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Salazar E, Reinink S, Faraji S. Providing theoretical insight into the role of symmetry in the photoisomerization mechanism of a non-symmetric dithienylethene photoswitch. Phys Chem Chem Phys 2022; 24:11592-11602. [PMID: 35531648 PMCID: PMC9116444 DOI: 10.1039/d2cp00550f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dithienylethene (DTE) molecular photoswitches have shown to be excellent candidates in the design of efficient optoelectronic devices, due to their high photoisomerization quantum yield (QY), for which symmetry is suggested to play a crucial role. Here, we present a theoretical study on the photochemistry of a non-symmetric dithienylethene photoswitch, with a special emphasis on the effect of asymmetric substitution on the photocyclization and photoreversion mechanisms. We used the Spin-Flip Time Dependent Density Functional Theory (SF-TDDFT) method to locate and characterize the main structures (conical intersections and minima) of the ground state and the first two excited states, S1 and S2, along the ring-opening/closure reaction coordinate of the photocyclization and photoreversion processes, and to identify the important coordinates governing the radiationless decay pathways. Our results suggest that while the main features that characterize the photoisomerization of symmetric DTEs are also present for the photoisomerization of the non-symmetric DTE, the lower energy barrier on S1 along the cycloreversion reaction speaks in favor of a more efficient and therefore a higher cycloreversion QY for the non-symmetric DTEs, making them a better candidate for molecular optoelectronic devices than their symmetric counterparts.
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Affiliation(s)
- Edison Salazar
- Theoretical Chemistry, Zernike Institute for Advanced Materials, University of GroningenNijenborgh 49747 AG GroningenThe Netherlands
| | - Suzanne Reinink
- Theoretical Chemistry, Zernike Institute for Advanced Materials, University of GroningenNijenborgh 49747 AG GroningenThe Netherlands
| | - Shirin Faraji
- Theoretical Chemistry, Zernike Institute for Advanced Materials, University of GroningenNijenborgh 49747 AG GroningenThe Netherlands
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Asokkumar R, Seow I, Chin Hong L, Chang J, Tan D, Salazar E. Rostered routine testing for severe acute respiratory coronavirus virus 2 infection among healthcare workers: Do we detect more? J Gastroenterol Hepatol 2022; 37:404-405. [PMID: 34694645 PMCID: PMC8656364 DOI: 10.1111/jgh.15720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 12/13/2022]
Affiliation(s)
- R Asokkumar
- Department of Gastroenterology and HepatologySingapore General HospitalSingapore,Duke‐NUS Graduate Medical SchoolSingapore
| | - I Seow
- Department of Colorectal SurgerySingapore General HospitalSingapore,Duke‐NUS Graduate Medical SchoolSingapore
| | - L Chin Hong
- Department of Upper Gastrointestinal and Bariatric SurgerySingapore General HospitalSingapore,Duke‐NUS Graduate Medical SchoolSingapore
| | - J Chang
- Department of Gastroenterology and HepatologySingapore General HospitalSingapore,Duke‐NUS Graduate Medical SchoolSingapore
| | - D Tan
- Department of Gastroenterology and HepatologySingapore General HospitalSingapore,Duke‐NUS Graduate Medical SchoolSingapore
| | - E Salazar
- Department of Gastroenterology and HepatologySingapore General HospitalSingapore,Duke‐NUS Graduate Medical SchoolSingapore
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Duchicela SA, Cuesta F, Tovar C, Muriel P, Jaramillo R, Salazar E, Pinto E. Microclimatic Warming Leads to a Decrease in Species and Growth Form Diversity: Insights From a Tropical Alpine Grassland. Front Ecol Evol 2021. [DOI: 10.3389/fevo.2021.673655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Due to warming, changes in microclimatic temperatures have shifted plant community structure and dynamics in tundra and alpine regions. The directionality and magnitude of these changes are less known for tropical alpine ecosystems. To understand the likely trajectory of these shifts in the Andes, we conducted a warming experiment in the northern Andes—using open-top chambers (OTC). In this study, we ask (1) how do OTCs affect air and soil temperatures in microclimates of tropical alpine regions, year-round and during the dry season? (2) What are the effects of 7 years of warming on (a) the aboveground biomass (AGB) and (b) the plant taxonomic and growth form diversity? We installed five monitoring blocks in 2012 at ca. 4,200 m asl with 20 OTCs and 50 control plots randomly distributed within each block. We measured AGB, plant community diversity, and growth form diversity between 2014 and 2019. After 7 years of warming, we found significant increases in mean monthly (+0.24°C), daily (+0.16°C), and night air temperatures (+0.33°C) inside the OTCs, and the OTCs intensified microclimatic conditions during the dry season. Additionally, OTCs attenuated extreme temperatures—particularly in the soil—and the number of freezing events. AGB significantly increased in OTCs, and by 2019, it was 27% higher in OTCs than in control. These changes were driven mainly by a progressive increment of tussock grasses such as Calamagrostis intermedia, typical of lower elevations. The increase of tussocks led to a significant decrease in species diversity and evenness inside OTCs, but not in species richness after accounting by sampling time. Furthermore, cushions and herbs decreased inside OTCs. Our results show that experimental warming using OTCs in equatorial regions leads to decreased daily thermal amplitude and night temperatures rather than the level of increase in mean temperatures observed in temperate regions. The increase of tussocks and decrease in diversity of species and growth forms due to prolonged modifications in microclimatic temperature might be a step toward shrub-dominated ecosystems. Further research on this topic would help understand shifts in growth form dominance and the direction and rate of change of the system.
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Goh R, Li H, Cheah M, Salazar E. Ready-to-use parenteral nutrition as a bridge to customized compounded bag in the acute hospital setting. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Salazar E, Faraji S. Theoretical study of cyclohexadiene/hexatriene photochemical interconversion using spin-Flip time-Dependent density functional theory. Mol Phys 2020. [DOI: 10.1080/00268976.2020.1764120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Edison Salazar
- Theoretical Chemistry, Zernike Institute for Advanced Materials, University of Groningen, Groningen, Netherlands
| | - Shirin Faraji
- Theoretical Chemistry, Zernike Institute for Advanced Materials, University of Groningen, Groningen, Netherlands
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Bueno-Gavilá E, Abellán A, Girón-Rodríguez F, Cayuela J, Salazar E, Gómez R, Tejada L. Bioactivity of hydrolysates obtained from bovine casein using artichoke (Cynara scolymus L.) proteases. J Dairy Sci 2019; 102:10711-10723. [DOI: 10.3168/jds.2019-16596] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/10/2019] [Indexed: 12/20/2022]
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Clermont Dejean N, Salazar E, Schwenger K, Noelting J, Allard J. PT09.4: HPN Patients with Severe Gastrointestinal Dysmotility have Similar Clinical Outcomes to Patients with Short Bowel Syndrome: A Canadian’s Perspective. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32591-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Introducción: El Modelo de Aceptación Tecnológica (TAM), ha sido ampliamente utilizado para predecir el uso de bases de datos científicas (BDC). No obstante, es preciso indagar el peso de otras variables identificadas en la revisión de la literatura. Objetivo: Identificar los factores influyentes en la aceptación y uso de las bases de datos científicas por parte de los estudiantes de la carrera de enfermería de una universidad privada.
Método: El estudio tiene un diseño no experimental, transversal de tipo descriptivo y correlacional. Se aplicó un cuestionario a estudiantes de la carrera de Enfermería (Chile). Se realizó un análisis basado en regresión de mínimos cuadrados parciales en SmartPLS.
