Current status of acupunctiure in British Columbia, Canada / 全日本鍼灸学会雑誌

This paper gives an overview of acupuncture and moxibustion usage in British Columbia (BC), Canada. In Canada, acupuncture and moxibustion are handled and regulated differently in each province; in BC, it is managed and supervised through the Health Regulatory Colleges under the Health Profession Act. In the field of oriental medicine and acupuncture, the College of Traditional Chinese Medicine Practitioners and Acupuncturists of BC (CTCMA) has been established to manage and supervise doctors of Traditional Chinese Medicine and oriental medicine practitioners, with specific duties that include public protection and the registration, examination, and evaluation of the quality of services of practitioners. The CTCMA is characterized by a centralization of operations that in Japan are carried out by several government agencies.Next, I will describe my impressions of acupuncture and moxibustion from those who I met in Vancouver, where I live, at the school I attended, at the clinic that I practice, etc. Although there are many Chinese immigrants, I did not feel that acupuncture and moxibustion are particularly widespread, but I got the impression that they are well recognized as a common treatment. Finally, I will briefly touch on the examinations and visa requirements for acupuncture and moxibustion practitioners who are considering immigration to Canada. Five years of education is required to take the examination, and although there are cases in which the content of education received in Japan can be transferred, it is better to receive acupuncture and moxibustion education in Canada. As health professionals, acupuncture and moxibustion practitioners can also earn points toward permanent residency. Canada's regulatory system for medical care is new in its institutional design and appears to be consistent throughout the health care system, as it comprehensively regulates all health professionals. The impression I gained is that acupuncture and moxibustion are recognized as effective treatments. Canada, a country of immigrants, has a national character that likes "new things" and accepts change flexibly, and there is much potential for acupuncture and moxibustion treatments to increase in the field of health care in the future.

A cross-sectional study on the prevalence and severity of suicidal ideations and behaviors of senior high school students using the Columbia-Suicide Severity Rating Scale (C-SSRS)

Objectives@#In the light of increased suicide risk among adolescents, this research aimed at determining the prevalence and severity of suicidal ideations and behaviors of senior high school students in a public secondary school in Metro Manila using the Columbia-Suicide Severity Rating Scale (C-SSRS).@*Methodology@#This is a descriptive cross-sectional school-based study, conducted on 236 senior high school students, 18 years old and above, in San Juan National High School (SJNHS) in San Juan, Metro Manila. The study employed convenience sampling. Upon selection, the C-SSRS was administered. Data on four constructs of suicide were gathered: 1) suicidal ideation severity; 2) intensity, which was quantified in terms of frequency, duration, control, deterrents and reasons for suicidal ideation; 3) suicidal behavior rated on a nominal subscale as actual, aborted, interrupted, preparatory behavior and non-suicidal injurious behavior; and lastly 4) lethality of actual suicide attempts on a 6-point ordinal scale, and if actual lethality was zero, potential lethality was further rated on a 3-point ordinal scale.@*Results@#The majority (67.8%) had mild suicidal ideations; 37.71% had active suicidal ideations with intent but not necessarily a specific plan and only 13.98% had active suicidal ideation with intent to act and a specific plan. The intensity of suicidal ideation was not that frequent in 35.59% of the respondents i.e.18.64% 1x/ week and 16.95% less than 1x/ week. About a third (30.07%) had very short duration of suicidal ideations i.e. fleetingly (19.92%) or less than an hour/ day (11.02%). A third (32.62%) were able to easily control (18.64%) or control with minimal difficulty (13.98%). Reason for suicidal ideation were either to get attention (10.59%) or to end the emotional pain (11.02%). A third (30.93%) had actual attempts (15.25%) and Non -Suicidal Self Injury (NSSI) (15.68%); while another 35.06 % had interrupted (16.53%) or aborted (19.07%) attempts. Those who had actual attempts, 41.67% had no physical injury while 50 % incurred minor injuries. Thirty- two (88.89%) had suicidal attempt that was likely to result in injury but not likely to cause death.@*Conclusion@#In light of these relatively high prevalence rates for suicidal ideation and behaviors, schoolwide intervention on education or awareness programs, gatekeeper training, peer leadership, skills training and screening or assessment may have to be instituted to curb the increased suicide risk of the senior high school students and further prevent suicide attempts.

