Registro de pacientes con distrofinopatías en Colombia

INTRODUCCIÓN. La distrofia muscular de Duchenne es una enfermedad neuromuscular con una herencia recesiva ligada al X que afecta a 1 de cada 3500 niños nacidos vivos. Se produce por mutaciones en el gen DMD que codifica para la distrofina. Se caracteriza por manifestaciones clínicas variables típicas de una distrofia muscular proximal progresiva. OBJETIVO. Realizar el primer registro en Colombia de los pacientes identificados con distrofinopatías, teniendo en cuenta características clínicas y paraclínicas, así como las mutaciones causales de esta patología. METODOLOGÍA Es un estudio descriptivo, transversal, de la revisión de historias clínicas de los pacientes con diagnóstico de DMD atendidos en la consulta de Genética de la Universidad del Rosario durante los años 2006 a 2015. RESULTADOS Se identificaron 99 pacientes, de los cuales 56 (56,56%) corresponden al fenotipo Duchenne y 12 (12,12%) al Becker. No fue posible clasificar a 31 pacientes (31,3%) por falta de datos clínicos. La edad de inicio de los síntomas fue en promedio de 4,41 años. Las mutaciones más frecuentes fueron las deleciones (69%), seguidas por las mutaciones puntuales(14%), las duplicaciones (11%) y por otras mutaciones (4%). CONCLUSIONES Este registro de distrofinopatías es el primero reportado en Colombia y el punto de partida para conocer la incidencia de la enfermedad, caracterización clínica y molecular de los pacientes, garantizando así el acceso oportuno a los nuevos tratamientos de medicina de precisión que permitan mejorar la calidad de vida de los pacientes y sus familias.

Modelo predictivo para uso del condón y consumo de alcohol como conductas de riesgo relacionadas con el contagio de VIH/SIDA en trabajadoras sexuales de Bogotá- 2015

Objetivo: Determinar un modelo predictivo para uso del condón y consumo de alcohol como conductas de riesgo relacionadas el contagio de VIH/Sida en mujeres trabajadoras sexuales de la ciudad de Bogotá en el año 2015. Métodos Estudio de tipo transversal con diseño observacional, se tomaron 255 mujeres trabajadoras sexuales de la ciudad de Bogotá; La información analizada fue tomada del estudio realizado en cinco ciudades de Colombia en el año 2015, las hipótesis planteadas se soportaron en la asociación entre las condiciones sociodemográficas, de conocimiento, practicas, hábitos, apoyo social y de ocupación propia de las mujeres trabajadoras sexuales que podían explicar y predecir la adopción de conductas riesgosas para VIH/sida como son el uso del condón y el consumo de alcohol en ejercicio de su ocupación. Resultados El promedio de edad de inicio en el trabajo sexual fue 22,1±7,1 años, tres cuartas partes son solteras y residen en estrato dos y tres; el 96,5% dijo usar el condón con el último cliente y el 27,8% de ellas consumió alcohol durante su último servicio. En la conducta de riesgo uso del condón, se encontraron asociados entre otras, la edad [OR=1,10(1,03-1,17)], vivir en estrato dos [OR=7,7(1,5-39,5)], el ingreso por trabajo sexual [OR=1,0(1,0-1,0)], la disponibilidad del condón para el servicio [OR=0,03(0,008-0,16)] y contar con otro método de planificación (ligadura de trompas) [OR=4,47(1,0-18,3)]. En la conducta de riesgo consumo de alcohol, se encontró asociado ente otros: estrato socioeconómico dos [OR=5,8(1,54-22,3)], nivel de escolaridad secundaria [OR=0,12(0,16-0,96)], vivir con otros familiares [OR=3,45(1,7-7,02)], ingreso por trabajo sexual [OR=1,0(1,0-1,0)] y el sitio donde se ofrece el servicio [OR=0,07(0,04-0,15)]. Después de ajustar, se encontró que las variables que mejor explican el uso del condón fueron edad [OR=1,1(1,02-1,17)] y disponibilidad del condón [OR=0,04(0,008-0,024)], el modelo tuvo poca sensibilidad 33,3% y buena capacidad predictiva (84,6%). Las variables que mejor explicaron el consumo de alcohol durante el servicio fueron edad [OR= 0,95(0,91-0,98)], Número de clientes por semana [OR=0,9(0,90-0,98)], sitio donde ofrece el servicio [OR=7,1(3,45-14,8)], y estrato socioeconómico [OR=1,8 (0,90-3,83)], resultando un modelo con buena sensibilidad (71,8%) y buena capacidad predictiva (86,4%). Conclusiones Aspectos como la edad, el estrato socioeconómico, escolaridad, estado civil, ingreso económico por trabajo sexual, edad de inicio en el trabajo sexual, número de clientes antiguos en la última semana, disponibilidad del condón para prestar el servicio y ligadura de trompas como método diferente de planificación, se asociaron estadísticamente con el uso del condón. Sin embargo al ajustar las variables solo la edad y la disponibilidad del condón se mantuvieron como variables explicativas. Cabe anotar, que aunque el modelo mostró buena capacidad predictiva (84,6%), la precisión en sus estimaciones fue baja debido a la poca frecuencia del no uso del condón con el ultimo cliente (3,5%), y la sensibilidad del modelo apenas fue del 33,3%. Por otro lado, factores como la edad, el estrato socioeconómico, nivel educativo, ingreso económico, sitio de oferta del servicio, composición familiar, número de hijos, número de clientes atendidos en la última semana y número de clientes antiguos mostraron asociación estadística con el consumo de alcohol. Sin embargo, al ajustar las variables solo edad, estrato socioeconómico, sitio donde se ofrece el servicio y número de clientes por semana mantuvieron asociación estadística; observándose además que el estrato socioeconómico (uno y dos) y sitio donde se ofrece el servicio (establecimiento), son factores de riesgo para el consumo de alcohol en ejercicio de la ocupación y la poca edad y un número reducido de clientes por semana se comportan como factores de protección para el consumo de alcohol. El modelo predictivo que se desarrolló para la conducta de riesgo de consumo de alcohol, con una sensibilidad del 71,8% y un poder predictivo del 86,4%. .

