Cross-cultural adaptation of the Cambridge Pulmonary Hypertension Outcome Review for use in patients with pulmonary hypertension in Colombia

OBJECTIVE

To conduct a cross-cultural adaptation of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) as an instrument to evaluate the perception of symptoms, functional limitation, and health-related quality of life (HRQoL) in subjects diagnosed with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) in Colombia.

METHODS

The adaptation process involved 3 phases: translation, cognitive debriefing interviews, and a validation survey. To evaluate the psychometric properties, we recruited individuals ≥ 18 years of age who had been diagnosed with PAH or CTEPH to take part in the latter two stages of the adaptation process. All individuals were being followed on an outpatient basis by the pulmonary hypertension programs at Hospital Universitario San Ignacio, Fundación Clínica Shaio,and Clínicos IPS, all located in the city of Bogotá, Colombia.

RESULTS

A Spanish-language version of the CAMPHOR was developed for use in Colombia. The internal consistency was excellent for the symptoms, functioning, and quality of life scales (Cronbach's alpha coefficients of 0.92, 0.87, and 0.93, respectively). Test-retest reliability was above 0.70. The evaluation of the convergent validity and known group validity of the CAMPHOR scales confirmed that there were moderate and strong correlations with the related constructs of the Medical Outcomes Study 36-item Short-Form Health Survey, version 2, as well as showing their capacity to discriminate disease severity.

CONCLUSIONS

The Spanish-language version of the CAMPHOR developed for use in Colombia was the result of a translation and cultural adaptation process that allows us to consider it equivalent to the original version, having shown good psychometric properties in the study sample. Therefore, its use to assess the impact of interventions on the HRQoL of patients with PAH or CTEPH is recommended, in research and clinical practice.

[Non-critical care hospital-acquired acute kidney injury. Analysis of 101 cases]

BACKGROUND

Non-critical care Hospital-Acquired Acute Kidney Injury (Non-ICU HA-AKI) is a preventable common complication.

AIM

To analyze its risk factors and outcomes in a general hospital ward.

MATERIAL AND METHODS

A retrospective paired case-control 1:2 study was carried out from April to December 2014. Non-ICU HA-AKI was defined as those patients who experienced a 1.5-fold, or 0.3 mg/dl rise in serum creatinine after 24 hours of hospitalization. Controls were randomly selected, paired by date of hospital admission and specialty causing the admission. We analyzed short-term outcomes and risk factors.

RESULTS

We included 101cases aged 65 ± 16 years (55% women). Mean length of stay at the time of diagnosis of AKI was 7.9 ± 8.9 days. Hospital length of stay was longer in patients with AKI (p < 0.01), The risk for intensive care unit (ICU) admission and mortality were also higher (odds ratio [OR], 2.43 [95% confidence intervals (CI), 1.24 to 4.75)p < 0.01 and OR, 26.2 [95% CI, 8.8 to 104, P < 0.01). In a multivariate analysis, sepsis (OR, 3.64 [95% CI, 1.30 to 10.16] p = 0.013), dehydration (OR, 14.4 [95% CI, 4.49 to 46.19), baseline glomerular filtration (OR, 0.96 [95% CI, 0.94-0.98), contrast medium exposure (OR, 4.33 [95% CI, 1.60 to 11.66), recent exposure to Nonsteroidal Anti-inflammatory Drugs (OR 3.23 [95% CI, 1.22 to 8.52 (p = 0.02)] and Charlson comorbidity index (OR, 1.23 [95% CI, 1.05 to 1.43 (p < 0.01) were independent risk factors for Non-ICU HA-AKI.

CONCLUSIONS

Non-ICU HA-AKI is associated with a longer hospital stay and higher risk of ICU admission and mortality. Most risk factors are potentially preventable.

