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PURPOSE: To evaluate the association between concurrent use of opioids and benzodiazepines (BZDs) and emergency room (ER) visits and hospital admissions in patients with cancer. METHODS: Data were obtained from the Puerto Rico Central Cancer Registry-Health Insurance Linkage. Odds ratios (ORs) with 95% CIs and incidence rate ratio (IRR) were estimated using logistic and negative binomial regression analyses to assess the association between concurrent use of opioids and BZDs (overlap of at least 7 days) and ER visits and hospital admissions. RESULTS: A total of 9,259 patients were included in the main analysis. The logistic regression results showed a significant association between concurrent use of opioids and BZDs and at least one ER visit (OR, 1.28 [95% CI, 1.07 to 1.54]) or hospital admission (OR, 1.42 [95% CI, 1.18 to 1.71]) compared with individuals with BZDs alone, after adjusting for age, sex, comorbidity index, cancer stage, health insurance, and health region. Compared with individuals with opioid use alone, the association did not reach significance. In the negative binomial regression, a significant association was observed for ER visits (IRR, 1.52 [95% CI, 1.31 to 1.76]) and hospitalizations (IRR, 1.34 [95% CI, 1.20 to 1.50]) when compared with individuals with BZDs alone. Compared with individuals with opioids alone, it only reached significance for ER visits (IRR, 1.39 [95% CI, 1.20 to 1.61]). CONCLUSION: Careful evaluation must be done before prescribing concurrent opioids and BZDs in patients with cancer, as the results suggest that coprescribing may increase the odds of ER visits and hospitalizations.

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Introducción: La candidemia es considerada el tipo de fungemia más frecuente asociada a pacientes en unidades de cuidados intensivos. Es una afección rápidamente progresiva con elevada mortalidad, la cual presenta dificultad en un diagnóstico precoz y capacidad de resistencia al tratamiento. Objetivos: Caracterizar aspectos epidemiológicos, clínicos y microbiológicos de las especies de Candida aisladas en niños hospitalizados en unidades de cuidados intensivos. Métodos: Se realizó un estudio descriptivo y transversal en 143 aislamientos de especies de Candida obtenidas en hemocultivos de pacientes menores de 18 años, en el laboratorio de Microbiología del Hospital Universitario Ginecobstétrico «Mariana Grajales», en el período de enero de 2009 a diciembre de 2018. Se utilizaron tablas de contingencia (prueba de Ji Cuadrado y V de Cramer); se utilizaron las variables: edad, sexo, factores de riesgo, especies y servicios hospitalarios. Resultados: Los mayores aislamientos de candidemia correspondieron a pacientes del sexo femenino de edades comprendidas entre 29 días y 18 años. Todos fueron sometidos al uso de antimicrobianos y con ventilación mecánica. El mayor número de aislamientos en pacientes de 9 años correspondió a Candida tropicalis, que fue la más aislada en la Unidad de Neonatología y Cuidados Intensivos Pediátricos, no así en Cuidados Intermedios donde predominó Candida sin precisar especie. Por estas razones se puede señalar que existe una relación entre las especies y los servicios hospitalarios. Conclusiones: Predominaron pacientes del sexo femenino mayores de 29 días y hasta 18 años hospitalizados en la Unidad de Cuidados Intensivos Pediátricos; la especie más aislada fue Candida tropicalis.

Introduction: candidemia is considered the most frequent type of fungemia associated with patients hospitalized in intensive care units. It is a rapidly progressive condition with high mortality, difficult to diagnose early and resistant to treatment. Objective: to characterize the epidemiological, clinical and microbiological aspects of Candida species isolated from children hospitalized in intensive care units. Methods: a descriptive and cross-sectional study was carried out on 143 isolates of Candida species corresponding to blood cultures from patients under 18 years of age and obtained in the Microbiology laboratory at "Mariana Grajales" Gynecological and Obstetric University Hospital, from January 2009 to December 2018. Contingency tables were used (Chi- square and Cramer's V tests); age, gender, risk factors, species and hospital services were the used variables. Results: the largest candidemia isolates corresponded to female patients aged between 29 days and 18 years. All were subjected to the use of antimicrobials and mechanical ventilation. The highest number of isolates in 9-year-old patients corresponded to Candida tropicalis, which was the most isolated species in the Neonatology and Pediatric Intensive Care Unit, but not in the Intermediate Care Unit where Candida predominated without specifying the species. For these reasons, it can be pointed out that there is a relationship between species and hospital services. Conclusions: female patients older than 29 days and up to 18 years hospitalized in the Pediatric Intensive Care Unit predominated; the most isolated species was Candida tropicalis.

