Prevalencia de Dientamoeba fragilisy otros protozoários intestinales en porcinos de una granja en la región Andina de Colombia / Prevalence of Dientamoeba fragilis and other intestinal protozoa from a swine farm at the Andean region of Colombia

RESUMEN Dientamoeba fragilis es un protozoário que parasita el intestino grueso del hombre y animales domésticos. Hasta el momento, aún no son claros aspectos de su ciclo de vida, como el rango de hospedadores, reservorios, mecanismo de infección, entre otros. Se postula que el cerdo es un hospedador natural para este protozoario y que, debido a su cercanía con el humano, podría facilitar una transmisión zoonótica. En Colombia no existen a la fecha estudios sobre la presencia de D. fragilis en hospedadores animales, incluidos los cerdos, y los datos sobre la prevalencia de otros protozoarios intestinales en estos animales son escasos. El objetivo fue determinar la frecuencia de protozoarios intestinales, incluyendo D. fragilis, en cerdos de una granja tecnificada de una zona rural de Medellín (región Andina de Colombia). Se recolectaron muestras de materia fecal de 70 cerdos en etapa de preceba, que fueron evaluadas mediante examen directo, tinción tricrómica y Ziehl-Neelsen modificado. Se realizaron análisis univariados con medidas de frecuencia relativa y tendencia central y análisis bivariados para la exploración de factores de riesgo. Se detectó la presencia de D. fragilis en un 13% de las muestras y de otros parásitos como Entamoeba spp. (66%), Blastocystis spp. (64%), Balantioides coli (36%), Cryptosporidium spp. (36%), Iodamoeba butschlii (17%), coccidias (4%) y Giardia spp. (1,4%). En este primer reporte de D. fragilis en cerdos en Colombia se observó la alta prevalencia de otros protozoarios patógenos, lo que corrobora el papel de los cerdos como importantes reservorios de infecciones humanas. Estudios sobre la presencia de este protozoario tanto en cerdos como en el personal encargado de su manejo contribuirían al conocimiento sobre su dinámica de transmisión.

ABSTRACT Dientamoeba fragilis is a protozoan that parasitizes the large intestine of humans and domestic animals. To date, some aspects regarding D. fragilis life cycle, including hosts, reservoirs, infection mechanism, among others, are not yet clear. Swine are considered natural hosts for this protozoan, therefore their close contact with humans promotes its zoonotic transmission. In Colombia there are no studies on the presence of D. fragilis in animal hosts, including pigs, and data about other intestinal protozoa are scarce. The objective was to determine the prevalence of intestinal protozoan, including D. fragilis, in pigs raised in a farm from a rural area of Medellin (Andean region of Colombia). Fecal samples from 70 pigs in prefattening stage were collected. Direct fecal smear examination, trichrome and modified Ziehl-Neelsen stain were used in the study. Univariate analysis (frequency distribution and central tendency measures) and bivariate analysis were used to explore risk factors. Dientamoeba fragilis was found in 13% of the evaluated fecal samples. Other parasites detected included: Entamoeba spp. (66%), Blastocystis spp. (64%), Balantioides coli (36%), Cryptosporidium spp. (36%), Iodamoeba butschlii (17%), coccidias (4%), and Giardia spp. (1,4%). This is the first report of D. fragilis in swine in Colombia, and the high prevalence of other pathogen protozoa was also observed, which corroborates the role of pigs as important reservoirs for human infections. Studies focused on the evaluation of both swine and swine-exposed farm workers should be done in order to know the dynamics of transmission of this parasite.

Cumplimentación del consentimiento informado para la transfusión de hemoderivados en los Servicios de Urología y Cirugía / Enforcement of informed consent request for blood transfusion in urology and surgery departments

Objetivo: Aplicar un círculo de mejora a la petición de consentimiento informado (CI) para la transfusión de hemoderivados en los servicios de Cirugía General y Urología. Métodos: Durante 8 meses se incluyeron 120 pa­cientes intervenidos en el Hospital General Reina Sofía de Murcia. Tras realizar un análisis de causa-efecto de Ishikawa, se establecieron 4 criterios: C1: identifica­ción del médico; C2: identificación del paciente; C3: firma del paciente; C4: fecha del documento. En el pri­mer periodo se incluyeron 60 pacientes. Se analizaron Ias causas de incumplimiento y se aplicaron las medidas correctoras, reevaluando los criterios en otros 60 pacientes. Resultados: Todos los criterios estaban por debajo del estándar: C1: 3%; C2: 95%; C3: 16% y C4: 65%. En la segunda evaluación el cumplimiento de C1 (70%), C3 (98%) y C4 (88%) mejoró significativamente pero aún así los resultados continúan, también significativamente, por debajo de los estándares establecidos. Los resultados se expresan en porcentaje de cumplimiento con un intervalo de confianza del 95%. Conclusiones: La realización de un ciclo de mejora ha permitido detectar y corregir incumplimientos en el C1 de transfusiones sanguíneas. El nivel de cumplimiento de los criterios mejoró en la segunda evaluación aunque continuamos por debajo del estándar establecido. Hemos conseguido una mayor concienciación por parte de los profesionales a la hora de cumplimentar el consentimiento.