Validation and cross-cultural adaptation of Columbia Cramp Scale in Serbian ALS patients

@#Background & Objectives: Muscle cramps are present in more than three quarter of amyotrophic lateral sclerosis (ALS) cases. The objective of the present study was to translate and validate Columbia Cramp Scale (CCS) for use in Serbian ALS patients, and to identify the potential epidemiological and clinical factors which could influence worse overall CCS score. Methods: This study involved 21 patients with muscle cramps and 17 patients with no previous cramps history. Patients with cramps were retested 3 months after first assessment. Main socio-demographic and clinical data were obtained from patients at time of testing. The revised ALS functional rating scale (ALS-FRS-R) was used to score activities of daily living. The study subjects were assessed with CCS, Hamilton scales for the assessment of anxiety (HAM-A) and depression (HAM-D) and 36-Item Short Form Survey (SF-36). Results: Mean CCS score was 17.2±6.7 (range 6-30). The Cronbach’s alpha coefficient reflecting internal consistency was 0.76, which suggest acceptable internal consistency. Multiple linear regression analysis including all parameters associated with worse CCS scores, showed that lower ALSFRS-R scores (beta=0.55, p<0.01) and depression (beta=0.52, p<0.01), were independent predictors of the worse CCS score (adjusted R2=0.35, p<0.01 for overall model). Subjects with cramp history were retested after 3 months and no statistically significant difference between CCS scores in this two time points was noted. Conclusion: Selection of appropriate measure for assessing muscle cramps is important. In ALS patients we recommend CCS questionnaire. Results of our study also show that high CCS scores correlate with depression and anxiety, worse QoL and some epidemiological and clinical characteristics.

Reliability and validity of the Columbia suicide screen in junior middle school students / 中华行为医学与脑科学杂志

Objective To examine the reliability and validity of the Columbia suicide screen (CSS) in detecting suicide risk for junior middle school students.Methods Using convenient sampling,902 students of a junior middle school were tested with CSS and Beck depression inventory (BDI).Cronbach's alpha coefficient,parity split-half coefficient and test-retest reliability were examined after two weeks.Content validity was evaluated using specialist analysis and sensibility analysis.The BDI was used to explore the correlative validity.The convergent validity of CSS and another suicide risk screening method was examined.Results The proportion of students with suicide problem (suicide ideation or suicide attempts),suicide ideation within the previous year and suicide attempts in the past were 14.97％ (135/902),14.19％ (128/902)and 3.66％ (33/902) respectively.The Cronbach's alpha coefficient and Parity split-half coefficient of CSS were 0.844 and 0.908,respectively.The test-retest reliability of CSS were screening of suicide ideation (ICC =0.897),screening of suicide attempts (ICC =0.798),screening of substance use (ICC =0.882),screening of suicide problem (ICC =0.881),and screening of suicide problem combine depression (ICC =0.829)(P＜0.01).Sensibility analysis of CSS showed the cronbach α ranged from 0.834 to 0.845.Correlative validity between CSS and BDI were screening of suicide ideation (ρ =0.238,0.337,0.334,0.599),screening of suicide attempts (ρ =0.122,0.231,0.310,0.221),screening of depression (ρ =0.335,0.309,0.196,0.215),screening of suicide problem(ρ =0.240,0.328,0.321,0.590)and screening of suicide problem combine depression(ρ=0.212,0.324,0.320,0.474) (P＜0.01).Convergent validity between CSS and another suicide risk screening method were screening of suicide ideation (ρ =0.468),screening of suicide attempts (ρ =0.349),screening of suicide problem (ρ =0.453),and screening of suicide problem combine depression(ρ=0.469)(P＜0.01).Conclusion CSS has good internal consistency reliability,split-half reliability and content validity.Screening of suicide ideation,suicide attempts,suicide problem and suicide problem combine depression have good test-retest reliability,but the correlative validity and convergent validity are not satisfying.These four screening methods can only be used for preliminary screening suicide risk in junior middle school students.