Resultados: Se corroboran como variables predictoras del uso de BDC a las variables TAM (intención de uso, utilidad y facilidad de uso) y a otras variables externas al modelo (obligatoriedad, las habilidades informacionales y el entrenamiento en tecnologías).
Discusión: La evidencia identifica que una de las principales barreras en el uso de las BDC son las habilidades informacionales y digitales para su utilización.
Conclusiones: Se hace necesario incorporar nuevas metodologías para aumentar la competencia de los estudiantes con el uso de estas bases, para este efecto se consideraron las variables que resultaron predictoras.
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Staneloni M, Burokas S, Salazar E, Clara L, Barcan L. Differences in the incidence of Carbapenem Resistant Enterobacteriae (CRE) and Vancomycin-resistant Enterococcus (VRE) in a major teaching hospital and factors with possible impact. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Alonso L, Genou N, Almada G, Salazar E, Ortiz J, Ilari S, Burokas S, Staneloni M. Implementation of multiple strategies for the reduction of contaminated blood culture. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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De Cristofano A, Salazar E, Ilari S, Staneloni M. Clostridium difficile infection in the pediatric population of a general hospital in Argentina. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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12
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Burokas S, Salazar E, Almada G, Daffada C, Staneloni M. Ventilator-Associated Pneumonia (VAP): Are we ready to let go of the old definitions. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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13
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Cornistein W, Staneloni M, Rodríguez V, Farina J, Mora C, Fabbro L, Robles D, Salazar E, Freuler C, Del Castillo M. Impact of discontinuing contact precautions against vancomycin resistant Enterococcus: Multicenter study in Argentina. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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14
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Sáenz R, Salazar E. [Prevention of cancer colorectal. From stone age to the cornerstone]. Acta Gastroenterol Latinoam 2016; 46:127-130. [PMID: 28704022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Covarrubias AA, Yeste M, Salazar E, Ramírez-Reveco A, Rodriguez Gil JE, Concha II. The Wnt1 ligand/Frizzled 3 receptor system plays a regulatory role in the achievement of the ‘in vitro’ capacitation and subsequent ‘in vitro’ acrosome exocytosis of porcine spermatozoa. Andrology 2015; 3:357-67. [DOI: 10.1111/andr.12011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 12/22/2014] [Accepted: 12/30/2014] [Indexed: 11/27/2022]
Affiliation(s)
- A. A. Covarrubias
- Facultad de Ciencias; Instituto de Bioquímica y Microbiología; Universidad Austral de Chile; Valdivia Chile
| | - M. Yeste
- Facultat de Veterinària; Unitat de Reproducció Animal; Universitat Autònoma de Barcelona; Bellaterra Barcelona Spain
| | - E. Salazar
- Facultad de Ciencias; Instituto de Bioquímica y Microbiología; Universidad Austral de Chile; Valdivia Chile
| | - A. Ramírez-Reveco
- Facultad de Ciencias Veterinaria; Instituto de Ciencia Animal; Universidad Austral de Chile; Valdivia Chile
| | - J. E. Rodriguez Gil
- Facultat de Veterinària; Unitat de Reproducció Animal; Universitat Autònoma de Barcelona; Bellaterra Barcelona Spain
| | - I. I. Concha
- Facultad de Ciencias; Instituto de Bioquímica y Microbiología; Universidad Austral de Chile; Valdivia Chile
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Pérez M, Biescas E, Reina R, Glaria I, Marín B, Marquina A, Salazar E, Álvarez N, de Andrés D, Fantova E, Badiola JJ, Amorena B, Luján L. Small ruminant lentivirus-induced arthritis: clinicopathologic findings in sheep infected by a highly replicative SRLV B2 genotype. Vet Pathol 2014; 52:132-9. [PMID: 24476938 DOI: 10.1177/0300985813519654] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We describe the clinicopathologic features of an arthritis outbreak in sheep induced by small ruminant lentivirus (SRLV), linked to the presence of a new SRLV isolate phylogenetically assigned to caprine arthritis encephalitis virus-like subgroup B2. Thirteen SRLV seropositive Rasa Aragonesa adult ewes were selected from 5 SRLV highly infected flocks (mean seroprevalence, 90.7%) for presenting uni- or bilateral chronic arthritis in the carpal joint. A complete study was performed, including symptomatology, histopathology, immunocytochemistry, immunohistochemistry, in situ hybridization, and microbiology. The carpus was the joint almost exclusively affected, with 10 sheep (76%) showing a moderate increase in carpal joint size (diameter range, 18-20 cm; normal range, 15-16 cm) without signs of locomotion problems and with 3 ewes (23%) showing severe inflammation with marked increase in diameter (21-24 cm), pain at palpation, and abnormal standing position. Grossly, chronic proliferative arthritis was observed in affected joints characterized by an increased thickness of the synovial capsule and synovial membrane proliferation. Microscopically, synovial membrane inflammation and proliferation and hyperplasia of synoviocytes were observed. More positive cases of SLRV infection were detected by immunocytochemistry of articular fluid than of bronchoalveolar lavage fluid. Immunohistochemistry and in situ hybridization also detected positive cells in the subsynovial connective tissue, lung, mediastinal lymph node, mammary gland, and mammary lymph node. All animals were negative for the presence of Mycoplasma or other bacteria in the articular space. The present outbreak likely represents an adaptation of a caprine virus to sheep. Our results underline the importance of the arthritis induced by SRLV in sheep, a clinical form that might be underestimated.
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Affiliation(s)
- M Pérez
- Department of Anatomy, Embryology and Genetics, University of Zaragoza, Zaragoza, Spain Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - E Biescas
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - R Reina
- Institute of Agrobiotechnology, CSIC-Public University of Navarra-Government of Navarra, Navarra, Spain
| | - I Glaria
- Institute of Agrobiotechnology, CSIC-Public University of Navarra-Government of Navarra, Navarra, Spain
| | - B Marín
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain Carnes Oviaragón SCL, Zaragoza, Spain
| | | | - E Salazar
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - N Álvarez
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - D de Andrés
- Institute of Agrobiotechnology, CSIC-Public University of Navarra-Government of Navarra, Navarra, Spain
| | - E Fantova
- Carnes Oviaragón SCL, Zaragoza, Spain
| | - J J Badiola
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - B Amorena
- Institute of Agrobiotechnology, CSIC-Public University of Navarra-Government of Navarra, Navarra, Spain
| | - L Luján
- Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain
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Pérez M, Muñoz JA, Biescas E, Salazar E, Bolea R, de Andrés D, Amorena B, Badiola JJ, Reina R, Luján L. Successful Visna/maedi control in a highly infected ovine dairy flock using serologic segregation and management strategies. Prev Vet Med 2013; 112:423-7. [PMID: 24054307 DOI: 10.1016/j.prevetmed.2013.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 07/26/2013] [Accepted: 07/31/2013] [Indexed: 11/19/2022]
Abstract
A control system for Visna/maedi virus (VMV) infection based on serologic segregation and management strategies was applied in an infected Spanish dairy Manchega breed sheep flock (n=670) that was affected by a severe respiratory process associated to VMV. The control started in 2004 and consisted on the serological study of animals, segregation in two different flocks (seropositive and seronegative), separate management of flocks, selection of young female lambs for replacement only from seronegative ewes offspring, immediate removal of seropositive animals detected in the seronegative flock and a management tending toward the reduction and final culling of the seropositive flock. The serological control was repeated yearly or twice a year, approximately. Initial VMV seroprevalence of the undivided flock was 66.4% (January 2004) that descended to 47.3%, 12.8%, 2.2% and 0.2% between July 2004 and May 2006. Residual seroprevalence fluctuated slightly thereafter with a peak of 2.2% in April 2008. After segregation, number of animals in the seronegative flock was 378 that descended to 323 in October 2005. Since then, this number has increased steadily reaching 650 sheep in December 2011. The seropositive flock was progressively reduced by culling until its total disappearance in June 2010. This work presents the detailed results obtained in the control strategy against VMV in a single dairy sheep flock by implementing a segregation system based on serologic testing. The system is highly successful, as it reduces to residual levels VMV infection in about two years without the need of culling a high number of animals, as required by other methods. Moreover, the original size flock was been recovered within 8 years and has led to a subjective improvement of animal health and welfare in the flock. The residual seroprevalence could be eliminated at this stage by applying more sensitive molecular or other serological techniques to reach eradication.
