ABSTRACT
The present work is a large epidemiological study aiming to detect the prevalence of subclinical mastitis and to investigate the major udder pathogens in Jalisco State, western Mexico. For this purpose, 2205 dairy cows, representing 33 Mexican dairy herds, were involved. Of 2205 cows, 752 mastitic animals were diagnosed and only 2,979 milk samples could be obtained for further investigation. All 2979 milk samples were subjected to California Mastitis Test (CMT) to differentiate clinical cases from subclinical ones where 1996 samples (67 %) reacted positively. Of these, 1087 samples (54.5%) came from cows suffering from clinical cases of mastitis. Bacteriological identification of the causative agents revealed the presence of a major group of pathogens including the Coagulase negative staphylococci (CNS), S.aureus, S.agalactiae, Corynebacterium spp. and Coliform bacteria which were detected in 464 (15.6%), 175 (5.9%), 200 (6.8%), 417 (14%) and 123 (4.1%) of the 2927 investigated quarters, 295 (15.4%), 118 (15.7%), 111 (14.8%), 227 (30.2%) and 109 (14.5%) of the 752 examined cows and in 33 (100%), 22 (66.7%), 19 (57.6%), 30 (90.1%) and 27 (81.8%) of the 33 herds involved, respectively. Other pathogens could be detected in the investigated milk samples such as S. dysgalactiae (0.4%), S.uberis (0.37%), Bacillus spp. (1%), Nocardia spp. (0.6%) und Candida spp. (0.1%). Meanwhile, others were present in a negligible ratio; including the Aerococcus viridans, and Enterococcus spp., Lactococcus lactis, S. bovis.
O trabalho atual é um estudo epidemiológico que objetiva detectar a predominância da mastite subclínica e investigar os micróbios patogênicos principais do úbere no México ocidental. Com esta finalidade, foram utilizadas 2205 vacas leiteiras, representando 33 rebanhos de leiteiras mexicanas. Além dessas 2205 vacas, 752 animais com mastite foram diagnosticados, considerando-se que somente 2979 amostras do leite poderiam ser obtidas para a posterior investigação. Todas as 2979 amostras do leite foram submetidas ao teste da mastite de Califórnia (CMT) para diferenciar casos clínicos dos subclínicos, visto que 1996 amostras (67%) reagiram positivamente. Além dessas, 1087 amostras (54.5%) vieram das vacas que sofrem de casos clínicos de mastite. A identificação bacteriológica dos agentes causais revelou a presença dos Staphylococcus negativos para coagulase (CNS), S. aureus, S. agalactiae, outros spp. Streptococcal, Corynebacterium spp., e as bactérias de coliformes foram detectadas em 464 (15.6%), 175 (5.9%), 200 (6.8%), 109 (3.9%), 417 (14%) e em 123 (4.1%) dos 2927 quartos investigados; em 295 (15.4%), 118 (15.7%), 111 (14.8%), 95 (12.6%), 227 (30.2%) e em 109 (14.5%) das 752 vacas examinadas e, finalmente, em 33 (100%), 22 (66.7%), 19 (57.6%), 30 (90.1%), 30 (90.1%) e em 27 (81.8%) dos 33 rebanhos envolvidos, respectivamente.
Subject(s)
Animals , Corynebacterium/pathogenicity , Microbiology , Mastitis, Bovine/pathology , Noxae/analysis , Cattle/classificationABSTRACT
El objetivo del presente es la caracterización de pacientes en terapia intensiva en el hospital de alta complejidad, y portadores de insuficiencia respiratoria aguda con requerimiento de asistencia ventilatoria mecánica, a su vez, el comportamiento de pacientes con infección por el virus influenza H1N1 que desarrollan síndrome de dificultad respiratorio agudo (SDRA).
Subject(s)
Influenza A virus , Respiratory Distress Syndrome , Respiratory Insufficiency , Influenza A Virus, H1N1 Subtype , Intensive Care UnitsABSTRACT
Este reporte de caso muestra una paciente con clase II esqueletal y una simetría condilar compatible con una reabsorción condilar progresiva unilateral, tratada según el protocolo de planificación de Arnett, con ortodoncia y cirugía ortognática.
