Validación del delta base déficit como modelo predictor de resultados en pacientes politraumáticos. Hospital Parc Taulí Sabadell. Estudio preliminar

Les escales de valoració al pacient politraumàtic són essencials per al seu maneig i pronòstic. Podem definir índexs de gravetat o probabilitat de supervivència. Segons quins paràmetres analitzi, podem parlar d’escales fisiològiques, anatòmiques, bioquímiques i els índexs de probabilitat de supervivència. El BISS és un model de probabilitat provat a Holanda que ha demostrat ser objectiu. El nostre treball consisteix en la validació del BISS als nostres pacients. Durant dos anys vàrem recollir 354 pacients podent incloure només 167 al nostre estudi. Els resultats van ser significatius amb l’estudi posterior, però degut a la gran pèrdua de pacients no podem afirmar la nostra hipòtesi.

Three-dimensional models of 14α-sterol demethylase (Cyp51A) from Aspergillus lentulus and Aspergillus fumigatus: an insight into differences in voriconazole interaction.

Aspergillus lentulus, an Aspergillus fumigatus sibling species, is increasingly reported in corticosteroid-treated patients. Its clinical significance is unknown, but the fact that A. lentulus shows reduced antifungal susceptibility, mainly to voriconazole, is of serious concern. Heterologous expression of cyp51A from A. fumigatus and A. lentulus was performed in Saccharomyces cerevisiae to assess differences in the interaction of Cyp51A with the azole drugs. The absence of endogenous ERG11 was efficiently complemented in S. cerevisiae by the expression of either Aspergillus cyp51A allele. There was a marked difference between azole minimum inhibitory concentration (MIC) values of the clones expressing each Aspergillus spp. cyp51A. Saccharomyces cerevisiae clones expressing A. lentulus alleles showed higher MICs to all of the azoles tested, supporting the hypothesis that the intrinsic azole resistance of A. lentulus could be associated with Cyp51A. Homology models of A. fumigatus and A. lentulus Cyp51A protein based on the crystal structure of Cyp51p from Mycobacterium tuberculosis in complex with fluconazole were almost identical owing to their mutual high sequence identity. Molecular dynamics (MD) was applied to both three-dimensional protein models to refine the homology modelling and to explore possible differences in the Cyp51A-voriconazole interaction. After 20ns of MD modelling, some critical differences were observed in the putative closed form adopted by the protein upon voriconazole binding. A closer study of the A. fumigatus and A. lentulus voriconazole putative binding site in Cyp51A suggested that some major differences in the protein's BC loop could differentially affect the lock-up of voriconazole, which in turn could correlate with their different azole susceptibility profiles.

Pharmacological Approaches to Antitrypanosomal Chemotherapy

There is an urgent need for new drugs for the chemotherapy of human African trypanosomiasis, Chagas disease and leishmaniasis. Progress has been made in the identification and characterization of novel drug targets for rational chemotherapy and inhibitors of trypanosomatid glycosomal enzymes, trypanothione reductase, ornithine decarboxylase, S-adenosylmethionine decarboxylase, cysteine proteases and of the purine and sterol biosynthetic pathways. However, less attention has been paid to the pharmacological aspects of drug design or to the use of drug delivery systems in the chemotherapy of African trypanosomiasis and Chagas disease. A review of research on pharmacology and drug delivery systems shows that there are new opportunities for improving the chemotherapy of these diseases.

Reacción a "Pyricularia grisea" de las variedades más importantes de arroz cultivadas en el Delta del Ebro, durante el período 2000-2008

La pyriculariosis del arroz, causada por el hongo Pyricularia grisea (Cooke) Sacc., es una enfermedad que provoca daños considerables en la zona arrocera del Delta del Ebro. El hongo puede infectar el cultivo en todos los estadios de crecimiento y también en las partes aéreas de la planta: hoja, nudo del tallo, cuello y panícula. El uso de variedades resistentes para el control de la enfermedad es un método económico y efectivo, pero esta resistencia puede verse modificada con la presencia en la zona de nuevas poblaciones de P. grisea de tipo virulento, por lo que esta herramienta se debe utilizar bajo un concepto dinámico. El presente trabajo se centra en el estudio del comportamiento frente a P. grisea de un grupo de variedades de arroz cultivadas en el Delta del Ebro durante el período 2000-2008. El perfil varietal del Delta del Ebro durante este período ha ido variando constantemente y la mayoría de variedades principales que se han cultivado o se cultivan actualmente han presentado un comportamiento de tipo moderado frente a P. grisea.