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Affiliation(s)
- M Pérez
- Department of Anatomy, Embryology and Genetics, University of Zaragoza, Spain
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Villoria M, Leginagoikoa I, Luján L, Pérez M, Salazar E, Berriatua E, Juste R, Minguijón E. Detection of Small Ruminant Lentivirus in environmental samples of air and water. Small Rumin Res 2013. [DOI: 10.1016/j.smallrumres.2012.11.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Salazar E, Cayuela JM, Abellán A, Poto A, Peinado B, Tejada L. A comparison of the quality of dry-cured loins obtained from the native pig breed (Chato Murciano) and from a modern crossbreed pig. Anim Prod Sci 2013. [DOI: 10.1071/an12237] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The effect of the Chato Murciano genotype (CM) and pig crossbreed genotypes (CG) on dry-cured loin quality was studied. Intramuscular fat and monounsaturated fatty acids were significantly higher in loins of CM than in CG (P < 0.05 and P < 0.01, respectively). Dry-cured loins from CM, which showed the highest intramuscular fat, showed higher scores for redness (P < 0.01), brightness (P < 0.001), marbling level (P < 0.05) and marbling size (P < 0.01), odour intensity (P < 0.05) and cured odour (P < 0.01), hardness (P < 0.001) and some flavour traits such as intensity (P < 0.05), cured flavour (P < 0.05) and after-taste (P < 0.05), and lower scores for sweetness (P < 0.01) and adhesiveness (P < 0.05), than dry-cured CG loins. Dry-cured loin from CM showed the highest level of consumer preference and acceptability.
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Abellán A, Tejada L, Pérez-Garrido A, Salazar E, Martinez-Cachá A, Cayuela J. Effects of cheese size on composition and proteolysis in goat’s milk cheese. Acta Alimentaria 2012. [DOI: 10.1556/aalim.41.2012.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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Glaria I, Reina R, Ramírez H, de Andrés X, Crespo H, Jauregui P, Salazar E, Luján L, Pérez MM, Benavides J, Pérez V, Polledo L, García-Marín JF, Riezu JI, Borrás F, Amorena B, de Andrés D. Visna/Maedi virus genetic characterization and serological diagnosis of infection in sheep from a neurological outbreak. Vet Microbiol 2012; 155:137-46. [PMID: 21940116 DOI: 10.1016/j.vetmic.2011.08.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 08/25/2011] [Accepted: 08/29/2011] [Indexed: 02/08/2023]
Abstract
An extensive outbreak characterized by the appearance of neurological symptoms in small ruminant lentivirus (SRLV) infected sheep has been identified in Spain, but the genetic characteristics of the strain involved and differential diagnostic tools for this outbreak remain unexplored. In this work, 23 Visna-affected naturally infected animals from the outbreak, 11 arthritic animals (both groups presenting anti-Visna/Maedi virus serum antibodies), and 100 seronegative animals were used. Eight of the Visna-affected animals were further studied post-mortem by immunohistochemistry. All had lesions in spinal cord, being the most affected part of the central nervous system in six of them. A representative strain of the outbreak was isolated. Together with other proviral sequences from the outbreak the virus was assigned to genotype A2/A3. In vitro culture of the isolate revealed that viral production was slow/low in fibroblast-like cells but it was high in blood monocyte-derived macrophages. The long terminal repeat (LTR) of the viral genome of this isolate lacked an U3-duplication, but its promoter activity in fibroblast-like cells was normal compared to other strains. Thus, viral production could not be inferred from the LTR promoter activity in this isolate. Analysis of the viral immunodominant epitopes among SRLV sequences of the outbreak and other known sequences allowed the design of a synthetic SU peptide ELISA that detected the Visna affected animals, representing a tool of epidemiological interest to control viral spread of this highly pathogenic strain.
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Affiliation(s)
- I Glaria
- Instituto de Agrobiotecnología (CSIC-UPNA-Gobierno de Navarra), 31192 Navarra, Spain
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Milán E, Iborra O, Hochel M, Rodríguez Artacho M, Delgado-Pastor L, Salazar E, González-Hernández A. Auras in mysticism and synaesthesia: A comparison. Conscious Cogn 2012; 21:258-68. [DOI: 10.1016/j.concog.2011.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 11/25/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
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Gimeno D, Felknor SA, Adejumo R, Aragon A, Berrios A, Salazar E, Coggon D. Psychosocial factors and musculoskeletal symptoms in a vulnerable working population in Nicaragua. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Medina-Aunon JA, Martinez-Bartolome S, Lopez-Garcia MA, Salazar E, Navajas R, Jones AR, Paradela A, Albar JP. The ProteoRed MIAPE web toolkit: A user-friendly framework to connect and share proteomics standards. Mol Cell Proteomics 2011. [DOI: 10.1074/mcp.o111.008334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Figar S, Aliperti V, Salazar E, Otero C, Schpilberg M, Taliercio V, Otero P, de Quirós FGB. Healthcare Information Systems to Assess Influenza Outbreaks: An analysis of the 2009 H1N1 Epidemic in Buenos Aires. Appl Clin Inform 2011; 2:75-85. [PMID: 23616861 DOI: 10.4338/aci-2010-05-ra-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 02/01/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine whether a private HIS could have detected the influenza epidemic outbreaks earlier through changes in morbidity and mortality patterns. METHODS Data Source included a health information system (HIS) from an academic tertiary health care center integrating administrative and clinical applications. It used a local interface terminology server which provides support through data autocoding of clinical documentation. Specific data subsets were created to compare the burden of influenza during the epidemiological week (EW) 21 to 26 for years 2007 to 2009 among 150,000 Health Maintenance Organization members in Argentina. The threshold for identifying an epidemic was considered met when the weekly influenza-like illness (ILI) rate exceeded 200 per 100,000 visits. Case fatality rates and mortality rates of severe acute respiratory infection (SARI) from 2007 to 2009 were retrospectively compared. Case fatality rates and mortality rates for A/H1N1 influenza 2009 also were estimated. RESULTS The HIS detected the outbreak in EW 23 while the government Ministry of Health (MoH) gave a national epidemic alert during EW 25. The number of visits for ILI increased more than fourfold when comparing 2009 to the period 2007-2008. The SARI mortality rate in 2009 was higher than in 2008 (RR 2.8; 95%CI 1.18-6.63) and similar to that of 2007 (RR 1.05; 95%CI 0.56-1.49). 2009 was the first year with mortalities younger than 65 years attributable to SARI. The estimated A/H1N1 case fatality rate for SARI was 6.2% (95%CI 2.5 to 15.5) and A/H1N1 mortality rate was 6 per 100,000 (95%CI 0 to 11.6). CONCLUSION Our HIS detected the outbreak two weeks before than the MoH gave a national alert. The information system was useful in assessing morbidity and mortality during the 2009 influenza epidemic H1N1 outbreak suggesting that with a private-public integration a more real-time outbreak and disease surveillance system could be implemented.
