Broad-spectrum ginsentides are principal bioactives in unraveling the cure-all effects of ginseng

Stress and illness connection is complex and involves multiple physiological systems. Panax ginsengs, reputed for their broad-spectrum "cure-all" effect, are widely prescribed to treat stress and related illnesses. However, the identity of ginseng's "cure-all" medicinal compounds that relieve stress remains unresolved. Here, we identify ginsentides as the principal bioactives that coordinate multiple systems to restore homeostasis in response to stress. Ginsentides are disulfide-rich, cell-penetrating and proteolytic-stable microproteins. Using affinity-enrichment mass spectrometry target identification together with in vitro, ex vivo and in vivo validations, we show that highly purified or synthetic ginsentides promote vasorelaxation by producing nitric oxide through endothelial cells via intracellular PI3K/Akt signaling pathway, alleviate α1-adrenergic receptor overactivity by reversing phenylephrine-induced constriction of aorta, decrease monocyte adhesion to endothelial cells via CD166/ESAM/CD40 and inhibit P2Y12 receptors to reduce platelet aggregation. Orally administered ginsentides were effective in animal models to reduce ADP-induced platelet aggregation, to prevent collagen and adrenaline-induced pulmonary thrombosis as well as anti-stress behavior of tail suspension and forced swimming tests in mice. Together, these results strongly suggest that ginsentides are the principal panacea compounds of ginsengs because of their ability to target multiple extra- and intra-cellular proteins to reverse stress-induced damages.

Pilot implementation of a computer-based training course on newborn hearing screening and teleaudiology among primary healthcare providers in low resource settings

Objective@#Newborn hearing screening (NHS) in the Philippines has been mandated by law since 2009. However, lack of awareness and knowledge about NHS remains a challenge, especially among healthcare providers. This paper describes the pilot implementation of a computer-based training (CBT) course on NHS and teleaudiology among primary healthcare providers (PHCPs) in rural Philippines. @*Methods@#A four-module web-based training course on newborn hearing screening and teleaudiology in an online learning management system (LMS) was field-tested among PHCPs from eight rural communities in the Philippines. Participants were given four weeks to complete the course. @*Results@#Forty-two PHCPs participated in the CBT. Thirty-four (81%) completed the whole course (mean attrition rate of 4.8% per module) at a mean duration of 10.2 days. Baseline data shows that participants had no NHS training, although the majority (83%) had information and communications technology (ICT) training. Comparison of preand post-test mean scores showed a 24.0% (p<0.001) significant increase in the post-test in all four modules. Passing rates (i.e., score ≥70%) from pre- to post-test increased by 54.6% (range: 38-80% increase). Usability of the CBT was rated high with a mean score of 4.32 out of 5 (range: 4.13 to 4.47), covering all eight parameters. Participants expressed general satisfaction and a positive attitude on CBT to improve knowledge on NHS and teleaudiology. @*Conclusion@#Even in low resource settings where gaps in ICT infrastructure exist, eLearning can be used as an alternative approach to increase awareness and support training of healthcare providers on newborn hearing screening.

Pilot implementation of a community-based, eHealth-enabled service delivery model for newborn hearing screening and intervention in the Philippines