Reliability and validity of the Columbia suicide screen in junior middle school students / 中华行为医学与脑科学杂志

Objective@#To examine the reliability and validity of the Columbia suicide screen (CSS) in detecting suicide risk for junior middle school students.@*Methods@#Using convenient sampling, 902 students of a junior middle school were tested with CSS and Beck depression inventory (BDI) .Cronbach's alpha coefficient, parity split-half coefficient and test-retest reliability were examined after two weeks.Content validity was evaluated using specialist analysis and sensibility analysis.The BDI was used to explore the correlative validity.The convergent validity of CSS and another suicide risk screening method was examined.@*Results@#The proportion of students with suicide problem (suicide ideation or suicide attempts), suicide ideation within the previous year and suicide attempts in the past were 14.97%(135/902), 14.19%(128/902)and 3.66%(33/902) respectively.The Cronbach's alpha coefficient and Parity split-half coefficient of CSS were 0.844 and 0.908, respectively.The test-retest reliability of CSS were screening of suicide ideation (ICC=0.897), screening of suicide attempts (ICC=0.798), screening of substance use (ICC=0.882), screening of suicide problem (ICC=0.881), and screening of suicide problem combine depression (ICC=0.829) (P<0.01). Sensibility analysis of CSS showed the cronbach α ranged from 0.834 to 0.845.Correlative validity between CSS and BDI were screening of suicide ideation(ρ=0.238, 0.337, 0.334, 0.599), screening of suicide attempts(ρ=0.122, 0.231, 0.310, 0.221), screening of depression(ρ=0.335, 0.309, 0.196, 0.215), screening of suicide problem(ρ=0.240, 0.328, 0.321, 0.590)and screening of suicide problem combine depression(ρ=0.212, 0.324, 0.320, 0.474)(P<0.01). Convergent validity between CSS and another suicide risk screening method were screening of suicide ideation(ρ=0.468), screening of suicide attempts(ρ=0.349), screening of suicide problem(ρ=0.453), and screening of suicide problem combine depression(ρ=0.469)(P<0.01).@*Conclusion@#CSS has good internal consistency reliability, split-half reliability and content validity.Screening of suicide ideation, suicide attempts, suicide problem and suicide problem combine depression have good test-retest reliability, but the correlative validity and convergent validity are not satisfying.These four screening methods can only be used for preliminary screening suicide risk in junior middle school students.

Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents / Validación psicométrica de la escala de Columbia de severidad de suicidio en adolescentes hispano-hablantes

Abstract Introduction: Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. Objetive: To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Methods: Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Results: Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively Conclusion: This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires.

Resumen Introducción: Suicidio adolescente es un problema de salud pública y su detección temprana es de gran interés. Hay numerosos instrumentos confiables para este objetivo, como la escala Columbia para la detección del riesgo de suicidio, pero no ha sido validada para población adolescente de habla hispana en Latinoamérica. Objetivo: Validar psicométricamente y explorar los puntos de corte para la escala Columbia en adolescentes de habla hispana. Métodos: Analisis exploratorio con extracción de componentes principales y rotación Varimax así como análisis confirmatorio fueron llevados a cabo sobre 782 y 834 participantes respectivamente (N=1616). La edad media fue de 24.8 años. El análisis ROC distinguió entre controles y adolescentes en riesgo de suicidio. Resultados: La rotación Promax arrojó dos factores de 10 ítems, para ideación y comportamiento suicida respectivamente. La C-SSRS correlaciono positivamente con otras escalas de detección de riesgo de suicidio como Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, o el PHQ-9. El análisis factorial confirmatorio ofreció una solución de 2 factores como el modelo con mejor ajuste. El análisis ROC tuvo puntos de corte ≥ 6 y ≥ 4 para las escalas de ideación y comportamiento suicida respectivamente Conclusión: Esta investigación ofrece datos que apoyan la validez psicométrica y confiabilidad de la C-SSRS en población de estudiantes adolescentes hispano-hablantes latinoamericanos. Beneficios adicionales son un sistema de puntaje flexible y facilidad de administración. Este cuestionario ofrece datos sobre distintos aspectos de suicidalidad siendo más robusto que la administración separada de varios cuestionarios diferentes.