Relación entre atrofia cortical difusa y desempeño cognitivo : estudio en población mayor de 60 años en un hospital universitario en la ciudad de Bogotá

El presente trabajo tuvo como objetivo evaluar la existencia de la relación entre la atrofia cortical difusa objetivada por neuroimagenes cerebrales y desempeños cognitivos determinados mediante la aplicación de pruebas neuropsicológicas que evalúan memoria de trabajo, razonamiento simbólico verbal y memoria anterógrada declarativa. Participaron 114 sujetos reclutados en el Hospital Universitario Mayor Méderi de la ciudad de Bogotá mediante muestreo de conveniencia. Los resultados arrojaron diferencias significativas entre los dos grupos (pacientes con diagnóstico de atrofia cortical difusa y pacientes con neuroimagenes interpretadas como dentro de los límites normales) en todas las pruebas neuropsicológicas aplicadas. Respecto a las variables demográficas se pudo observar que el grado de escolaridad contribuye como factor neuroprotector de un posible deterioro cognitivo. Tales hallazgos son importantes para determinar protocoles tempranos de detección de posible instalación de enfermedades neurodegenerativas primarias.

Flowering synchronization in hybrid rice parental lines.

The cultivation of hybrid rice is a technology that allows for an increase in grain yield of 30% relative to the grain yield of conventional cultivars. However, the main challenge for this technology is related to seed production, which has high production costs and low seed yields. Therefore, agronomic techniques that could enhance flowering synchrony of parental lines in the field are essential for an efficient production system of hybrid rice seeds. The objective of this work was to study the effects of sowing depth, plant density and fertilization with nitrogen or phosphorus as potential techniques to increase the pollen availability in the field and, consequently, the flowering synchrony between parental lines in the production of hybrid rice seeds. The experiments were conducted during two growing seasons in the Central Region of Brazil. All of the experiments were conducted as a randomized complete block in a split plot scheme; however, the experiment with P fertilization had a factorial design. Our research allow inferring that nitrogen fertilization technique applied to the soil or foliar at the time of panicle differentiation does not affect the time of onset of flowering of rice varieties INTA Puitá CL and L106R, which are potential R lines for the production of hybrid rice. Agronomic techniques of variation in sowing depth, seeding rate and the phosphate fertilization affect the time of onset of flowering from 10 to 19 degree-days, which could represent two days in the crop cycle, for the line L106R. Such techniques constitute potential alternatives for use in hybrid rice seed production systems and could be applied in alternated blocks of R lines in the field to obtain longer periods of pollen availability in the field.