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Background: Anxiety and depression symptoms are known to increase cancer symptom burden, yet little is known about the longitudinal integrations of these among Hispanic/Latinx patients. The goal of this study was to explore the trajectory and longitudinal interactions among anxiety and depression, cancer symptom burden, and health-related quality of life in Hispanic/Latinx cancer patients undergoing chemotherapy. METHODS: Baseline behavioral assessments were performed before starting chemotherapy. Follow-up behavioral assessments were performed at 3, 6, and 9 months after starting chemotherapy. Descriptive statistics, chi-square tests, Fisher's exact tests, and Mann-Whitney tests explored associations among outcome variables. Adjusted multilevel mixed-effects linear regression models were also used to evaluate the association between HADS scores, follow-up visits, FACT-G scale, MDASI scale, and sociodemographic variables. RESULTS: Increased cancer symptom burden was significantly related to changes in anxiety symptoms' scores (adjusted ß^ = 0.11 [95% CI: 0.02, 0.19]. Increased quality of life was significantly associated with decreased depression and anxiety symptoms (adjusted ß^ = -0.33; 95% CI: -0.47, -0.18, and 0.38 adjusted ß^= -0.38; 95% CI: -0.55, -0.20, respectively). CONCLUSIONS: Findings highlight the need to conduct periodic mental health screenings among cancer patients initiating cancer treatment.

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RESUMEN Introducción: Las infecciones de las úlceras del pie diabético son comunes, complejas, de alto costo y constituyen la principal causa de amputación no traumática de las extremidades inferiores. Objetivo: Identificar los microorganismos aislados para estimar tanto la sensibilidad a los antibióticos como la coincidencia entre el tratamiento empírico y los resultados microbiológicos en pacientes con úlceras del pie diabético. Métodos: Se realizó una investigación descriptiva-retrospectiva. La población de estudio estuvo constituida por 210 pacientes ingresados en el Hospital Universitario Clínico Quirúrgico "Comandante Faustino Pérez Hernández" de Matanzas entre junio de 2017 y junio de 2020. Las variables de salida fueron la frecuencia y el tipo de germen, la cantidad de gérmenes por úlcera, la sensibilidad para cada tipo de antibiótico, y el porcentaje de coincidencia entre el tratamiento empírico y el resultado microbiológico. Resultados: Se identificaron 259 gérmenes y se observaron 1,23 gérmenes por úlcera. El 62,5 por ciento de los gérmenes encontrados fueron Gram negativos, pero el germen más representado fue el Staphylococcus aureus. El 58,8 por ciento de los Staphylococcus aureus se mostraron resistentes a la meticillin. La vancomicina y el linezolid resultaron efectivos en el 100 por ciento de los Gram positivos. La amikacina fue el antibiótico más efectivo para los Gram negativos. Se observó coincidencia entre el tratamiento empírico y el resultado del antibiograma en el 27,6 por ciento de los pacientes. Conclusiones: Resulta necesario un apropiado diagnóstico microbiológico de las úlceras del pie diabético para identificar los gérmenes presentes en las lesiones y diseñar algoritmos de terapia antimicrobiana adecuados(AU)

ABSTRACT Introduction: Diabetic foot ulcer infections are common, complex, high cost and are the leading cause of non-traumatic lower extremity amputation. Objective: To identify the microorganisms isolated to estimate both the sensitivity to antibiotics and the coincidence between empirical treatment and microbiological results in patients with diabetic foot ulcers. Methods: A descriptive-retrospective investigation was performed. The study population consisted of 210 patients admitted to the University Hospital "Comandante Faustino Pérez Hernández" of Matanzas between June 2017 and June 2020. The output variables were the frequency and type of germ, the number of germs per ulcer, the sensitivity for each type of antibiotic, and the percentage of coincidence between the empirical treatment and the microbiological result. Results: A total of 259 germs were identified and 1.23 germs per ulcer were observed. The 62.5 percent of the germs found were Gram negative, but the most represented germ was Staphylococcus aureus. Of the Staphylococcus aureus, 58.8 percentwere resistant to methicillin. Vancomycin and linezolid were effective in 100 percent of Gram positives. Amikacin was the most effective antibiotic for Gram-negatives. Agreement between empirical treatment and antibiogram result was observed in 27.6 percent of patients. Conclusions: An appropriate microbiological diagnosis of diabetic foot ulcers is necessary to identify the germs present in the lesions and to design adequate antimicrobial therapy algorithms(AU)

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OBJECTIVE: To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS: Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS: Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION: The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy.

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OBJECTIVE: To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS: Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS: Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION: The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy. DESCRIPTORS: Autopsy. Hemorrhagic Fevers, Viral, etiology. Arbovirus Infections, mortality

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ABSTRACT OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy.