Lactated Ringer's solution or 0.9 por cento sodium chloride as fluid therapy in pigeons (Columba livia) submitted to humerus osteosynthesis / Fluidoterapia com Ringer lactato ou cloreto de sódio 0.9 percent em pombos (Columbia livia) submetidos à osteossíntese de úmero

The study aimed to compare the effects of intraosseous infusion of lactated Ringer's and 0.9% sodium chloride solutions on the electrolytes and acid-base balance in pigeons submitted to humerus osteosynthesis. Eighteen pigeons were undergoing to isoflurane anesthesia by an avalvular circuit system. They were randomly assigned into two groups (n=9) receiving lactated Ringer's solution (LR) or 0.9% sodium chloride (SC), in a continuous infusion rate of 20mL/kg/h, by using an intraosseous catheter into the tibiotarsus during 60-minute anesthetic procedure. Heart rate (HR), and respiratory rate (RR) were measured every 10 min. Venous blood samples were collected at 0, 30 and 60 minutes to analyze blood pH, PvCO2, HCO3 -, Na+ and K+. Blood gases and electrolytes showed respiratory acidosis in both groups during induction, under physical restraint. This acidosis was evidenced by a decrease of pH since 0 min, associated with a compensatory response, observed by increasing of HCO3 - concentration, at 30 and 60 min. It was not observed any changes on Na+ and K+ serum concentrations. According to the results, there is no reason for choosing one of the two solutions, and it could be concluded that both fluid therapy solutions do not promote any impact on acid-base balance and electrolyte concentrations in pigeons submitted to humerus osteosynthesis...

O presente estudo avaliou os efeitos da infusão das soluções de Ringer lactato ou cloreto de sódio 0,9%, no equilíbrio ácido-base e hidroeletrolítico de pombos submetidos à osteossíntese de úmero. Foram utilizados 18 animais, os quais foram submetidos à anestesia por isofluorano, e mantidos em circuito avalvular durante o período anestésico (60 min). Os animais foram distribuídos aleatoriamente em dois grupos (n=9) recebendo Ringer lactato (LR) ou cloreto de sódio 0,9% (SC), administradas na taxa de 20mL/kg/h pela via intraóssea (tibiotarso). Foram monitoradas as frequências cardíaca e respiratória a cada 10 minutos e colhidas amostras sanguíneas venosas aos 0, 30 e 60 min de anestesia, obtendo-se a partir destas, valores de pH sanguíneo, bicarbonato (HCO3), pressão venosa de CO2 (PvCO2), sódio (Na+) e potássio (K+). Os valores referentes ao equilíbrio ácido-base indicam que houve acidose respiratória em ambos os grupos, a qual foi decorrente do processo de indução sob contenção física, caracterizada por diminuição no pH desde o 0 min, associado ao aumento compensatório nos valores de HCO3 -, nos momentos 30 e 60 min. No entanto, no que se refere aos valores obtidos de Na+ e K+ séricos, durante a infusão de ambos os fluidos, não foram observadas alterações que justifiquem a predileção por alguma destas soluções. Diante destes resultados conclui-se que a escolha entre uma das soluções avaliadas não promoveu impacto sob o equilíbrio ácido-base e hidroeletrolítico de pombos submetidos a osteossíntese de úmero...

Metodologia científica na formação do médico veterinário: experiênciateórico-prática na análise de fontes urbanas de Cryptococcus spp – Jaboticabal, SP – Brasil / Scientific methodology in veterinary medical training: a theoretical andpractical experience in the analysis of urban sources of Cryptococcus spp in Jaboticabal, SP – Brazil / Metodología científica en la formación médica veterinaria: la experienciateórica y práctica en el análisis de fuentes urbanas de Cryptococcus spp de Jaboticabal, SP – Brasil

O artigo apresenta resultados de um projeto de ensino de Metodologia Científica em Curso de Graduação deMedicina Veterinária. Pautou-se por uma reflexão crítica da necessidade de interação entre as dimensões teórica eprática na formação do profissional e realizou-se análise de fontes urbanas de Cryptococcus spp em fezes de pombos(Columbia livia), evidenciando a importância de orientação à população sobre os riscos de contágio, caracterizando a patogenicidade dos agentes identificados em dez ambientes públicos.

