Problemas de salud y la vulnerabilidad social en pacientes inmigrantes ingresados con patología infecciosa: estudio caso-control

Introducción. La necesidad de recursos sanitarios de la población inmigrante ha aumentado en los últimos años. El estudio de los problemas de salud y la vulnerabilidad social planteados durante el ingreso hospitalario de estos pacientes ayudaría a mejorar su cuidado. Pacientes y métodos. Estudio caso-control realizado en el Hospital Clínic de Barcelona. Se incluyeron pacientes inmigrantes ingresados con patología infecciosa de octubre de 2002 a septiembre de 2003. Los casos fueron apareados por edad, sexo e infección por virus de la inmunodeficiencia humana (VIH). Se evaluaron variables clínicas (visitas a Urgencias, días y número de ingresos, cantidad de procedimientos y fármacos, diagnóstico etiológico y control post alta) y de vulnerabilidad social (utilización de trabajo social, tarjeta sanitaria, cuidador de referencia, consumo de tóxicos, barrera idiomática y alta de enfermería). Resultados. Se estudiaron 102 pacientes (51 casos y 51 controles, todos varones). El 56% estaban infectados por VIH en ambos grupos. El número de procedimientos diagnósticos o terapéuticos fue mayor en el grupo de inmigrantes (p = 0,02), se llegó en menor proporción a un diagnóstico etiológico (el 82% frente al 98%, p = 0,021) y el número de visitas post alta fue inferior (el 55% frente al 77%, p = 0,04). Los pacientes inmigrantes tuvieron unos índices de vulnerabilidad social mayores que la población autóctona y en un 35% de ellos existía una barrera idiomática. Un menor número tenían tarjeta sanitaria (el 63% frente al 94%, p < 0,0001) y un número mayor tuvieron necesidad de traslado a un centro sociosanitario (el 16% frente al 2%, p = 0,01). Discusión La vulnerabilidad social de los pacientes inmigrantes influye en una menor obtención del diagnóstico etiológico, mayor número de procedimientos durante la hospitalización y un menor seguimiento posterior al alta.

Immunologic work up of subjects who didn't respond appropriately to a rabies post exposure prophylaxis

Background New recommendations for rabies postexposure prophylaxis (rPEP) were published by the Centers for Disease Control and Prevention and the World Health Organization in 2010. In view of these new recommendations, the adequacy of rPEP among patients consulting the travel clinic of the University Hospital of Lausanne has been investigated and 6,8% of patients have been identified as non-responders with the new rPEP regimen. In this study we have selected the non-responders for a complete immunologic work up. Method Clinical and paraclinical immunologic investigations have been done to the non- responders patients. Those investigations have been conducted to look for an increased susceptibility to infections and an immunodeficiency. The investigations included a clinical evaluation, a full blood count, measurement of the immunoglobulin levels, a numeration of the subpopulations of the lymphocytes, a HIV test and an evaluation of the humoral response to tetanus, pneumococcal, and hepatitis B vaccinations. A lymphocyte proliferation assay with rabies antigen was performed to assess the cellular immune response. Results 9 subjects with rabies antibody titers ≤0,5 IU/ml after an rPEP with 4 doses were included in this study (=non-responders). 8/9 of these non-responders had an unremarkable medical history. 9/9 of them had normal paraclinical tests that did not suggest an immunodeficiency. The results of the lymphocyte proliferation assay with rabies antigen showed a significant correlation between the level of the humoral and cellular response. Conclusion These results suggest that a 4 dose intramuscular rPEP elicits in some patients a relatively poor humoral and cellular response, even in the absence of any immunosuppression. A serology on day 21 of the rPEP seems therefore useful to identify the patients who don't respond appropriately. Those non-responders should receive additional doses until they reach an antibody titer above 0.5 IU/ml.

A randomized double-blind control study of early intra-coronary autologous bone marrow cell infusion in acute myocardial infarction: the REGENERATE-AMI clinical trial?.

