated mice (X2, p=0.0001), at the same time. No difference was seen regarding to CD25+ cells. The results show that thymulin 5CH treatment is able to improve the granuloma inflammatory process by modulating local and systemic phagocyte differentiation, as well as T cell migration into the local lymph node.

Background: The 2015 – 2016 Zika epidemic highlighted gaps in health and social care services for parents of children with developmental disabilities. In response, we developed the ‘Juntos’ intervention, a 10 week community-based early intervention support group for parents of children with congenital Zika syndrome (CZS). The intervention's components include participatory learning sessions, practical skill acquisition, peer support, and psychological support, aiming to improve caregiver’s knowledge and confidence in caring for their children. This study aimed to evaluate the feasibility of implementing ‘Juntos’ in Colombia. Methods: Two facilitators delivered ‘Juntos’ to four groups of 8-10 caregivers between 2017 and 2018. One researcher observed each group. Data were collected from: observation notes from 40 sessions, focus group discussions held after each session, pre- post intervention questionnaires with 34 caregivers, and semi-structured interviews conducted with four facilitators, 12 caregivers and three stakeholders. We used the Bowen framework in data analysis. Results: The feasibility evaluation revealed that 'Juntos' was highly acceptable and in demand among the target population. The intervention was predominantly delivered with fidelity. Practicality was facilitated by providing transport costs and selecting convenient locations. Additional organisational and social media support was required for successful implementation. Community health worker training may support integration and the established groups could facilitate programme expansion. However, participants perceived lack of prioritisation as a limitation within existing health systems. Participants’ knowledge and confidence to care for their child improved after programme enrolment. Conclusion: The 'Juntos' intervention demonstrated high acceptability, demand, and practicality in supporting parents of children with CZS in Colombia. However, its implementation faces challenges due to existing gaps in health system support for children with CZS.

[EN] Service-learning (SL) is a methodology that contributes to the formation of values and the citizenship of university students, who can acquire a relevant role in the construction of a more dignified, inclusive, cohesive and equitable citizenship. The objective of the work is to quantify how the SL methodology implemented in a subject improves the competences of the students in the same course of implementation and after one year of implementation. Four experimental groups were formed: a) group LS-course 2017-2018; b) group NO-LS-course 2017-2018; c) group LS-course 2018-2019; d) group NO-LScourse 2018-2019. Each one of the groups was evaluated during the academic year 2018-2019 in the competencies developed in the subject Clinical Neurology applied to the speech therapist where the LS project is implemented. The results were compared by means of a t-Student. The results showed that the LS-course 2018-2019 group of students obtained significantly higher grades than the NO-LS-course 2018-2019 group. Surprisingly, this result was maintained during the academic year 2018-2019, in the students where the LS project had been implemented in the academic year 2017-2018, so that the LScourse 2017-2018 group continued to maintain higher and significantly higher grades than the NO-LS- course 2017-2018., [ES] El aprendizaje-servicio (ApS) es una metodología que contribuye a la formación en valores y para la ciudadanía de los estudiantes universitarios, los cuales pueden adquirir un papel relevante en la construcción de una ciudadanía más digna, inclusiva, cohesionada y equitativa. El objetivo del trabajo es cuantificar cómo la metodología ApS instaurada en una asignatura mejora las competencias del alumnado en el mismo curso de implantación y pasado un año de la implantación. Para ello se han formaron cuatro grupos experimentales: a) grupo ApS-curso 2017-2018; b) grupo NO-ApS-curso 2017-2018; c) grupo APS-curso 2018-2019; d) grupo NO-ApS-curso 2018-2019. Cada uno de los grupos fue evaluado durante el curso 2018-2019 en las competencias desarrolladas en la asignatura Neurología clínica aplicada a la logopeda donde se implanta el proyecto ApS. Los resultados se compararon mediante un t-Test. Los resultados mostraron que el grupo de alumnos ApS-curso 2018-2019 obtuvieron notas significativamente superiores al grupo NO-ApS curso 2018-2019. Sorprendentemente, este resultado se mantenía durante el curso 2018-2019, en los alumnos donde se había implantado el proyecto ApS en el curso 2017-2018, de forma que el grupo ApS curso 2017-2018 seguía manteniendo notas superiores y significativamente superiores respecto al grupo NO-ApS-curso 2017-2018., Innovation Project Universitat de Valencia nº UV-SFPIE_RMD18-841128.