Numeric model to estimate pesticide deposition and losses from aerial spraying.

Pesticides applications have been described by many researches as a very inefficient process. In some cases, there are reports that only 0.02% of the applied products are used for the effective control of the problem. The main factor that influences pesticides applications is the droplet size formed on spraying nozzles. Many parameters affects the dynamic of the droplets, like wind, temperature, relative humidity, and others. Small droplets are biologically more active, but they are affected by evaporation and drift. On the other hand, the great droplets do not promote a good distribution of the product on the target. In this sense, associated with the risk of non target areas contamination and with the high costs involved in applications, the knowledge of the droplet size is of fundamental importance in the application technology. When sophisticated technology for droplets analysis is unavailable, is common the use of artificial targets like water-sensitive paper to sample droplets. On field sampling, water-sensitive papers are placed on the trials where product will be applied. When droplets impinging on it, the yellow surface of this paper will be stained dark blue, making easy their recognition. Collected droplets on this papers have different kinds of sizes. In this sense, the determination of the droplet size distribution gives a mass distribution of the material and so, the efficience of the application of the product. The stains produced by droplets shows a spread factor proportional to their respectives initial sizes. One of methodologies to analyse the droplets is a counting and measure of the droplets made in microscope. The Porton N-G12 graticule, that shows equaly spaces class intervals on geometric progression of square 2, are coulpled to the lens of the microscope. The droplet size parameters frequently used are the Volumetric Median Diameter (VMD) and the Numeric Median Diameter. On VMD value, a representative droplets sample is divided in two equal parts of volume, in such away one part contains droplets of sizes smaller than VMD and the other part contains droplets of sizes greater that VMD. The same process is done to obtaining the NMD, which divide the sample in two equal parts in relation to the droplets size. The ratio between VMD and NMD allows the droplets uniformity evaluation. After that, the graphics of accumulated probability of the volume and size droplets are plotted on log scale paper (accumulated probability versus median diameter of each size class). The graphics provides the NMD on the x-axes point corresponding to the value of 50% founded on the y-axes. All this process is very slow and subjected to operator error. So, in order to decrease the difficulty envolved with droplets measuring it was developed a numeric model, implemented on easy and accessfull computational language, which allows approximate VMD and NMD values, with good precision. The inputs to this model are the frequences of the droplets sizes colected on the water-sensitive paper, observed on the Porton N-G12 graticule fitted on microscope. With these data, the accumulated distribution of the droplet medium volumes and sizes are evaluated. The graphics obtained by plotting this distributions allow to obtain the VMD and NMD using linear interpolation, seen that on the middle of the distributions the shape of the curves are linear. These values are essential to evaluate the uniformity of droplets and to estimate the volume deposited on the observed paper by the density (droplets/cm2). This methodology to estimate the droplets volume was developed by 11.0.94.224 Project of the CNPMA/EMBRAPA. Observed data of herbicides aerial spraying samples, realized by Project on Pelotas/RS county, were used to compare values obtained manual graphic method and with those obtained by model has shown, with great precision, the values of VMD and NMD on each sampled collector, allowing to estimate a quantities of deposited product and, by consequence, the quantities losses by drifty. The graphics of variability of VMD and NMD showed that the quantity of droplets that reachs the collectors had a short dispersion, while the deposited volume shows a great interval of variation, probably because the strong action of air turbulence on the droplets distribution, enfasizing the necessity of a deeper study to verify this influences on drift.