This article presents the results of an educational project for the Scientific Methodology degree course for veterinary medicine. The project was guided by the critical reflection on the necessity for the interaction between the theoretical and practical dimensions of professional training. An analysis was performed of urban sources of Cryptococcus spp in excrements of pigeons (Columbia livia), indicating the need for education of the population about the risks factors of transmission and characterizing the pathogenicity of the identified agents in ten public places.

El artículo presenta los resultados de un proyecto de enseñanza de Metodología Científica en el Curso de Graduaciónde Medicina Veterinaria. Se marcó por una reflexión crítica da la necesidad de la interacción entre las dimensionesteóricas y prácticas en la formación del profesional y se realizó un análisis de fuentes urbanas de Cryptococcus sppen excremento de palomas (Columbia livia), mostrando la importancia de la orientación a la población sobre losriesgos del contagio, caracterizando la patogenicidad de los agentes identificados en diez ambientes públicos.

Evaluación biológica de dos sistemas de apareamiento en ovinos de raza Columbia en producción intensiva / Biological evaluation of two breeding systems of intensive production in the Columbia breed sheep

The biological efficiency of two breeding systems for sheep in the Mexican high plateau was evaluated. A total of 300 adult and 60 replacement sheep of the Columbia breed were randomly distributed into two groups of 150 adults and 30 young ones (mean age to first birth of 18 months). Mates of 36 days with natural mount every eight months (March, November and July) were done in the first group (intensive system). In the second group (annual system), a 45-day mating was done starting on November every year. Marker males were introduced 15 days before mating in all cases, which were replaced on the first day of mating for stallions at a one male for every 20 female ratios. The physical condition of all females was evaluated every month. The animals grazed 8 to 9 hours in grasslands of alfalfa (Medicago sativa) and Orchard (Dactylis glomerata) and Rye (Lolium perenne) grasses irrigated by aspersion. Only the sheep in the intensive system received supplement during lactation and re-mating. Breeding was achieved in both systems in all seasons. The mean fertility of the three breeding of the intensive system was 83.9%; while the mean fertility of the two annual breeding was 88.3% (P < 0.05). Prolificacy was 1.12 vs 1.32 (P < 0.05) for the intensive and annual breeding, respectively; mortality at weaning was 5.3% vs 6.4% (P < 0.05), weaning rate was 0.89 vs 1.09 (P < 0.05), the number of weaned lambs per ewe in two years was 2.5 vs 2.0 and lamb weight was 55.9 vs 44.4 kg (P < 0.05), respectively. Adult ewes were superior to the young ones in all the evaluated parameters, regardless of the kind of mating (P < 0.05). Results in this study allowed to compare the biological efficiency between an intensive breeding system every eight months and an annual breeding system. They also show the possibility of mating sheep of the Columbia breed in an intensive way.

Se evaluó la eficacia biológica de dos sistemas de apareamiento en ovinos del altiplano central de México. Un total de 300 ovejas adultas y 60 de reemplazo de la raza Columbia se distribuyeron al azar en dos grupos de 150 adultas y 30 jóvenes (edad promedio al primer parto de 18 meses). En el primer grupo (sistema intensivo) se realizaron empadres de 36 días, con monta natural cada ocho meses (marzo, noviembre y julio), mientras que en el segundo grupo (sistema anual) se llevó a cabo un empadre de 45 días, iniciando en noviembre de cada año. En todos los casos, quince días antes del empadre se introdujeron machos marcadores, que en la fecha de inicio del empadre se sustituían por sementales en proporción de un macho por cada 20 hembras. Mensualmente se evaluó la condición física de todas las hembras. Los animales pastorearon de ocho a nueve horas diarias en praderas de alfalfa (Medicago sativa) y pastos orchard (Dactylis glomerata) y rye grass (Lolium perenne) irrigadas por aspersión. Solamente las ovejas del sistema intensivo recibieron complemento durante la lactancia y el reempadre. En los dos sistemas se lograron apareamientos en todas las épocas, la fertilidad en los tres empadres del sistema intensivo fue de 83.9%, mientras que el promedio de los dos empadres anuales fue de 88.3% (P < 0.05). En el mismo orden, la prolificidad fue de 1.12 vs 1.32 (P < 0.05); la mortalidad al destete, 5.3% vs 6.4% (P > 0.05); la tasa de destete, 0.89 vs 1.09 (P < 0.05); el número de corderos destetados por oveja en dos años fue de 2.5 vs 2.0, y de kg de cordero de 55.9 vs 44.4 kg (P < 0.05). Independientemente del tipo de empadre, las ovejas adultas fueron superiores a las jóvenes en todos los parámetros evaluados (P < 0.05). Los resultados de este estudio permiten comparar la eficacia biológica entre un sistema de apareamiento intensivo cada ocho meses y uno anual, también muestra la posibilidad de aparear ovejas de la raza Columbia en forma intensiva.

