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Resumen Introducción: Previos trabajos han reportado una asociación entre la infección del virus del papiloma humano (VPH) y el desarrollo de cáncer colorrectal, aunque existe controversia al respecto. Materiales y Método: Estudio observacional, transversal, descriptivo, retrospectivo, no ciego. Se utilizaron 50 muestras de patología con diagnóstico de adenocarcinoma colorrectal, incluidas en parafina, para aislar ADN de las muestras. Se realizó la extracción de ADN mediante protocolos establecidos para extracción, lisis y rehidratación de muestra. Se identificó y genotipicó el ADN del virus para amplificar y detectar subtipos oncogénicos de entre 35 subtipos diferentes incluidos en la prueba, secuenciando las muestras positivas, utilizando protocolos ya establecidos de purificación y análisis de muestra, mediante microarreglos. Resultados: Se identificaron 14 muestras de 50 (28%) estudiadas positivas para el virus de papiloma humano de las cuales 11 (22%) incluyen uno o más subtipos de alto riesgo para neoplasia. No se identificaron diferencias estadísticamente significativas entre grupos en cuanto a edad, sexo, localización del tumor, grado de diferenciación, infiltración, ganglios afectados, metástasis o número de paquetes/año. Conclusión: La detección de los subtipos de VPH de alto riesgo en un alto porcentaje de las muestras positivas, sugiere una asociación entre la infección con el desarrollo de cáncer colorrectal.

Introduction: Previous works have reported an association between human papilloma virus (HPV) infection and the development of colorectal cancer, and although controversy regarding this association exists. Materials and Method: This was an observational, cross-sectional, descriptive, retrospective unblinded study. Fifty pathology samples embedded in paraffin with a diagnosis of colorectal adenocarcinoma were used to isolate DNA from the tissue. DNA was extracted according to established protocols for extraction, lysis and sample rehydration. Viral DNA was identified and genotypified to amplify and detect oncogenic subtypes among 35 different subtypes included in the study, sequencing positive samples with established protocols of purification and sample analysis using microarrays. Results: Fourteen of 50 (28%) samples were identified as positive for human papilloma virus; of these 11 (22%) included one or more high-risk subtypes for neoplasia. Statistically significant differences were not found between the groups regarding age, sex, tumor location, degree of differentiation, infiltration, affected lymph nodes, metastasis and number of pack years. Conclusion: The detection of high-risk VPH subtypes in a high percentage of positive samples, suggests an association between infection and the development of colorectal cancer.

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El pectus excavatum es la deformidad de la caja torácica frecuente, siendo el sexo masculino el mayormente afectado. Presentamos el caso de un varón de 16 años con pectus excavatum e índice de Haller de 4, a quien se somete a cirugía de pectus up con sistema de tracción esternal externa y fijación con tornillos. Se obtuvo una muy buena respuesta funcional y estética en su posoperatorio. La cirugía de pectus up como método poco invasivo da buenos resultados posoperatorios.The pectus excavatum is the most frequent deformity of the rib cage, with the male sex being the most affected. We present the case of a 16-year-old male with the presence of pectus excavatum with a Haller's index of 4 who undergoes pectus up surgery with an external sternal traction system and screw fixation. A very good functional and aesthetic response was obtained. The pectus up surgery as a less invasive technique has good postoperative results.

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OBJECTIVES: To determine the association between mean airway pressure and 90-day mortality in patients with acute respiratory failure requiring mechanical ventilation and to compare the predictive ability of mean airway pressure compared with inspiratory plateau pressure and driving pressure. DESIGN: Prospective observational cohort. SETTING: Five ICUs in Lima, Peru. SUBJECTS: Adults requiring invasive mechanical ventilation via endotracheal tube for acute respiratory failure. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of potentially eligible participants (n = 1,500), 65 (4%) were missing baseline mean airway pressure, while 352 (23.5%) were missing baseline plateau pressure and driving pressure. Ultimately, 1,429 participants were included in the analysis with an average age of 59 ± 19 years, 45% female, and a mean PaO2/FIO2 ratio of 248 ± 147 mm Hg at baseline. Overall, 90-day mortality was 50.4%. Median baseline mean airway pressure was 13 cm H2O (interquartile range, 10-16 cm H2O) in participants who died compared to a median mean airway pressure of 12 cm H2O (interquartile range, 10-14 cm H2O) in participants who survived greater than 90 days (p < 0.001). Mean airway pressure was independently associated with 90-day mortality (odds ratio, 1.38 for difference comparing the 75th to the 25th percentile for mean airway pressure; 95% CI, 1.10-1.74) after adjusting for age, sex, baseline Acute Physiology and Chronic Health Evaluation III, baseline PaO2/FIO2 (modeled with restricted cubic spline), baseline positive end-expiratory pressure, baseline tidal volume, and hospital site. In predicting 90-day mortality, baseline mean airway pressure demonstrated similar discriminative ability (adjusted area under the curve = 0.69) and calibration characteristics as baseline plateau pressure and driving pressure. CONCLUSIONS: In a multicenter prospective cohort, baseline mean airway pressure was independently associated with 90-day mortality in mechanically ventilated participants and predicts mortality similarly to plateau pressure and driving pressure. Because mean airway pressure is readily available on all mechanically ventilated patients and all ventilator modes, it is a potentially more useful predictor of mortality in acute respiratory failure.

