Ulceración rectal como una complicación del uso de sistema de control fecal Fexi-Seal: relato de casos

El Sistema Fexi-Seal es un dispositivo desarrollado para proporcionar mejores cuidados a los pacientes críticos con incontinencia fecal. Existen trabajos que demuestran la seguridad y eficacia del dispositivo, siendo escasos los relatos relacionados con eventos adversos. El presente artículo presenta dos casos de pacientes críticos portadores de Fexi-Seal que desarrollaron complicaciones con su uso. El sistema se mostró eficaz para el tratamiento, sin embargo, es necesaria atención especial en su manejo, particularmente en cuanto al alivio periódico de la presión de la ampolla rectal y al posicionamiento correcto de la bolsa colectora en la cama para evitar tracción excesiva. El Sistema Flexi-Seal permite manejar adecuadamente la diarrea en pacientes críticos, mejorando su bienestar y disminuyendo las complicaciones asociadas a ella, aunque se torna necesario aumentar el conocimiento sobre las complicaciones relacionadas con su empleo.

Iowa Egg Council, Independent Auditor's Reports, Financial Statements and Schedule of Findings, June 30, 2004 & 2005

State Audit Reports

Iowa Egg Council, Independent Auditor's Reports, Financial Statements, Schedule of Findings, June 30, 2005 & 2006

State Audit Reports

Fecal Source Tracking in Iowa, 2004

Water fact sheet for Iowa Department of Natural Resources and the Geological Bureau.

Development and Validation of Decision Rules to Guide Frequency of Monitoring CD4 Cell Count in HIV-1 Infection before Starting Antiretroviral Therapy.

Background: Although CD4 cell count monitoring is used to decide when to start antiretroviral therapy in patients with HIV-1 infection, there are no evidence-based recommendations regarding its optimal frequency. It is common practice to monitor every 3 to 6 months, often coupled with viral load monitoring. We developed rules to guide frequency of CD4 cell count monitoring in HIV infection before starting antiretroviral therapy, which we validated retrospectively in patients from the Swiss HIV Cohort Study.Methodology/Principal Findings: We built up two prediction rules ("Snap-shot rule" for a single sample and "Track-shot rule" for multiple determinations) based on a systematic review of published longitudinal analyses of CD4 cell count trajectories. We applied the rules in 2608 untreated patients to classify their 18 061 CD4 counts as either justifiable or superfluous, according to their prior >= 5% or < 5% chance of meeting predetermined thresholds for starting treatment. The percentage of measurements that both rules falsely deemed superfluous never exceeded 5%. Superfluous CD4 determinations represented 4%, 11%, and 39% of all actual determinations for treatment thresholds of 500, 350, and 200x10(6)/L, respectively. The Track-shot rule was only marginally superior to the Snap-shot rule. Both rules lose usefulness for CD4 counts coming near to treatment threshold.Conclusions/Significance: Frequent CD4 count monitoring of patients with CD4 counts well above the threshold for initiating therapy is unlikely to identify patients who require therapy. It appears sufficient to measure CD4 cell count 1 year after a count > 650 for a threshold of 200, > 900 for 350, or > 1150 for 500x10(6)/L, respectively. When CD4 counts fall below these limits, increased monitoring frequency becomes advisable. These rules offer guidance for efficient CD4 monitoring, particularly in resource-limited settings.

Step count is associated with lower nighttime systolic blood pressure and increased dipping.

BACKGROUND: Higher nighttime blood pressure (BP) and the loss of nocturnal dipping of BP are associated with an increased risk for cardiovascular events. However, the determinants of the loss of nocturnal BP dipping are only beginning to be understood. We investigated whether different indicators of physical activity were associated with the loss of nocturnal dipping of BP. METHODS: We conducted a cross-sectional study of 103 patients referred for 24-hour ambulatory monitoring of BP. We measured these patients' step count (SC), active energy expenditure (AEE), and total energy expenditure simultaneously, using actigraphs. RESULTS: In our study population of 103 patients, most of whom were hypertensive, SC and AEE were associated with nighttime systolic BP in univariate (SC, r = -0.28, P < 0.01; AEE, r = -0.20, P = 0.046) and multivariate linear regression analyses (SC, coefficient beta = -5.37, P < 0.001; AEE, coefficient beta = -0.24, P < 0.01). Step count was associated with both systolic (r = 0.23, P = 0.018) and diastolic (r = 0.20, P = 0.045) BP dipping. Nighttime systolic BP decreased progressively across the categories of sedentary, moderately active, and active participants (125mm Hg, 116mm Hg, 112mm Hg, respectively; P = 0.002). The degree of BP dipping of BP increased progressively across the same three categories of activity (respectively 8.9%, 14.6%, and 18.6%, P = 0.002, for systolic BP and respectively 12.8%, 18.1%, and 22.2%, P = 0.006, for diastolic BP). CONCLUSIONS: Step count is continuously associated with nighttime systolic BP and with the degree of BP dipping independently of 24-hour mean BP. The combined use of an actigraph for measuring indicators of physical activity and a device for 24-hour measurement of ambulatory BP may help identify patients at increased risk for cardiovascular events in whom increased physical activity toward higher target levels may be recommended.