Objectives@#This study explores the potential of the HeLe Service Delivery Model, a community-based newborn hearing screening (NHS) program supported by a web-based referral system, in improving provision of hearing care services. @*Methods@#This prospective observational study evaluated the HeLe Service Delivery Model based on records review and user perspectives. We collected system usage logs from July to October 2018 and data on patient outcomes. Semi-structured interviews and review of field reports were conducted to identify implementation challenges and facilitating factors. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data, respectively. @*Results@#Six hundred ninety-two (692) babies were screened: 110 in the RHUs and 582 in the Category A NHS hospital. Mean age at screening was 1.4±1.05 months for those screened in the RHU and 0.46±0.74 month for those in the Category A site. 47.3% of babies screened at the RHU were ≤1 month old in contrast to 86.6% in the Category A hospital. A total of 10 babies (1.4%) received a positive NHS result. Eight of these ten patients were referred via the NHS Appointment and Referral System; seven were confirmed to have bilateral profound hearing loss, while one patient missed his confirmatory testing appointment. The average wait time between screening and confirmatory testing was 17.1±14.5 days. Facilitating factors for NHS implementation include the presence of champions, early technology adopters, legislations, and capacity-building programs. Challenges identified include perceived inconvenience in using information systems, cost concerns for the patients, costly hearing screening equipment, and unstable internet connectivity. The lack of nearby facilities providing NHS diagnostic and intervention services remains a major block in ensuring early diagnosis and management of hearing loss in the community. @*Conclusion@#The eHealth-enabled HeLe Service Delivery Model for NHS is promising. It addresses the challenges and needs of community-based NHS by establishing a healthcare provider network for NHS in the locale, providing a capacity-building program to train NHS screeners, and deploying health information systems that allows for documentation, web-based referral and tracking of NHS patients. The model has the potential to be implemented on a larger scale — a deliberate step towards universal hearing health for all Filipinos.

Multidisciplinary strategies to enhance therapeutic effects of flavonoids from Epimedii Folium:Integration of herbal medicine,enzyme engineering,and nanotechnology / 药物分析学报

Flavonoids such as baohuoside I and icaritin are the major active compounds in Epimedii Folium(EF)and possess excellent therapeutic effects on various diseases.Encouragingly,in 2022,icaritin soft capsules were approved to reach the market for the treatment of hepatocellular carcinoma(HCC)by National Medical Products Administration(NMPA)of China.Moreover,recent studies demonstrate that icaritin can serve as immune-modulating agent to exert anti-tumor effects.Nonetheless,both production effi-ciency and clinical applications of epimedium flavonoids have been restrained because of their low content,poor bioavailability,and unfavorable in vivo delivery efficiency.Recently,various strategies,including enzyme engineering and nanotechnology,have been developed to increase productivity and activity,improve delivery efficiency,and enhance therapeutic effects of epimedium flavonoids.In this review,the structure-activity relationship of epimedium flavonoids is described.Then,enzymatic en-gineering strategies for increasing the productivity of highly active baohuoside I and icaritin are dis-cussed.The nanomedicines for overcoming in vivo delivery barriers and improving therapeutic effects of various diseases are summarized.Finally,the challenges and an outlook on clinical translation of epi-medium flavonoids are proposed.

Association of Anosmia and Positive SARS-CoV-2 (COVID-19) RT-PCR Test Results Among Patients in the Quezon City General Hospital

AbstractObjective: To determine the association of anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR test results among patients in a tertiary government hospital in Metro Manila.Methods: Design: Cross-SectionalStudy Setting: Tertiary Government Training HospitalParticipants: Patients aged 18 years old and above who consulted or were admitted with COVID-19 symptoms at the Quezon City General Hospital in the Philippines from July to September 2020 answered an offline version of the American Academy of Otolaryngology - Head and Neck Surgery AAO-HNS COVID-19 Anosmia Reporting Tool prior to undergoing (COVID-19) RT-PCR testing.Results: Out of 172 participants, 63 (36.6%) presented with anosmia. Sixty (95.2%) out of 63 of those with anosmia had a positive COVID-19 RT-PCR test result. Forty-one (65%) participants reported anosmia as the first symptom while the most common associated symptoms were fever (59%), cough (50%), and rhinorrhea (31%). There was a significant association between anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR tests (X2 =33.85, df=1, pConclusion: Anosmia was associated with a positive SARS-CoV-2 (COVID-19) RT-PCR test in more than 95% of those who reported the symptom. Anosmia should be considered as a red flag sign which should be included in the screening of persons suspected of being infected with COVID-19 to help mitigate further spread of the virus.Keywords: anosmia; olfactory dysfunction; loss of sense of smell; coronavirus; SARS-CoV-2; pandemic; 2019-NCoV; COVID-19