Subject(s)
Humans , Female , Adult , Mandibular Condyle/abnormalities , Mandibular Condyle/pathology , Malocclusion, Angle Class II/surgery , Malocclusion, Angle Class II/therapy , Facial Asymmetry/surgery , Facial Asymmetry/therapy , Mandibular Advancement/methods , Clinical Protocols , Cephalometry/methods , Esthetics, Dental , Serial Extraction/methods , Occlusal Splints , Osteotomy, Le Fort/methods , Patient Care Planning , Bone Resorption/etiologyABSTRACT
BACKGROUND/AIMS: Our aims were to establish the clinical utility of assessing the intraepithelial lymphocyte (IEL) density in intestinal biopsies from a large series of individuals and to determine the best threshold discriminating celiac disease (CD) patients and controls in two populations with different pre-test prevalence. METHODS: We prospectively performed intestinal biopsy and CD-related serology in 349 subjects undergoing upper GI endoscopy. While 116 had symptoms suggestive of a small bowel disorder (high prevalence), 233 individuals were randomly selected from patients referred to endoscopy because upper GIsymptoms (low prevalence). Diagnosis of CD was based on the concordance of classical histological features and a positive CD serology. RESULTS: While 58 patients had a newly diagnosed CD (52 in the high and 6 in the low prevalence groups), 291 subjects did not meet diagnostic criteria of the disorder. Patients had a highly significant greater IEL density than controls (p < 0.00001). Based on the ROC curve, a count of 22.8 IEL/100 epithelial cells had the highest performance for diagnosing CD in the overall population and for subjects in the high pre-test probability subgroup and 22.5% was ,he best cut-off for those diagnosed in the low risk population (area under the curves: 0.979, 0.979 and 0.993, respectively). An abnormal CD serology confirmed the diagnosis of CD in all the four patients with counts below 22.8%. CONCLUSIONS: Our study confirms that an IEL density of 22.8% is an adequate threshold to discriminate CD patients and controls in individuals irrespective of the prevalence of the disorder.
Introducción: El recuento elevado de linfocitos intraepiteliales (LIEs) es un rasgo destacado aunque inespecífico de la enteropatía de la enfermedad celíaca (EC). Un recuento mayor a 40 LIEs/100 células epiteliales ha sido considerado por mucho tiempo esencial para el diagnóstico. Sin embargo, estudios recientes con escaso número de muestras han cuestionado este valor de corte. Objetivos: Determinar el rango normal de LIEs en biopsias intestinales y establecer su capacidad diagnóstica de EC en dos poblaciones con diferente prevalencia. Métodos: Realizamos prospectivamente biopsias de duodeno distal y serología para EC en 349 pacientesconsecutivos a quienes se les realizó una videoendoscopia digestiva alta. El grupo A consistió en 116 pacientes derivados a biopsia intestinal por síntomas sugestivos de malabsorción (considerados de alta prevalencia de EC) y el grupo B consistió en 233 pacientes randomizados entre quienes fueron derivados a endoscopía alta por síntomas gastrointestinales no sugestivos de EC (baja prevalencia de EC). El diagnóstico de EC se basó en criterios histológicos clásicos y serología positiva. Resultados: Cincuenta y ocho pacientes tuvieron EC (52 en el grupo de alto riesgo y 6 en el de baja prevalencia) y 291 individuos no tuvieron criterios de la enfermedad. Los pacientes tuvieron una densidad de LIEs significativamente mayor que los controles (p<0.00001). Basado en las curvas ROC, el conteo de 22.8 LIEs/100 células epiteliales tuvo la mejor sensibilidad y especificidad para el diagnóstico de EC en la población general y entre los sujetos con alta probabilidad y 22.5% fue el mejor valor de corte para la población de bajo riesgo (áreas bajo las curvas: 0.979, 0.979 y 0.993, respectivamente). Todos aquellos pacientes celíacos con recuento de LIEs por debajo de 22% (n=4), tuvieron serología positiva para EC. El clásico valor de 40% tuvo una sensibilidad del 55%. Conclusiones: Nuestro estudio confirma que una...