Objective: To analyze the degree of compliance with a variety of standards defined for the quality control of the informed consent request for human blood products transfusion in our departments of Surgery and Urology. Material and method: Retrospective study of patients treated during 8 consecutive months in a university teaching hospital (n=120). Assessment of quality was performed through measurements of compliance using 4 criteria: C1, Physician Identification; C2, patient identification; C3, patient signature; C4, document date. In the first period 60 patients were included. Corrective measures aimed at resolving the quality problem were applied to the deficient criteria during one month, paying particular attention to those criteria with the highest percentage of errors in the study. During a third period of six months (60 patients) the information of all criteria was gathered again and the improvement with regard to the standard values and to the compliance of the first period was evaluated. Results: Compliance of all criteria was significantly below standard values in the first evaluation: C1 :3%; C2: 95%; C3: 16% and C4: 65%. In the second period all the criteria below its standard improved with regard to the first period; nonetheless the results are, also significantly, below the established standards. Conclusions: This improvement cycle enabled us to detect and correct breaches on the informed consent request for human blood products transfusion. Corrective measures introduced were effective since it was improved in all the criteria below standard. We have achieved a good awareness of health professionals to complete the authorization.

Reação de maracujazeiro amarelo a Meloidogyne incognita raça 3 / Reaction of yellow passion fruit to Meloidogyne incognita race 3

Neste trabalho estudou-se a reação de maracujazeiro amarelo 'Maguari' e 'Afruvec' ao fitonematoide Meloidogyne incognita raça 3, em casa-de-vegetação. Adotou-se o delineamento inteiramente casualizado, com três tratamentos (Maguari, Afruvec e Tomateiro cv. Rutgers) e quatro repetições, sendo a parcela constituída por um vaso contendo uma planta. Após seis meses, avaliou-se o índice de galhas e de massa de ovos nas cultivares de maracujazeiro amarelo e no tomateiro cv. Rutgers. A classificação da resistência ao fitonematoide foi feita utilizando o critério do fator de reprodução (FR). A 'Maguari' apresentou zero de índice de galhas e de massa de ovos, enquanto que 'Afruvec' mostrou baixo índice de galhas e massa de ovos comparativamente com o tomateiro cv. Rutgers. De acordo com o FR, a 'Maguari' enquadrou-se como imune ao nematoide, sendo a 'Afruvec' resistente e o tomateiro cv. Rutgers como suscetível.

This study concerned the reaction of yellow passion fruit 'Maguary' and 'Afruvec' to the phytonematode Meloidogyne incognita race 3 in greenhouse conditions. An entirely randomized experimental design with 3 treatments ('Maguary', 'Afruvec', and tomato cv. 'Rutgers') and 4 repetitions was used, each plot consisting of 1 vase containing 1 plant. After 6 months, an evaluation was made of the index of galls and egg mass in the yellow passion fruit varieties and in the tomato cv. 'Rutgers'. The classification of resistance to the phytonematode was made by criterion of the reproduction factor (RF). 'Maguary' presented a zero index of galls and egg mass, while 'Afruvec' showed a low index of galls and egg mass in relation to the tomato cv. Rutgers. According to the RF, 'Maguary' was characterized as immune to the phytonematode, while 'Afruvec' was resistant, and the tomato cv. 'Rutgers' was susceptible.

Malformacoes congenitas: estudo prospectivo de dois anos em tres maternidades de Sao Paulo. / Congenital malformation: prospective study of two years in three maternity hospitals

Durante um periodo de dois anos foram estudados, de maneira prospectiva, as malformacoes congenitas passiveis de diagnostico pelo exame clinico no bercario em uma populacao de 14.020 nascidos vivos. Encontrou-se nessa populacao 235 recem-nascidos com malformacoes (1,67%). Essa incidencia aproxima-se muito da de dados publicados em 1966 para a cidade de Sao Paulo e e ligeiramente inferior a de varias outras publicacoes nacionais e estrangeiras. Foi estudada a correlacao de malformacoes com idade dos pais, idade gestacional, usos de raios X durante a gestacao, presenca de malformacao na familia, paridade, existencia de abortos espontaneos e induzidos, historia de natimortos, drogas durante a gestacao e doencas e intercorrencias incidindo no 1o trimestre da gravidez. Foi tambem estudada a distribuicao sazonal das malformacoes e a distribuicao geografica do domicilio de 141 maes com filhos malformados e de igual numero de controles com filhos normais