Analyses of oligodontia phenotypes and genetic etiologies / 国际口腔科学杂志·英文版

Oligodontia is the congenital absence of six or more teeth and comprises the more severe forms of tooth agenesis. Many genes have been implicated in the etiology of tooth agenesis, which is highly variable in its clinical presentation. The purpose of this study was to identify associations between genetic mutations and clinical features of oligodontia patients. An online systematic search of papers published from January 1992 to June 2021 identified 381 oligodontia cases meeting the eligibility criteria of causative gene mutation, phenotype description, and radiographic records. Additionally, ten families with oligodontia were recruited and their genetic etiologies were determined by whole-exome sequence analyses. We identified a novel mutation in WNT10A (c.99_105dup) and eight previously reported mutations in WNT10A (c.433 G > A; c.682 T > A; c.318 C > G; c.511.C > T; c.321 C > A), EDAR (c.581 C > T), and LRP6 (c.1003 C > T, c.2747 G > T). Collectively, 20 different causative genes were implicated among those 393 cases with oligodontia. For each causative gene, the mean number of missing teeth per case and the frequency of teeth missing at each position were calculated. Genotype-phenotype correlation analysis indicated that molars agenesis is more likely linked to PAX9 mutations, mandibular first premolar agenesis is least associated with PAX9 mutations. Mandibular incisors and maxillary lateral incisor agenesis are most closely linked to EDA mutations.

Association of anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR Test results among patients in the Quezon City General Hospital

Objective@#To determine the association of anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR test results among patients in a tertiary government hospital in Metro Manila.@*Methods@#Design: Cross-Sectional Study. Setting: Tertiary Government Hospital. Participants: Patients aged 18 years old and above who consulted or were admitted with COVID-19 symptoms at the Quezon City General Hospital in the Philippines from July to September 2020 answered an offline version of the American Academy of Otolaryngology-Head and Neck Surgery AAO-HNS COVID-19 Anosmia Reporting Tool prior to undergoing (COVID-19) RT-PCR testing.@*Results@#Out of 172 participants, 63 (36.6%) presented with anosmia. Sixty (95.2%) out of 63 of those with anosmia had a positive COVID-19 RT-PCR test result. Forty-one (65%) participants reported anosmia as the first symptom while the most common associated symptoms were fever (59%), cough (50%), and rhinorrhea (31%). There was a significant association between anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR tests (X2 =33.85, df=1, p<.0001). @*Conclusion@#Anosmia was associated with a positive SARS-CoV-2 (COVID-19) RT-PCR test in more than 95% of those who reported the symptom. Anosmia should be considered as a red flag sign which should be included in the screening of persons suspected of being infected with COVID-19 to help mitigate further spread of the virus.

Association between burnout and wellness culture among emergency medicine providers

Objective@#Burnout is a common occurrence among healthcare providers and has been associated with provider wellness culture. However, this association has not been extensively studied among emergency medicine (EM) providers. We aim to determine the association between EM provider burnout and their culture of wellness, and to elicit the independent wellness culture domains most predictive of burnout prevention. @*Methods@#This was a multi-center observational study. We enrolled EM physicians and advanced practice providers from sixteen different emergency departments (EDs). Provider wellness culture and burnout surveys were performed. The wellness culture domains included in this study are personal/organizational value alignment, provider appreciation, leadership quality, self-controlled scheduling, peer support, and family support. Correlations between each wellness culture domain and burnout were analyzed by Pearson correlation co-efficiency, and their associations were measured by multivariate logistic regression with adjustments of other confounders. @*Results@#A total of 242 ED provider surveys were entered for final analysis. The overall burnout rate was 54% (130/242). Moderate correlations were found between burnout and two wellness culture domains (value alignment: r=-0.43, P<0.001 and provider appreciation: r=-0.49, P<0.001). The adjusted odds ratio of provider appreciation associated with burnout was 0.44 (95% confidence interval, 0.25–0.77; P=0.004), adjusted odds ratio of family support was 0.67 (95% confidence interval, 0.48–0.95; P=0.025). @*Conclusion@#ED providers have a relatively high burnout rate. Provider burnout might have certain associations with wellness culture domains. Provider appreciation and family support seem to play important roles in burnout protection.