Resumen El presente artículo expone los resultados de un proceso de investigación-acción, en el marco del convenio entre la Secretaría de Educación Municipal y el Instituto de Educación y Pedagogía de la Universidad del Valle, desarrollado con 24 Instituciones Educativas Oficiales, con el fin de reestructurar y actualizar su Proyecto Educativo Institucional, PEI. Para ello, se usaron dos estrategias en simultáneo en el periodo agosto-diciembre de 2017: la primera, la formación docente sobre aspectos del PEI, la caracterización escolar e institucional y la redefinición del modelo pedagógico; y la segunda, el acompañamiento y seguimiento a cada institución. Como resultados se muestran los alcances y limitaciones de la experiencia, prioridades y recomendaciones sobre la necesidad de ampliar la mirada al contexto de la comunidad educativa, desde lo global a lo local, en coherencia con el momento histórico de construcción de cultura de paz en el país. Abstract This article shows the results of an action research process, within the framework of the agreement between La Secretaria de Educación Municipal and the Instituto de Pedagogía de la Universidad del Valle, developed with 24 official educational institutions in order to restructure and update their Institutional Educational Project(IEP). For this, two strategies were used simultaneously between the months of August and December 2017. Firstly, a teacher training was required on aspects of the IEP, school and institutional characterization, and redefinition of the pedagogical model. Secondly, support and follow-up to each institution. The results show the scope and limitations of the experience, priorities and recommendations on the need to broaden the perspective of the educational community, from global to local, in coherence with the historical moment of construction of a culture of peace in the country.

[EN] Service-learning (SL), through a process of action-reflection-action collaborates in an efficient and practical way to the consolidation of basic and specific competencies that contribute to a successful life and good social functioning. The aim of the work is to analyse how the SL methodology improves general and specific competences in the students. To this end, two experimental groups were formed: a) SL group; b) NO-SL group (control). Each of the groups was evaluated in specific competences (exploration of cranial pairs) and general competences (communication, adaptation,..). The results were compared using the t-Student test. The results showed that the SL group significantly improved, in a majority way, the competences evaluated in relation with the control group., [ES] El Aprendizaje-Servicio (ApS), mediante un proceso de acción-reflexión-acción colabora de manera eficiente y práctica a la consolidación de competencias básicas y específicas que contribuyen a una vida exitosa y al buen funcionamiento social. El objetivo del trabajo es analizar cómo la metodología ApS mejora competencias generales y específicas en el alumnado. Para ello se han formaron dos grupos experimentales: a) grupo ApS; b) grupo NO-ApS (control). Cada uno de los grupos fue evaluado en competencias específicas (exploración de pares craneales) y generales (comunicación, adaptación, etc.). Los resultados se compararon mediante el test t-Student. Los resultados mostraron que el grupo ApS mejoraban significativamente, de forma mayoritaria, las competencias evaluadas respecto al grupo control., Innovation Project Universitat de Valencia nº UV-SFPIE_RMD18-841128.

Importance Ivermectin is widely prescribed as a potential treatment for COVID-19 despite uncertainty about its clinical benefit. Objective To determine whether ivermectin is an efficacious treatment for mild COVID-19. Design, Setting, and Participants Double-blind, randomized trial conducted at a single site in Cali, Colombia. Potential study participants were identified by simple random sampling from the state’s health department electronic database of patients with symptomatic, laboratory-confirmed COVID-19 during the study period. A total of 476 adult patients with mild disease and symptoms for 7 days or fewer (at home or hospitalized) were enrolled between July 15 and November 30, 2020, and followed up through December 21, 2020. Intervention Patients were randomized to receive ivermectin, 300 μg/kg of body weight per day for 5 days (n = 200) or placebo (n = 200). Main Outcomes and Measures Primary outcome was time to resolution of symptoms within a 21-day follow-up period. Solicited adverse events and serious adverse events were also collected. Results Among 400 patients who were randomized in the primary analysis population (median age, 37 years [interquartile range {IQR}, 29-48]; 231 women [58%]), 398 (99.5%) completed the trial. The median time to resolution of symptoms was 10 days (IQR, 9-13) in the ivermectin group compared with 12 days (IQR, 9-13) in the placebo group (hazard ratio for resolution of symptoms, 1.07 [95% CI, 0.87 to 1.32];P = .53 by log-rank test). By day 21, 82% in the ivermectin group and 79% in the placebo group had resolved symptoms. The most common solicited adverse event was headache, reported by 104 patients (52%) given ivermectin and 111 (56%) who received placebo. The most common serious adverse event was multiorgan failure, occurring in 4 patients (2 in each group). Conclusion and Relevance Among adults with mild COVID-19, a 5-day course of ivermectin, compared with placebo, did not significantly improve the time to resolution of symptoms. The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes. Trial Registration ClinicalTrials.gov Identifier:NCT04405843