El efecto macho como inductor de la actividad reproductiva en sistemas intensivos de apareamiento en ovinos / Use of the male effect to induce reproductive activity in ovine intensive breeding systems

The presence of the male effect and its importance in the reproductive management of Columbia ewes was evaluated during a comparative study between a herd of ewes subjected to an annual breeding system with services in November (AS) and another herd subjected to an intensive system with breeding periods in November, July and March (IS). The two herds were kept on intensive irrigated prairies with moderate climate: the ewes in the IS were supplemented during the lactation and rebreeding periods. Estrus expression was detected by the presence of marks on the rump left by aniline-impregnated teaser males. In addition, the concentrations of progesterone were determined in blood samples from 20 adult ewes and 5 ewe-lambs from each breeding system. These samples were taken twice per week from the time the teaser males were introduced. The conception date for each ewe was retrospectively calculated from the date of lambing. The results indicate a clear male effect in the IS group during the breeding periods of July and March, when such a male effect proved to be very important for the reproductive success of the herd. In contrast, the male effect was not apparent during November breeding periods because the animals of both herds were already cycling when the teaser males were introduced at that time of the year. It is concluded that the use of the male effect can improve the reproductive efficiency of Columbia ewes exposed to intensive breeding systems in Mexico.

Se determinó la presencia del efecto macho y su importancia en el manejo reproductivo de ovejas de la raza Columbia, en un estudio comparativo entre un rebaño sometido a un sistema de apareamiento anual con empadres en noviembre (S-A) y otro intensivo con empadres en noviembre, julio y marzo (S-I). Los rebaños se mantuvieron en condiciones de pastoreo intensivo en praderas irrigadas de clima templado: las ovejas en el S-I se complementaron durante la lactancia y el reempadre. Se estableció la ocurrencia de estros por medio de la presencia de marcas de anilina que los machos vasectomizados dejaron en la grupa. Además, en cada sistema de empadre se determinaron las concentraciones de progesterona en muestras sanguíneas de 20 ovejas adultas y cinco primalas dos veces por semana a partir de la introducción de los machos. La distribución de los partos permitió calcular la fecha de concepción. Los resultados indican un claro efecto macho en el grupo S-I durante los empadres de julio y marzo, cuando dicho efecto macho confirmó su importancia en el éxito reproductivo del rebaño.. En cambio, el efecto macho no se presentó durante el empadre de noviembre del grupo S-I, ni durante los empadres del grupo S-A, debido a que al inicio de dichos empadres las ovejas se encontraban ciclando. Se concluye que el efecto macho puede ser utilizado para mejorar la eficiencia reproductiva de ovejas de la raza Columbia sometidas a sistemas intensivos de apareamiento en México.

Comparación de medios de cultivos y procedimientos para detectar colonización por Streptococcus agalactiae en mujeres embarazadas / Comparison between culture media and procedures to detect Streptococcus agalactiae in pregnant women