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged, 80 and over , Celiac Disease/diagnosis , Intestinal Mucosa/cytology , Biopsy , Lymphocyte Count , ROC Curve , Celiac Disease/immunology , Prospective Studies , Case-Control Studies , Sensitivity and Specificity , Predictive Value of TestsABSTRACT
Se abordan los eventos virtuales en general, su definición, origen y evolución y se ofrecen ejemplos de eventos virtuales celebrados en diversos lugares. Se realiza una breve reseña histórica del servicio de eventos virtuales de Infomed: Cencomed, los eventos celebrados en Cuba y la necesidad del perfeccionamiento de este servicio y las posibilidades de soportar sus servicios en las herramientas disponibles en Internet. Se analizan los sistemas gestores de contenidos más respresentativos y con mayores posibilidades de utilizarse. Se presentan las experiencias del Congreso Virtual de Informática en Salud y las posibilidades de Plone como sistema de soporte.
Virtual events in general their definition origin and evolution are approached and examples of virtual events celebrated in different places are offered. A brief historic review of the virtual event service of Infomed: Cencomed, the events celebrated in Cuba and need of to improve this service, and potentials for use of the tools available from Internet to support their services. The systems managing the most representative contents, and with the largest utilization possibilities, are analyzed. The experiences of the Virtual Informatic Health Congress are presented, and the possibilities of Plone use as support system.
Subject(s)
Congress , Internet , Management Service Organizations , SoftwareABSTRACT
BACKGROUND/AIM: Smooth muscle antibody (SMA) specific for the protein actin, a major component of the cytoskeleton of epithelial cells, is one of the most prevalent non-organ specific autoantibodies in the serum of celiac disease (CD) patients. Our aim was to explore the clinical relevance of the presence of IgA type anti-actin antibody (AAA) and SMA in a series of patients with CD. METHODS: We evaluated frozen serum samples collected at diagnosis from 92 adult patients with CD and 52 control individuals in whom CD was excluded. Patients were re-evaluated a median time of 5 yr after treatment. IgA type AAA was detected using a modified commercial ELISA assay and IgA SMA was detected using indirect immunofluorescence on primate esophagus substrate. RESULTS: At diagnosis, samples from CD patients had significantly higher AAA values than controls (p<0.00001). While all active CD patients had serum AAA values over the cut-off for healthy controls, we observed a very significant reduction of these antibodies after treatment (p>0.0001). AAA had a highly significant correlation with both, tissue, transglutaminase (r=0.62) and antigliadin (r=0.60, p<0.00001) antibodies as well as the severity of the intestinal injury (p<0.05). SMA was detected in sera of 35 consecutive CD patients. At diagnosis, SMA positive patients had significantly higher values of AAA (p<0.0002), increased number of autoimmune disorders (p<0.04), delayed menarche (p<0.04), lower hemoglobin levels (p<0.01), increased fecal a-I antitrypsin clearance (p<0.01) and more severe diarrhea (p<0.06). We also detected a trend to more severe complications at follow-up (p=0.059). CONCLUSIONS: Based on our findings we suggest that the presence of increased IgA AAA serum levels is a highly sensitive marker of the disturbed architecture of intestinal epithelial cells of CD patients with a potential relevance to diagnosis and follow-up. The presence of SMA seems to define a distinct subset of CD patients with ...
