Epidemiology of bovine tuberculosis in Mexico, bordering the United States, at establishment of controlling strategies / Epidemiologia da tuberculose bovina na fronteira do México com os Estados Unidos, por ocasião do estabelecimento das estratégias de controle

A case-control study was carried out for determining epidemiological patterns at the beginning of the Mexican campaign against bovine tuberculosis (BTB) in the State of Tamaulipas, Mexico, bordering the United States of America. From January 1995 to March 1998, 599 direct tissue smears of cattle from routine slaughterhouse inspection were analyzed for the presence of Mycobacterium bovis acid-fastness with Ziehl-Neelsen stain. BTB status was associated with year of diagnosis, age, breed, geographical origin of cattle, and type of slaughterhouse using the odds ratio (OR) (95 percent confidence level). The prevalence at slaughterhouse surveillance was 15.36 percent, which was considerably higher in 1995 (41.38 percent, OR=5.78, P<0.0001), in comparison with 8.09 percent, 14.42 percent, and 10.14 percent for the years 1996, 1997, and 1998, respectively. BTB was associated with cattle from the State of Tamaulipas (19.73 percent, OR= 4.438, P=0.01), adult cattle (19.13 percent, OR=2.19, P<0.0001), Bos taurus (22.54 percent, OR=2.135, P<0.0001) and B. taurus x B. indicus cross bred animals (29.31 percent, 2.769, P<0.0001), and cattle slaughtered at federal inspected abattoir (17.58 percent, OR=1.23, P<0.0001).

O estudo foi realizado para determinar os padrões epidemiológicos no início da campanha mexicana contra a tuberculose bovina (BTB), no Estado de Tamaulipas, fronteira com os Estados Unidos da América. De janeiro de 1995 a março de 1998, 599 amostras de tecidos bovinos, obtidas em inspeção de rotina em abatedouros, foram analisadas para a presença de Mycobacterium bovis, fixadas em corante Ziehl-Neelsen. O status BTB foi associado ao ano do diagnóstico, idade, raça e origem geográfica do bovino utilizando a razão de probabilidade (OR) (com intervalo de confiança de 95 por cento). A prevalência no abatedouro sob inspeção foi de 15,36 por cento, consideravelmente maior em 1995 (41,38 por cento, OR=5,78), P<0,0001) em relação a 8,09 por cento, 4,42 por cento e 10,14 por cento para 1996, 1997 e 1998, respectivamente. Houve associação entre BTB e animais provenientes do estado de Tamaulipas (19,73 por cento; OR=0.438; P=0.01), idade adulta (19,13 por cento; OR=2,19; P<0,0001), Bos taurus (22,54 por cento; OR=2,135; P<0,0001) e cruzamentos B. taurus x B. indicus (29,31 por cento; 2,769; P<0,0001), e animais abatidos em abatedouros federais inspecionados (17,58 por cento; OR=1,23; P<0,0001).

Prospective study using standardized methodology for antimicrobial susceptibility of gram-positive cocci isolated from the Puerto Rico Medical Center

The Gram-positive cocci (GPC), Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis and Enterococcus faecium, have become important causes of community and nosocomial-acquired infections. The prevalence of multiple resistant isolates to standard antimicrobial drugs has significantly increased over the past decades. Few prospective studies have been performed in Puerto Rico (PR) concerning the GPC antimicrobial susceptibilities pattern. The purpose of this study was to evaluate the in vitro susceptibility of GPC clinical isolates from PR to selected standard antibiotics and to the new antimicrobial agents, linezolid (LZ), quinupristin/dalfopristin (Q/D) and gemifloxacin (GM). The in vitro susceptibility utilizing disk diffusion and Etest methods to selected antibiotics was determined for a total of 429 isolates obtained during a period of 5 months from the Puerto Rico Medical Center Bacteriology Laboratory. The distribution of GPC collected was as follows: 213 S. aureus isolates, 162 E. faecalis, 16 E. faecium and 38 S. pneumoniae. The results of the susceptibility test demonstrated: 1) that in S. aureus, 100 per cent of the isolates were susceptible to vancomycin (VAN), LZ and Q/D; 93 per cent to GM; and 61 per cent to methicillin/oxacillin; 2) in S. pneumoniae, 100 per cent were susceptible to LN and GM; 87 per cent to Q/D; and 53 per cent to penicillin; 3) in E. faecalis, 99 per cent were susceptible to ampicillin; 93 per cent to LZ; 79 per cent to GM; 78.6 per cent to VAN; and 0 per cent to Q/D. Sixty eight and 66 per cent of the E. faecalis isolates were susceptible to gentamicin and streptomycin respectively; and 4) in E. faecium, 100 per cent were susceptible to LZ; 94 per cent to Q/D; 69 per cent to GM; 37.5 per cent to VAN and 20 per cent to ampicillin. In E. faecium isolates, 50 per cent and 31 per cent were susceptible to gentamicin and streptomycin, respectively. Of the vancomycin resistant enterococci, 88.9 per cent and 21 per cent of E. faecium and faecalis showed VanA phenotypic resistance, respectively...

Extubación precoz en pacientes pediatricos sometidos a cirugía cardiovascular / Precocious extubation in pediatric patients subjected vascular to cardiovascular surgery

Está planteada la controversia entre el uso de la ventilación mecánica "profiláctica" y la extubación precoz de los pacientes sometidos a cirugía cardiovascular. En este trabajo analizamos morbilidad, mortalidad e incidencia de reintubación en 130 pacientes pediátricos operados en nuestro centro, en los cuales aplicamos parámetros definidos para decidir o no la extubación precoz al término de la operación. En los 93 pacientes extubados precozmente solo fueron reintubados 4 (4.3%), por complicaciones. La mortalidad de este grupo fue del 0%. En los 37 pacientes no extubados 27 (73%) presentaron complicaciones y la mortalidad fue 8 casos (21.6%). Concluimos que los parámetros de extubación precoz son confiables y que la ventilación mecánica no debe utilizarse en forma rutinaria e indiscriminada

Determinación de volumen corpuscular medio, gamma-glutamil transpeptidasa y creatinfosfokinasa en la valoración de la abstinencia alcohólica / Mean corpuscular volume, gamma-glutamyl transpeptidase and creatine phosphokinase determination in the evaluation of alcoholic with drawal

Se han determinado VCM, GGT y CPK en 220 pacientes alcohólicos ingresados en la Unidad de Alcoholismo del Hospital Psiquiátrico, a fin de estudiar su interés en el seguimiento de la abstinencia alcohólica. Los resultados fueron comparados con los de un grupo de 48 voluntarios sanos procedentes del personal sanitario de este hospital. Se establecieron dos grupos clínicos en función de la severidad de la hepatopatía: grupo A, formado por 144 pacientes con índice de Orrego inferior a 5. Grupo B: 76 pacientes con índice igual o superior a 5 o bien filiados de hepatitis/cirrosis mediante biopsia. Se llega a la conclusión de que la alta sensibilidad diagnóstica y su precoz normalización, hacen de la CPK el marcador más útil para dar por terminada una cura de desintoxicación. Por otro lado, la de GGT no puede ser utilizada como índice de cese de ingesta de alcohol en todos los pacientes, al menos para valorar precozmente la abstinencia, pues su normalización se ve influenciada de forma apreciable por la severidad de la enfermedad hepática