Introducción: La detección de Streptococcus agalactiae en la vagina y/o el recto de las mujeres embarazadas y la administración de profilaxis antimicrobiana intraparto en las colonizadas, es el método recomendado para prevenir la infección neonatal precoz por este patógeno. En consecuencia, es importante seleccionar los medios de cultivos y el sitio de toma de muestra más adecuado para la detección de S. agalactiae en mujeres colonizadas. Objetivo: Comparar diferentes medios de cultivos y procedimientos para la recuperación de S. agalactiae en mujeres embarazadas con complicaciones gineco-obstétricas. Metodología: Se tomaron hisopados vagino-ano-rectales y endocer-vicales de 60 mujeres embarazadas. Con la primera muestra se realizó cultivo directo en agar sangre Columbia selectivo (ASCSD), y caldo selectivo Todd Hewitt (CSTH) incubados a 37 °C, y subcultivos a las 4 y 18 horas en agar sangre Columbia selectivo (ASCS). La segunda muestra se cultivó en ASCS. El ASCSD y ASCS se incubaron en atmósfera microaeróñla a 37 °C durante 24 a 48 horas. La identificación de S. agalactiae se realizó mediante pruebas convencionales. Resultados: Utilizando hisopado vagino-ano-rectal se detectaron 21 pacientes colonizadas con S. agalactiae, de la siguiente manera: 19(31,7 por ciento) en el ASCSD, 21 (35 por ciento) en el CSTH a las 4 horas y 20 (33,3 por ciento) a las 18 horas. De las 21 pacientes colonizadas sólo a una paciente se le detectó S. agalactiae en la muestra de secreción vagino-ano-rectal y endocervical simultáneamente. Conclusión: Los tres procedimientos ensayados presentaron igual efectividad para la recuperación de S. agalactiae; sin embargo, con el uso del ASCSD, se disminuyen los costos y el tiempo de identificación de dicho microorganismo. Por otra parte, el hisopado vagino-ano-rectal resultó ser la muestra más idónea para detectar colonización por S. agalactiae en mujeres embarazadas.

Detection of Streptococcus agalactiae in pregnant women's vagina and rectum and intrapartum antibiotic prophylaxis administered to colonized women are currently recommended to prevent neonatal precocious infections by this organism. In turn, it is very important to select the culture media and adequate sample collection site for S. agalactiae detection in colonized women. To standardize this methods in laboratory, different culture media and procedures for S. agalactiae recovery in pregnant women with obstetric and gynecologic complications were compared. Vaginorectal and endocervical swab specimens were collected from 60 pregnant women. The first sample was placed onto selective Columbia blood agar directly and onto selective Todd-Hewitt broth incubated at 37 °C and subcultured onto selective Columbia blood agar at 4 and 18 hours. The second sample was cultured on selective Columbia blood agar. Both culture media were incubated in a microaerophilic atmosphere at 37 °C from 24 to 48 hours. S. agalactiae was identified using conventional tests. 21 patients colonized with S. agalactiae were detected using vaginoanorectal samples. 19 (31.7 percent) patients tested positive for S. agalactiae through the culture of specimens directly onto selective Columbia blood agar; 21 (35 percent) and 20 (33 percent) patients were found to be positive for S. agalactiae by the selective Todd-Hewitt broth at 4 and 18 hours, respectively. Only one patient tested positive for S. agalactiae in the endocervical tract. The results show that the three procedures followed for S. agalactiae recovery are effective. Nevertheless, the procedure in which the sample was placed directly onto selective Columbia blood agar permits reducing costs and the time for bacteria identification. On the other hand, the vaginoanorectal swab was the best sample to detect colonization by S. agalactiae in pregnant women.

Improvement of the Positive Culture Rate Using New Enriched Broth in Cellulitis / 대한피부과학회지

BACKGROUND: Staphylococcus aureus and Group A beta-hemolytic Streptococci are the etiologic agents most commonly associated with cellulitis, but many other bacteria have also been shown to cause this condition. The positive bacterial culture rate is the most important factor in the treatment of cellulitis. However, the positive bacterial culture rate in the commonly used media, tends to be quite low. OBJECTIVE: The principal objective of this study was to improve the positive culture rate in cellulitis patients by using a new enriched broth. METHODS: Brewer modified thioglycollate medium (BTM) and Columbia broth (CB), both of which are widely utilized in clinical bacteriology for enriched growth, were compared with several novel enriched broths. These new enriched broths were mixtures of BTM-CB broth and added growth supplement factors. They included BTM-CB (BC), Modified BTM-CB (MBC) and supplement VX-BTM-CB (VXBC). MBC media included several growth supplements, such as hemin, vitamin K1, VX supplement, and Campylobacter growth supplement. Strains utilized in this study were common pathogens (Staphylococcus aureus, Streptococcus pyogenes, et al.), anaerobes, fastidious pathogens (Bacteroides fragilis, Campylobacter jejuni, Prevotella melaninogenica), uncommon pathogens (Actinobacter baumannii, Enterococcus faecalis, Streptococcus agalactiae). Positive culture rates were evaluated in each medium and measured via spectrophotometry at 660 nm. RESULTS: In vitro, all strains used in this study grew more quickly and densely in MBC media. CONCLUSION: Our results suggest that MBC media in a new enriched broth may improve bacterial culture rates in cellulitis patients. It will be necessary to study the efficacy of the MBC media in the culturing etiologic agents from tissues of cellulitis patients.