Sleep disorders in Multiple System Atrophy: a longitudinal study

Introduction: A higher frequency of sleep and breathing disorders in Multiple System Atrophy (MSA) populations is documented in literature. The analysis of disease progression and prognosis in patients with sleep and breathing disorders could shed light on specific neuropathology and pathophysiology of MSA. Objective: To characterize sleep disorders and their longitudinal modifications during disease course in MSA patients, and to determine their prognostic value. Methods: This is a retrospective and prospective cohort study including 182 MSA patients (58.8% males). Type of onset was defined by the first reported motor or autonomic symptom/sign related to MSA. The occurrence of symptoms/signs and milestones of disease progression and their latency were collected. REM sleep behaviour disorder (RBD) and stridor were video-polysomnography (VPSG)-confirmed. VPSG recordings were analysed in a standardized fashion during the disease course. Survival data were based on time to death from the first symptom of disease. Results: Isolated RBD represented the first MSA symptom in 30% of patients, preceding disease onset according to international criteria with a median of 3(1–5) years. Patients developing early stridor or presenting with RBD at disease onset showed a more rapid and severe disease progression. These features had independent negative prognostic value for survival. Sleep architecture was characterized by peculiar features which could represent negative markers in MSA prognosis. Patients with stridor treated with tracheostomy showed a reduced risk of death. Conclusions: This is one of the first studies focusing on longitudinal progression of sleep in MSA. Sleep disorders are key features of disease, playing a role in presentation, prognosis and progression. In our MSA cohort, RBD represented the most frequent mode of disease presentation. Moreover, some specific clinical and instrumental sleep features could represent a hallmark of MSA and could be involved in prognosis and, in particular, in sudden death and death during sleep.

Data-driven multivariate flood hazard modeling

The present Dissertation shows how recent statistical analysis tools and open datasets can be exploited to improve modelling accuracy in two distinct yet interconnected domains of flood hazard (FH) assessment. In the first Part, unsupervised artificial neural networks are employed as regional models for sub-daily rainfall extremes. The models aim to learn a robust relation to estimate locally the parameters of Gumbel distributions of extreme rainfall depths for any sub-daily duration (1-24h). The predictions depend on twenty morphoclimatic descriptors. A large study area in north-central Italy is adopted, where 2238 annual maximum series are available. Validation is performed over an independent set of 100 gauges. Our results show that multivariate ANNs may remarkably improve the estimation of percentiles relative to the benchmark approach from the literature, where Gumbel parameters depend on mean annual precipitation. Finally, we show that the very nature of the proposed ANN models makes them suitable for interpolating predicted sub-daily rainfall quantiles across space and time-aggregation intervals. In the second Part, decision trees are used to combine a selected blend of input geomorphic descriptors for predicting FH. Relative to existing DEM-based approaches, this method is innovative, as it relies on the combination of three characteristics: (1) simple multivariate models, (2) a set of exclusively DEM-based descriptors as input, and (3) an existing FH map as reference information. First, the methods are applied to northern Italy, represented with the MERIT DEM (∼90m resolution), and second, to the whole of Italy, represented with the EU-DEM (25m resolution). The results show that multivariate approaches may (a) significantly enhance flood-prone areas delineation relative to a selected univariate one, (b) provide accurate predictions of expected inundation depths, (c) produce encouraging results in extrapolation, (d) complete the information of imperfect reference maps, and (e) conveniently convert binary maps into continuous representation of FH.

Onset of recent rapid sea-level rise in the western Atlantic Ocean

A high-resolution record of sea-level change spanning the past 1000 years is derived from foraminiferal and chronological analyses of a 2m thick salt-marsh peat sequence at Chezzetcook, Nova Scotia, Canada. Former mean tide level positions are reconstructed with a precision of +/- 0.055 in using a transfer function derived from distributions of modern salt-marsh foraminifera. Our age model for the core section older than 300 years is based on 19 AMS C-14 ages and takes into account the individual probability distributions of calibrated radiocarbon ages. The past 300 years is dated by pollen and the isotopes Pb-206, Pb-207, Pb-210, Cs-137 and Am-241. Between AD 1000 and AD 1800, relative sea level rose at a mean rate of 17cm per century. Apparent pre-industrial rises of sea level dated at AD 1500-1550 and AD 1700-1800 cannot be clearly distinguished when radiocarbon age errors are taken into account. Furthermore, they may be an artefact of fluctuations in atmospheric C-14 production. In the 19th century sea level rose at a mean rate of 1.6mm/yr. Between AD 1900 and AD 1920, sea-level rise accelerated to the modern mean rate of 3.2mm/yr. This acceleration corresponds in time with global temperature rise and may therefore be associated with recent global warming. (c) 2005 Elsevier Ltd. All rights reserved.