Association between burnout and wellness culture among emergency medicine providers

Objective@#Burnout is a common occurrence among healthcare providers and has been associated with provider wellness culture. However, this association has not been extensively studied among emergency medicine (EM) providers. We aim to determine the association between EM provider burnout and their culture of wellness, and to elicit the independent wellness culture domains most predictive of burnout prevention. @*Methods@#This was a multi-center observational study. We enrolled EM physicians and advanced practice providers from sixteen different emergency departments (EDs). Provider wellness culture and burnout surveys were performed. The wellness culture domains included in this study are personal/organizational value alignment, provider appreciation, leadership quality, self-controlled scheduling, peer support, and family support. Correlations between each wellness culture domain and burnout were analyzed by Pearson correlation co-efficiency, and their associations were measured by multivariate logistic regression with adjustments of other confounders. @*Results@#A total of 242 ED provider surveys were entered for final analysis. The overall burnout rate was 54% (130/242). Moderate correlations were found between burnout and two wellness culture domains (value alignment: r=-0.43, P<0.001 and provider appreciation: r=-0.49, P<0.001). The adjusted odds ratio of provider appreciation associated with burnout was 0.44 (95% confidence interval, 0.25–0.77; P=0.004), adjusted odds ratio of family support was 0.67 (95% confidence interval, 0.48–0.95; P=0.025). @*Conclusion@#ED providers have a relatively high burnout rate. Provider burnout might have certain associations with wellness culture domains. Provider appreciation and family support seem to play important roles in burnout protection.

Productive infection and transduction by bacteriophage P1 in the species Salmonella bongori

Background: Horizontal gene transfer (HGT) is the most important mechanism in the evolution of new genetic capabilities in bacteria, including specific degradative pathways, virulence factors, and resistance to antibiotics. Among the processes involved in HGT, transduction is noteworthy. This is a mechanism for gene transmission mediated by a bacteriophage that functions both as a reservoir and as a vector of exogenous genes, which remain protected from environmental effects in the bacteriophage's capsid. Within this context, this investigation aimed to evaluate the ability of the generalized transducing bacteriophage P1 to productively infect and transduce in the bacterial species Salmonella bongori. Results: We could establish that a derivative of bacteriophage P1, P1Cm, infects strains of S. bongori with frequencies of lysogenization in the order of ~10−2 lysogens/UFP. Through thermal induction, infective viral progeny was obtained, and we could show that P1Cm readily formed plaques on S. bongori lawns, a phenomenon thus far not reported for other members of the genus Salmonella. Finally, we showed P1Cm-mediated transduction of the model plasmid RP4 at frequencies of ~10−7 transductants/donor. Conclusion: Therefore, bacteriophage P1 can be used as a tool for the genetic manipulation in the species S. bongori.

Content analysis of tweets of pregnant women with diabetes

OBJECTIVES: Describe health beliefs of pregnant women with diabetes using tweets. Describe how information on diabetes in pregnancy is shared on Twitter. METHODS: Tweets by women with diabetes were identified from Symplur Signals. "Status" tweets were mapped to the Health Belief Model. Tweets by women with preexisting diabetes and gestational diabetes (GD) were analyzed separately. Links within tweets were surveyed for the Health on the Net (HON) Foundation seal. RESULTS: Women with GD tweeted about cravings and the connection of high carbohydrate meals with big babies. Perceived barriers included food restriction, hunger, lab tests, clinic consults and blood glucose monitoring. Perceived benefits of blood glucose testing and a healthy diet were linked to healthy babies. Blood glucose monitoring, weight gain, and age of gestation were cues to action. Perceived barriers of women with preexisting diabetes were feelings of helplessness, loss of control, and anger. Nine domains (9.7%) had the HON Code seal. Women with preexisting diabetes shared blog posts. Women with GD shared links from organizations. CONCLUSION: Women with GD and preexisting diabetes had differing perceptions of susceptibility, severity, barriers, benefits, cues to action, and self-efficacy; and shared links to information differently on Twitter.