AIMS: Clinical trials suggest that intracoronary delivery of autologous bone marrow-derived cells (BMCs) 1-7 days post-acute myocardial infarction (AMI) may improve left ventricular (LV) function. Earlier time points have not been evaluated. We sought to determine the effect of intracoronary autologous BMC on LV function when delivered within 24 h of successful reperfusion therapy. METHODS AND RESULTS: A multi-centre phase II randomized, double-blind, and placebo-controlled trial. One hundred patients with anterior AMI and significant regional wall motion abnormality were randomized to receive either intracoronary infusion of BMC or placebo (1:1) within 24 h of successful primary percutaneous intervention (PPCI). The primary endpoint was the change in left ventricular ejection fraction (LVEF) between baseline and 1 year as determined by advanced cardiac imaging. At 1 year, although LVEF increased compared with baseline in both groups, the between-group difference favouring BMC was small (2.2%; 95% confidence interval, CI: -0.5 to 5.0; P = 0.10). However, there was a significantly greater myocardial salvage index in the BMC-treated group compared with placebo (0.1%; 95% CI: 0.0-0.20; P = 0.048). Major adverse events were rare in both treatment groups. CONCLUSION: The early infusion of intracoronary BMC following PPCI for patients with AMI and regional wall motion abnormality leads to a small non-significant improvement in LVEF when compared with placebo; however, it may play an important role in infarct remodelling and myocardial salvage. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov NCT00765453 and EudraCT 2007-002144-16.

Differential Regulation of c-FLIP Isoforms Through Post-translational Modifications

Cells are constantly responding to signals from the surrounding tissues and the environment. To dispose of infected and potentially dangerous cells, to ensure the optimal execution of developmental processes and to maintain tissue homeostasis, a multicellular organism needs to tightly control both the number and the quality of its cells. Apoptosis is a form of active cellular self-destruction that enables an organism to regulate its cell number by deleting damaged or potentially dangerous cells. Apoptosis can be induced by death ligands, which bind to death receptors on the cell surface. Ligation of the receptors leads to the formation of an intracellular death inducing signaling complex (DISC). One of the DISC components is caspase-8, a protease that triggers the caspase cascade and is thereby a key initiator of programmed cell death. The activation of caspase-8 is controlled by the cellular FLICE-inhibitory proteins (c-FLIPs). Consequently, sensitivity towards receptor-mediated apoptosis is determined by the amount of c-FLIP, and the c-FLIP levels are actively regulated for example during erythroid differentiation of K562 erythroleukemia cells and by hyperthermia in Jurkat leukemia cells. The aim of my thesis was to investigate how c-FLIP is regulated during these processes. We found that c-FLIP isoforms are short-lived proteins, although c-FLIPS had an even shorter half-life than c-FLIPL. In both experimental models, increased death receptor sensitivity correlated with induced ubiquitylation and consequent proteasomal degradation of c-FLIP. Furthermore, we elucidated how phosphorylation regulates the biological functions and the turnover of c-FLIP, thereby contributing to death receptor sensitivity. We mapped the first phosphorylation sites on c-FLIP and dissected how their phosphorylation affects c-FLIP. Moreover, we demonstrated that phosphorylation of serine 193, a phosphorylated residue common to all c-FLIPs, is primarily mediated by the classical PKC. Furthermore, we discovered a novel connection between the phosphorylation and ubiquitylation of c-FLIP: phosphorylation of S193 protects c-FLIP from ubiquitylation. Surprisingly, although all c-FLIP isoforms are phosphorylated on this conserved residue, the biological outcome is different for the long and short isoforms, since S193 specifically prolongs the half-lives of the short c-FLIP isoforms, but not c-FLIPL. To summarize, we show that c-FLIP proteins are modified by ubiquitylation and phosphorylation, and that the biological outcomes of these modifications are isoform-specifically determined.

Minimum number of assessment times to compare chemical control treatments for papaya fruit anthracnose

The chemical treatment evaluation in the field to control post-harvest fruit anthracnose (Colletotrichum gloeosporioides) requires a suitable disease incidence assessment on harvested papaya (Carica papaya) fruits. The minimum number of papaya fruit harvests was determined for valid treatment comparison in field trials for anthracnose chemical control. Repeatability analysis was done using previously published data. The coefficient determination (R²) estimate range, using four methods, and based on means of 12 assessment times, was 92.58 < R² < 94.45%. The number of assessment times required for R²=90% varied from seven to nine. The R² values of 85.1 < R² < 91.3% estimated by ANOVA suggested that any seven successive assessment times were sufficient for treatment comparison.