Chronotopographical analysis of the pattern onset visual evoked magnetic response (VEMR):Implications for waveform peak identification

The topography of the visual evoked magnetic response (VEMR) to a pattern onset stimulus was studied in five normal subjects using a single channel BTi magnetometer. Topographic distributions were analysed at regular intervals following stimulus onset (chronotopograpby). Two distinct field distributions were observed with half field stimulation: (1) activity corresponding to the C11 m which remains stable for an average of 34 msec and (2) activity corresponding to the C111 m which remains stable for about 50 msec. However, the full field topography of the largest peak within the first 130 msec does not have a predictable latency or topography in different subjects. The data suggest that the appearance of this peak is dependent on the amplitude, latency and duration of the half field C11 m peaks and the efficiency of half field summation. Hence, topographic mapping is essential to correctly identify the C11 m peak in a full field response as waveform morphology, peak latency and polarity are not reliable indicators. © 1993.

Distributed source analysis of the pattern onset visual evoked magnetic response

Distributed source analyses of half-field pattern onset visual evoked magnetic responses (VEMR) were carried out by the authors with a view to locating the source of the largest of the components, the CIIm. The analyses were performed using a series of realistic source spaces taking into account the anatomy of the visual cortex. Accuracy was enhanced by constraining the source distributions to lie within the visual cortex only. Further constraints on the source space yielded reliable, but possibly less meaningful, solutions.

Beam Energy Dependence Of Moments Of The Net-charge Multiplicity Distributions In Au+au Collisions At Rhic.

We report the first measurements of the moments--mean (M), variance (σ(2)), skewness (S), and kurtosis (κ)--of the net-charge multiplicity distributions at midrapidity in Au+Au collisions at seven energies, ranging from sqrt[sNN]=7.7 to 200 GeV, as a part of the Beam Energy Scan program at RHIC. The moments are related to the thermodynamic susceptibilities of net charge, and are sensitive to the location of the QCD critical point. We compare the products of the moments, σ(2)/M, Sσ, and κσ(2), with the expectations from Poisson and negative binomial distributions (NBDs). The Sσ values deviate from the Poisson baseline and are close to the NBD baseline, while the κσ(2) values tend to lie between the two. Within the present uncertainties, our data do not show nonmonotonic behavior as a function of collision energy. These measurements provide a valuable tool to extract the freeze-out parameters in heavy-ion collisions by comparing with theoretical models.

Oxidative Stress And Susceptibility To Mitochondrial Permeability Transition Precedes The Onset Of Diabetes In Autoimmune Non-obese Diabetic Mice.

Beta cell destruction in type 1 diabetes (TID) is associated with cellular oxidative stress and mitochondrial pathway of cell death. The aim of this study was to determine whether oxidative stress and mitochondrial dysfunction are present in T1D model (non-obese diabetic mouse, NOD) and if they are related to the stages of disease development. NOD mice were studied at three stages: non-diabetic, pre-diabetic, and diabetic and compared with age-matched Balb/c mice. Mitochondria respiration rates measured at phosphorylating and resting states in liver and soleus biopsies and in isolated liver mitochondria were similar in NOD and Balb/c mice at the three disease stages. However, NOD liver mitochondria were more susceptible to calcium-induced mitochondrial permeability transition as determined by cyclosporine-A-sensitive swelling and by decreased calcium retention capacity in all three stages of diabetes development. Mitochondria H2O2 production rate was higher in non-diabetic, but unaltered in pre-diabetic and diabetic NOD mice. The global cell reactive oxygen species (ROS), but not specific mitochondria ROS production, was significantly increased in NOD lymphomononuclear and stem cells in all disease stages. In addition, marked elevated rates of 2',7'-dichlorodihydrofluorescein (H2DCF) oxidation were observed in pancreatic islets from non-diabetic NOD mice. Using matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) and lipidomic approach, we identified oxidized lipid markers in NOD liver mitochondria for each disease stage, most of them being derivatives of diacylglycerols and phospholipids. These results suggest that the cellular oxidative stress precedes the establishment of diabetes and may be the cause of mitochondrial dysfunction that is involved in beta cell death.