Fatty Acid and Sterol Composition of Three Phytomonas Species

Fatty acid and sterol analysis were performed on Phytomonas serpens and Phytomonas sp. grown in chemically defined and complex medium, and P. françai cultivated in complex medium. The three species of the genus Phytomonas had qualitatively identical fatty acid patterns. Oleic, linoleic, and linolenic were the major unsaturated fatty acids. Miristic and stearic were the major saturated fatty acids. Ergosterol was the only sterol isolated from Phytmonas sp. and P. serpens grown in a sterol-free medium, indicating that it was synthesized de novo. When P. françai that does not grow in defined medium was cultivated in a complex medium, cholesterol was the only sterol detected. The fatty acids and sterol isolated from Phytomonas sp. and P. serpens grown in a chemically defined lipid-free medium indicated that they were able to biosynthesize fatty acids and ergosterol from acetate or from acetate precursors such as glucose or threonine.

A 35.7 kb DNA fragment from the Bacillus subtilis chromosome containing a putative 12.3 kb operon involved in hexuronate catabolism and a perfectly symmetrical hypothetical catabolite-responsive element.

The Bacillus subtilis strain 168 chromosomal region extending from 109 degrees to 112 degrees has been sequenced. Among the 35 ORFs identified, cotT and rapA were the only genes that had been previously mapped and sequenced. Out of ten ORFs belonging to a single putative transcription unit, seven are probably involved in hexuronate catabolism. Their sequences are homologous to Escherichia coli genes exuT, uidB, uxaA, uxaB, uxaC, uxuA and uxuB, which are all required for the uptake of free D-glucuronate, D-galacturonate and beta-glucuronide, and their transformation into glyceraldehyde 3-phosphate and pyruvate via 2-keto-3-deoxygluconate. The remaining three ORFs encode two dehydrogenases and a transcriptional regulator. The operon is preceded by a putative catabolite-responsive element (CRE), located between a hypothetical promoter and the RBS of the first gene. This element, the longest and the only so far described that is fully symmetrical, consists of a 26 bp palindrome matching the theoretical B. subtilis CRE sequence. The remaining predicted amino acid sequences that share homologies with other proteins comprise: a cytochrome P-450, a glycosyltransferase, an ATP-binding cassette transporter, a protein similar to the formate dehydrogenase alpha-subunit (FdhA), protein similar to NADH dehydrogenases, and three homologues of polypeptides that have undefined functions.

Toxic phytoplankton response to warming in two Mediterranean bays of the Ebro Delta

The analysis of the phytoplankton and environmental parameters of the time series in Alfacs and Fangar bays (north western Mediterranean) from 1990 to 2009 shows some trends. There is an increase in the average water column temperature, 0.11, 0.01, 0.80 and 0.23 ºC for spring, summer, fall and winter respectively in Alfacs Bay and 1.76, 0.71, 1.33, 0.89 ºC for spring, summer, fall and winter in Fangar Bay. The trends in phytoplankton populations show a shift in the timing of occurrence of Karlodinium spp. blooms and an increase of the Pseudo-nitzschia spp. abundances. There is a lack of correlation between the average seasonal temperatures and the toxic phytoplankton abundances.

IPH response to Department of Environment (NI) Planning Policy Statement 7

The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health.  The Institute promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. IPH acknowledge that health is influenced by a wide range of social determinants, including economic, environmental, social and biological factors.  Housing and residential areas are identified as key determinants of health and IPH welcomes the opportunity to comment on the Department of the Environment (DoE), Draft Addendum to Planning Policy Statement 7.

CMO Annual Report 2011-12 (PDF 7.64MB)

Chief Medical Officer Annual Report 2011-2012

7 steps to cleanliness (PDF 280 KB)

7 steps to cleanliness poster for hospital use

Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase of isolates from the Amazon Region of Brazil

Since the late 1970s pyrimethamine-sulfadoxine (PS; FansidarTM Hoffman-LaRoche, Basel) has been used as first line therapy for uncomplicated malaria in the Amazon basin. Unfortunately, resistance has developed over the last ten years in many regions of the Amazon and PS is no longer recommended for use in Brazil. In vitro resistance to pyrimethamine and cycloguanil (the active metabolite of proguanil) is caused by specific point mutations in Plasmodium falciparum dihydrofolate reductase (DHFR), and in vitro resistance to sulfadoxine has been associated with mutations in dihydropteroate synthase (DHPS). In association with a proguanil-sulfamethoxazole clinical trial in Brazil, we performed a nested mutation-specific polymerase chain reaction to measure the prevalence of DHFR mutations at codons 50, 51, 59, 108 and 164 and DHPS mutations at codons 436, 437, 540, 581 and 613 at three sites in the Brazilian Amazon. Samples from two isolated towns showed a high degree of homogeneity, with the DHFR Arg-50/Ile-51/Asn-108 and DHPS Gly-437/Glu-540/Gly-581 mutant genotype accounting for all infections in Peixoto de Azevedo (n = 15) and 60% of infections in Apiacás (n = 10), State of Mato Grosso. The remaining infections in Apiacás differed from this predominant genotype only by the addition of the Bolivia repeat at codon 30 and the Leu-164 mutation in DHFR. By contrast, 17 samples from Porto Velho, capital city of the State of Rondônia, with much in- and out-migration, showed a wide variety of DHFR and DHPS genotypes.