Introduccion/objetivo: El anticuerpo anti-musculo liso (SMA) dirigido contra la proteína actina, un componente mayor del citoesqueleto de las células epiteliales, es el anticuerpo no-órgano específico más prevalente en enfermedad celíaca (EC). Nuestro objetivo fue explorar la importancia clínica de los anticuerpos anti-actina (AAA) y SMA en una serie de pacientes con EC. Métodos: Evaluamos 92 muestras serológicas de pacientes celíacos adultos recolectadas al momento del diagnóstico y la de 52 individuos controles no celíacos. Los pacientes fueron re-evaluados luego de un tiempo medio de 5 años en tratamiento. Evaluamos AAA tipoIgA mediante ELISA empleando un equipo commercial modificado y SMA IgA por inmunofluorescencia indirecta sobre sustrato de esófago de mono. Resultados: Al momento del diagnóstico, los pacientes celíacos tuvieron valores de AAA significativamente más elevados que los controles (p<0.00001). Todos los pacientes con EC activa presentaron niveles de AAA por encima del valor de corte determinado para el grupo control sano y se evidenció una reducción significativa de los nivelesluego del tratamiento (p>0.0001). Los AAA presentaron una correlación significativa con los anticuerpos anti-transglutaminasa tisular (r=0.62) y anti-gliadina (r=0.60) (p<0.00001), de igual modo que con la severidad del daño intestinal (p<0.05). Al momento del diagnóstico, se detectó SMA en el suero de 35 pacientes no controles. Los pacientes SMA positivos tuvieron valores significativamente mayores de AAA (p<0.002), un incremento del número de enfermedades autoinmunes asociadas (p<0.04), menarca tardía (p<0.04), niveles bajos de hemoglobina (p<0.01), incremento del clearance de a-1 antitripsina fecal (p<0.01) y mayor severidad de la diarrea (p<0.06).En ellos se evidenció una tendencia al desarrollo de complicaciones más severas durante el seguimiento (p=0.059). Conclusiones: Sugerimos que la presencia de un valor sérico aumentado de AAA tipo IgA...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Autoantibodies , Actins/immunology , Celiac Disease/immunology , Immunoglobulin A/blood , Muscle, Smooth/immunology , Enzyme-Linked Immunosorbent Assay , Celiac Disease/diagnosis , Celiac Disease/diet therapy , Case-Control Studies , Biomarkers/blood , Follow-Up Studies , Fluorescent Antibody Technique, Indirect , Severity of Illness IndexABSTRACT
Motility disorders of the digestive tract have long been implicated in the pathophysiology of diarrhea in patients with celiac sprue. However, the contribution of the colon to the intestinal transit of celiac sprue has not been reported. Our aim was to determine whether sprue alters gut transit and whether differences in the clinical status of the disease influences colonic transit. We prospectively studied 25 patients with untreated celiac sprue, 15 treated patients and 15 healthy controls. Oro-cecal transit time, measured by the lactulose breath H2 test, was significantly delayed in untreated patients compared with treated patients and controls (p<0.001 and p<0.01 respectively). The delayed transit through the stomach and small bowel was not related to the presence of the steatorrhea. Transit of radiopaque makers, a measure of total colonic tansit, was significantly faster in untreated patients (p<0.05). The major finding was that this abnormal colonic behavior was principally due to a subpopulation of untreated patients with very fast transit times (<18 hours). A weakly significant inverse correlation between transit and fecal weight (r:-0.55, p<0.01), and between transit and steatorrhea (r:-0.38, p<0.05), was observed. We confirm previous descriptions of delayed oro-cecal transit time in untreated patients, and also provide the first evidence that disordered colonic transit contributes to the pathophysiology of the diarrhea in sprue.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Colon/physiopathology , Diarrhea/physiopathology , Celiac Disease/physiopathology , Gastrointestinal Transit/physiology , Analysis of Variance , Breath Tests , Contrast Media , Gastrointestinal Motility , Prospective StudiesABSTRACT
La enfermedad Celíaca suele complicarse con hipofunción esplénica cuya patogenia es desconocida. Analizamos la frecuencia de signos de hipofunción esplénica y su comportamiento frente a una dieta libre de gluten (DLG) en 17 pacientes con enfermedad celíaca. Los signos de hipoesplenismo fueron evaluados a través de cambios en la morfología de los glóbulos rojos (Cuerpos de Howell-jolly, esferocitosis, acantositosis), en relación con la edad de los pacientes, antigüedad de los síntomas, severidad del cuadro clínico, alteración histológica y su respuesta al tratamiento. Concluímos que el porcentaje de pacientes con hipofunción esplénica fue del 82,4% y que hay tendencia a la recuperación luego de la DLG
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Spleen/physiopathology , Diet , Celiac Disease/physiopathology , Celiac Disease/diet therapy , Celiac Disease/blood , Erythrocytes/pathologyABSTRACT
Se presenta un caso de enfermedad de Kawasaki en una nina de 13 meses de edad. Clinicamente presentaba exantema, adenopatia unilateral cervical, hipertemia que no remitia con antipireticos, lesiones en labios y mucosas, inyeccion conjuntival, artritis y artralgias, eritema de palmas y plantas, descamacion periungueal, estrias longitudinales en las unas, trombocitos y eritrosedimentacion elevada.En nuestro conocimiento este seria el cuarto caso publicado en nuestro medio y el primero en la ciudad de Buenos Aires