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Affiliation(s)
- S Figar
- Division of Epidemiology , Department of Internal Medicine
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Luján L, Crespo T, Deb A, Arif A, Borjal R, Salazar E, Álvarez N, Pérez M, Dorrestein G, Hammer S. Aa Amyloidosis in Captive Beira Antelopes (Dorcatragus Megalotis) Linked to Mycoplasmal Pleuropneumonia. J Comp Pathol 2009. [DOI: 10.1016/j.jcpa.2009.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pérez M, Biescas E, de Andrés X, Leginagoikoa I, Salazar E, Berriatua E, Reina R, Bolea R, de Andrés D, Juste RA, Cancer J, Gracia J, Amorena B, Badiola JJ, Luján L. Visna/maedi virus serology in sheep: survey, risk factors and implementation of a successful control programme in Aragón (Spain). Vet J 2009; 186:221-5. [PMID: 19747864 DOI: 10.1016/j.tvjl.2009.07.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 07/29/2009] [Accepted: 07/29/2009] [Indexed: 10/20/2022]
Abstract
A serological survey of Visna/maedi virus (VMV) infection involving 274,048 sheep from 554 flocks was undertaken during 2002-2007 in Aragón, North-East Spain. One hundred and two of these flocks enrolled in a VMV control programme to reduce seroprevalence by selecting replacement lambs from seronegative dams and gradual culling of seropositive sheep. Twenty-five flocks were also visited to collect flock management and housing data. All study flocks had seropositive animals and 52.8% of animals tested were seropositive. Among flocks that joined the control programme 66 adopted the proposed measures and reduced seroprevalence significantly by between 26.1% and 76.9% whereas the remaining 36 flocks did not apply the measures and seroprevalence significantly increased. Seroprevalence increased with flock size and the number of days the sheep were housed, and decreased with increasing weaning age and shed open area, suggesting a reduced risk of VMV infection in sheep associated with better ventilation. At the end of the period, 24 flocks were certified as VMV-controlled with a seroprevalence <5%, and seven as VMV-free with 0% seroprevalence. These are the first officially recognised VMV-free flocks in Spain and represent a nucleus of VMV-free replacement animals for other flocks. Moreover, they are evidence of the possibility of eliminating VMV infection without resorting to whole-flock segregation or culling of seropositive sheep.
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Affiliation(s)
- M Pérez
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, 177 Miguel Servet Street, 50013 Zaragoza, Spain
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Carrión AG, Laguna-Torres VA, Soto-Castellares G, Castillo M, Salazar E, Negron E, Kolevic L, Montano SM, Sánchez JL, Bautista CT, Oberhelman RA, Kochel TJ. Molecular characterization of the human immunodeficiency virus type 1 among children in Lima, Peru. AIDS Res Hum Retroviruses 2009; 25:833-5. [PMID: 19678768 DOI: 10.1089/aid.2009.0016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In Peru, there is a lack of information on molecular analysis in pediatric human immunodeficiency virus (HIV) infection. At present, the mother-to-child transmission rate is estimated at approximately 2-4%. The objective of this study was to assess the molecular epidemiology of HIV-1 in infected children. Children with suspected or confirmed pulmonary tuberculosis were evaluated at two public hospitals between 2002 and 2007. Whole blood samples were obtained from 90 HIV-positive children, who were confirmed to be positive by enzyme-linked immunosorbent assay and Western blot. The specimens were subjected to envelope heteroduplex mobility assay (env HMA) followed by gag and pol gene region sequence analysis. Subtype B was found in 88 (98%) of 90 children and 2 (2%) children were subtype BF recombinants. This is the first report of recombinant HIV strains in HIV-infected children in Peru. Understanding the origin, diversity, and spread of HIV strains worldwide will be necessary for the development of an effective vaccine that targets pediatric populations throughout the world.
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Affiliation(s)
- A G Carrión
- U.S. Naval Medical Research Center Detachment (NMRCD), Lima, Perú
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Hernández A, Zamora J, González N, Salazar E, Sánchez MDC. Anhydrobiosis quotient: a novel approach to evaluate stability in desiccated bacterial cells. J Appl Microbiol 2009; 107:436-42. [PMID: 19291234 DOI: 10.1111/j.1365-2672.2009.04216.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The major objective of this study was the development of a methodology to quantify the anhydrobiotic ability of bacteria and its application to evaluate the stability of desiccated bacterial cells using the biocontrol agent Tsukamurella paurometabola C-924 as a model of anhydrobiote. METHODS AND RESULTS Tsukamurella paurometabola C-924 was desiccated by spray-drying. Samples of desiccated cells were stored at several temperatures and viability and residual moisture were measured at different intervals of time. The term anhydrobiosis quotient (epsilon) was defined, and a scale of anhydrobiotic ability for classifying micro-organisms in terms of tolerance to desiccation was established (1 < or = epsilon < or = 15). The anhydrobiosis quotient was used to evaluate the stability of the anhydrobiotic cells. As a main result, changes in the anhydrobiosis quotient at several temperatures were fitted using a reparameterized Weibull model, which was found to be robust for the prediction of the stability at 4 degrees C. CONCLUSIONS A novel methodology was developed to evaluate the desiccated state in bacteria. The anhydrobiosis quotient allows the quantitative estimation of the anhydrobiotic ability, and the mathematical model developed allows the prediction of the desiccated state of bacterial populations. SIGNIFICANCE AND IMPACT OF THE STUDY The new methodology could be applied in studying the anhydrobiosis state of bacterial populations as a predictive tool for industrial and environmental microbiology.
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Affiliation(s)
- A Hernández
- Center for Genetic Engineering and Biotechnology, Camagüey, Cuba.
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Abstract
BACKGROUND Pregnancy can cause life-threatening complications in women with mitral stenosis. Frequently, there is an urgent need to increase the mitral valve area mechanically. In selected cases, percutaneous mitral balloon valvotomy (PMBV) has emerged as a safe and effective alternative to surgical commissurotomy. HYPOTHESIS The study evaluates the effects of PMBV by the Inoue technique in nine pregnant patients with severe symptomatic mitral stenosis. METHODS The patients were in New York Heart Association (NYHA) functional class II to IV and had echocardiographic scores of < or = 8. The mean gestational age was 24.8 +/- 6.1 weeks. The patient's pelvic and abdominal regions were covered with a lead apron to protect the fetus from radiation. A stepwise dilatation technique was used. Fluoroscopy time was kept to 10 to 15 min. RESULTS One patient developed severe mitral regurgitation requiring emergency valve replacement. The remaining eight patients showed marked immediate symptomatic and hemodynamic improvement. After dilatation, the transmitral pressure gradient decreased from 20.8 +/- 6.5 to 7.3 +/- 1.4 mmHg (p = 0.001) and the calculated mitral valve area increased from 0.9 +/- 0.1 to 1.8 +/- 0.4 (p < 0.001). All patients had uneventful term deliveries of normal babies. On follow-up they were in NYHA functional class I. CONCLUSIONS Percutaneous mitral balloon valvotomy is a safe and effective procedure for selected pregnant patients with severe mitral stenosis. The procedure is well tolerated by the fetus. Severe mitral regurgitation requiring immediate surgery may occur occasionally. The possible harmful effects to the fetus from its exposure to radiation during PMBV are unknown.
