Systemic candidiasis is a frequent opportunistic mycosis that can be life-threatening. Its main etiological agent is Candida albicans; however, the isolation of non-albicans Candida species has been increasing. Some of these species exhibit greater resistance to antifungals, so the rapid and specific identification of yeasts is crucial for a timely diagnosis and optimal treatment of patients. Multiple molecular assays have been developed, based mainly on polymerase chain reaction (PCR), showing high specificity and sensitivity to detect and identify Candida spp. Nevertheless, its application in diagnosis has been limited due to specialized infrastructure or methodological complexity. The objective of this study was to develop a PCR assay that detects and identifies some of the most common pathogenic Candida species and evaluate their diagnostic utility in blood samples and bronchial lavage. A pair of oligonucleotides was designed, CandF and CandR, based on sequence analysis of the 18S-ITS1-5.8S-ITS2-28S region of the rDNA of Candida spp., deposited in GenBank. The designed oligonucleotides identified C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei/Pichia kudriazevii, C. guilliermondii/Meyerozyma guilliermondii, C. lusitaniae/Clavispora lusitaniae, and C. dubliniensis using simplex PCR based on the amplicon size, showing a detection limit of 10 pg/μL of DNA or 103 yeasts/mL. Based on cultures as the gold standard, it was determined that the sensitivity (73.9%), specificity (96.3%), and the positive (94.4%) and negative (81.2%) predictive values of the PCR assay with the designed oligonucleotides justify their reliable use in diagnosis.
Mexico ranks third in COVID-19 worldwide mortality [1]. After a year of the onset of the first cases, one of the main concerns of this global pandemic is to mitigate contagion. The CDC recently issued a statement requesting the use of double face masks to prevent the spread of the new B 1.1.7 variants, which have a 75% higher transmissibility than variants 501.Y2 and P.1 [2,3]. SARS-CoV-2 is transmitted through droplet particles (> 5 to 10 μm) or aerosols (≤5 μm). These particles are released when an infected ARTICLE INFO ABSTRACTIntroduction: One of the main routes of transmission of SARS-CoV-2 is through the nostrils. The virus binds to the ACE2 cellular receptor facilitating its spread to the Central Nervous System (CNS), whose affectation can cause epilepsy, encephalitis, and acute respiratory distress syndrome (ARDS). The nasal mask is a protective barrier that allows the correct filtration of inhaled and exhaled air, preventing the entry of various respiratory microorganisms. Material and Methods:The prototyping materials were polypropylene fabric (100%) Spunbond-Meltblown-Spunbond, commonly known as SMS, which is a hypoallergenic, breathable, tri-laminate fabric that has a particle capture efficiency of 0.3 µm. SMS also allows adequate ventilation and is water-repellent, so it blocks the passage of pathogenic microorganisms from bodily fluids through the fabric, providing an efficiency greater than 99%. Results and Discussion:The nasal mask will not displace the face mask. On the contrary, it will be an additional protective measure in daily activities where the conventional face mask has to be removed, reducing SARS-CoV-2 infections, and preventing the virus from spreading to the CNS. The final prototype adapts appropriately to the face, allowing adequate air filtration, and it does not affect the palatability of food. It can be used under the face mask, providing comfort, double protection, and easy access when removing the face mask and leaving the mouth uncovered. Conclusion:The nasal mask is an alternative for patients treated in dental offices, diners in restaurants when actively eating or drinking, and long-duration flight passengers eating meals. The nasal mask will allow the economic reactivation of these productive activities while reducing the risk of contagion.
Objetivo: Con el objetivo de mejorar la atención del paciente en nuestro hospital, se implementó la auditoría de la «entrega de guardia». Métodos: El formato de entrega de guardia fue diseñado para evaluar la calidad y la efectividad de la atención del paciente, el intervalo establecido para la implementación de las acciones de mejora en cada turno fue de septiembre de 2015 a octubre de 2016. Resultados: Posterior al periodo de implementación el porcentaje de cumplimiento con estas 5 acciones medidas fueron 1) Interconsulta por un médico especialista, solicitado en el turno por otro personal médico, 98%; 2) Procedimiento diagnóstico y / o terapéutico solicitado y ejecutado en el mismo turno, 98%; 3) Ejecución de pendientes entregados y no realizados en el turno previo 97%; 4) Realización del Formato de Entrega de Guardia 97%; 5) Adecuado llenado del Formato de Entrega de Guardia 100%. A pesar de tener mejoría significativa la efectividad neta posterior a la implementación de acciones de mejora fue menor del 40%. Conclusiones: Una vez que estas cinco acciones de mejora fueron implementadas basadas en los procesos de autoevaluación y mejora continua, el porcentaje de cumplimiento de los parámetros evaluados y la eficiencia incrementaron de manera sustancial, en beneficio a la atención de los pacientes del Hospital Regional de Alta Especialidad de Ixtapaluca.Palabras clave: Auditoria Clínica. Entrega de guardia. Calidad.Background: With the aim of improving patient care at our hospital, a Handoff Audit was carried out. Methods: A Handoff format was designed evaluating the quality and effectiveness of patient care. A time interval was established for the implementation of improvement actions on each work shift, from September 2015 through October 2016. Results: After the implementation period, the percentages of compliance with the 5 actions measured were: 1) interconsultation by a medical specialist, requested on the working day by another physician, 98%; 2) diagnostic and / or therapeutic procedure requested and executed on the same working day, 98%; 3) execution of pending tasks not completed in the previous turn, 97%; 4) compliance with the Handoff Format, 97%; and 5) adequate completion of the Handoff Format, 100%. Despite the significant progress made after the implementation of improvement actions, the net efficacy was less than 40%. Conclusions: Once these five actions were implemented based on the self-assessment and continuous improvement processes, the percentage of compliance with the evaluated parameters and efficacy increased substantially, benefiting patient care at the High-Specialty Regional Hospital of Ixtapaluca.
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