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RESUMEN Introducción: la psicología social comunitaria toma a la comunidad como su objeto de estudio particular. En esta revisión teórica de la psicología social comunitaria, se mostraron las consideraciones desde una visión marxista, las cuales facilitaron investigaciones de problemáticas sociales en la atención primaria de salud. Objetivo: implementar programas para promover estilos de vida saludables y la prevención de enfermedades en las comunidades, mediante los aportes del marxismo. Métodos: se realizó una revisión bibliográfica sistemática sobre el tema. Para la recolección de los datos se elaboró una ficha instructiva y para el tratamiento de estos se aplicó un análisis de contenido de tipo directo. Conclusiones: las consideraciones sobre la psicología social comunitaria permitieron, desde lo teórico, realizar aportes en el trabajo interventivo en la comunidad, para que la atención primaria de salud pueda dar respuesta a problemas sociales y sanitarios, y contribuyeron a la promoción de conductas saludables y la prevención de enfermedades.

ABSTRACT Introduction: community social psychology takes the community as its particular object of study. The considerations were shown from a Marxist perspective in this theoretical review of community social psychology, which will facilitate investigations of social problems in primary health care. Objective: to implement programs for promoting healthy lifestyles and disease prevention in communities through the contributions of Marxism. Methods: a systematic bibliographic review on the subject was carried out. An instructive card was elaborated for data collection and a direct content analysis was applied for their processing. Conclusions: the considerations on the social community psychology allowed, from the theoretical point of view, to make contributions in the intervention work in the community; that primary health care can respond to social and health problems; and contributed to the promotion of healthy behaviors and disease prevention.

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For the preservation of tissue samples, formalin fixation followed by paraffin embedding (FFPE) has been the method of choice for decades, mainly because it maintains the morphologic characteristics of the original tissue particularly preserved, as well as its genetic material. FFPE cells can be used to perform molecular tests, such as conventional (c) or quantitative (q) reverse transcriptase polymerase chain reaction (RT-PCR), in retrospective investigations. However, extracting RNA from archived FFPE tissues is a challenging procedure, as it requires time and the use of complex extraction methods. As specific FFPE extraction methods are not always available in the laboratories, the objective of this study was to evaluate the performance of a method based on phenol-chloroform (PC) and 2 commercial methods for RNA extraction, adapting their protocols for FFPE tissues. For this study, a pool of FFPE tissues underwent RNA extraction by PC, QIAmp Viral RNA Mini, and RNeasy Mini Kit. Both the RT-cPCR and the RT-qPCR results were favorable, demonstrating the viability of the RNA. As these results expanded the alternatives for low-budget FFPE extraction, the choice of the ideal method to be used will depend on the availability of reagents and kits.

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RESUMEN Los principales problemas de la producción de pepino, residen mayormente en la escasez de fertilizantes minerales, afectaciones climatológicas y limitado uso de los biofertilizantes, por lo cual, es importante buscar alternativas eficientes que aumenten la productividad, la racionalidad y la sustentabilidad. El objetivo de esta investigación fue evaluar la utilización individualizada y asociada de los biofertilizantes microorganismos eficientes y vermicompost lixiviado en el incremento agroproductivo del pepino. El trabajo fue desarrollado en la unidad productiva "El Estadio", Sancti Spíritus, Cuba, entre enero a abril de 2015 y fue utilizado el cultivar Su Yi Sung de pepino. Los tratamientos aplicados fueron un control, inoculación al suelo y aplicaciones foliares de Microorganismos eficientes y vermicompost lixiviado, a 100 y 200mL L-1 y la inoculación al suelo, con Microorganismos eficientes, a 100mL L-1 y aplicaciones foliares con vermicompost lixiviado, a 100mL L-1. Las variables evaluadas fueron el número de hojas, de flores femeninas y de frutos por planta, longitud de frutos (cm), masa de los frutos (g) y el rendimiento (kg m-2). Los resultados mostraron que la aplicación individual y combinada de los biofertilizantes tuvieron un efecto bioestimulante en la producción de pepino y la aplicación de microorganismos eficientes a 100mL L-1 y la combinación con vermicompost lixiviado a 100mL L-1 constituyen una alternativa en la productividad del cultivo, especialmente, porque aumentaron el número de hojas, flores femeninas, frutos, masa y longitud de los frutos e incrementaron el rendimiento en 42% con relación al tratamiento control.