Immunomodulatory Effects of Adipose Tissue-Derived Stem Cells on Elastin Scaffold Remodeling in Diabetes

Diabetes is a major risk factor for the progression of vascular disease, contributing to elevated levels of glycoxidation, chronic inflammation and calcification. Tissue engineering emerges as a potential solution for the treatment of vascular diseases however there is a considerable gap in the understanding of how scaffolds and stem cells will perform in patients with diabetes. We hypothesized that adipose tissue-derived stem cells (ASCs) by virtue of their immunosuppressive potential would moderate the diabetes-intensified inflammatory reactions and induce positive construct remodeling. To test this hypothesis, we prepared arterial elastin scaffolds seeded with autologous ASCs and implanted them subdermally in diabetic rats and compared inflammatory markers, macrophage polarization, matrix remodeling, calcification and bone protein expression to control scaffolds implanted with and without cells in nondiabetic rats. ASC-seeded scaffolds exhibited lower levels of CD8+ T-cells and CD68+ pan-macrophages and higher numbers of M2 macrophages, smooth muscle cell-like and fibroblast-like cells. Calcification and osteogenic markers were reduced in ASCseeded scaffolds implanted in non-diabetic rats but remained unchanged in diabetes, unless the scaffolds were first pre-treated with penta-galloyl glucose (PGG), a known anti-oxidative elastin-binding polyphenol. In conclusion, autologous ASC seeding in elastin scaffolds is effective in combating diabetes-related complications. To prevent calcification, the oxidative milieu needs to be reduced by elastin-binding antioxidants such as PGG.

Major Decline in Malaria Morbidity and Mortality in the Union of Comoros between 2010 and 2014: The Effect of a Combination of Prevention and Control Measures

BACKGROUND:Malaria remains a public health challenge in sub-Saharan Africa. In response to this; many countries are working towards achieving the World Health Assembly and Roll Back Malaria Partnership target of a 75% decline in malaria incidence.OBJECTIVE:To assess trends in malaria morbidity and mortality in the three islands of the Comoros Archipelago from 2010 to 2014.METHODS:This was a retrospective study in which all confirmed malaria cases and deaths recorded between 2010 and 2014 were accessed from the national malaria control database. Trends and comparisons in malaria incidence and case fatality rates for all age groups; including under-5 children and pregnant women; were analysed using Microsoft Excel and SPSS version 16.RESULTS:A substantial decline in malaria incidence was observed for each island between 2010 and 2014; from 75.98 cases per 1 000 population in 2010 to 0.14 in 2014 in Moheli; 60.60 to 0.02 in Anjouan and 235.36 to 5.47 in Grand Comoro. Additionally; a general reduction in malaria case fatalities was observed. In Moheli; there were no case fatalities between 2010 and 2014; while there was a decline in the case fatality rate in Anjouan (from 1.20 fatalities per 1 000 cases to 0) and Grand Comoros (0.51 to 0). There were also significant differences (petlt;0.05) in malaria incidence and case fatalities between the three islands. A similar trend was observed for pregnant women and under-5 children. CONCLUSIONS:Our study indicates a significant decline in malaria morbidity and mortality in the islands of Moheli; Anjouan and Grand Comoro from 2010 to 2014. This considerable reduction is attributed to a combination of malaria prevention and control interventions implemented during the study period

Uso de agentes antiarrítmicos y resultados clínicos en pacientes añosos con fibrilación auricular y enfermedad coronaria concomitante

