Predictors of 30-day unplanned hospital readmissions among maintenance dialysis patients

Background and Objectives@#Patients on dialysis are twice as likely to have early readmissions. This study aimed to identify risk factors for 30-day unplanned readmission among patients on maintenance dialysis in a tertiary hospital.@*Methods@#We conducted a retrospective, unmatched, case-control study. Data were taken from patients on maintenance hemodialysis admitted in the University of the Philippines–Philippine General Hospital (UP-PGH) between January 2018 and December 2020. Patients with 30-day readmission were included as cases and patients with >30-day readmissions were taken as controls. Multivariable regression with 30-day readmission as the outcome was used to identify significant predictors of early readmission. @*Results@#The prevalence of 30-day unplanned readmission among patients on dialysis is 36.96%, 95%CI [31.67, 42.48]. In total, 119 cases and 203 controls were analyzed. Two factors were significantly associated with early readmission: the presence of chronic glomerulonephritis [OR 2.35, 95% CI 1.36 to 4.07, p-value=0.002] and number of comorbidities [OR 1.34, 95% CI 1.12 to 1.61, p-value=0.002]. The most common reasons for early readmission are infection, anemia, and uremia/underdialysis. @*Conclusion@#Patients with chronic glomerulonephritis and multiple comorbidities have significantly increased odds of early readmission. Careful discharge planning and close follow up of these patients may reduce early readmissions.

Peligros microbiológicos relacionados con alimentos fermentados de elaboración artesanal comercializados en Tunja, Nariño y Cauca / Microbiological risks related to artisanal fermented foods marketed in Tunja, Nariño and Cauca

RESUMEN Varios factores intervienen en la calidad de los alimentos, como los físicos, químicos, nutricionales, sensoriales y microbiológicos. Este último es importante, ya que, afecta las propiedades organolépticas del producto terminado y, además, puede ocasionar riesgos de salud pública asociados a peligros microbiológicos. Colombia es un país rico en gastronomía, incluyendo alimentos fermentados de elaboración artesanal (AFEA), los cuales son una alternativa actual para sistemas agroalimentarios que buscan alimentos más naturales. El objetivo de este estudio fue evaluar los criterios microbiológicos en AFEA y el cumplimiento de requisitos sanitarios para sensibilizar a productores de bebidas artesanales y revalorizar los productos. Se tomaron en cuenta 11 productores artesanales de Masato, Champús y Almidón agrio de yuca en zonas rurales del país, que voluntariamente aceptaron participar. Se midieron los parámetros de pH, humedad, sólidos solubles y recuentos microbiológicos. Con estos resultados, se pudo calcular el porcentaje de conformidad de los alimentos, de los cuales el 36 % de productos evaluados fueron aptos para el consumo. Se incumplieron los límites establecidos para Escherichia coli, Staphylococcus aureus, Bacillus cereus y Salmonella sp. Los análisis fisicoquímicos mostraron que el Masato y el Champús aportan condiciones abióticas para el crecimiento microbiano. Además, los productores Almidón agrio de yuca tuvieron mayor valoración en el cumplimiento de requisitos sanitarios y menor cumplimiento que los productores de Champús. Los análisis realizados indican que la mayoría de los alimentos incumplieron los límites permitidos por lo cual se debe capacitar a los productores en buenas prácticas de manufactura.

ABSTRACT Several factors intervene in the quality of the food, such as physical, chemical, nutritional, sensory, and microbiological. The latter is important as it affects the sensory properties of the finished product, and it can also cause public health risks associated with microbiological hazards. Colombia is a country rich in gastronomy, including artisanal fermented foods (AFEA), which are a current alternative for agri-food systems seeking for more natural foods. The objective of this study was to evaluate the microbiological criteria in AFEA and its compliance with the sanitary requirements to raise the awareness among crafted beverages producers and revalue the products. Eleven artisan producers of masato, champús and sour cassava starch in rural areas of the country, who voluntarily agreed to participate, were considered. The parameters of pH, humidity, soluble solids, and microbiological counts were measured. With these results, it was possible to calculate the compliance rate of the food, from which 36% of the products evaluated were fit for consumption. The limits established for Escherichia coli, Staphylococcus aureus, Bacillus cereus and Salmonella spp were breached. Physicochemical analysis showed that Masato and Champús provide abiotic conditions for microbial growth. In addition, the Sour cassava starch producers had higher compliance ratings regarding sanitary requirements but lower compliance ratings than champús producers. The performed analysis indicates that most of the food did not comply with the permitted limits, which is why producers must be trained in good manufacturing practices.