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Affiliation(s)
- J Martínez-Reding
- Instituto Nacional de Cardiología Ignacio Chávez, México City, México
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Ramírez-Trujillo JA, Encarnación S, Salazar E, de los Santos AG, Dunn MF, Emerich DW, Calva E, Hernández-Lucas I. Functional characterization of the Sinorhizobium meliloti acetate metabolism genes aceA, SMc00767, and glcB. J Bacteriol 2007; 189:5875-84. [PMID: 17526694 PMCID: PMC1952029 DOI: 10.1128/jb.00385-07] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The genes encoding malate synthase (glcB) and isocitrate lyase (aceA) and a 240-bp open reading frame (SMc00767) located downstream of aceA were isolated and functionally characterized in Sinorhizobium meliloti. Independent and double interposon mutants of each gene were constructed, and the corresponding phenotypes were analyzed. aceA mutants failed to grow on acetate, and mutants deficient in SMc00767 were also affected in acetate utilization. In contrast, mutants deficient in glcB grew on acetate similar to wild-type strain Rm5000. Complementation experiments showed that aceA and SMc00767 gene constructs were able to restore the growth on acetate in the corresponding single mutants. aceA-glcB, aceA-SMc00767, and glcB-SMc00767 double knockouts were also unable to grow on acetate, but this ability was recovered when the wild-type aceA-glcB or aceA-SMc00767 loci were introduced into the double mutants. These data confirm the functional role of aceA and SMc00767 and show that glcB, in the absence of SMc00767, is required for acetate metabolism. Isocitrate lyase and malate synthase activities were measured in strain Rm5000, the mutant derivatives, and complemented strains. aceA and glcB were able to complement the enzymatic activity lacking in the corresponding single mutants. The enzymatic activities also showed that SMc00767 represses the activity of isocitrate lyase in cells grown on acetate. Gene fusions confirmed the repressor role of SMc00767, which regulates aceA expression at the transcriptional level. Comparison of the transcriptional profiles of the SMc00767 mutant and wild-type strain Rm5000 showed that SMc00767 represses the expression of a moderate number of open reading frames, including aceA; thus, we propose that SMc00767 is a novel repressor involved in acetate metabolism in S. meliloti. Genetic and functional analyses indicated that aceA and SMc00767 constitute a functional two-gene operon, which is conserved in other alpha-proteobacteria. Alfalfa plants infected with the aceA and glcB mutants were not impaired in nodulation or nitrogen fixation, and so the glyoxylate cycle is not required in the Rhizobium-legume symbiosis.
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Affiliation(s)
- J A Ramírez-Trujillo
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Av. Universidad 2001, Cuernavaca, Morelos 62210, México
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Dumas G, Delisle A, Hussein A, Upjohn T, Charpentier K, Salazar E, Leger A, Plamondon A. REPRODUCIBILITY OF LANDMARK DIGITIZING USED TO ASSESS JOINT ANGLES. J Biomech 2007. [DOI: 10.1016/s0021-9290(07)70347-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Salazar E, Izaguirre R. [Heart disease, anticoagulants and pregnancy]. Rev Esp Cardiol 2002; 54 Suppl 1:8-16. [PMID: 11535183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
In patients with mechanical prosthetic heart valves, long-term anticoagulant therapy is mandatory to prevent thromboembolic phenomena. Anticoagulation is also necessary in patients with mitral valvular disease and atrial fibrillation. The risk of maternal thromboembolic events is heightened during pregnancy because of the patient's hypercoagulable state. Controversy exists concerning the appropriate treatment of these patients. No method of anticoagulation is risk free. Coumarin derivatives provide adequate protection against thromboembolism and should be used during pregnancy in patients with mechanical prostheses. The administration of coumarin derivatives in the first trimester is associated with an incidence of 26.7% of spontaneous abortion and a risk of 4.1% of coumarin embryopathy. Heparin does not cross the placental barrier and it is the obvious therapeutic alternative. The teratogenic effects of the coumarinics are prevented if these agents are discontinued and replaced by heparin from before the 6th until the end of the 12th week of gestation. However, subcutaneous unfractionated heparin, in the doses that have been employed, does not provide adequate prophylaxis against thromboembolism in these women. In patients treated with heparin, the incidence of spontaneous abortion is similar to that observed when the mothers are treated with coumarin agents. In order to avoid the delivery of an anticoagulated infant, intravenous heparin in full doses, should be substituted for the coumarin agent in the last two weeks of gestation.When anticoagulant therapy is not necessary, the course of pregnancy in women with bioprostheses is similar to that of the general population. However, the short duration of tissue valves is a clear disadvantage for these women
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Affiliation(s)
- E Salazar
- Instituto Nacional de Cardiología Ignacio Chávez. México DF
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Campos F, García-Gómez BI, Solórzano RM, Salazar E, Estevez J, León P, Alvarez-Buylla ER, Covarrubias AA. A cDNA for nuclear-encoded chloroplast translational initiation factor 2 from a higher plant is able to complement an infB Escherichia coli null mutant. J Biol Chem 2001; 276:28388-94. [PMID: 11356831 DOI: 10.1074/jbc.m100605200] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Formation of the initiation translation complex containing the three initiation factors, IF1, IF2, and IF3, tRNA(fMet), and GTP constitutes the earliest event in the protein synthesis. IF2, a GTP-binding protein, is the principal factor involved in selecting and binding fMet-tRNA(fMet) to the 30 S ribosomal subunit. Although some chloroplast initiation translational factors have been identified and purified from algae, none of these factors have been characterized from plants. In this work, we report the molecular characterization of a nuclear-encoded chloroplastic IF2 gene from common bean (PvIF2cp). We show that the PvIF2cp gene encodes a protein containing a chloroplast translocation signal peptide, able to target a green fluorescent protein fusion protein to chloroplasts. A high accumulation of PvIF2cp transcript was found in photosynthetic tissues, whereas low mRNA levels were detected in etiolated plants and in nonphotosynthetic organs. Additional data indicate that the PvIF2cp transcript accumulation is modulated by light. The PvIF2cp gene encodes a functional factor, since the PvIF2cp conserved region, containing the G-domain and the C-terminal end, complements an Escherichia coli infB null mutation. Phylogenetic analysis using the PvIF2cp conserved region suggests that the PvIF2cp gene originated via endosymbiotic gene transfer to the nucleus and that it may be a useful marker for phylogeny reconstruction.
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MESH Headings
- Active Transport, Cell Nucleus
- Amino Acid Sequence
- Biological Transport
- Blotting, Northern
- Cell Nucleus/metabolism
- Chloroplasts/metabolism
- Cloning, Molecular
- DNA, Complementary/metabolism
- Escherichia coli/metabolism
- Gene Library
- Genes, Plant
- Genetic Complementation Test
- Genetic Markers
- Green Fluorescent Proteins
- Luminescent Proteins/metabolism
- Microscopy, Fluorescence
- Models, Genetic
- Molecular Sequence Data
- Mutation
- Peptide Initiation Factors/chemistry
- Peptide Initiation Factors/genetics
- Photosynthesis/genetics
- Phylogeny
- Plants, Toxic
- Prokaryotic Initiation Factor-2
- Protein Biosynthesis
- Protein Structure, Tertiary
- RNA, Messenger/metabolism
- Recombinant Fusion Proteins/metabolism
- Sequence Analysis, DNA
- Time Factors
- Tissue Distribution
- Nicotiana/genetics
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Affiliation(s)
- F Campos
- Departamento de Biologia Molecular de Plantas del Instituto de Biotecnologia, Universidad Nacional Autónoma de México, A. P. 510-3, Cuernavaca, Morelos 62250, México
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Salazar E, Lasses LA. [Cardiovascular disease in the elderly. Geriatric cardiology]. Arch Cardiol Mex 2001; 71:109-13. [PMID: 11565301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
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Salazar E, Espinola N, Molina FJ, Reyes A, Barragán R. Heart surgery with cardiopulmonary bypass in pregnant women. Arch Cardiol Mex 2001; 71:20-7. [PMID: 11565358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
OBJECTIVE Definite data in heart surgery with extracorporeal circulation during pregnancy is limited. This report analyzes our experience in this area. METHODS Fifteen women underwent open heart surgery under cardiopulmonary bypass during pregnancy at our institution between 1972 and 1998. Surgical procedures included valve replacement in 13 patients (12 mitral, 1 aortic), declotting of a tilting disk mitral prosthesis in one and closure, of an atrial septal defect in the remaining patient. RESULTS Thirteen patients were in New York Heart Association functional class III to IV and were operated on urgently. Eight of these women had severe acute dysfunction of either a mechanical or a biological mitral prosthesis. There were 2 maternal operative deaths for a rate of 13.3%. Fetal losses resulted at the time of these maternal deaths. Fetal deaths occurred in 5 of the 13 pregnancies (38.5%) in women who survived the surgical procedure. CONCLUSIONS Because of the fetal risks, open heart surgery during pregnancy should be advised only in extreme emergencies. Although pregnancy per se does not increase the maternal risk, a high maternal mortality results from the emergency nature of the surgical intervention. Fetal mortality remains high.