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Copolymers of l-lactide and poly(propylene glycol) diglycidyl ether (PPGDGE380) were synthesized by ring opening polymerization (ROP). Stannous octoate was used as the catalyst and 1-dodecanol as the initiator. The effect of the variables on the thermal properties of the copolymers was investigated by differential scanning calorimetry (DSC). Contact angle measurements were made in order to study the wettability of the synthesized copolymers. The copolymers differed widely in their physical characteristics, ranging from weak elastomers to tougher thermoplastics, according to the ratio of l-lactide and PPGDGE380. The results showed that the copolymers were more hydrophilic than neat Poly(lactide) (PLA) and the monomer ratio had a strong influence on the hydrophilic properties.

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The title molecule (diethyl ketone triperoxide, DEKTP), C(15)H(30)O(6), is a cyclic triperoxide closely related to triacetone triperoxide (TATP), one of the most unstable explosives known. However, the stability of DEKTP is ca 20-50 times greater than that of TATP. DEKTP crystallizes with two molecules in the asymmetric unit, with virtually identical geometry. The cyclononane core is stabilized in a twisted boat-chair conformation (approximate D(3) symmetry), very close to that previously described for TATP. The explanation for the safe thermal behaviour of DEKTP compared with TATP should thus not be sought in the molecular dimensions, but rather in the thermal decomposition kinetics.

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Diarrheogenic Escherichia coli isolates from 45 (73%) of 62 hospitalized patients were resistant to common antimicrobial drugs. Sixty-two percent were multidrug resistant, and >70% were resistant to trimethoprim-sulfamethoxazole and ampicillin. Ciprofloxacin and cefotaxime were uniformly active. Effective and safe oral agents are needed to treat children with bacterial diarrhea.

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We developed a novel multiplex PCR assay for enteroaggregative Escherichia coli (EAEC) detection, by using three plasmid-borne genes (the aggregative adherence [AA] probe, aap, and aggR). One or more of the loci were detected in 24 (86%) of 28 patient isolates analyzed. The multiplex PCR assay is a fast, convenient, and sensitive molecular test to detect EAEC.

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We developed and tested a single multiplex polymerase chain reaction (PCR) that detects enterotoxigenic, enteropathogenic, enteroinvasive, and Shiga toxin-producing Escherichia coli. This PCR is specific, sensitive, and rapid in detecting target isolates in stool and food. Because of its simplicity, economy, and efficiency, this protocol warrants further evaluation in large, prospective studies of polymicrobial substances.

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Se reporta a un joven de 22 años de edad, que ingirió ácido muriático que le produjo una severa esofagitis caústica, con estenosis total del lumen esofágico; situación que motivó progresivamente un estado de caquexia severa. Se decidió nutrición parental total para mejorar el status nutricional previo al acto quirúrgico planeado (transposición de colon); en la 8va. semana de nutrición parenteral presenta signos y síntomas característicos de un sindrome de deficiencia aguda de zinc: dermatitis foruncular en cara, dermatitis eczematoide periorificial, lesiones bulosas en extremidades, alopecía, depresión, diarrea y ageusia. Se documentan éstos hallazgos clínicos con el dosaje de Zinc sérico disminuido: 0.3 ug/dl (VN: 0.6 a 1.2). Es el primer reporte del déficit de éste oligoelemento en la literatura nacional, en el presente trabajo revisamos aspectos relacionados a la disminución de éste y otros elementos "traza" con la nutrición parenteral total

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