In recent years it has been shown that the causes of chronic myeloproliferative neoplasms (MPNs) are more complex than a simple signaling aberration and many other mutated genes affecting different cell processes have been described. For instance, mutations in genes encoding epigenetic regulators are more frequent than expected. One of the latest genes described as mutated is SET binding protein 1 (SETBP1). In silico tools have revealed that there are several human SETBP1 paralogous to nuclear receptor binding SET domain protein 1 (NSD1), NSD2 and NSD3, for example, which are also involved in the development of other hematological malignancies. Therefore, the present study analyzed the mutational status of NSD1, NSD2, NSD3 and SETBP1 in BCR-ABL1 negative MPNs with or without Janus kinase 2 (JAK2) p.V617F mutation. The present study revealed that the NSD genes are not frequently mutated in MPNs. However, a novel SETBP1 mutation was identified in a patient with p.V617F JAK2 positive primary myelofibrosis. These results provide further insight into the genetic complexity of MPNs.

The pisciculture sector in Colombia, has grown 13% annually between 1988 and 2013, and it is the sixth major water user. Considering the influence that pisciculture has over the water resources, the water footprint of pisciculture was studied as a sustainability indicator, a method was developed to estimate the water footprint of the sector, which include not only the direct and indirect components, but also the green, blue and grey water footprint. The method was applied to the three most produced species in the country: tilapia (Oreochromis mossambicus), cachama (Piaractus brachypomus) and trout (Oncorhynchus mykiss), to corresponding case studies in Valle del Cauca, Colombia. It was found that the water footprint of tilapia culture is 5,486 m3/Ton, cachama culture is 6,193 m3/Ton, and trout culture is 19,854 m3/Ton. The highest total water footprint for tilapia was that of the concentrated feed, followed by the blue water footprint, associated with the amount of water that remains stored in the ponds, whereas for the cachama and trout, the highest water footprint was grey, due to the high concentrations of solids and nutrients present in fish excretions and unconsumed feed. Resumen El sector piscícola en Colombia creció en promedio 13% anual de 1988 a 2013 y es el sexto mayor usuario de agua en el país. Considerando la presión que ejerce la producción piscícola sobre las fuentes de agua, se estudió la huella hídrica (HH) de la piscicultura como un indicador de sostenibilidad. Para ello se desarrolló una metodología que mide la HH en el sector, que incluye sus componentes directos e indirectos, así como las huellas hídricas verde, azul y gris. La metodología se aplicó a las tres especies piscícolas más producidas en el país: tilapia (Oreochromis mossambicus), cachama (Piaractus brachypomus) y trucha (Oncorhynchus mykiss), para sendos casos de estudio en el Valle del Cauca, Colombia. Se encontró que la HH total del cultivo de tilapia es de 5,486 m3/Ton, la del cultivo de cachama de 6,193 m3/Ton y la del cultivo de trucha de 19,854 m3/Ton. La huella hídrica total más alta para la tilapia fue la del alimento concentrado, seguida por la huella hídrica azul, asociada a la cantidad de agua que permanece almacenada en los estanques; en la cachama y trucha la mayor huella hídrica total fue la gris, relacionada con las altas concentraciones de sólidos y nutrientes, presentes en las excretas de los peces y en el alimento concentrado no consumido.

Resumen Introduccion: Durante la infeccion de la malaria, tanto el parasito como el hospedero estan bajo los efectos de estres oxidativo, dado que se aumenta la produccion de especies reactivas del oxigeno, las cuales pueden inducir danos en el ADN debido a su gran efecto genotoxico. Objetivo: Evaluar el efecto genotoxico en linfocitos humanos en una cohorte de pacientes con malaria de Medellin y Quibdo. Metodos: Se realizo un estudio ob-servacional transversal en 100 personas con malaria y 100 controles sanos. Se incluyeron pacientes infectados con Plasmodium , que consultaron en el Instituto Colombiano de Medicina Tropical de Medellin y el Hospital Ismael Roldan Valencia de Quibdo. Se realizo una valoracion transversal del efecto (dano genetico) mediante electro-foresis en gel de celulas individuales (ensayo Cometa). Resultados: El promedio de longitud de la cola de los pacientes (26,9 ± 9,8) fue significativamente mayor que la media de los controles sanos (14,8 ± 3,2) (p < 0,01).