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Affiliation(s)
- E Salazar
- Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, 14080 México, D.F
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Salazar E. [Pregnancy in patients with rheumatic cardiopathy]. Arch Cardiol Mex 2001; 71 Suppl 1:S160-3. [PMID: 11565325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Pregnancy can cause life-threatening complications in women with rheumatic heart disease. Mitral stenosis is the most common valvular lesion found in the gravida. Percutaneous mitral balloon commissurotomy has emerged as a safe and effective procedure in symptomatic pregnant patients. Immediate clinical and hemodynamic improvement was observed in 8 pregnant women treated by the Inoue technique at the Institute. The procedure was well tolerated by the fetus. Thirteen gravid patients with rheumatic valvular disease have undergone open heart surgery at the Institute. Maternal mortality was 15.4% and was related to the critical preoperative condition. Because of the high fetal mortality (38.5%) these procedures should be indicated only in extreme emergencies. The management of women with prosthetic heart valves during pregnancy poses a particular challenge. At the Institute 393 pregnancies have been studied in 304 women with these valves. Patients with mechanical prostheses require anticoagulant therapy to prevent thromboembolic phenomena. Coumarin agents provide adequate protection against these complications but their use was associated in our series with an increased abortion rate (26.7%) and with an incidence of coumarin embryopathy of 4.1%. Different regimens of subcutaneous heparin have not been effective to prevent prosthetic thrombosis (5.2% in our cases). Controversy exists regarding the appropriate treatment of these patients. Patients with bioprostheses may not require anticoagulation. However the limited duration of these valves is a significant disadvantage in these women.
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Affiliation(s)
- E Salazar
- Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, 14080 México, D.F
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Nicoletti A, Reggio A, Bartoloni A, Failla G, Bartalesi F, Roselli M, Gamboa H, Salazar E, Paradisi F, Tempera G, Hall A. A neuroepidemiological survey in rural Bolivia: background and methods. Neuroepidemiology 2000; 17:273-80. [PMID: 9705587 DOI: 10.1159/000026180] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A door-to-door survey was carried out in rural areas of the Cordillera province, Santa Cruz Department, Bolivia. A cluster sample of 10,124 inhabitants was selected. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism and peripheral neuropathy) in this population using a modification of the World Health Organization screening instrument. 1,130 subjects screened positive and were then investigated by neurologists. In this paper we describe the background and methods of the survey and the characteristics of the population.
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Affiliation(s)
- A Nicoletti
- Institute of Neurological Science, University of Catania, Italy.
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Nicoletti A, Sofia V, Giuffrida S, Bartoloni A, Bartalesi F, Bartolo ML, Fermo SL, Cocuzza V, Gamboa H, Salazar E, Reggio A. Prevalence of stroke : a door-to-door survey in rural Bolivia. Stroke 2000; 31:882-5. [PMID: 10753992 DOI: 10.1161/01.str.31.4.882] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE We carried out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia. A cluster sample of 10 124 inhabitants was selected, and 9955 subjects were screened. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in this population. METHODS We used a modified version of the World Health Organization screening instrument. On screening we found that 1130 subjects tested positive, and 1027 underwent a complete neurological examination. According to the World Health Organization guidelines, we defined stroke as "rapidly developing clinical signs of focal (or global) disturbance of cerebral functions, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin." We considered only first stroke and excluded a possible stroke. RESULTS We found 16 subjects (cases) who had experienced 1 complete stroke on prevalent day (November 1, 1994). The crude prevalence of stroke was 174/100 000 (322/100 000 age-adjusted to the world standard population) and 663/100 000 in subjects aged >/=35 years. Prevalence was >2-fold higher in men than in women (247/100 000 and 99/100 000, respectively) and increased rapidly with age. Seven cases were hospitalized and received specific treatment. CONCLUSIONS Our crude prevalence is lower compared with rates from developed countries, probably because of a high case fatality rate. Our findings are comparable with those reported from other surveys carried out in rural developing countries.
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Affiliation(s)
- A Nicoletti
- Institute of Neurological Science, University of Catania, and the Institute of Infectious Diseases, University of Florence, Florence, Italy.
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Salazar E, Zaremba S, Arlen PM, Tsang KY, Schlom J. Agonist peptide from a cytotoxic t-lymphocyte epitope of human carcinoembryonic antigen stimulates production of tc1-type cytokines and increases tyrosine phosphorylation more efficiently than cognate peptide. Int J Cancer 2000; 85:829-38. [PMID: 10709104 DOI: 10.1002/(sici)1097-0215(20000315)85:6<829::aid-ijc16>3.0.co;2-k] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The identification of an agonist peptide (YLSGADLNL, designated CAP1-6D) to an immunodominant cytotoxic T-lymphocyte (CTL) epitope (designated CAP1) of human carcinoembryonic antigen (CEA) has previously been reported. The agonist peptide harbors a single amino acid substitution at a non-MHC anchor residue and is proposed to exert its effects at the level of the T-cell receptor (TCR). The type and magnitude of cytokines produced by CAP1-reactive CTL upon stimulation with the agonist peptide, CAP1-6D, were compared to those obtained upon stimulation with the cognate CAP1 peptide. In addition, early events in the TCR signaling pathway were examined for differences in tyrosine phosphorylation. Upon stimulation with the agonist peptide CAP1-6D, several different CEA-specific CTL lines exhibited a marked shift in the peptide dose response, which resulted in as much as a 1,000-fold increase in the levels of GM-CSF and gamma-IFN produced as compared with the use of the CAP1 peptide. However, levels of IL-4 and IL-10, which are associated with anti-inflammatory effects, were very low or non-existent. The cytokine profile of CAP1- and CAP1-6D-specific CTL is consistent with a Tc1-type CTL. Consistent with these findings, CEA-specific CTL showed increased tyrosine phosphorylation of TCR signaling proteins ZAP-70 and TCR zeta chains in response to both peptides. However, when CAP1-6D was compared with the wild-type peptide, the increase in ZAP-70 phosphorylation was greater than the increase in zeta phosphorylation. CTL generated with the CAP1-6D agonist were shown capable of lysis of human carcinoma cells expressing native CEA. The ability to upregulate the production of GM-CSF, gamma-IFN, TNFalpha and IL-2 with the agonist peptide, as compared with CAP1, may help in initiating or sustaining anti-tumor immune responses and thus potentially prove to be useful in the treatment of CEA-positive tumors.