Transmitted drug resistant HIV-1 and association with virologic and CD4 cell count response to combination antiretroviral therapy in the EuroSIDA Study.

OBJECTIVES: To investigate prevalence of transmitted drug-resistant human immunodeficiency virus (TDR) and factors associated with TDR and to compare virological and CD4 count response to combination antiretroviral therapy. METHODS: In this study, 525 mostly chronically infected EuroSIDA patients were included who had genotypic resistance tests performed on plasma samples collected while antiretroviral therapy naive. TDR was defined as at least one resistance mutation from a list proposed for genotypic TDR surveillance. Multivariable logistic regression was used to analyze factors associated with detection of TDR, with virological (viral load<500 copies/mL) and CD4 count response (>or=50% increase) to combination antiretroviral therapy at months 6-12. RESULTS: The overall prevalence of TDR was 11.4%, which was stable over 1996-2004. There were no significant differences in virological suppression (those resistant to at least one drug prescribed versus susceptible), adjusted odds ratio: 0.68 (95% confidence interval: 0.27 to 1.71; P=0.408) or CD4 count response, adjusted odds ratio: 1.65 (95% confidence interval: 0.73 to 3.73; P=0.231). CONCLUSIONS: Prevalence of TDR in antiretroviral-naive patients was found to be in line with other European studies. No significant differences were found in virological and CD4 count response after initiation of first-line combination antiretroviral therapy between resistant and susceptible patients, possibly due to the small number of patients with resistance and consequently low power.

Audit report on the Iowa Egg Council for the years ended June 30, 2007 and 2006

Audit report on the Iowa Egg Council for the years ended June 30, 2007 and 2006

Immatures of Gratiana conformis (Boheman) (Coleoptera, Chrysomelidae, Cassidinae)

Egg cases and larvae of Gratiana conformis (Boheman, 1854) were collected on Solanum paniculatum L. and reared in laboratory. Egg case, egg, third instar and mature larvae and pupa are described and illustrated. Biological notes and a comparison with the immatures of other Gratiana species and Charidotis gemellata Boheman, 1855, are also presented.

Host preference of the egg parasitoids Telenomus remus and Trichogramma pretiosum in laboratory

Host preference of the egg parasitoids Telenomus remus and Trichogramma pretiosum in laboratory. This research aimed to evaluate the host preference of the egg parasitoids Telenomus remus and Trichogramma pretiosum. Trials were carried out in laboratory, under controlled environmental conditions (25 ± 2ºC temperature; 70 ± 10% RH; and 14 h photophase). The parasitoid searching behavior was evaluated based on the distribution (%) of eggs parasitized by each parasitoid, on egg masses of each host species. Results showed the host preference of T. remus by Spodoptera cosmioides eggs. T. pretiosum, reared in A. gemmatalis eggs, choose to parasitize always eggs of the host where the parasitoid had been reared. The egg preference was not observed when T. pretiosum was reared in S. frugiperda eggs. These results show that, in general, host preference of T. remus is less influenced by the host where it is developed than T. pretiosum. Host preference is an important parameter for biological control programs because more than one pest species may occur in the field, different from those where they were reared in the laboratory.

Ultramorphological features of the egg of Telmatoscopus albipunctatus (Williston) (Diptera, Psychodidae)

Ultramorphological features of the egg of Telmatoscopus albipunctatus (Williston) (Diptera, Psychodidae). Psychodidae flies, also known as sewage, sand and filter flies are important for medical and veterinary purposes. General information about life cycle and adult habits is available, but few species are known about the egg morphology. Therefore, in this study, the egg ultramorphology of Telmatoscopus albipunctatus (Williston, 1893) was analyzed by scanning electron microscopy to describe its structure, generating data for further comparison between different fly species and genera. General aspects of T. albipunctatus egg are similar to other Psychodidae; egg measuring approximately 0.4 mm in length and 0.1 mm in width. However, based on the continuous and discontinuous longitudinal ridge sculptures observed on the exochorion, which can be species-specific, we can infer that T. albipunctatus eggs can survive under dry or moist conditions, making their control much more difficult. Our data emphasize the advantages of the electron microscope approach in the study of the exochorion patterns. Eggshell morphology of T. albipunctatus can be used as basis for further studies and as a tool to compare different species of Psychodidae flies.