Essential oil of mustard to control Rhizoctonia solani causing seedling damping off and seedling blight in nursery

The essential oil extracted from mustard (Brassica rapa) seeds was evaluated for its effect on suppression of Rhizoctonia solani growth in vitro, and in field soils, for reducing saprophytic substrate colonization and seedling damping off and blight using snap beans as indicator plant, the in vitro growth was completely inhibited at a concentration of 50 mul/l. The saprophytic substrate colonization in soils 24 h after treatment was drastically reduced to 45% at 150 mul/kg soil concentration, in contrast to 100% colonization at concentrations of 0, 50, or 75 mul/kg. This recovery rate gradually declined to 6% and 60%, respectively, in nine days. A control of pre and post-emergence seedling damping off and blight in common beans (Phaseolus vulgaris), without any apparent phytotoxic effect was achieved by irrigating R. solani infested soils with water containing the emulsified essential oil to provide 150 mul/l soil volume ten days prior to planting, gave over 95%. The effect of the mustard essential oil was not influenced by the physical soil texture, and it appears to be a good substitute for methyl bromide fumigation in nurseries for seedling production.

Quantitative control of Lettuce mosaic virus fitness and host defence inhibition by P1-HCPro

Two Lettuce mosaic virus isolates capable of overcoming the resistance afforded by the resistance gene mo1² in lettuce, LMV-AF199 from Brazil, and LMV-E, an European isolate, were evaluated for the rapidity and severity of symptoms induced on the lettuce variety Salinas 88 (mo1²). The mosaic symptoms on Salinas 88 plants inoculated with LMV-AF199 appeared 7 days post-inoculation (dpi) and 15 dpi for LMV-E. The symptoms induced by LMV-AF199 in this cultivar were also more severe than those induced by LMV-E. In order to identify the region of the viral genome responsible for this phenotype, recombinant viruses were constructed between these isolates and the phenotype of each recombinant was analysed. The region encoding proteins P1 and HcPro from LMV-AF199 was associated with the increased virulence in Salinas 88.

Performance during post-harvest storage of banana cv. 'prata', 'maçã' and 'nanica' exposed to physical and chemical treatments

Banana is the most consumed fruit in the world and Brazil is the second largest producer. Despite its global position, Brazil has an average of 40% losses during the post-harvest period. So, this experiment aimed at evaluating the efficiency of post-harvest treatments to improve the storage of banana cultivars cv. 'Prata', 'Maçã' and 'Nanica'. The fruits were acquired at CEASA with green peel, and were submitted to six different treatments: T- immersion in drinking water for 3 minutes (control), H3 - hot water (50 °C for 3 minutes), H8 - hot water (50 °C for 8 minutes), HP - immersion in hypochlorite 0.2% for 3 minutes, OS - immersion in soybean oil 10% for 3 minutes, and OM - immersion in mineral oil 10% for 3 minutes. The fruits were stored at room temperature at about 21 °C for 14 days and evaluated in three periods (1, 7 and 14 days) comparing peel color, flesh/peel ratio, titratable acidity (TA), soluble solids (SS), SS/TA ratio, and pH. The fruits of cv. 'Prata' and 'Maçã' submitted to the treatments H3, H8 and HP ripened at the same time as the control for peel color, which showed increased soluble solids, flesh/peel ratio, acidity and a decrease in pH. On the other hand, the cv. 'Nanica' did not respond significantly different when compared to the applied treatments and the control. The fruits treated with OM and OS were kept green for a longer time for the cultivars 'Prata' and 'Nanica', but there were some changes on peel color due dark spots in 'Prata' banana and a softening aspect in 'Nanica', indicating some level of toxicity of these treatments. Fruits of the 'Maçã' cultivar continued green with the application of mineral oil, without toxicity symptoms. In conclusion, the treatments applied did not show any advantage for storage of these fruits.