Bulk Polymerization of Styrene using Multifunctional Initiators in a Batch Reactor: A Comprehensive Mathematical Model

A detailed, comprehensive mathematical model for bulk polymerization of styrene using multifunctional initiators – both linear and cyclic – in a batch reactor was developed. The model is based on a kinetic mechanism that considers thermal initiation and chemical initiation by sequential decomposition of labile groups, propagation, transfer to monomer, termination by combination and re-initiation reactions due to undecomposed labile groups. The model predicts the evolution of global reaction variables (e.g, concentration of reagents, products, radical species and labile groups) as well as the evolution of the detailed complete polymer molecular weight distributions, with polymer species characterized by chain length and number of undecomposed labile groups. The mathematical model was adjusted and validated using experimental data for various peroxide-type multifunctional initiators: diethyl ketone triperoxide (DEKTP, cyclic trifunctional), pinacolone diperoxide (PDP, cyclic bifunctional) and 1,1-bis(tert-butylperoxy)cyclohexane (L331, linear bifunctional). The model very adequately predicts polymerization rates and complete molecular weight distributions. The model is used to theoretically evaluate the influence of initiator structure and functionality as well as reaction conditions.

Molecular diversity of bovine viral diarrhea virus in uruguay

Bovine viral diarrhea (BVD) affects bovine production and reproduction causing significant economic losses all over the world. Two viral species has been recognized: BVDV-1 and BVDV-2, both distributed worldwide. Recently, novel specie of BVDV named HoBi-like pestivirus was discovered. The presence of BVDV was confirmed in 1996 in Uruguay, however, does not exist until today a schedule of compulsory vaccination along the country. Serological studies with samples from all Uruguayan herds were performed during 2000 and 2001 demonstrating that all of them were seropositive to BVDV with a mean prevalence of 69%. In addition, there have been no new studies done since those previously described and it is important to mention that the genetic diversity of BVD has never been described in Uruguay. Nowadays, there is strongly suspect that BVDV is one of the most important causes of reproductive failures in our herds. The aim of this study was to describe for the first time in Uruguay the genetic diversity of BVDV with samples collected from different regions along the country. Serological status of 390 non-vaccinated animals against BVDV with reproductive problems from farms of Rivera, Tacuarembó and Florida departments of Uruguay were studied. All herds were seropositive to BVDV and high proportion of animals were positive (298/390), while 4.1% (16/390) of the animals were positive to Antigen Capture ELISA test and Real Time PCR. Phylogenetic analysis performed with concatenated sequences from the 5'UTR and Npro genomic regions revealed that BVDV-1 and BVDV-2 are infecting our herds, being BVDV-1 the most frequently found. The major subtype was BVDV-1a, followed by BVDV-1i and BVDV-2b. This is the first study that describes the genetic diversity of BVDV in Uruguay and it will contribute to the elaboration of sanitization programs.

Evidence that the proliferation stage of micropropagation procedure is determinant in the expression of banana streak virus integrated into the genome of the FHIA 21 hybrid (Musa AAAB)

Banana streak virus (BSV) is causing increasing concern in almost every producing area of banana and plantain (Musa spp.) worldwide. This situation appeared partially linked to some breeding lines and micropropagated hybrids. A complete BSV sequence integrated into the genome of a triploid plantain has been recently characterised and it has been hypothesised that it could give rise to infectious virus via recombination. In this study, we evaluated the effect of a routine micropropagation procedure on the expression of BSV in the FHIA 21 tetraploid hybrid. The widespread presence of integrated sequences and the absence of episomal BSV in thirty FHIA 21 "mother plants" selected for micropropagation were first confirmed by specific PCR and IC-PCR tests. The proliferation stage of the procedure, characterised by an intensive production of neoformed buds, appeared determinant in BSV expression whereas the rooting and acclimatisation stages had little or no effect. The duration in culture and the way of subdividing the clumps of proliferation influenced greatly the percentage of episomal BSV infections, reaching 58% of infected micropropagated lines after six in vitro subcultures. These data suggest that the expression of episomal BSV observed during the in vitro procedure is correlated with the presence of an integrated form.