Objetivo: la fibrilación auricular (FA) y la enfermedad coronaria (EC) son comunes en los pacientes añosos. En este estudio nos propusimos describir el uso de agentes antiarrítmicos (AAA) y los resultados clínicos en estos pacientes. Métodos y resultados: se analizó el tratamiento con AAA y los resultados observados en 1.738 pacientes mayores (edad ³65) con FA y EC registrados en el Banco de Datos para Enfermedad Cardiovascular de Duke. Los resultados primarios fueron mortalidad y rehospitalización al año y a los cinco años. En términos generales, 35% de los pacientes recibían un AAA al inicio, 43% eran mujeres y 85% eran blancos. Fueron frecuentes los antecedentes de infarto de miocardio (IM, 31%) e insuficiencia cardíaca (41%). La amiodarona era el AAA más frecuente (21%), seguida de agentes de Clase III pura (sotalol 6,3%, dofetilida 2,2%). La persistencia de los AAA fue baja (35% al año). Luego del ajuste, el uso de AAA al inicio no se asoció con la mortalidad al año (cociente de riesgo ajustado (HR) 1,23, intervalo de confianza (IC) 95%: 0,94-1,60) o con la mortalidad cardiovascular (HR ajustado 1,27, IC 95% 0,90-1,80). Sin embargo, el uso de AAA sí se asoció con un aumento de la rehospitalización por todas las causas (HR ajustado 1,20, IC 95%: 1,03-1,39) y rehospitalización cardiovascular (HR ajustado 1,20, IC 95% 1,01-1,43) al año. Esta asociación no se mantiene a los cinco años; sin embargo, estos pacientes tuvieron un elevado riesgo de muerte (55% para los >75 años y que recibían AAA) y rehospitalización (87% para aquellos >75 años que recibían AAA) a los cinco años. Conclusiones: en pacientes añosos que padecen FA y EC, la terapia antiarrítmica se acompañó de aumento de la rehospitalización al año. En términos generales, estos pacientes presentan un alto riesgo de internación y muerte a largo plazo. Se necesitan desarrollar terapias más seguras, mejor toleradas y que brinden un control de los síntomas más eficaz en esta población de alto riesgo.

Micronutrient Deficiencies in Pre-school Age Children and Women of Reproductive Age in Jordan.

Objectives: Jordan's 2010 National Micronutrient Survey assessed the prevalence and severity of anemia and micronutrient deficiencies in Jordanian women and children. Methods: A stratified multistage cluster sampling was used to establish a nationally representative household-based sample of Jordanian children (12 - 59 months) and non-pregnant women of reproductive age (15-49 years). Weighted descriptive statistics were used to calculate national prevalence and multivariate analyses were undertaken for the determination of risk factors of vitamin D deficiency Results: Anemia in children (hemoglobin < 110g/L) and women (hemoglobin < 120g/L) was a mild (17.0%) and moderate (30.6%) public health problem, respectively. Vitamin A deficiency (serum retinol < 0.70 umol/L) was prevalent in 18.3% of children and 4.8% of women. Vitamin D deficiency (25(OH)D3 < 11.0 ng/mL and < 12.0 ng/mL in children and women, respectively) was prevalent in 19.8% of children and 60.3% of women. Vitamin D deficiency was significantly more likely in women who routinely cover themselves with a scarf compared to those women who do not cover. In urban areas, children whose mothers were vitamin D deficient were more likely to be vitamin D deficient than children whose mothers were not deficient. Conclusions: With the exception of vitamin A, a higher burden of micronutrient deficiencies is seen in Jordanian women than children. Vitamin D deficiency in women is the most prevalent micronutrient deficiency in Jordan with approximately 3 out of 5 women being deficient.

Assessment of Jordan's Wheat Flour Fortification External Monitoring System.