Audit report on the Iowa Egg Council for the year ended June 30, 2008

Audit report on the Iowa Egg Council for the year ended June 30, 2008

Adaptive sequence evolution in a color gene involved in the formation of the characteristic egg-dummies of male haplochromine cichlid fishes.

BACKGROUND: The exceptionally diverse species flocks of cichlid fishes in East Africa are prime examples of parallel adaptive radiations. About 80% of East Africa's more than 1 800 endemic cichlid species, and all species of the flocks of Lakes Victoria and Malawi, belong to a particularly rapidly evolving lineage, the haplochromines. One characteristic feature of the haplochromines is their possession of egg-dummies on the males' anal fins. These egg-spots mimic real eggs and play an important role in the mating system of these maternal mouthbrooding fish. RESULTS: Here, we show that the egg-spots of haplochromines are made up of yellow pigment cells, xanthophores, and that a gene coding for a type III receptor tyrosine kinase, colony-stimulating factor 1 receptor a (csf1ra), is expressed in egg-spot tissue. Molecular evolutionary analyses reveal that the extracellular ligand-binding and receptor-interacting domain of csf1ra underwent adaptive sequence evolution in the ancestral lineage of the haplochromines, coinciding with the emergence of egg-dummies. We also find that csf1ra is expressed in the egg-dummies of a distantly related cichlid species, the ectodine cichlid Ophthalmotilapia ventralis, in which markings with similar functions evolved on the pelvic fin in convergence to those of the haplochromines. CONCLUSION: We conclude that modifications of existing signal transduction mechanisms might have evolved in the haplochromine lineage in association with the origination of anal fin egg-dummies. That positive selection has acted during the evolution of a color gene that seems to be involved in the morphogenesis of a sexually selected trait, the egg-dummies, highlights the importance of further investigations of the comparative genomic basis of the phenotypic diversification of cichlid fishes.

Egg parasitoids of Edessa meditabunda (Fabricius) (Pentatomidae) in lettuce crop

Egg parasitoids of Edessa meditabunda (Fabricius) (Pentatomidae) in lettuce crop. This study evaluated the occurrence of parasitoids in eggs of the stink bug, Edessa meditabunda (Fabricius, 1794) (Heteroptera, Pentatomidae) found on lettuce crop in Mato Grosso State, Brazil. Samples were collected in the vegetable garden "Cheiro Verde", in the municipality of Tangará da Serra, in curly lettuce. A bed of lettuce was selected randomly, where the eggs of E. meditabunda were collected. Five-hundred and seventy eight eggs of E. meditabunda were collected, 86.3% of them parasitized by Telenomus podisi Ashmead, 1893 (Hymenoptera, Platygastridae), Trissolcus urichi Crawford, 1913 (Hymenoptera, Platygastridae) and Neorileya albipes Girault, 1913 (Hymenoptera, Eurytomidae), representing respectively 57.0%, 38.2% and 4.8% of the emerged individuals. This is the first record of these three species parasitizing eggs of E. meditabunda in lettuce.

Egg laying site selection by a host plant specialist leaf miner moth at two intra-plant levels in the northern Chilean Atacama Desert

Egg laying site selection by a host plant specialist leaf miner moth at two intra-plant levels in the northern Chilean Atacama Desert. The spatial distribution of the immature stages of the leaf miner Angelabella tecomae Vargas & Parra, 2005 was determined at two intra-plant levels (shoot and leaflet) on the shrub Tecoma fulva fulva (Cav.) D. Don (Bignoniaceae) in the Azapa valley, northern Chilean Atacama Desert. An aggregated spatial pattern was detected for all the immature stages along the shoot, with an age dependent relative position: eggs and first instar larvae were clumped at apex; second, third and fourth instar larvae were mostly found at intermediate positions; meanwhile the spinning larva and pupa were clumped at basis. This pattern suggests that the females select new, actively growing leaflets for egg laying. At the leaflet level, the immature stages were found more frequently at underside. Furthermore, survivorship was higher for larvae from underside mines. All these results highlight the importance of an accurate selection of egg laying site in the life history of this highly specialized leaf miner. By contrast, eventual wrong choices in the egg laying site selection may be associated with diminished larval survivorship. The importance of the continuous availability of new plant tissue in this highly human modified arid environment is discussed in relation with the observed patterns.