Kinetic behavior of nitrification in the post-treatment of poultry wastewater in a sequential batch reactor

A sequential batch reactor with suspended biomass and useful volume of 5 L was used in the removal of nutrients and organic matter in workbench scale under optimal conditions obtained by central composite rotational design (CCRD), with cycle time (CT) of 16 h (10.15 h, aerobic phase, and 4.35 h, anoxic phase) and carbon: nitrogen ratio (COD/NO2--N+NO3--N) equal to 6. Complete cycles (20), nitrification followed by denitrification, were evaluated to investigate the kinetic behavior of degradation of organic (COD) and nitrogenated (NH4+-N, NO2--N and NO3--N) matter present in the effluent from a bird slaughterhouse and industrial processing facility, as well as to evaluate the stability of the reactor using Shewhart control charts of individual measures. The results indicate means total inorganic nitrogen (NH4+-N+NO2- -N+NO3--N) removal of 84.32±1.59% and organic matter (COD) of 53.65±8.48% in the complete process (nitrification-denitrification) with the process under statistical control. The nitrifying activity during the aerobic phase estimated from the determination of the kinetic parameters had mean K1 and K2 values of 0.00381±0.00043 min-1 and 0.00381±0.00043 min-1, respectively. The evaluation of the kinetic behavior of the conversion of nitrogen indicated a possible reduction of CT in the anoxic phase, since removals of NO2--N and NO3--N higher than 90% were obtained with only 1 h of denitrification.

Control of ammonia emissions in naturally ventilated dairy cattle facilities in Portugal

We conducted a study of the processes associated to NH3 emission in naturally ventilated dairy cattle facilities, having described factors that regulate NH3 emission, as well as methodologies for measuring these emissions at these facilities. Appropriate techniques to mitigate NH3 emission in facilities located in regions with warm climates were also identified. The most effective mitigation techniques with simple implementation include strategies associated to: (i) installation design and flooring, which lead to reduced emissions, (ii) excreta pre-excretion, namely the use of diets with optimized crude protein content and increased milk production at farm level; and (iii) excreta post-excretion, particularly by changing the conditions of environmental monitoring within the premises, practice introduction or additive application in the management of excreta deposited on floors.

‘Sweet grape’ tomato post harvest packaging

ABSTRACT This paper aims at evaluating the shelf life of mini tomatoes (Lycopersicum esculentum Mill.) cultivar ‘Sweet Grape’, grown in hydroponics, and stored under environmental and refrigerated conditions inside different packages. We adopted a completely randomized design, in which treatments were combinations of storage conditions: environment (e) and refrigerated (r) with packaging: polyvinyl chloride film (PVC); low-density polyethylene (LDPE); biofilm of tomato fruit of Solanum lycocarpum A.St.-Hil (lobeira) (TFB); cassava starch biofilm (CSB); carnauba wax (Copernicia prunifera) (CW), and without packaging - control (C). Physicochemical and sensory tests were carried out at the beginning (day zero), and at 8, 19, and 33 days of storage (DS). Fruit stored inside PVCr, LDPEe, LDPEr, and CWr had an acceptable shelf life of 33 days. The use of cassava and tomato starches were not effective in controlling fruit fresh weight loss. ‘Sweet Grape’ tomato postharvest conservation was enhanced under refrigerated conditions. The sensory evaluation results revealed that CWr treatment most pleased appraisers, while PCV had the highest rejection rate.

Reflectance indices as a diagnostic tool for weed control performed by multipurpose equipment in precision agriculture

Several tools of precision agriculture have been developed for specific uses. However, this specificity may hinder the implementation of precision agriculture due to an increasing in costs and operational complexity. The use of vegetation index sensors which are traditionally developed for crop fertilization, for site-specific weed management can provide multiple utilizations of these sensors and result in the optimization of precision agriculture. The aim of this study was to evaluate the relationship between reflectance indices of weeds obtained by the GreenSeekerTM sensor and conventional parameters used for weed interference quantification. Two experiments were conducted with soybean and corn by establishing a gradient of weed interference through the use of pre- and post-emergence herbicides. The weed quantification was evaluated by the normalized difference vegetation index (NDVI) and the ratio of red to near infrared (Red/NIR) obtained using the GreenSeekerTM sensor, the visual weed control, the weed dry matter, and digital photographs, which supplied information about the leaf area coverage proportions of weed and straw. The weed leaf coverage obtained using digital photography was highly associated with the NDVI (r = 0.78) and the Red/NIR (r = -0.74). The weed dry matter also positively correlated with the NDVI obtained in 1 m linear (r = 0.66). The results indicated that the GreenSeekerTM sensor originally used for crop fertilization could also be used to obtain reflectance indices in the area between rows of crops to support decision-making programs for weed control.