ABSTRACT The main problems of cucumber production reside fundamentally by the mineral fertilizer's shortage, climatic affectation and limited use of biofertilizers, which is important to looking for efficient alternatives that increase productivity, rationality and sustainability. The objective of this research was to evaluate the effect of individualized and associated use of biofertilizers efficient microorganisms and lixiviate vermicompost on the agro-productive increase of cucumber. The work was developed in the productive unit "El Estadio", Sancti Spíritus, Cuba, between January to April 2015 and Su Yi Sung cultivar of cucumber was used. The treatments used were a control (no application), soil inoculation and foliar applications with efficient microorganisms and lixiviate vermicompost at 100 and 200mL L-1, and soil inoculation with efficient microorganisms at 100mL L-1 and foliar applications with lixiviate vermicompost at 100mL L-1. The following variables were observed: number of leaves, female flowers and fruits per plant, length of fruits (cm), mass of fruits (g) and yield (kg m-2). The results showed that the individual and combined application of biofertilizers had a biostimulants effect on cucumber production. The efficient microorganism's application at 100mL L-1 and the combination with lixiviate vermicompost to 100mL L-1 constituting a sustainable alternative in the cucumber productivity, especially because they increased the number of leaves, female flowers, fruits, mass and length of fruits and increasing the yield by 42 % compared to control treatment.

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RESUMEN La maternidad en las adolescentes significa un riesgo para su salud y la de su hijo. Se realizó una investigación cuantitativa, descriptiva, correlacional, de corte transversal, cuya muestra total estuvo conformada por 115 adolescentes y el objetivo fue describir características clínicas y epidemiológicas de las adolescentes embarazadas, según variables de interés entre enero 2016 - diciembre 2017. Se pudo constatar que el 71,30 % de la muestra estaba en la etapa media de la adolescencia. El mayor porcentaje correspondió a pacientes de Secundaria Básica (58,26 %). El 59,13 % tenía pareja estable, mientras que el 63,33 % eran estudiantes. El inicio de las primeras relaciones sexuales fue entre los 12-14 años de edad, (59,13 %). Predominaron las adolescentes embarazadas entre 15-18 años de edad. Se constató la no planificación del embarazo. Prevalecieron las que usaban condón, ocasionalmente durante las relaciones sexuales y las enfermedades con mayor incidencia fueron: anemia e infección vaginal.

ABSTRACT Maternity in adolescents means a risk for their own health and their child. A quantitative, descriptive, correlational and cross-sectional investigation, whose total sample consisted of 115 adolescents, was aimed at describing clinical and epidemiological characteristics of pregnant adolescents, according to variables of interest, between January 2016 and December 2017. It was found that the 71.30% of the sample was in middle adolescence. The highest percentage corresponded to patients from Secondary School (58.26%). The 59.13% had a steady partner, while 63.33% were students. The initiation of the first sexual intercourse was between 12 and 14 years of age (59.13%). Pregnant teenagers between 15 and 18 years predominated. It was found that pregnancies were unplanned. Those who occasionally used the condom during intercourse prevailed, and the diseases with higher incidence were anemia and vaginal infection.

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OBJECTIVE: The purpose of this study was to describe the preferences, the use, satisfaction of mental health services (MHS) among a sample of Puerto Rican patients with cancer undergoing oncology treatment. METHODS: A convenience sample of 120 patients diagnosed with cancer was recruited. Self-report questionnaires assessed socio-demographic and background questions, and the Mental Health Service Preference, Utilization and Satisfaction Questionnaire (MHSPUS). The Socio-demographic and Background Questionnaire inquired about participants' demographic and socioeconomic characteristics, and included questions such as history of psychiatric diagnosis and spiritual practices. Univariate and Chi square analyses were used for descriptive purposes. Logistic regressions were used to explore associations between sociodemographic factors and MHS preferences and use. RESULTS: The majority of the sample were females (53.8%), 61 and older (53.8%), and married or living with partner (57.1%), and reported an income equal to or less than $12,000 per year (44.4%), which places them under the US federal poverty line. Most of the participants (66.7%) reported being receptive to seeking services. Findings showed a significant association between living situation and past (p < .05) and lifetime use (p < .05) of MHS and past use of MHS. Participants living alone were more like to have used MHS in the past and during their lifetime. Adjusted logistic regression analyses revealed that living with someone was a protective factor for not using MHS in their lifetime (OR = 0.28; C1 = 0.08-0.95). Participants preferred to receive MHS at the oncology clinic, preferably on the date of their oncology appointments and during morning hours. CONCLUSION: Findings support the integration of mental health services within the oncology practice setting.

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El cáncer de próstata es una neoplasia hormono-dependiente de importante heterogeneidad. El comportamiento clínico, la respuesta a tratamientos y la supervivencia varían dependiendo de cada paciente. Más del 95% de los cánceres prostáticos son adenocarcinomas, las variantes que no lo son pueden dividirse en dos grupos con base en su origen celular: epitelial y no epitelial. Las variantes epiteliales son más diferenciadas y biológicamente menos agresivas, mientras que las no epiteliales tienen un comportamiento muy invasor. Su tratamiento está orientado al alivio de la sintomatología, al control de su expansión y a elevar las probabilidades de curación.