La paracoccidioidomicosis, enfermedad sistémica fungémica, es causada por Paracoccidioides brasiliensis. Se produce por la inhalación de conidias, conduciendo a una infección pulmonar transitoria que por lo general, se autoresuelve. En jovenes puede progresar a una forma aguda o subaguda. Generalmente quienes la padecen son agricultores, ya que los principales lugares donde se localiza el gérmen es en los cultivos de café, cacao y algodón. Las manifestaciones clinicas pueden ser en piel, mucosas, sistema reticuloendotelial, pulmones, y glandula suprarrenal, entre otros. Su manejo es con antimicóticos por tiempo prolongado y por lo general se requieren combinaciones de los mismos. Sepresenta el caso de una adolescente con paracoccidioidomicosis subaguda.

Lymphadenopathy is a common cause for medical consultation in the child population, accounting for up to 44% in children under 5 years old. In some cases, it is required to take lymph node biopsy specimens in order to clarify the diagnosis.To describe the clinical and histological features of paediatric patients with lymphadenopathy and lymph node biopsies.Descriptive and retrospective study conducted in Medellin (Colombia) in a fourth-level hospital between January 1st of 2009 and December 31st of 2012. In the study, lymph node biopsy specimens were taken from children under 15 years old. Demographic, clinical and laboratory features, and characteristics of the patients were evaluated, as well as the histopathological diagnosis of the lymph node biopsies.From the child population, 61 children met the eligibility criteria and 33 (54.1%) of them were male with an average age of 6 years old. The most common pathological diagnoses in the study group were as follows: reactive hyperplasia (50.8%), neoplasms (27.9%), chronic granulomatous disease (4.9%), and bacterial infection (3.3%). It could be concluded from the findings in the study that Hodgkin lymphoma is very common among the neoplastic diseases, with 18%, and the most frequent location was the neck with 60.6%.This study demonstrates the importance of performing a differential diagnosis when approaching patients with lymphadenopathy. As reported in the world medical literature, benign origin is the most common cause of lymphadenopathy in children.

SUMMARYGrass growth in temperate regions is highly seasonal and difficult to predict. A model that can predict grass growth from week to week would offer a valuable management and budgeting tool for grassland farmers. Many grass growth models have been developed, varying from simple empirical to complex mechanistic models. Three published grass growth models developed for perennial ryegrass swards in temperate climates were selected for evaluation: Johnson & Thornley (1983) (J&T model), Jouvenet al.(2006) (J model) and Breretonet al.(1996) (B model). The models were evaluated using meteorological data and grass growth data from Teagasc Moorepark as a framework for further refinement for Irish conditions. The accuracy of prediction by the models was assessed using root mean square error (RMSE) and mean square prediction error (MSPE). The J&T model over-predicted grass growth in all 5 years examined and predicted a high primary grass growth peak, while the J and B models predicted grass growth closer to that measured. Overall, the J model had the smallest RMSE in 3 of the 5 years and the B model in 2 of the 5 years. In spring (February–April), the B model had the lowest RMSE and MSPE. In mid-season (April–August), the B model had the closest prediction to measured data (lowest RMSE), while in autumn (August–October) the J model had the closest prediction. The models with the greatest potential for grass growth prediction in Ireland, albeit with some modifications, are the J model and the B model.

