National Autonomous University of Nicaragua

About: National Autonomous University of Nicaragua is a education organization based out in Managua, Nicaragua. It is known for research contribution in the topics: Population & Public health. The organization has 775 authors who have published 715 publications receiving 9791 citations.

Association of Genetic Polymorphisms in DC-SIGN, Toll-Like Receptor 3, and Tumor Necrosis Factor α Genes and the Lewis-Negative Phenotype With Chikungunya Infection and Disease in Nicaragua.

Abstract: Background Chikungunya infections range from subclinical infection to debilitating arthralgia and to chronic inflammatory rheumatism. Tumor necrosis factor (TNF) α, DC-SIGN (dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin), Toll-like receptor (TLR) 3, and blood groups have been directly or indirectly implicated in the susceptibility and pathogenesis of chikungunya. Methods To test the hypothesis that polymorphisms in genes coding for these molecules determine clinical outcomes of chikungunya infection, a retrospective case-control study was performed in Leon, Nicaragua. The study included 132 case patients and 132 controls, matched for age, sex and neighborhood. Case patients had clinical symptoms of chikungunya, which was diagnosed by means of polymerase chain reaction. Controls were individuals not reporting abrupt presentation of clinical chikungunya-like symptoms. Polymorphisms were identified by TaqMan single-nucleotide polymorphism genotyping assays. Results After adjustment for sociodemographic risk factors, chikungunya disease was associated with polymorphism in DC-SIGN and TLR3 genes (odds ratios, 5.2 and 3.3, respectively), and TNF-α with reduced persistent joint pain (0.24). Persistent joint pain was also associated with age, female sex and other comorbid conditions. Most interestingly, the Lewis-negative phenotype was strongly associated with both symptomatic chikungunya and immunoglobulin G seropositivity (odds ratios, 2.7, and 3.3, respectively). Conclusion This study identified polymorphisms in DC-SIGN, TLR3, and TNF-α genes as well as Lewis-negative phenotype as risk factors for chikungunya infection and disease progression.

Exploring Risk Factors of Patient Falls: A Retrospective Hospital Record Study in Japan.

Abstract: Patient falls are common adverse medical events in hospitals. The objectives of this study were to clarify the factors of patient falls at hospitalization or transfer to another ward, which could be assumed that patients experience new environment. Patients who were hospitalized or transferred to another ward at a hospital in Japan, between January 14 and February 14, 2014 were included. We used a risk assessment sheet and applied stepwise regression analysis to identify factors of patient falls. We also investigated changes in patient conditions on the risk assessment sheet by the chi-square test. A total of 1,362 patients (53.2% female; mean age, 57.1 ± 18.0 years) were eligible for analysis, and 38 (2.8%) fell during the study period. The fallers were significantly older than the non-fallers (63.8 ± 18.0 vs. 56.9 ± 18.7 years, P = 0.03), but no significant difference was seen in sex (55.3% vs. 53.1% female). "History of falls", "Tubes inserted", "Need assistance/supervision for toileting" and "Excretion more than two times per night" were significantly related to patient falls (adjusted odds ratios [95% confidence interval]: 2.41 [1.05-5.53], 3.64 [1.57-8.43], 4.52 [2.00-10.23] and 3.92 [1.38-11.09]). Among 30 fallers, "Overestimation or non-understanding of own physical abilities" was significantly more frequent after falls (30.0%) than before falls (6.7%, P = 0.02). The factors found in this study might be useful for identifying patients at higher risk of falls.

Diversity of intestinal Escherichia coli populations in Nicaraguan children with and without diarrhoea