Prostate cancer is a hormone-dependent neoplasm of significant heterogeneity. Clinical behavior, response to treatments and survival vary depending on each patient. More than 95% of prostate cancers are adenocarcinomas, variants that cannot be, are divided into two groups based on their cellular origin: epithelial and non-epithelial. Epithelial variants are more differentiated and biologically less aggressive, whereas non-epithelial variants have a very invading behavior. Its treatment is oriented to the relief of the symptomatology, the control of its expansion and to increase the probabilities of cure.

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La tiña negra es una micosis cutánea superficial causada por un hongo levaduriforme denominado Hortaea werneckii, es frecuente en regiones cálidas y en zonas de playa. Se comunica su aislamiento de la palma de la mano de un niño sin antecedentes de contacto con fuente infecciosa ni de hiperhidrosis que fue tratado con pomada de Whitfield con azufre desapareciendo la lesión al mes sin recidivas. Se considera significativo presentar este caso dada la escasa frecuencia de su diagnóstico.

Tinea nigra is a superficial cutaneous mycosis, caused by the yeasty-form fungus called Hortaea werneckii. It is frequent in warm regions and in beach zones. Its isolation in the hand palm of a boy without antecedents of infectious contact or hyperhidrosis is reported in this article. He was treated with an ointment of benzoic acid, salicylic acid and sulfur; lesions disappeared after a month without recurrence. The presentation of the case was considered significant due to the scarce frequency of this diagnose.

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Introducción: La cirugía de la hemorragia subaracnoidea aneurismática (HSA) realizada en las primeras 72 horas es beneficiosa. Cuando los casos arriban transcurrido este período el mejor momento quirúrgico es controversial. Objetivo. Evaluar la influencia sobre los resultados de la cirugía en la HSA de un protocolo para decidir el momento quirúrgico apoyado en el monitoreo con Doppler transcraneal (DTC). Material y Método: Se comparan los resultados quirúrgicos al alta y al año de seguimiento según la escala de Glasgow para resultados (EGR), en una serie de 233 casos con HSA rotos operados Enero de 2006 - Diciembre de 2010 y seguidos hasta Enero de 2012, en los que la cirugía en el período intermedio se decidió teniendo en cuenta las velocidades de flujo de los segmentos proximales del polígono de Willis registradas por DTC, con los de un grupo control histórico operado Diciembre de 1983 - Diciembre de 2005 sin la ayuda de dicho monitoreo. Resultados: La mortalidad al alta y al año en la serie de estudio fue de 4,3 y 4,5 por ciento y en el grupo control 7 y 7,7 por ciento respectivamente. Se observaron resultados satisfactorios (grados 4 y 5 en EGR) en el 93,1 al alta y 92,8 por ciento al año en la serie de estudio. Entre los controles históricos estos índices fueron 85,6 y 88,1 por ciento respectivamente (p = 0,004 y p = 0,036). Conclusiones: Los resultados del tratamiento microquirúrgico de la HSA se benefician con la atención protocolizada y la consideración de los resultados del DTC para seleccionar el momento quirúrgico.

Background: Aneurysmal subarachnoid hemorrhage (SAH) surgery, practiced in the first 72 hours is beneficial. The optimal surgical timing, for microsurgical clipping of ruptured intracranial aneurysms, remains controversial when patients arrive between 4 and 14 days. Some surgeons favor a prompt operation regardless the timing. Other ones prefer to wait 2 weeks. Most patients in developing countries are taken to neurosurgical attention late, which not permit an early surgery. Object. To evaluate the surgical outcome in a series of patients with subarachnoid hemorrhage (SAH) managed according to a dynamic protocol. Methods: The authors evaluated surgical outcome by means of Glasgow Outcome Scale (GOS) score in a series of 233 patients with SAH who received neurosurgical clipping in the years 2006-2010 and were followed until January 2012, whose surgical timing was decided according to transcranial Doppler (TD) monitoring. These outcomes were compared with results in a series of 445 historic controls operated 1983-2005. Results: Series mortality at the discharge and at the year were 4.3 and 4.5 percent, and 7 and 7.7 percent in the control group respectively. Series show good outcomes (grade 4 and grade 5 in GOS score) in 93.1 at the discharge and 92.8 percent at the year. Among the historic controls cases with good outcome were 85.6 and 88.1 percent respectively (p = 0.004 y p = 0.036). Conclusions: Surgical outcomes of SAH can be favored by the impact of protocolized attention and TD to decide the best surgical timing in SAH.

