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Los pseudoaneurismas posquirúrgicos de la aorta ascendente presentan un cuadro clínico muy variado, y se manifiestan desde una forma asintomática hasta un cuadro tóxico infeccioso grave o la rotura. También expresan diversidad en cuanto a localización, tiempo de aparición posterior a la primera cirugía y hallazgos quirúrgicos. Se presentan tres casos operados en el Servicio de Cirugía Cardiovascular del Hospital “Hermanos Ameijeiras”, en un período de cuatro años. El primero es un paciente operado de comunicación interauricular que días después de su cierre quirúrgico comenzó con un cuadro febril. El segundo caso es una paciente que tres meses posteriores a una cirugía de sustitución valvular aórtica se diagnostica el pseudoaneurisma, donde se recoge, como único antecedente, cuadros febriles a repeticiones; y el tercero, es un enfermo que había sido intervenido de coartación aórtica y al año siguiente, de reemplazo de la valvula aórtica; 17 años más tarde comenzó con dolor precordial, astenia y pérdida de conciencia. Los pseudoaneurismas posquirúrgicos aórticos constituyen un desafío para todos los servicios de cardiología y cirugía cardiovascular, pues muestran gran variedad en sus formas de presentación clínico-quirúrgicas.

Se realizó un estudio prospectivo observacional que incluyó 191 episodios de bacteriemia monomicrobiana por bacilos gram negativos en los que se combinó el uso del sistema Bact-Alert de hemocultivos con el sistema de identificación y sensibilidad Vitek 2C. Se compararon los resultados con los correspondientes a los de colonia aislada en medios sólidos. La correlación obtenida en la identificación fue del 99 %. Con respecto a la sensibilidad a los antibióticos, la correlación total en categoría fue del 99 % (0,22 % de errores muy mayores, 0,17 % de errores mayores y 0,61 % de errores menores). De los 191 episodios de infecciones del torrente sanguíneo, 108 (56,5 %) recibieron los antibióticos adecuados en forma empírica. Una vez comunicado el resultado del antibiograma directo del frasco, se cambió el tratamiento antibiótico en 116 episodios (60,7 %).A prospective observational study was conducted in two hospitals of Buenos Aires city (Argentina); 191 clinically significant monomicrobial gram-negative bloodstream infections were included in the study, which combined the Bact-Alert System Blood culture machine and the Vitek 2C System. Organism identification and susceptibility results directly from blood culture bottles were compared with those obtained from cards inoculated with a standardized bacterial suspension obtained following subculture on agar. By comparing the results obtained from pure cultures with those by the Vitek 2C System as reference method, the agreement between the reference method and the direct identification from positive blood cultures was 99 %. By antimicrobial susceptibility testing, the overall categorical accuracy was 99 % (0.22 %, very major errors, 0.17 %, major errors and 0.61 %, minor errors). One hundred and eight (56,8 %) bloodstream infections were treated empirically with adequate antibiotics. After the results obtained directly from the bottles were reported, antimicrobial therapy was changed in 116 (60.7 %) of the episodes.

