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Resumen: Introducción: El objetivo de este estudio fue desarrollar un modelo predictivo sobre la presencia de tuberculosis pulmonar activa utilizando datos clínico-epidemiológicos y hallazgos de radiografía simple (Rx) y tomografía computadorizada (TC) de tórax. Material y métodos: Se realizó un estudio observacional, retrospectivo, descriptivo y analítico, que recopiló 22 variables clínico-epidemiológicas, 11 hallazgos radiológicos en Rx de tórax y 23 en la TC, que se realizaron en pacientes con sospecha clínica de tuberculosis pulmonar durante un período de 10 años. Se aplicó un modelo de regresión logística multivariado a los predictores potenciales de cultivo positivo, obteniendo un modelo predictivo. Resultados: Se recogieron 1.540 pacientes con sospecha clínica de tuberculosis a los que se les realizó Rx y TC torácico. El cultivo fue positivo en 101 casos. Se utilizó un proceso de eliminación hacia atrás para obtener el mejor conjunto de variables predictivas. Se obtuvieron 24 variables que fueron significativas (6 clínicas, 5 de Rx y 13 de TC) y se les asignó una puntuación. A la suma de estas puntuaciones se restó la edad en años multiplicada por 0,03. El modelo sugiere el diagnóstico de tuberculosis pulmonar activa en pacientes con una puntuación superior a 1,845. Obtuvo una sensibilidad de 85,1%, especificidad de 83,6%, valor predictivo positivo de 26,6%, y valor predictivo negativo de 98,7%. El área bajo la curva ROC fue de 0,9163. Conclusión: Este sistema de puntuación basado en criterios clínico-epidemiológicos y hallazgos radiológicos puede ayudar a diagnosticar tuberculosis pulmonar activa en casos de sospecha diagnóstica.

Abstract:Introduction: The objective of this study was to develop a predictive model on the presence of active pulmonary tuberculosis using clinical-epidemiological data and findings of chest radiography and thoracic computed tomography (CT). Material and methods: An observational, retrospective, descriptive and analytical study was conducted, which collected 22 clinical and epidemiological variables, 11 radiological findings on chest x-ray and 23 on CT that were performed in patients with clinical suspicion of pulmonary tuberculosis during a period of 10 years. A multivariate logistic regression model was applied to the potential predictors of positive culture, obtaining a predictive model. Results: We collected 1,540 patients with clinical suspicion of tuberculosis who underwent radiography and thoracic CT. The culture was positive in 101 cases. A backward elimination process was used to obtain the best set of predictive variables. We obtained 24 variables that were significant (6 clinical, 5 of chest plain films and 13 of CT) and were assigned a score. The sum of these scores was subtracted from the age in years and multiplied by 0.03. The model suggests the diagnosis of active pulmonary tuberculosis in patients with a score higher than 1.845. The model obtained a sensitivity of 85.1%, specificity of 83.6%, positive predictive value of 26.6, and negative predictive value of 98.7%. The area under the ROC curve was 0.9163. Conclusion: This scoring system based on clinical-epidemiological criteria and radiological findings can help rule out active pulmonary tuberculosis in cases of diagnostic suspicion.

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Se presenta el caso de un paciente con dolor abdominal de seis días de evolución, anorexia y pérdida de peso. Se le realiza una TC en la que se aprecia una herniación de la pared del borde antimesentérico del íleon, la cual produjo luego una seudoobstrucción y una peritonitis fecaloidea tras una perforación intestinal. La hernia de Richter presenta una clínica lentamente progresiva, por lo cual es común que se demore su diagnóstico. La cirugía tardía aumenta la morbimortalidad asociada

This is the case of a patient presenting abdominal pain for 6 days, as well as anorexia and weight loss. A CT scan is performed, showing a hernia of the antimesenteric border of the distal ileum, resulting in pseudo-obstruction and peritonitis due to intestinal perforation. Richter's hernia presents a slowly progressive clinical presentation, with often delayed diagnosis. Late surgery increases associated morbidity and mortality

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The sorption of Fe(II) and Fe(III) by extracellular polymeric substances (EPS) of acidophilic bacteria Acidiphilium 3.2Sup(5) and Acidithiobacillus ferrooxidans, harvested from the ecosystem of the Tinto River (Huelva, Spain), was investigated. EPS from mixed cultures of both bacteria (EPS(mixed)) and pure cultures of A. 3.2Sup(5) (EPS(pure)) were extracted with ethylenediamine tetraacetic acid (EDTA) and were characterized by Fourier-transform infrared (FTIR), electron photoemission (XPS), x-ray diffraction (DRX), and energy dispersive x-ray (EDX) spectroscopy and scanning electron microscopy (SEM). EPS pure were loaded, in sorption tests, with Fe(II) and Fe(III). The results obtained indicate that the biochemical composition and structure of EPS(mixed) was very similar to that of EPS(pure). Besides, results indicate that EPS(mixed) adsorbed Fe(II) and Fe(III) by preferential interaction with the carboxyl group, which favored the formation of Fe(II)/Fe(III) oxalates. These species were also formed in EPS(pure) loaded with Fe(II)/Fe(III). All this behavior suggested that the sorption of iron by EPS(mixed) was similar to sorption of EPS(pure), which fitted the Freundlich model. Thus, the iron uptake of EPS(mixed) reached 516.7 ± 23.4 mg Fe/g-EPS at an initial concentration of 2.0 g/L of Fe(total) and Fe(II)/Fe(III) ratio of 1.0.

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A Gram-negative, non-spore-forming bacterial strain with the ability to solubilize highly insoluble phosphatic minerals was isolated from a high-phosphorous iron ore from Minas Gerais State, Brazil. This strain, designated FeGl01(T), was subjected to a polyphasic taxonomic investigation. Comparative 16S rRNA gene sequence analysis indicated that it formed a distinct phylogenetic lineage within the genus Burkholderia together with several other species of the genus, e.g. Burkholderia sacchari, Burkholderia tropica and Burkholderia unamae. Partial nucleotide sequencing and analysis of the recA gene roughly corroborated the phylogenetic position of strain FeGl01(T) within the genus Burkholderia. The chemotaxonomic properties of strain FeGl01(T), such as ubiquinone Q-8 as the predominant quinone system and C(16 : 0), C(17 : 0) cyclo, C(18 : 1)omega7c and C(19 : 0)omega8c cyclo as the major fatty acids, were also consistent with its classification within the genus Burkholderia. DNA-DNA hybridization experiments between strain FeGl01(T) and the type strains of B. unamae, B. sacchari and B. tropica yielded reassociation values of 40 % or lower, which, together with qualitative and quantitative differences in fatty acid composition and with differences in several phenotypic traits, support the separation of the new isolate from the phylogenetically most closely related species. Therefore, it is suggested that strain FeGl01(T) represents a novel species of the genus Burkholderia, for which the name Burkholderia ferrariae sp. nov. is proposed. The type strain is FeGl01(T) (=LMG 23612(T)=CECT 7171(T)=DSM 18251(T)).

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