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Scrapie is a disease that affects sheep and goats and is characterized by the accumulation of an abnormal isoform (PrPSc) of the cellular prion protein, PrPC, in the central nervous system (CNS) and in lymphoid tissues. Detection of PrPSc in these tissues can be attempted by a variety of techniques, including immunohistochemistry (IHC) and western blotting (WB), for which a wide range of monoclonal and polyclonal antibodies are commercially available. The objective of this study was to test and compare the efficacy of monoclonal antibodiesF89/160.1.5, F99/97.6.1, and P4 and polyclonal antibodies M52 and R486 in the detection of PrPSc in lymphoid and CNS tissue samples by using IHC. Positive and negative control samples of sheep brain and tonsils were provided by the Animal Health and Veterinary Laboratories Agency (AHVLA, UK). The IHC examination of CNS samples with both monoclonal and polyclonal antibodies confirmed the granular deposition of PrPSc in the neurons of the positive control tissues. However, while the monoclonal antibodies did not produce positive reactions in the negative controls, the polyclonal antibodies showed some non-specific staining. The testing of positive control tonsil samples with polyclonal and monoclonal antibodies identified positive control-specific reactions, whereas the negative control tissues were IHC-negative with all antibodies, although P4...(AU)

Scrapie é uma doença que afeta ovinos e caprinos, sendo definida pelo acúmulo de uma isoforma anormal (PrPSc) da proteína priônica celular (PrPC) no Sistema Nervoso Central (SNC) e em tecidos linfoides. Para as técnicas de eleição do diagnóstico de scrapie, imunohistoquímica (IHQ) e western blotting (WB), podem ser utilizados uma vasta gama de anticorpos monoclonais e policlonais comercialmente disponíveis. O objetivo deste estudo foi testar e comparar a eficácia dos anticorpos monoclonais disponíveis comercialmente, F89/160.1.5, F99/97.6.1 e P4, e os anticorpos policlonais R486 e M52, para a identificação da presença da PrPSc em amostras de tecido linfoide e SNC através da técnica de IHQ. Foram utilizadas nas avaliações de IHQ amostras positivas e negativas de cérebro e tonsila palatina de ovinos, cedidas pelo Animal Health Veterinary Laboratory Agency (AHVLA), Reino Unido. Para WB, foram utilizadas amostras de encéfalo, baço, linfonodo, terceira pálpebra e mucosa retal de ovino. As análises IHQ utilizando anticorpos monoclonais e policlonais em amostras positivas de cérebro confirmaram a deposição da PrPSc em neurônios, caracterizada por marcações de aspecto granular intraneural. Na amostra negativa de cérebro, os anticorpos monoclonais não identificaram marcações positivas, o que foi possível verificar ao utilizar os anticorpos policlonais. Testando a amostra positiva de...(AU)

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Scrapie is a disease that affects sheep and goats and is characterized by the accumulation of an abnormal isoform (PrPSc) of the cellular prion protein, PrPC, in the central nervous system (CNS) and in lymphoid tissues. Detection of PrPSc in these tissues can be attempted by a variety of techniques, including immunohistochemistry (IHC) and western blotting (WB), for which a wide range of monoclonal and polyclonal antibodies are commercially available. The objective of this study was to test and compare the efficacy of monoclonal antibodiesF89/160.1.5, F99/97.6.1, and P4 and polyclonal antibodies M52 and R486 in the detection of PrPSc in lymphoid and CNS tissue samples by using IHC. Positive and negative control samples of sheep brain and tonsils were provided by the Animal Health and Veterinary Laboratories Agency (AHVLA, UK). The IHC examination of CNS samples with both monoclonal and polyclonal antibodies confirmed the granular deposition of PrPSc in the neurons of the positive control tissues. However, while the monoclonal antibodies did not produce positive reactions in the negative controls, the polyclonal antibodies showed some non-specific staining. The testing of positive control tonsil samples with polyclonal and monoclonal antibodies identified positive control-specific reactions, whereas the negative control tissues were IHC-negative with all antibodies, although P4...