Introduccion: La neutropenia es una de las complicaciones mas comunes en los ninos con cancer y el principal parametro para determinar el riesgo de infeccion. Ademas, en estos pacientes los signos clinicos de infeccion pueden ser escasos y en ocasiones la fiebre es la unica manifestacion, por lo que todo paciente neutropenico y febril se debe manejar como si presentara una posible infeccion grave. Objetivo: Describir el comportamiento clinico y de laboratorio de los pacientes con neutropenia febril (NF) atendidos en nuestra institucion para racionalizar el manejo futuro de esta complicacion. Pacientes y Metodos : Se reviso los registros clinicos acumulados durante un periodo de 36 meses, de todos los pacientes de 0 a 15 anos internados por cancer y NF. Resultados: En este estudio se encontro el foco infeccioso en 48,6% de 105 episodios y se logro aislamiento bacteriano por hemocultivos y/o urocultivo en 38%. Las bacterias encontradas con mayor frecuencia fueron S. aureus sensible a meticilina (20,8%) y E. coli no productora de BLEE (20,8%). El antimicrobiano de primera linea mas usado fue piperacilina/tazobactam (87,6%) y de segunda linea meropenem (18%). Se uso factor estimulante de colonias de granulocitos en 61,9% de los pacientes. La mortalidad asociada a estos episodios fue de 6,7%. Conclusion: Las caracteristicas clinicas y hallazgos de laboratorio en nuestra institucion no difieren mayormente de lo descrito en poblacion pediatrica en otras series.

El metaneumovirus humano es un nuevo patógeno asociado a infecciones respiratorias, principalmente en niños, que produce cuadros clínicos que van desde leves hasta graves, los cuales pueden incluso requerir tratamiento en unidades de cuidados intensivos. Hasta el momento, la reacción en cadena de la polimerasa con transcripción inversa y el cultivo celular son los métodos más usados para su diagnóstico. Se presentan los seis primeros casos de metapneumovirus humano en niños de Medellín, Colombia. doi: http//dx.doi.org/10.7705/biomedica.v32i2.644

Introducción: Las infecciones causadas por bacterias multi-resistentes son difíciles de tratar debido a las pocas opciones terapéuticas disponibles. Tigeciclina es un antimicrobiano relativamente nuevo que tiene un amplio espectro de acción, incluyendo algunas de estas bacterias. En adultos se utiliza para el tratamiento de algunas infecciones producidas por Klebsiella pneumoniae productora de carbapenemasas (Kpn KPC). Sin embargo, por pertenecer al grupo de las tetraciclinas, su uso no ha sido aprobado en niños temiendo los posibles efectos adversos sobre el esmalte dental. Material y Métodos: Estudio de serie de casos. Se realizó una revisión de las historias clínicas de todos los niños de 0 a 14 años que recibieron tigeciclina en forma compasiva entre enero de 2008 y marzo de 2010. Resultados: 9 pacientes recibieron tigeciclina para tratamiento de peritonitis, bacteriemia, neumonía y sepsis por Kpn KPC. La dosis utilizada fue de 1 mg/kg/dosis cada 12 horas. No se encontraron efectos adversos importantes. La infección se consideró curada en 6 pacientes. Conclusiones: Tigeciclina puede ser considerada como una alternativa en el tratamiento de infecciones por bacterias multi-resistentes en niños. Su uso en la edad pediátrica sigue siendo compasivo y en esta serie de casos fue seguro.

Human metapneumovirus is a newly discovered pathogen associated with respiratory disease and occurring mainly in children. It produces an acute viral respiratory disease picture that varies from mild disease to severe, and which can require strict surveillance in intensive care units. Currently, reverse transcriptase polymerase chain reaction and cell culture are the most common methods for its diagnosis. The first six cases of human metapneumovirus in Colombia are presented from Medellín.

Hurtado-Beca Cristina. La vie des quartiers populaires sous la dictature. Rapports quotidien et quartiers populaires périphériques. In: Raison présente, n°93, 1er trimestre 1990. Comment tombent les dictatures ? pp. 39-45.

An exile who returns to his homeland has constitutively become a foreigner in his own country. He has, for one, undergone a radical change and secondly, there an imaginary idealization of his memories has taken place. He finds himself isolated on the fringe of society or called upon to fulfil the hopes placed in him by those who stayed behind. He speaks a different language and through discussion he has to build a horizon of meaning, become involved in reconstructing a common world, re-establish a space which he can make into the place that reveals his individuality (Hanna Arendt). The question is one of identity, in this case the identity of a woman, an academic working in the social sciences, and of her return to Chile where, despite democratization, the mark of authoritarianism left by 16 years of military dictatorship is still present in the mentalities and structures of the country.