Fibroblast Growth Factor-23 is associated with High-density lipoprotein in Systemic sclerosis Female patients

@#INTRODUCTION: Fibroblast growth factor-23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and has been implicated as a putative pathogenic factor in cardiovascular disease. The objectives of this study were: to compare serum FGF23 levels between systemic sclerosis (SSc) patients and healthy controls and to investigate possible associations between FGF23 and serum lipid profile in SSc patients. METHODS: This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. We enrolled 62 consecutive female patients affected by SSc and 62 healthy women who served as controls. Cardiovascular risk factors and related biochemical parameters were collected. Serum FGF23 was analyzed using enzyme- linked immunosorbent assay (ELISA). Linear regression was used to examine the cross-sectional associations of serum FGF23 concentrations with high density lipoprotein-cholesterol (HDL-c). RESULTS: There was no significant differences in FGF23 levels between the patients and controls (78.2 ± 60.5 vs. 80.3 ± 56.3 pg/mL, p= 0.662), but we found a statistically significant inverse relationship between FGF23 and HDL-c measurements (r= -0.27; p= 0.03) in women with SSc. In addition, in the linear regression model, higher FGF23 concentrations were associated with lower HDL-c [β = -1.45 95% CI (-2.81, -0.08); p < 0.05]. CONCLUSIONS: We report an association between circulating FGF23 and HDL-c in SSc female patients, representing a novel pathway linking high FGF23 to an increased cardiovascular risk.

Evaluation of activity of triclabendazole against Taenia solium metacestode in naturally infected pigs

OBJECTIVE@#To assess the efficacy of triclabendazole (TCBZ) in porcine cysticercosis.@*METHODS@#Eighteen naturally infected cysticercosis pigs were divided into 3 groups of 6 individuals each. The first group was treated orally with TCBZ at a single dose of 30 mg/kg of body weight, the second group was treated orally with oxfendazole at a single dose of 30 mg/kg of body weight and the third group received a placebo (control group). All animals were kept under the same management conditions. The pigs were euthanized 17 wk post-treatment and the number of surviving cysts in muscles was assessed and compared between groups.@*RESULTS@#All pigs treated with oxfendazole had only degenerated cysts in their carcasses. In contrast, TCBZ had very little effect against the parasitic cysts. Cysts from pigs in the TCBZ group looked apparently normal after treatment. However, histological evaluation showed a mild to moderate degree of inflammation.@*CONCLUSIONS@#TCBZ is not an efficacious drug against Taenia solium cysticercosis in swine using a single dose.

Evaluation of activity of triclabendazole against Taenia solium metacestode in naturally infected pigs

Objective: To assess the efficacy of triclabendazole (TCBZ) in porcine cysticercosis. Methods: Eighteen naturally infected cysticercosis pigs were divided into 3 groups of 6 individuals each. The first group was treated orally with TCBZ at a single dose of 30 mg/kg of body weight, the second group was treated orally with oxfendazole at a single dose of 30 mg/kg of body weight and the third group received a placebo (control group). All animals were kept under the same management conditions. The pigs were euthanized 17 wk post-treatment and the number of surviving cysts in muscles was assessed and compared between groups. Results: All pigs treated with oxfendazole had only degenerated cysts in their carcasses. In contrast, TCBZ had very little effect against the parasitic cysts. Cysts from pigs in the TCBZ group looked apparently normal after treatment. However, histological evaluation showed a mild to moderate degree of inflammation. Conclusions: TCBZ is not an efficacious drug against Taenia solium cysticercosis in swine using a single dose.

Trichinella papuae: a zoonotic nematode present in Papua New Guinea

@#The zoonotic nematode, Trichinella papuae, was first discovered in wild and domestic pigs in the Bensbach area, Morehead District, Western Province of Papua New Guinea (PNG) in 1988. 15 years later, T. papuae was found in wild pigs and captive crocodiles (Crocodylus porosus) in the Kikori area, Gulf Province of PNG. An overall prevalence of anti-Trichinella IgG was detected in 10% (0.0%-36.7%) of 1536 villagers living in Morehead District by using an ELISA as screening test and a Western blot as confirmatory test. No anti-Trichinella IgG antibodies were detected in 313 villagers living in the Kikori District in spite of the fact that T. papuae was circulating in wild pigs in the district. These results may reflect the different methods of cooking in the two districts. Specific symptoms typical of trichinellosis were not reported by serologically positive persons living in Morehead District, although some non-pathognomonic symptoms, common to trichinellosis and other ailments, were noted. In Thailand, trichinellosis caused by T. papuae was attributed to the custom of eating large quantities of raw pig meat, a food behaviour not found in people living in Morehead and Kikori Districts. This fact probably accounts for the lack of pathognomonic symptoms of trichinellosis in serologically positive people of Morehead District, although they, as well as the Kikori people, occasionally eat tidbits of raw pork sufficient, in the case of the Morehead people, to develop an immune response. The importance of consumer education to eat only thoroughly cooked meat in the localities where T. papuae is circulating is emphasized.