Scrapie é uma doença que afeta ovinos e caprinos, sendo definida pelo acúmulo de uma isoforma anormal (PrPSc) da proteína priônica celular (PrPC) no Sistema Nervoso Central (SNC) e em tecidos linfoides. Para as técnicas de eleição do diagnóstico de scrapie, imunohistoquímica (IHQ) e western blotting (WB), podem ser utilizados uma vasta gama de anticorpos monoclonais e policlonais comercialmente disponíveis. O objetivo deste estudo foi testar e comparar a eficácia dos anticorpos monoclonais disponíveis comercialmente, F89/160.1.5, F99/97.6.1 e P4, e os anticorpos policlonais R486 e M52, para a identificação da presença da PrPSc em amostras de tecido linfoide e SNC através da técnica de IHQ. Foram utilizadas nas avaliações de IHQ amostras positivas e negativas de cérebro e tonsila palatina de ovinos, cedidas pelo Animal Health Veterinary Laboratory Agency (AHVLA), Reino Unido. Para WB, foram utilizadas amostras de encéfalo, baço, linfonodo, terceira pálpebra e mucosa retal de ovino. As análises IHQ utilizando anticorpos monoclonais e policlonais em amostras positivas de cérebro confirmaram a deposição da PrPSc em neurônios, caracterizada por marcações de aspecto granular intraneural. Na amostra negativa de cérebro, os anticorpos monoclonais não identificaram marcações positivas, o que foi possível verificar ao utilizar os anticorpos policlonais. Testando a amostra positiva de...

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RESUMO

La vaginosis bacteriana es un trastorno frecuente de la flora vaginal en mujeres de edad reproductiva, caracterizado por presencia de secreción grisácea maloliente, debido a la disminución de lactobacilos, incremento del ph vaginal y presencia de bacterias anaerobias. Se estima que aproximadamente el 30 % de las mujeres entre 14-49 años presentan vaginosis bacteriana. Se asocia con afecciones perinatológicas que incluyen: rotura prematura de membranas, parto prematuro, recién nacidos de peso bajo y enfermedad inflamatoria pélvica. El diagnóstico de vaginosis bacteriana puede ser efectuado aplicando criterios clínicos (criterios de Amsel), o por evaluación de los morfotipos bacterianos presentes en el gram de la secreción vaginal, mediante procedimientos microbiológicos, los cuales se crearon como una alternativa al diagnóstico clínico, reemplazándolo paulatinamente. Los primeros métodos microbiológicos descritos y estandarizados fueron los de Spiegel y Nugent. Posteriormente Ison y Hay ampliaron el sistema de evaluación de Nugent, incluyendo dos nuevas categorías que destacan la dominancia de las cocáceas gram positivas en el ecosistema vaginal y la ausencia de bacterias en un frotis, respectivamente. El más reciente estudio sobre el tema lo constituye la validación del estudio del Balance del Contenido Vaginal (BACOVA), el cual demostró que la integración de los criterios de Nugent y Amsel, mejora la sensibilidad y especificidad de la prueba.

Bacterial vaginosis is a frequent disorder of the vaginal flora in reproductive-age women, characterized by the presence of a grey unpleasant smelling secretion, due to the decrease of lactobacilli, the vaginal Ph increase and the presence of anaerobic bacteria. It is estimated that around 30 % of women aged 14-49 years have bacterial vaginosis. It is associated with perinatologic diseases including: premature membrane breaking, premature birth, low-weight newborns and inflammatory pelvic disease. The bacterial vaginosis diagnosis could be made applying clinical criteria (Amsel criteria) or by evaluation of the bacterial morphotypes found in the vaginal secretion gram through microbiological procedures created as an alternative to the clinical diagnosis that gradually replaced it. The firstly described and standardized microbiological methods were the Spiegel's and Nugent's ones. Later, Ison and Hay widened Nugent's evaluation system, including two new categories respectively, emphasizing the dominance of gram positive cocci in the vaginal ecosystem and the absence of bacteria in a smear. The most recent study on the theme is the validation of the study Vaginal Content Balance (VACOBA), showing that Nugent's and Amsel's criteria integration increases the test sensibility and specificity.

RESUMO

Se realizó un estudio observacional analítico transversal, para determinar la frecuencia de Chlamydia trachomatis y factores asociados en 298 mujeres sexualmente activas en los hospitales Comandante Faustino Pérez y Julio Alfonso Medina, de Matanzas, desde junio del 2010 a 2012, seleccionándose no aleatoriamente 149 mujeres de cada hospital. Se diagnosticó clamidiasis por el test-CHLAMY-CHECK-1 y otros gérmenes asociados por exudado vaginal. Se realizó análisis divariado, estimando relación entre clamidiasis y las variables seleccionadas. Se utilizó tablas de contingencias para análisis de riesgo calculándose el Odds ratio, con intervalos de confianza del 95 %. Para la asociación estadística significativa se utilizó el CHI², siendo estadísticamente significativa cuando el valor de P sea menor de 0,05. El 72,5 % de las mujeres estudiadas resultaron infectadas, siendo las menores de 24 años, con un 85,8 % las de mayor incidencia. El inicio de las relaciones sexuales antes de los 18 años predominó, presentándose en el 80,2 %. El 87,1 % de las mujeres tuvieron como factor de riesgo la inestabilidad en la pareja sexual, predominando las parejas con síntomas, para un 94 % de las infectadas. Fue significativo que el 89,3 % de las afectadas tuvieran antecedentes de infección de transmisión sexual; otro factor de riesgo importante fue el no uso del condón en el 73,1 % de las mismas. Presentaron leucorrea el 70 % de los casos.