Factors Associated With The Onset Of Hypertension In Women Of 50 Years Of Age Or More In A City In Southeastern Brazil.

To evaluate factors associated with hypertension in Brazilian women of 50 years of age or more. A cross-sectional population based study using self-reports. A total of 622 women were included. The association between sociodemographic, clinical and behavioral factors and the woman's age at the onset of hypertension was evaluated. Data were analyzed according to cumulative continuation rates without hypertension, using the life-table method and considering annual intervals. Next, a Cox multiple regression analysis model was adjusted to analyze the occurrence rates of hypertension according to various predictor variables. Significance level was pre-established at 5% (95% confidence level) and the sampling plan (primary sampling unit) was taken into consideration. Median age at onset of hypertension was 64.3 years. Cumulative continuation rate without hypertension at 90 years was 20%. Higher body mass index (BMI) at 20-30 years of age was associated with a higher cumulative occurrence rate of hypertension over time (coefficient=0.078; p<0.001). Being white was associated with a lower cumulative occurrence rate of hypertension over time (coefficient= -0.439; p=0.003), while smoking >15 cigarettes/day was associated with a higher rate over time (coefficient=0.485; p=0.004). The results of the present study highlight the importance of weight control in young adulthood and of avoiding smoking in preventing hypertension in women aged ≥50 years.

Factors Associated With The Age Of The Onset Of Diabetes In Women Aged 50 years Or More: A Population-based Study.

Investigate factors associated with the onset of diabetes in women aged more than 49 years. Cross-sectional, population-based study using self-reports with 622 women. The dependent variable was the age of occurrence of diabetes using the life table method. Cox multiple regression models were adjusted to analyse the onset of diabetes according to predictor variables. Sociodemographic, clinical and behavioural factors were evaluated. Of the 622 women interviewed, 22.7% had diabetes. The mean age at onset was 56 years. The factors associated with the age of occurrence of diabetes were self-rated health (very good, good) (coefficient=-0.792; SE of the coefficient=0.215; p=0.0001), more than two individuals living in the household (coefficient=0.656, SE of the coefficient=0.223; p=0.003), and body mass index (BMI) (kg/m(2)) at 20-30 years of age (coefficient= 0.056, SE of the coefficient=0.023; p=0.014). Self-rated health considered good or very good was associated with a higher rate of survival without diabetes. Sharing a home with two or more other people and a weight increase at 20-30 years of age was associated with the onset of type 2 diabetes.

Onset Of Hypertension During Pregnancy Is Associated With Long-term Worse Blood Pressure Control And Adverse Cardiac Remodeling.

Up to 20% of women with hypertensive pregnancy disorders might persist with chronic hypertension. This study compared clinical and echocardiographic features between women whose hypertension began as hypertensive pregnancy disorders (PH group) and women whose diagnosis of hypertension did not occur during pregnancy (NPH group). Fifty PH and 100 NPH women were cross-sectionally evaluated by clinical, laboratory, and echocardiography analysis, and the groups were matched by duration of hypertension. PH exhibited lower age (46.6 ± 1.4 vs. 65.3 ± 1.1 years; P < .001), but higher systolic (159.8 ± 3.9 vs. 148.0 ± 2.5 mm Hg; P = .009) and diastolic (97.1 ± 2.4 vs. 80.9 ± 1.3 mm Hg; P < .001) blood pressure than NPH, although used more antihypertensive classes (3.4 ± 0.2 vs. 2.6 ± 0.1; P < .001). Furthermore, PH showed higher left ventricular wall thickness and increased prevalence of concentric hypertrophy than NPH after adjusting for age and blood pressure. In conclusion, this study showed that PH may exhibit worse blood pressure control and adverse left ventricular remodeling compared with NPH.