Streptococcus agalactiae es una causa importante de morbimortalidad en mujeres embarazadas y neonatos en todo el mundo. El objetivo del presente trabajo fue determinar la utilidad del medio cromogénico chromID Strepto B de bioMérieux para detectar S. agalactiae en embarazadas cuando la muestra es sembrada directamente en dicho medio o después del enriquecimiento en caldo de Todd Hewitt selectivo, opciones que se compararon con la metodología propuesta por el CDC . Se analizaron 1924 hisopados, 962 de introito vaginal y 962 rectales, correspondientes a 962 embarazadas entre la semana 35 y 37 de gestación, asistidas en distintos hospitales. Los hisopados se sembraron directamente en el medio chromID Strepto B (CR) y luego se colocaron en un caldo de Todd Hewitt selectivo, suplementado con 15 µg/ml de ácido nalidíxico y 10 µg/ml de colistina (CTH-sel). Luego de 24 h de incubación, se realizaron subcultivos en el medio CR y en agar con 5% de sangre de carnero (ASO). La prevalencia global de S. agalactiae fue de 17,4%. La sensibilidad, la especificidad y los valores predictivos positivo y negativo del subcultivo en CR del material desarrollado en el CTH -sel fueron 98,8%, 100%, 100% y 99,7% respectivamente, con una incubación de 48 h. Los valores correspondientes de la siembra directa fueron 57,8%, 100%, 100% y 90%. La sensibilidad del subcultivo en ASO del material desarrollado en el CTH -sel fue del 85%. Se destaca el excelente rendimiento del subcultivo en CR luego del enriquecimiento en caldo de Todd Hewitt selectivo en comparación con el método propuesto por el CDC.Streptococcus agalactiae is a significant worldwide cause of morbidity and mortality in pregnant women and their newborn infants. The objective of this work was to determine the usefulness of bioMrieux chromogenic medium chromID Strepto B (CR) for detecting S. agalactiae in pregnant women from the selective Todd-Hewitt broth (sel-THB ) against the methods proposed by the CDC . A total of 1924 swabs were analyzed, 962 from vaginal introitus and 962 rectal, belonging to 962 women in weeks 35-37 of pregnancy. The swabs were directly seeded in CR. Both swabs were later placed in sel-THB with 15 µg/ml supplement of nalidixic acid and 10 µg/ml colistin. After 24 h of incubation, subcultures in CR medium and agar containing 5% sheep blood (SBA) were performed. The prevalence found was 17.4%. Sensitivity, specificity, positive and negative predictive values of sel-THB subcultures with CR supplement and 48 h incubation were: 98.8, 100, 100 and 99.7%, respectively. The corresponding values of direct harvest of the sample were 57.8, 100, 100, and 90%, respectively. Sensitivity of sel-THB in SBA was 85%. Sel-THB subculture performance in CR was outstanding in comparison with the method proposed by the CDC.

Por medio de la tarjeta NH del sistema Vitek 2C (bioMérieux, Marcy L'Etoile, Francia) se ensayó un total de 115 aislamientos clínicos únicos de Neisseria gonorrhoeae y 54 cepas de otros géneros y especies incluidas en la base de datos de esta tarjeta. Los aislamientos de gonococos fueron identificados previamente por medio de pruebas bioquímicas convencionales y por aglutinación con partículas de látex y anticuerpos monoclonales usando el Phadebact Monoclonal GC Test (Bactus AB, Suecia). La tarjeta NH identificó correctamente a 111 (96,5 %) de las cepas; una (0,86 %) cepa fue identificada con bajo poder de discriminación, una (0,86 %) fue identificada erróneamente como N. meningitidis y 2 (1,7 %) no fueron identificadas. La especificidad en la identificación de N. gonorrhoeae fue del 100 %. Los resultados fueron obtenidos dentro de las 6 horas. La tarjeta NH puede ser considerada como una herramienta útil y confiable para la identificación rutinaria de N. gonorrhoeae.A total of 115 unique clinical isolates of Neisseria gonorrhoeae and 54 strains of other genera and species included in the database of the NH card were tested by the Vitek 2C System (bioMérieux, Marcy L'Etoile, Francia). The gonoccocal isolates had been previously identified by conventional biochemical tests and by the latex agglutination test with monoclonal antibodies using the Phadebact Monoclonal GC Test (Bactus AB, Sweeden). The NH card correctly identified 111 (96.5 %) strains of 115 isolates; one strain was identified with low discriminatory power (0.86 %), one (0.86 %) was misidentified (as Neisseria meningitidis) whereas the other two (1.7 %) remained unidentified. The NH card for N. gonorrhoeae identification provided 100 % specificity. The results were available within 6 hours. The NH card could be considered a reliable and useful tool for routine use in Neisseria gonorrhoeae identification.

Alcohol-intoxicated suspects’ confessions are admissible in U.S. courts; however, it is unknown how jurors evaluate such confessions. Study 1 assessed potential jurors’ perceptions of intoxication in interrogative contexts. Many respondents were unaware that questioning intoxicated suspects and presenting subsequent confessions in court are legal, and respondents generally reported they would rely less on intoxicated than sober confessions. In Study 2, potential jurors read a case about a defendant who had confessed or not while sober or intoxicated. Participants who read about an intoxicated defendant perceived the interrogation as more inappropriate and the defendant as more cognitively impaired than did participants who read about a sober defendant, and as a result, they were less likely to convict. Furthermore, intoxicated confessions influenced conviction decisions to a lesser extent than did sober confessions. Findings suggest that investigators might consider abstaining from interrogating intoxicated suspects or else risk jurors finding confessions unconvincing in court.