An observational, cross-sectional, analytical study was carried out to determine the frequency of Chlamydia trachomatis and its associated factors in 298 sexually active women assisting the hospitals Comandante Faustino Pérez y Julio Alfonso Medina, of Matanzas, from June 2010 to June 2012, selecting 149 women from each hospital in a no randomized way. Chlamydiasis was diagnosed by CHLAMY-CHECK-1 test and other associated germs were diagnosed by vaginal exudates. Bivariate analyses were performed, estimating relation between chlamydiasis and selected variables. We used contingency charts to analyze the risk calculating the Odd ration, with a confidence interval of 95 %. For the significant statistic association we used Chi2, being statistically significant when P value was less than 0,05. 72,5 % of the studied women were infected, being the age group of less than 24 years the one with higher incidence (85, 8 %). Starting having sexual relationships before the age of 18 was predominant, with 80,2 %. 87,1 % of the women showed instability in sexual partnership as a risk factor, predominating symptomatic partners in 94 % of the infected one. It was significant that 89,3 % of the affected patients had antecedents of sexually transmitted infections; another important risk factor was that 73, 1 % of them do not use condoms. 70 % of the cases had leucorrhea.

RESUMO

Para contribuir al uso racional de los antibióticos se necesita disponer de un diagnóstico rápido que permita determinar el agente etiológico y su sensibilidad en el momento de iniciar la atención al paciente. Es indispensable, por tanto, la existencia de un programa de vigilancia, que permita conocer los patrones locales de susceptibilidad y resistencia. Se realizó un estudio observacional descriptivo transversal, con el objetivo de analizar el nivel de resistencia a los antimicrobianos en los gérmenes aislados en las unidades de cuidados intensivos e intermedios del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez, de Matanzas, durante el año 2010. Se trabajó con el total de cepas positivas obtenidas de los pacientes ingresados en las unidades de cuidados intensivos e intermedio. Para la recogida de la información se revisaron los libros de los registros microbiológicos existentes en el laboratorio. Para la determinación de resistencia y susceptibilidad de los gérmenes se aplicó el método de difusión en agar en placa de Mueller-Hinton, interpretándose los resultados según el National Commite for Clinical Laboratory Standar. Los principales resultados obtenidos mostraron que los gérmenes Gram negativos representaron el mayor por ciento de aislamiento en el estudio. Dentro de los gérmenes gram positivos que más frecuentemente fueron aislados están: Staphyloccocus coagulasa negativo y el Staphylococcus aureus. Los gérmenes gram negativos mostraron elevada resistencia frente a cefalosporinas. Mientras que los gram positivos mostraron elevada resistencia a la penicilina, oxacillina y kanamicina. Los gérmenes aislados con mayor frecuencia en cultivo de secreción endotraqueal fueron BNF, enterobacter, y pseudomona aeruginosa, quienes mostraron marcada resistencia a las cefalosporinas.

For contributing to the antibiotics rational usage we need a fast diagnosis allowing determining the etiologic agent and its sensibility at the moment of beginning the patient’s attention. Thus, it is unavoidable the existence of a surveillance program allowing to know the local patterns of susceptibility and resistance. We carried out the current cross-sectional observational descriptive study with the objective of analyzing the antimicrobial resistance level of the germs isolated in the intermediate and intensive care units of the University Clinico-Surgical Hospital Comandante Faustino Pérez, of Matanzas, during 2010. We worked with the total of the positive strains obtained from the in-patients of the before mentioned units. To collect the information we reviewed the microbiological records kept in the laboratory. To determine the germs resistance and susceptibility, we applied the method of agar diffusion in a plate of Mueller-Hinton, reading the results according to the National Committee for Clinical Laboratory Standard. The main obtained results showed that Gram negative germs represented the highest percent of isolation in the study. Among the Gram positive germs that were isolated are the negative Staphylococcus coagulasa and the Staphylococcus aureus. The Gram negative germs showed a high resistance to the cephalosporin, while the Gran positive ones showed a high resistance to the penicillin, the oxacillin and the kanamycin. The germs isolated more frequently in a culture of endotracheal secretion were the BFN, the enterobacter and the pseudomona aeruginosa, and showed a remarked resistance to the cephalosporin.