ResumenLa criptococosis puede afectar niños de todas las edades, especialmente aquellos inmunocomprometidos. Usualmente se adquiere a través de la inhalación de esporas del medio ambiente, aunque existen otras formas de transmisión. Describimos un caso de criptococosis congénita adquirido de una madre con síndrome de inmunodeficiencia adquirida (SIDA) y tratado en forma exitosa con combinación de antimicoticos.AbstractCryptococcosis may affect children of all ages, specially those who are inmunocompromised. It is usually acquired from the inhalation of environmental spores, although other sources of transmission exist. We describe a case of congenital cryptococcosis transmitted from a mother with acquired immunodeficiency syndrome (AIDS), which was successfully treated with combination antifungal agents.

ResumenIntroducciónLas adenopatías son una causa muy frecuente de consulta en la población infantil, estando presente hasta en el 44% de los niños menores de 5 años. En algunos casos se requiere la toma de biopsias ganglionares para esclarecer el diagnóstico.ObjetivoDescribir las características clínicas e histopatológicas de pacientes pediátricos con adenopatías sometidos a biopsias ganglionares.Pacientes y métodoEstudio descriptivo, retrospectivo. Se incluyó la totalidad de los niños menores de 15 años a los que se les realizó biopsia ganglionar en hospital de alta complejidad en un periodo de 4 años. Se evaluaron las características demográficas, clínicas y de laboratorio de los pacientes, así como el diagnóstico histopatológico de las biopsias realizadas.ResultadosSesenta y un niños, 54,1%, fueron del sexo masculino, mediana de edad de 6 años. El diagnóstico patológico más frecuente fue hiperplasia reactiva (50,8%), seguido de enfermedad neoplásica (27,9%), enfermedad granulomatosa crónica (4,9%) e infección bacteriana (3,3%). De las enfermedades neoplásicas, el linfoma de Hodgkin fue el más común, siendo su localización más frecuente la cervical (60,6%).ConclusionesCon este estudio se demuestra la importancia de realización de diagnósticos diferenciales en el abordaje de pacientes con adenopatías. Al igual que lo reportado en la literatura mundial, la etiología benigna es la causa más común de adenopatías en niños.AbstractBackgroundLymphadenopathy is a common cause for medical consultation in the child population, accounting for up to 44% in children under 5 years old. In some cases, it is required to take lymph node biopsy specimens in order to clarify the diagnosis.ObjectiveTo describe the clinical and histological features of paediatric patients with lymphadenopathy and lymph node biopsies.Patients and methodDescriptive and retrospective study conducted in Medellin (Colombia) in a fourth-level hospital between January 1st of 2009 and December 31st of 2012. In the study, lymph node biopsy specimens were taken from children under 15 years old. Demographic, clinical and laboratory features, and characteristics of the patients were evaluated, as well as the histopathological diagnosis of the lymph node biopsies.ResultsFrom the child population, 61 children met the eligibility criteria and 33 (54.1%) of them were male with an average age of 6 years old. The most common pathological diagnoses in the study group were as follows: reactive hyperplasia (50.8%), neoplasms (27.9%), chronic granulomatous disease (4.9%), and bacterial infection (3.3%). It could be concluded from the findings in the study that Hodgkin lymphoma is very common among the neoplastic diseases, with 18%, and the most frequent location was the neck with 60.6%.ConclusionsThis study demonstrates the importance of performing a differential diagnosis when approaching patients with lymphadenopathy. As reported in the world medical literature, benign origin is the most common cause of lymphadenopathy in children.

Ireland has conditions that favour grass growth throughout most of the year, resulting in a competitive advantage in providing ruminant production systems with a cheap feed source. Grass growth is highly seasonal with little growth over the winter period due to low temperatures and low levels of sunshine/solar radiation. Peak grass growth occurs in late spring and early summer, and growth in the late summer and autumn is restricted as temperature and solar radiation decrease. Meteorological conditions influence grass growth over the course of the growing season, as a result there are variations in grass growth within and between years, making grass budgeting at farm level challenging. Meteorological patterns were examined, factors having the greatest influence on grass growth were determined and start of grass growth was studied from 1982 to 2010 at Teagasc, Animal & Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland. Statistically significant patterns over the studied period were found in all of the meteorological variables studied. As expected, temperature had a big influence on grass growth in all seasons; evapotranspiration also plays a key role. These results suggest that it may be possible to use meteorological data to predict grass growth to help farmers to anticipate and organise the grazing management to match feed supply and demand. The study suggests that there are significant patterns in climate in Ireland, and that it might have future consequences on the rate of grass growth and on farm grassland management.