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Affiliation(s)
- E Salazar
- Laboratory of Tumor Immunology and Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1750, USA
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Nicoletti A, Reggio A, Bartoloni A, Failla G, Sofia V, Bartalesi F, Roselli M, Gamboa H, Salazar E, Osinaga R, Paradisi F, Tempera G, Dumas M, Hall AJ. Prevalence of epilepsy in rural Bolivia: a door-to-door survey. Neurology 1999; 53:2064-9. [PMID: 10599782 DOI: 10.1212/wnl.53.9.2064] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To carry out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia, to determine the prevalence of neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in a sample of approximately 10,000 inhabitants. METHODS A team of nondoctor health workers administered a standard screening instrument for neurologic diseases-a slightly modified version of the World Health Organization protocol. All subjects found positive during the screening underwent a neurologic examination. RESULTS On screening, the authors found 1,130 positive subjects, of whom 1,027 were then investigated by neurologists. On the basis of the definition proposed by the International League Against Epilepsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of whom had active epilepsy (prevalence, 11.1/1,000) on the prevalence day (November 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year age group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1,000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standard EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the International League Against Epilepsy. The mean age at onset was 20.7 years for partial seizures and 13.6 years for generalized seizures. Only 10.5% of patients had received specific treatment for more than 2 months of their life. CONCLUSION This report on epilepsy prevalence in Bolivia confirms that epilepsy is a major health problem in rural areas of developing countries.
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Affiliation(s)
- A Nicoletti
- Institutes of Neurological Science, University of Catania, Italy
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Abstract
BACKGROUND This study sought to evaluate the effect of pregnancy on the rate of deterioration of bovine pericardial bioprostheses. To avoid the fetal and maternal risks associated with anticoagulant therapy during pregnancy, the use of bioprostheses has been advocated for young women with cardiac valve disease who may later wish to bear children. Several reports have suggested the probability of pregnancy-related accelerated deterioration of these valves. METHODS AND RESULTS The incidence of prosthetic dysfunction and the freedom from deterioration were investigated in 48 women who had 58 pregnancies and in a control group of 167 patients in the same age range. There were 39 cases of prosthetic dysfunction (deaths plus reoperations resulting from valve failure): 12 in the pregnant group for a linearized rate of 3.5% +/- 0.99% (SE) per patient-year and 27 in the control group or 3.4% +/- 0.65% per patient-year (P = not significant). The actuarial freedom from dysfunction was 90.4% (95% confidence interval 77.9 to 96.2) at 5 years and 77.0% (59.7 to 88.3) at 8 years for the pregnancy group and 86.3% (77.3 to 92.0) and 73.4% (56.6 to 84.8), respectively, for the control group ( P = not significant). In the Cox proportional hazard regression analysis, pregnancy did not influence dysfunction. A direct correlation was found between freedom from dysfunction and the patient's age at surgery. CONCLUSIONS Pregnancy does not accelerate the rate of deterioration of bovine pericardial bioprostheses. It is more likely that biological valves deteriorate more rapidly in these patients because of their young age.
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Affiliation(s)
- E Salazar
- Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No 1, México, D.F. 14080, Mexico
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Fuchs JL, Salazar E. Effects of whisker trimming on GABA(A) receptor binding in the barrel cortex of developing and adult rats. J Comp Neurol 1998; 395:209-16. [PMID: 9603373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Both sensory deprivation and blockade of gamma-aminobutyric acid A (GABA(A)) receptors result in signs of cortical disinhibition. To investigate whether down-regulation of GABA(A) receptors could underlie effects of sensory deprivation, [3H]muscimol binding was assessed in rat whisker barrels after chronic whisker trimming. Vibrissae in row C or rows A,B,D, and E were trimmed during certain developmental periods. When whiskers were trimmed for the first 6 postnatal weeks, [3H]muscimol binding was 8.3% lower in deprived barrel rows than in adjacent nondeprived rows (P < 0.001). The effect may be somewhat selective for GABA(A) receptors because there was no evident change in N-methyl-D-aspartate (NMDA) receptors as indicated by [3H]MK-801 binding. Ten weeks after whiskers were allowed to regrow, the decrease in [3H]muscimol binding was partly reversed (P < 0.002), leaving a 3.3% decrease (P < 0.001). These declines in GABA(A) receptors could contribute to persisting electrophysiological signs of reduced inhibition in similarly deprived barrel neurons (Simons and Land [1987] Nature 326:694-697). A 6-week deprivation beginning in adulthood resulted in a 7.7% decrease (P < 0.001), indicating that the effect is not restricted to an early critical period. In rats trimmed for the first 10 postnatal days, [3H]muscimol binding declined 2.3% (P < 0.05), which is a small change compared with the magnitude of the developmental peak; thus, normal whisker input apparently is not required for the developmental increase in GABA(A) receptors. The present study suggests that sensory input can regulate cortical GABA(A) receptors in adulthood and during ontogeny. Down-regulation of cortical GABA(A) receptors may be a compensatory mechanism that serves to disinhibit the reduced sensory input.
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Affiliation(s)
- J L Fuchs
- Department of Biological Sciences, University of North Texas, Denton 76203, USA.
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Bartoloni A, Cutts F, Leoni S, Austin CC, Mantella A, Guglielmetti P, Roselli M, Salazar E, Paradisi F. Patterns of antimicrobial use and antimicrobial resistance among healthy children in Bolivia. Trop Med Int Health 1998; 3:116-23. [PMID: 9537273 DOI: 10.1046/j.1365-3156.1998.00201.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the incidence of antimicrobial-resistant, nonpathogenic Escherichia coli among healthy children aged 6-72 months in Camiri town and a rural village, Javillo, in south-eastern Bolivia. METHOD A community-based survey: stool samples were obtained from 296 healthy children selected by modified cluster sampling in Camiri and all 25 eligible children in Javillo. E. coli isolates were tested for antimicrobial susceptibility according to the standard disc diffusion method. By a questionnaire survey of 12 pharmacies and by using simulated patients, we investigated the antimicrobial availability and the usage patterns in Camiri town. RESULTS In Camiri, over 90%, and in Javillo over 70% of children carried E. coli resistant to ampicillin, trimethoprim-sulphamethoxazole (TMP/SMX) or tetracycline. Overall, 63% of children carried E. coli with multiple resistance to ampicillin, TMP/SMX, tetracycline and chloramphenicol. In the simulated patients study, antimicrobials were dispensed inappropriately for 92% of adults and 40% of children with watery diarrhoea, and were under-prescribed for males with urethral discharge (67%) or females with fever and dysuria (58%). The dose and/or duration of antimicrobials dispensed was almost always too low. CONCLUSION Our study showed a disturbingly high prevalence of carriage of nonpathogenic E. coli resistant to antimicrobials. The prevalence of resistance to ampicillin and TMP/SMX was higher than that previously reported in developing countries. The existence of a large reservoir of resistance genes in healthy individuals in developing countries represents a threat to the success of antimicrobial therapy throughout the world. Programmes to improve rational and effective drug use in developing countries are urgently needed.
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Affiliation(s)
- A Bartoloni
- Clinica Malattie Infettive, Università di Firenze, Italy.