Objectives: To assess the performance of the external monitoring system utilized in Jordan according to the CDC criteria for surveillance systems. Methods: The performance of the external monitoring system was assessed qualitatively following the CDC's Updated Guidelines for Evaluating Public Health Surveillance Systems. Specifically, seven attributes of the system (simplicity, flexibility, data quality, acceptability, representativeness, timeliness, and stability) were assessed. Results: The monitoring system uses five key indicators that are representative, simple to collect, and collected in a flexible manner. Indicators include 1) monthly production of wheat flour, 2) monthly number of 25 kg premix boxes used, 3) average addition rate (calculated), 4) addition rate as a % of 250 g/MT target (calculated), and 5) iron concentration in flour sample. While data on production of fortified flour and premix utilization can be provided in a timely manner, on-site mill monitoring and flour sample collection are more challenging due to resource constraints. Conclusions: The frequent collection of a small number of indicators can provide program managers with timely information with which to base decisions, and successfully documents the performance of each mill and the whole fortification program. Moreover, the system is acceptable to participating agencies and millers and is stable due to mandatory fortification legislation which provides the legal framework for external monitoring. This system can serve as a model for other national fortification programs considering external monitoring approaches. Citation: Wirth JP et al. Nutrients, 11:4741-4759,2013.

Una mezcla de bacteriófagos reduce los recuentos de Salmonella enterica serovar. Enteritis en tejidos de salmón fresco y ahumado / Bacteriophage cocktail reduces Salmonella enterica serovar. Enteritis counts in raw and somoked salmon tissues

El uso de bacteriófagos en el biocontrol de patógenos está adquiriendo cada vez más aceptación. En este estudio se evaluó la efectividad de bacteriófagos en la reducción de los recuentos de Salmonella Enteritidis en salmón fresco y ahumado. Para ello, 25 muestras por grupo fueron contaminadas con S. Enteritidis, tratadas con una mezcla de bacteriófagos e incubadas durante 10 días a 18 °C o a 4 °C. A los días 3, 6 y 10 se obtuvo una reducción signifi cativa de los recuentos de S. Enteritidis en las muestras de salmón fresco incubadas a ambas temperaturas: la reducción fue de entre 0,75 y 3,19 log10 UFC/g a 18 °C y de entre 2,82 y 3,12 log10 UFC/g a 4 °C. En salmón ahumado las reducciones fueron menores (entre 1,02 y 1,96 log10 UFC/g a 18 °C y entre 0,50 y 1,16 log10 UFC/g a 4 °C). Los resultados indican que estos bacteriófagos constituyen una potencial herramienta de biocontrol de S. Enteritidis en tejidos de salmón fresco y ahumado. © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L. Todos los derechos reservados

The use of bacteriophages for the biocontrol of food-borne pathogens is increasingly gaining acceptance. In this study, the effectiveness of bacteriophages to reduce Salmonella Enteritidis counts was evaluated in raw and smoked salmon tissues. Groups of 25 samples each were contaminated with S. Enteritidis, treated with a phage mix and then incubated for ten days at 18 °C and 4 °C. A signifi cant bacterial reduction was obtained on days 3, 6 and 10 in raw salmon samples incubated at 18 °C (from 0.75 to 3.19 log10 CFU/g) and at 4 °C (from 2.82 to 3.12 log10 CFU/g), whereas in smoked salmon lower reductions were achieved (from 1.02 to 1.96 log10 CFU/g at 18°C and from 0.50 to 1.16 log10 CFU/g at 4 °C). These results show the potential effectiveness of this bacteriophage cocktail as a biocontrol agent against S. Enteritidis in raw and smoked salmon tissues

Small area variation in diabetes prevalence in Puerto Rico / Variación en un área pequeña de la prevalencia de la diabetes en Puerto Rico

OBJECTIVE: To estimate the 2009 prevalence of diagnosed diabetes in Puerto Rico among adults > 20 years of age in order to gain a better understanding of its geographic distribution so that policymakers can more efficiently target prevention and control programs. METHODS: A Bayesian multilevel model was fitted to the combined 2008-2010 Behavioral Risk Factor Surveillance System and 2009 United States Census data to estimate diabetes prevalence for each of the 78 municipios (counties) in Puerto Rico. RESULTS: The mean unadjusted estimate for all counties was 14.3% (range by county, 9.9%-18.0%). The average width of the confidence intervals was 6.2%. Adjusted and unadjusted estimates differed little. CONCLUSIONS: These 78 county estimates are higher on average and showed less variability (i.e., had a smaller range) than the previously published estimates of the 2008 diabetes prevalence for all United States counties (mean, 9.9%; range, 3.0%-18.2%).