Intoxicated witnesses are common, making it important to understand alcohol's impact on witness accuracy and suggestibility. Participants assigned to an immediate retrieval condition encoded and recalled in one of the three intoxication conditions: sober control, placebo, or intoxicated. Participants in the delayed retrieval condition were assigned to encode in one of the three intoxication conditions, returned a week later, and were assigned to retrieve in one of the three intoxication conditions. Intoxication condition at encoding was fully crossed with intoxication condition at retrieval in the delayed condition. Participants encoded a mock crime video and retrieved via a forced-choice test, with answers already circled (purportedly by a prior participant); half of the precircled responses were incorrect. When recalling after a delay only, intoxication at encoding increased agreement with incorrect suggested answers and decreased accuracy. Results suggest intoxicated witnesses may benefit from being interviewed immediately rather than after a sobering delay.

Se presenta el caso de una paciente de 52 años portadora de estenosis aórtica crítica, esplenectomizada, hipotiroidea, que tenía como antecedente linfoma de Hodgkin diagnosticado en 2004. En abril de 2011 ingresó al Servicio de Cardiología por insuficiencia cardíaca global y registros febriles, con respuesta tórpida al tratamiento diurético-vasodilatador. El ecocardiograma transesofágico mostró imágenes ecodensas en válvulas aórtica, pulmonar y mitral compatibles con vegetaciones, por lo que el cuadro se interpretó como probable endocarditis infecciosa. En dos muestras de hemocultivos desarrolló un cocobacilo gram negativo que fue identificado como Bordetella holmesii. Se realizó tratamiento con ceftriaxona 1 g cada 12 h durante 28 días, y se observó una evolución favorable.

Although it is well-known that biased lineup instructions (i.e., those that do not inform witnesses the perpetrator may not be in the lineup) inflate false identifications, their effects on witness confidence are less well understood due to methodological limitations of past studies. We report two studies that use novel methodologies to obviate these limitations. Study 1 (N = 177) demonstrated that biased lineup instructions increased witnesses' average estimates of the likelihood that a lineup member is guilty. Study 2 (N = 137) introduces a novel debiasing paradigm that allows a parsing of choosers into those who made an identification only because of the biased instructions (induced choosers), and those who would have chosen despite the instructions (inherent choosers). Biased lineup instructions inflated confidence only among induced choosers, but not among inherent choosers. Contrary to legal reasoning, witness confidence is an insufficient metric to determine the suggestiveness of biased instructions.

Rapport building is a widely recommended investigative technique that sometimes improves eyewitness recall. However, a clear understanding of how rapport impacts witness recall is lacking. We explored benevolence as a mediator between rapport and eyewitness recall while fixing the pre‐interview interaction to 3 min. Further, we explored whether rapport would lead to benevolence transferring to a subsequent unrelated task. A total of 109 participants viewed a mock crime and were interviewed about the crime either with or without rapport. Afterward, participants were asked to volunteer for a future research opportunity. Results indicated that rapport participants reported higher benevolence than control participants. Additionally, rapport participants volunteered to help the investigator more often than control participants. Exploratory factor analysis extracted two "benevolence" factors: (1) Effortful informativeness and (2) positive and rewarding. Our findings have implications for real‐world investigators who may appeal to witnesses' desire to be helpful and their resultant sense of satisfaction. [ABSTRACT FROM AUTHOR]

In this paper, we characterized the k -cost effective dominating sets in the corona and lexicographic product of graphs. Further, we give some formulas for the corona of graphs and upper bound for the lexicographic product of graphs. [ABSTRACT FROM AUTHOR]

Measure of dependence is a particular way of looking at the association between random variables, and one way to capture stochastic dependence is through the use of copula. In this study, a Rushendorf Method was applied to a bivariate function to obtain a copula through the use of a special case of Rodriguez-Lallena and Ubeda-Flores (RLUF) copula. Properties of the RLUF copula such as the density, measures of dependence, and lower and upper tail dependence were studied. In particular, measures of dependence such as Spearman's rho, Kendall's tau and Blomqvist's beta of RLUF copula are given. Moreover, the Root-Mean-Square Error (RMSE), Sum-Square Error (SSE), Mean Absolute Error (MAE), Mean Square Error (MSE), Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used in deriving the best joint distribution between monthly precipitation and temperature in the Philippines from 1974 to 2013. The results showed that considering the monthly precipitation and temperature datas, RLUF copula outperformed the other existing bivariate copulas such as Ali-Mikhail-Haq (AHM), Farlie-Gumbel-Morgenstern (FGM), and Clayton copulas. [ABSTRACT FROM AUTHOR]