Abstract: Escherichia coli remains an important aetiological agent of infantile diarrhoea in Nicaragua. However, little is known about whether there is a high prevalence of endemic strains or whether infection is due to the epidemic spread of virulent clones. This study was undertaken to determine the diversity and distribution of clonal groups in a population of intestinal E. coli isolated from the faeces of children from Leon, Nicaragua, with (n=381) and without (n=145) diarrhoea, between March 2005 and September 2006. All samples had been screened previously for the presence of diarrhoeagenic E. coli (DEC) markers by multiplex PCR. From each sample, 8 E. coli colonies (where available) were analysed by biochemical fingerprinting (PhP-RE system), yielding a total of 4009 tested isolates. On average, three different biochemical phenotypes (BPTs) were found among the eight colonies analysed from each sample. The total diversity, measured as Simpson's diversity index (Di), was 0.97 among all 4009 isolates studied. Cluster analysis of data from all 4009 isolates revealed 24 common BPTs (identified in at least 1 % of the isolates) and 234 less common BPTs. Similar Di values were obtained among isolates from infants with and without diarrhoea, indicating that no widespread outbreak of DEC had occurred. Moreover, among samples that were positive for the DEC types enteroaggregative E. coli, enteropathogenic E. coli and enterotoxigenic E. coli (ETEC) carrying the eltB gene, the diversities were almost as high as among non-DEC samples, whereas samples positive for ETEC carrying estA, enteroinvasive E. coli and enterohaemorrhagic E. coli showed lower diversities, indicating the prevalence of virulent clonal groups among these samples. The PhenePlate patterns of the 24 common BPTs identified here were compared with those obtained from E. coli isolated in a cohort infant study performed in 1991-1992 in the same area. Only 4 % of the isolates from the 1990s were similar to any of the common BPTs found in the present study.

Temporal and spatial distribution of waterborne mercury in a gold miner's river.

Abstract: We examined the spatial and temporal (hourly) variation of aqueous concentrations of mercury in a gold miner's river to determine factors that control transport, retention, and export of mercury. The mercury flux was estimated to account for episodic inputs of mercury through mining tailings, variations in flow rate, and the partitioning of mercury between dissolved and particulate phases. Water samples were collected upstream and downstream of two gold mining sites in the Artiguas river, Nicaragua. The samples were analyzed for dissolved and suspended mercury, total solids, dissolved organic carbon, and total iron in water. Water velocity was also measured at the sampling sites. We found that mercury was mainly transported in a suspended phase, with a temporal pattern of diurnal peaks corresponding to the amalgamation schedules at the mining plants. The concentrations decreased with distance from the mining sites, suggesting dilution by tributaries or sedimentation of particle-bound mercury. The lowest total mercury concentrations in the water were less than 0.1 μg l(-1) and the highest concentration was 5.0 μg l(-1). The mercury concentrations are below the present WHO guidelines of 6 μg l(-1) but are considered to lead to a higher risk to aquatic bacteria and fish in the stream than to humans. The aqueous concentrations exceed the hazard endpoints for both groups by a probability of about 1%. Particulate mercury accounted for the largest variation of mercury fluxes, whereas dissolved mercury made up most of the long-range transport along the stream. The estimated total mass of mercury retained due to sedimentation of suspended solids was 2.7 kg per year, and the total mass exported downstream from the mining area was 1.6 kg per year. This study demonstrates the importance of the temporal and spatial resolution of observations in describing the occurrence and fate of mercury in a river affected by anthropogenic activities.

Síndrome de Burnout en médicos y personal de enfermería del Hospital Escuela “Oscar Danilo Rosales Argüello”, León, 2007.

Abstract: Se realizo un estudio de corte transversal para estudiar la presencia del sindrome de Burnout en el Hospital Escuela Oscar Danilo Rosales Arguello (HEODRA) de la ciudad de Leon, Nicaragua, en el ano 2007. La poblacion de estudio estuvo constituida por un total de 65 medicos y 100 del personal de enfermeria. Se presentaron el doble de casos en el personal de enfermeria que en los medicos. La dinamica de trabajo fue el factor mas percibido como desfavorable. La relacion antiguedad laboral-casos tuvo comportamiento inverso, entre el personal de enfermeria, a mas anos labores mas casos, y lo contrario entre los medicos. La mayor parte de casos son jovenes y se encuentran casados. Los casos predominantes en el personal de enfermeria fueron del sexo femenino, en los medicos fue el masculino. Se recomienda buscar la equidad en la distribucion de los horarios y trato interpersonal. Promover y mantener en forma permanente sistemas de evaluacion del personal, y crear grupos terapeuticos de contencion emocional dirigidos a todos el personal de trabajo, con el fin de promover mayor solidaridad, dialogo y respeto por las opiniones de los otros, mejorando los canales de comunicacion entre los companeros de trabajo.