Chemical control of Pileamicrophylla in cattleya seedlings (Cattleyatenebrosa x Cattleyaleopoldy)

Species of the orchidaceae family are grown for marketing flowers and among them the genus Cattleya stands out. However, due to its slow growth, the substrate is subjected to weed infestation. Therefore, this study aims to evaluate the selectivity and efficiency of herbicides in controlling Pilea microphylla in Cattleya orchid seedlings (Cattleya tenebrosa x Cattleya leopoldy). We used a completely randomized design with four replications. The evaluated herbicides were oxyfluorfen (0, 120, 240 and 480 g ha-1), flumioxazin (0, 12.5, 25 and 40 g ha-1), nicosulfuron (0, 20, 40 and 80 g ha-1) mesotrione (0, 96, 144 and 192 g ha-1), clethodim (0, 60, 84 and 108 g ha-1) and metsulfuron-methyl (0, 1.2, 1.8 and 2.4 g ha-1). At post-emergence applying time, the Cattleya plants had three bulb sand were 10 cm tall, while P. microphylla, where 5 cm tall. Nicosulfuron, mesotrione and clethodim herbicides did not control P. microphylla, while oxyfluorfen and flumioxazin showed over 90% efficiency level sin controlling P. microphyllafrom 14 days after application (DAA). As to metsulfuron-methyl, it showed efficiency superior to 90% from the control dose of 1.8 g ha-1 at 28 DAA. All herbicides were selective plants of Cattleya, however, only oxyfluorfen, flumioxazin and metsulfuron-methyl were effective in controlling P. microphylla.

Selectivity of chemical weed control systems in conventional cotton

Cotton is highly susceptible to the interference imposed by weed community, being therefore essential to adopt control measures ensuring the crop yield. Herbicides are the primary method of weed control in large-scale areas of production, and usually more than one herbicide application is necessary due to the extensive crop cycle. This study aimed to evaluate the selectivity of different chemical weed control systems for conventional cotton. The experiment took place in the field in a randomized block design, with twenty nine treatments and four replications in a split plot layout (adjacent double check). Results showed that triple mixtures in pre-emergence increased the chance of observing reductions in the cotton yield. To avoid reductions in crop yield, users should proceed to a maximum mixture of two herbicides in pre-emergence, followed by S-metolachlor over the top, followed by one post-emergence mixture application of pyrithiobac-sodium + trifloxysulfuron-sodium.

EFFECT OF POST-EMERGENCE HERBICIDE APPLICATIONS ON RICE CROP WEED COMMUNITIES IN TOLIMA, COLOMBIA

ABSTRACTThe weed communities of agricultural systems are dynamic and respond to changes in agronomic practices. This study aimed to evaluate the effect of post-emergence herbicide control programs made by farmers on weed communities and commercial lots of rice. The evaluations were carried out in 96 commercial lots located in the Centro, Meseta and Norte zones of the department of Tolima. In each lot, 1 ha was marked off, in which the evaluations were carried out by randomly throwing a 0.2 x 0.2 m sampling-square 5 times. Samples were taken before the first post-emergence application, after the first post-emergence application, after the second post-emergence application, and once the post-emergence applications were finished. The evaluated variables included density and cover of the weeds and the crops. The IVI of each species was calculated and the control program was analyzed in terms of decreases in the number of individuals for the 15 more encountered species. Before the applications, higher density values were found. The first and second post-emergence applications reduced the average density by 41% and 12%, respectively, throughout the department. Between the first and fourth evaluations, the density of the weeds and crops decreased throughout the department by 51.7% and 39%, respectively. The weed density variable proved to be the most influential in the populations after the herbicide programs were carried out.