Evidence that the proliferation stage of micropropagation procedure is determinant in the expression of banana streak virus integrated into the genome of the FHIA 21 hybrid (Musa AAAB)

Banana streak virus (BSV) is causing increasing concern in almost every producing area of banana and plantain (Musa spp.) worldwide. This situation appeared partially linked to some breeding lines and micropropagated hybrids. A complete BSV sequence integrated into the genome of a triploid plantain has been recently characterised and it has been hypothesised that it could give rise to infectious virus via recombination. In this study, we evaluated the effect of a routine micropropagation procedure on the expression of BSV in the FHIA 21 tetraploid hybrid. The widespread presence of integrated sequences and the absence of episomal BSV in thirty FHIA 21 "mother plants" selected for micropropagation were first confirmed by specific PCR and IC-PCR tests. The proliferation stage of the procedure, characterised by an intensive production of neoformed buds, appeared determinant in BSV expression whereas the rooting and acclimatisation stages had little or no effect. The duration in culture and the way of subdividing the clumps of proliferation influenced greatly the percentage of episomal BSV infections, reaching 58% of infected micropropagated lines after six in vitro subcultures. These data suggest that the expression of episomal BSV observed during the in vitro procedure is correlated with the presence of an integrated form.

Phosphorylation protects sperm-specific histones H1 and H2B from proteolysis after fertilization

At intermediate stages of male pronucleus formation, sperm-derived chromatin is composed of hybrid nucleoprotein particles formed by sperm H1 (SpH1), dimers of sperm H2A-H2B (SpH2A-SpH2B), and a subset of maternal cleavage stage (CS) histone variants. At this stage in vivo, the CS histone variants are poly(ADP-ribosylated), while SpH2B and SpH1 are phosphorylated. We have postulated previously that the final steps of sperm chromatin remodeling involve a cysteine-protease (SpH-protease) that degrades sperm histones in a specific manner, leaving the maternal CS histone variants unaffected. More recently we have reported that the protection of CS histones from degradation is determined by the poly(ADP-ribose) moiety of these proteins. Because of the selectivity displayed by the SpH-protease, the coexistence of a subset of SpH together with CS histone variants at intermediate stages of male pronucleus remodeling remains intriguing. Consequently, we have investigated the phosphorylation state of SpH1 and SpH2B in relation to the possible protection of these proteins from proteolytic degradation. Histones H1 and H2B were purified from sperm, phosphorylated in vitro using the recombinant alpha-subunit of casein kinase 2, and then used as substrates in the standard assay of the SpH-protease. The phosphorylated forms of SpH1 and SpH2B were found to remain unaltered, while the nonphosphorylated forms were degraded. On the basis of this result, we postulate a novel role for the phosphorylation of SpH1 and SpH2B that occurs in vivo after fertilization, namely to protect these histones against degradation at intermediate stages of male chromatin remodeling.

[Epizootic outbreaks of trichinosis in 2 pig farms from the Metropolitan Region of Chile]

In Chile swine trichinosis has presented a progressive decreasing in the last two decades of XX century. T. spiralis pig infection descended from an average of 0.683 per 1000 in 1980-1984 to 0.315 in 1985-1989 and to 0.115 in 1990-1996. In the particular case of Metropolitan Region this decreasing has been more marked: from an average of 0.058 per 1000 in 1990-1994 to 0.003 in 1995-1999. Between the end of June 1999 and middle January 2000 in Metropolitan Region abattoirs T. spiralis was detected in 15 (4.9%) out of 306 swine from two pigsties located in El Monte (E.M.) and Padre Hurtado (P.H.) 45 and 30 km south-west from Santiago. In the same period another four pigs from the same premises were found infected in abattoirs of other regions. During inspection visits it was stated that both pig farms had deficient sanitary conditions. Phototrichinoscopy was positive in three out of five Rattus norvegicus collected in E.M. In pigsty PH the examination of diaphragm samples of 25 dogs and 17 cats resulted negative. In the premises originating T. spirali infected swine the Metropolitan Environmental Health Service Abattoirs Program carries out an epidemiological vigilance consisting in the follow-up of animals destined for slaughtering in order to initiate prophylactic actions oriented to eliminate eventual sources of trichinosis infection for human and rearing pigs.