recreational use value in Spanish protected natural landscapes: proposal for a nature park [serrania de Cuenca]

Environmental protection is not at odds with the proper use of all the offered possibilities. Along these lines, the touristic products available to the consumer has increased exponentially over the last few years which has made it possible to convert territorial and patrimonial resources into significant elements of recreational use put into value at service of the consumer. Surveys on the recreational usage value in protected national parks are still incipient in Spain and so it is highly recommendable analyse what their future possibilities are and what applications are feasibly achievable. If the various options are taken into account for evaluating the natural resources currently available to tourists, this paper examines a proposal for studying the values of the recreational use of the [Serrania de Cuenca] national park, which occupies more than fifty thousand hectares in the Province of Castilla-La Mancha. Taking into consideration that large number of varied tourist segments that it is possible to encounter in a market, protected natural landscapes have become truly differentiating elements in a quality touristic offer that strictly meets the most demanding sustainability criteria

Ultrastructural study of the endocrine pancreas of the toad Bufo arenarum

The aim of the present report was to identify by electron microscopy the different endocrine cell types of the toad pancreas. Thus, we studied the pancreas from male specimens of Bufo arenarum with routine techniques for transmission electron microscopy. The results showed the presence of four endocrine cells types which would correspond to those responsible for the different pancreatic hormonal secretions in other species (B, A, D and PP cells). Type 1 cells contained rounded secretory granules with a clear halo which responded to two varieties: a) measuring 200 to 400 mm, and b) having a crystalloid core and a diameter of 400 to 600 nm; these cells would correspond to B cells showed rounded or irregular granules of 104 to 400 nm; they would be equivalent to A cells. Type 3 cells presented polymorphic ganules, most of them peanut-shaped, measuring 115 to 850 nm; they would resemble D cells. Finally, Type 4 cells contained rounded granules of 80 to 400 nm; these cells would correspond to PP cells. In addition, we also observed mixed cells exhibiting similar characteristics to acinar cells, but containing secretory granules resembling those found in some of the endocrine cell types; these would correspond to the acinar-islet cells reported in other animals. In conclusion, we described the ultrastructure of the toad endocrine pancreas and compare it with previous observations made in other amphibians.

Estructura y ultraestructura del pancreas endocrino de ratones transgenicos diabeticos / Structure and ultrastructure of the endocrine pancreas in diabetic transgenic mice

El objetivo del trabajo fue corroborar los cambios estructurales y determinar las alteraciones ultraesctructurales ocurridas en el páncreas endocrino de ratones con un síndrome inducido de diabetes mellitus insulinodependiente (DMID). Para ello se utilizaron ratones transgénicos (OVE 27) que sobreexpresan el gen de calmodulina en las células beta del páncreas endocrino; en estos animales, el aumento de calmodulina disminuye los niveles de calcio citosólico de las células beta, produciendo alteraciones morfológicas y funcionales que desencadenan una DMID de curso severo. Para nuestro estudio se obtuvieron y procesaron porciones del páncreas (cola) de 4 ratones transgénicos machos diabéticos de 5 semanas de edad (glucemia: 376 + 2 mg/del) y de 4 controles no transgénicos de la misma cepa, sexo y edad (glucemia: 113 + 13 mg/dl). El estudio inmunohistoqu­mico con microscop­a de luz confirmó que los ratones transgénicos presentan una disminución del número y tama o de los islotes con distorsión de su arquitectura, sin respuesta inflamatoria asociada. Los estudios ultraestructurales demostraron diversos grados de da o en las células Beta, tales como la presencia de interdigitaciones de membrana y alteraciones de sus organelas y de sus gránulos de secreción. Estos hallazgos coinciden con el deterioro cuantitativo y funcional de las células beta y la conservación de las problaciones celulares no-beta de los islotes. Estos cambios ultraestructurales en las células beta del páncreas del modelo experimental estudiado, sumados a las alteraciones inmunohistoquímicas previamente descriptas, contribuyen a explicar la manifestación de la diabetes.

Endomiocardiofibrose: modelo de miocardiopatia restritiva / Endomyocardial fibrosis: model of restrictive myocardiopathy

Os autores, nesta revisao literária, analisam uma importante causa de miocardiopatia tipo restritiva no nosso meio, a endomiocardiofibrose. Descrevem a etiopatogenia, patologia, diagnóstico clínico e complementar e seu tratamento. Concluem que a etiologia ainda é desconhecida, que seu diagnóstico tem evoluido às custas da ecocardiografia Doppler e que o tratamento permanece pouco eficaz, uma vez que a mortalidade cirúrgica, apesar do avanço nas técnicas, é maior que a esperada e a história natural dos pacientes tratados clinicamente também demonstra alta taxa de óbitos em curto espaço de tempo.