OBJETIVO: Calcular la prevalencia en el año 2009 de casos con diagnóstico de diabetes en Puerto Rico en adultos de 20 años de edad o mayores, para conocer mejor su distribución geográfica con objeto de que los responsables políticos puedan encauzar más eficientemente los programas de prevención y control. MÉTODOS: Se ajustó un modelo multinivel bayesiano a la combinación de datos del Sistema de Vigilancia de Factores de Riesgo del Comportamiento 2008-2010 y del Censo de los Estados Unidos del 2009 para calcular la prevalencia de la diabetes en cada uno de los 78 municipios de Puerto Rico. RESULTADOS: El cálculo del valor medio no ajustado para todos los municipios fue de 14,3% (intervalo por municipio de 9,9 a 18,0%). La amplitud promedio de los intervalos de confianza fue de 6,2%. Hubo poca diferencia entre los cálculos ajustados y los no ajustados. CONCLUSIONES: Los valores obtenidos mediante estos cálculos correspondientes a 78 municipios fueron por término medio más elevados y mostraron menor variabilidad (es decir, el intervalo era más pequeño) que los cálculos anteriormente publicados sobre la prevalencia de la diabetes en todos los municipios de los Estados Unidos en el 2008 (media, 9,9%; intervalo de 3,0 a 18,2%).

Morbidity and Mortality at five years after initiating Category I treatment among patients with new sputum smear positive pulmonary tuberculosis.

Background: Evaluation of disease outcome is central to the assessment of tuberculosis control programmes. Most of the follow up studies in RNTCP are short term. Five year follow up studies have not been done previously in this region. The objective of the present study is to evaluate the outcome of Category I treatment in smear positive tuberculosis, five years after treatment in terms of relapse, sequelae and death and to know the associated factors. Material and Methods: Patients who had registered for Category 1 treatment during the period 2002 – 2004 were followed up at five years with clinical evaluation, Chest X-ray, ESR and sputum AFB smear. Results: Of the 224 patients who were studied, 81% patients were males. Addictions, including smoking and alcoholism, were prevalent in 136 patients (61%). Treatment success rate at six months was 94.2%. At the end of five years, 124 patients (57.9%) were symptomatic, 59% patients had radiological sequelae, relapse in 10 patients (4.5%), and mortality in 12 (5.4%) patients. Diabetes mellitus was the most common comorbid illness. Smoking and age > 45 years were associated with radiological sequelae. Smoking was significantly associated with mortality. Smokers had worse outcomes in all parameters. Conclusions: Relapse rate was 4.5% and overall mortality was 5.4% at the end of five years. Significant proportion of patients has radiological sequelae. Smoking was the preventable risk factor associated with sequelae, relapse and mortality.

Paroxysmal dystonia and neuromyelitis optica / Distonia paroxística e neuromielite óptica

Paroxysmal dyskinesias (PD) are thought to be rare movement disorders. The overwhelming majority of reported cases are primary. Secondary PD has seen reported to occur in some conditions, mainly in multiple sclerosis and head trauma. The anatomic origin of the lesion is also rarely seen at the spinal cord. Our objective was to describe four patients with paroxysmal dystonia secondary to spinal lesions during the recovering phase of a neuromyelitis optica (NMO) bout. In the reviewed literature, we do not find any report of PD related to NMO.

Discinesias paroxísticas (DP) são distúrbios do movimento raros. A maioria dos casos relatados é de origem primária. DP secundárias têm sido relatadas em algumas condições, principalmente na esclerose múltipla e no trauma craniano. A origem anatômica da lesão também é raramente observada na medula. O objetivo deste trabalho foi descrever quatro pacientes com distonia paroxística secundária a lesões medulares, ocorrida durante a fase de recuperação do surto de neuromielite óptica (NMO). Na literatura consultada, não encontramos qualquer relato de DP secundárias à NMO.