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Salazar E, Izaguirre R, Verdejo J, Mutchinick O. Failure of adjusted doses of subcutaneous heparin to prevent thromboembolic phenomena in pregnant patients with mechanical cardiac valve prostheses. J Am Coll Cardiol 1996; 27:1698-703. [PMID: 8636556 DOI: 10.1016/0735-1097(96)00072-1] [Citation(s) in RCA: 121] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES This report describes our experience with the use of an anticoagulant regimen of adjusted doses of subcutaneous heparin during pregnancy in women with cardiac valve prostheses. BACKGROUND Gravid patients with prosthetic heart valves require long-term anticoagulant therapy. To avoid the increased incidence of fetal morbidity and mortality associated with the use of coumarin agents in such patients during pregnancy, anticoagulation with subcutaneous heparin has been suggested. Controversy exists concerning the appropriate treatment of these patients. METHODS Forty pregnancies in 37 women with prosthetic heart valves were prospectively followed up. Subcutaneous heparin was administered from the 6th until the end of the 12th week and in the last 2 weeks of gestation. Heparin was given every 8 h in the first 36 cases and every 6 h in the last 4 cases, and the dose adjusted to maintain the activated partial thromboplastin time at 1.5 to 2.5 times the control level. Acenocoumarol was used at other times. RESULTS The incidence rate of spontaneous abortions was 37.5%; there was one neonatal death (2.5%) due to cerebral hemorrhage. No signs of coumarin-induced embryopathy were found in any of the 16 live-born infants studied by the geneticist. One mother died of gastrointestinal bleeding while receiving oral anticoagulant agents. There were two cases of fatal massive thrombosis of a mitral tilting-disk prosthesis during heparin therapy. The study was interrupted after the last of these two cases. CONCLUSIONS The regimen of adjusted doses of subcutaneous heparin used in this study is not effective to prevent thrombosis of mechanical valve prostheses during pregnancy. The use of heparin from the 6th to the 12th week of gestation does not decrease the high incidence of fetal wastage associated with anticoagulant therapy. Coumarin agents provide adequate protection against thromboembolism during pregnancy in patients with mechanical valve prostheses.
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Affiliation(s)
- E Salazar
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
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Gaxiola E, Olvera Cruz S, Salazar E. [Ischemic cardiopathy in women: the role of estrogens in the coronary vascular wall and in syndrome X]. Arch Inst Cardiol Mex 1995; 65:461-7. [PMID: 8678703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- E Gaxiola
- Instituto Nacional de Cardiología Ignacio Chávez, INCICH, México, D.F
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Gotuzzo E, Butron B, Seas C, Penny M, Ruiz R, Losonsky G, Lanata CF, Wasserman SS, Salazar E, Kaper JB. Safety, immunogenicity, and excretion pattern of single-dose live oral cholera vaccine CVD 103-HgR in Peruvian adults of high and low socioeconomic levels. Infect Immun 1993; 61:3994-7. [PMID: 8359923 PMCID: PMC281106 DOI: 10.1128/iai.61.9.3994-3997.1993] [Citation(s) in RCA: 91] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Groups of 122 Peruvian adults of low socioeconomic level (SEL) and 125 of high SEL received a randomly allocated 5 x 10(9)- or 5 x 10(8)-CFU dose of CVD 103-HgR live oral cholera vaccine or a placebo. The vaccine was well tolerated. Vibriocidal seroconversions occurred in 78% of high-SEL and 72% of low-SEL subjects who ingested the high dose and in 78 and 49%, respectively, of those who received the low dose.
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Affiliation(s)
- E Gotuzzo
- Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima
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48
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Jourdan P, Salazar E. Brassica carinata resynthesized by protoplast fusion. Theor Appl Genet 1993; 86:567-72. [PMID: 24193704 DOI: 10.1007/bf00838710] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/1992] [Accepted: 11/03/1992] [Indexed: 05/15/2023]
Abstract
Brassica carinata (bbcc) was resynthesized by protoplast fusion betweenB. nigra (bb) andB. oleracea (cc). In two fusion experiments 64 hybrid plants were obtained and identified to be true hybrids by isoenzyme analysis, nuclear DNA content, chromosome number, and intermediate morphology. Of these plants 56% were normal amphidiploids with 2n=34 chromosomes and a DNA content equivalent to that of naturalB. carinata. The remaining plants were polyploid, morphologically abnormal, and infertile. The majority of the hybrids contained both chloroplasts and mitochondria fromB. nigra, but some plants combined chloroplast and mitochondria from the different progenitors. Hybrids with a DNA content equivalent to that ofB. carinata had a wide range of male fertility (4-98%), but consistently low female fertility. Only a few selfed seed were produced, but these germinated and grew into vigorous plants.
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Affiliation(s)
- P Jourdan
- Department of Horticulture, The Ohio State University, 2001 Fyffe Ct., 43210-1096, Columbus, OH, USA
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Pazzaglia G, Sack RB, Salazar E, Yi A, Chea E, Leon-Barua R, Guerrero CE, Palomino J. High frequency of coinfecting enteropathogens in Aeromonas-associated diarrhea of hospitalized Peruvian infants. J Clin Microbiol 1991; 29:1151-6. [PMID: 1864933 PMCID: PMC269961 DOI: 10.1128/jcm.29.6.1151-1156.1991] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Rectal swabs from 391 infants less than 18 months of age who were hospitalized with acute diarrhea and from 138 similarly aged healthy infants were examined for the etiologic agents of diarrhea. Aeromonas spp. were recovered from 205 of 391 (52.4%) diarrheic patients, whereas they were recovered from 12 of 138 (8.7%) controls (P less than 10(-11). Among the 205 Aeromonas-positive diarrheic patients, 118 (57.6%) were found to be coinfected with other common enteropathogens. Of the 164 Aeromonas-positive initial diarrheic specimens, 82 (50.0%) had one or more other enteropathogens present; 30 patients were coinfected with rotavirus, 20 with enterotoxigenic Escherichia coli, 16 with Campylobacter spp., 14 with Shigella spp., 13 with enteropathogenic E. coli, 4 with Vibrio spp., 1 with Salmonella spp., and 1 with Plesiomonas spp. of Aeromonas strains from cases compared with that from controls supports an etiologic role for this organism. However, frequent concomitant infections with other well-recognized enteropathogens and a lack of disease correlation with common Aeromonas phenotypes suggest that only a subset of Aeromonas strains may be diarrhea causing and that such strains may be common to several of the existing species.
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Affiliation(s)
- G Pazzaglia
- U.S. Naval Medical Research Institute Detachment, Department of Pediatrics, Hospital Nacional Cayetano Heredia, Peru
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Kuri J, Martínez-Sánchez C, Moreno M, Clemente A, Virgós A, Fernández de la Vega P, Fajardo P, Salazar E. [A low-level stress test, in the early phase of myocardial infarction and its correlation with coronary angiography]. Arch Inst Cardiol Mex 1989; 59:279-86. [PMID: 2782991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In a prospective 24-month trial at the Instituto Nacional de Cardiologia, 56 patients were studied. All patients had acute myocardial infarction (AMI), diagnosed by clinical, electrocardiographic and enzymatic means. They were studied in two groups: Group A with single localized AMI (n = 30) and Group B with AMI at two locations (n = 26); a resting electrocardiogram (EKG) was analyzed in each case and a low level stress test was performed within the 2nd and 3rd postinfarction weeks; coronary angiography was done between the 8th and 9th postinfarction weeks. In Group A the low level stress test (LLST) was positive for ischemia at a distance from the infarction site in 21, and eighteen of them had multi-vessel injuries (MVI); in 9 the LLST was negative; of these 7 had single-vessel injury; only the remaining 2 had MVI (p less than 0.001) with 90% sensitivity and 78% specificity. In Group B there was no significant relationship between LLST and coronary angiography (64% sensitivity, and 62% specificity). Relating the ischemic change at a distance in the resting EKG with coronary angiography, we found 75% sensitivity and 55% specificity in Group A. In Group B, sensitivity and specificity were even lower. We conclude that LLST in the early postinfarction phase in Group A is a safe and reliable method to suspect MVI, allowing the early identification of patients with lesions that could be treated by surgical means.
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Affiliation(s)
- J Kuri
- Instituto Nacional de Cardiología Ignacio Chávez, México, D.F
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