Perspectiva Bioética del cuidado de Enfermería / Ethics. Moral. Bioethics. Care Ethics and Nursing.

En el presente artículo se presenta una aproximación a la perspectiva bioética del cuidado de Enfermería, se plantean inicialmente algunos elementos de reflexión acerca de la ética y la moral y sus aportes a la reflexión bioética; seguidamente se analizan elementos conceptuales de la bioética: origen, concepto, rasgos característicos, áreas de estudio, tendencias de la bioética en América latina y el Caribe y su relación con la ética del cuidado, propio de Enfermería

An approach to the nursing care bioethics perspective is shown in the present article, initially reflection elements about the ethics and the moral are taking into account, together with a bioethics reflection, followed by the analysis of bioethics conceptual elements: origin, concept, characteristics, different study fields, Latin America and Caribbean bioethics tendencies and the relation of the bioethics with the care ethics of nursing.

Avances nosológicos de las demencias. Caracterización de los pacientes con demencia frontotemporal / Clinical characterization of the fronto-temporal dementia patients

En la última década se ha dado un marcado avance en el cono-cimiento de la enfermedad de Alzheimer (EA), pero no en otras demencias. Es así como las características clínicas y psicométri-cas de los pacientes con demencia frontotemporal (DFT) -segun-da causa de demencias degenerativas primarias-, empiezan a ser descritas en series de casos de los principales centros del mundo, donde se tiene la posibilidad de realizar diagnóstico por consenso por grupos de expertos. Por tal motivo se analizó una muestra de pacientes de la Clínica de Memoria del Hospital Universitario de San Ignacio (Bogotá, Colombia), en donde fueron evaluadas en forma protocolizada 348 personas, de las cuales 45 cumplían criterios de DFT, 259 para EA y 44 eran controles. El análisis es-tadístico se realizó con la prueba de comparación Kruskal Wallis (significación del 5 por ciento), teniendo como medida de análisis el rango intercuartílico. Todas las diferencias señaladas fueron el producto de pruebas con valores de p< 0.017. Los hallazgos que mejor definían al los pacientes con DFT eran: mayor predominio de hombres (73 por ciento vs. 31 por ciento en los que tenían EA), edad menor (mediana 65 años vs. mediana de 76 años en los que tenían EA), escala comportamental de Columbia más comprometida (mediana de 10 vs. 7 en pacientes con EA y 1 en los controles) y minimental más deteriorado en comparación con el grupo control (mediana de 24 vs. 27) pero mejor que los pacientes que tenían EA (mediana de 24 vs. 20). Estos hallazgos nos ayudan a poder definir mejor el perfil clínico y psicométrico de los pacientes con DFT, pero a su vez nos abren nuevos interrogantes que iremos despejando en la medida en que podamos hacer un seguimiento longitudinal de estas personas.[Cano CA, Ramírez CA. Avances nosológicos de las demencias. Caracterización de los pacientes con demencia frontotemporal. MedUNAB 2004; 7:84-8]

Clinical characterization of the fronto-temporal dementia patients. Thee clinical and psychometric profiles of patients with fronto-tem-poral dementia (FTD) has been recently described as cases series from the most important research centers of the world, where there is the possibility for a diagnosis by a consensus criteria. In this article, a group of patients from the Memory Clinic at the Hospital Universitario de San Ignacio, in Bogotá City has been studied. Three hundred and forty eight patients were studied by the Memory Clinic Group, of which 45 had the criteria for FTD, 259 the criteria for Alzheimer's disease (AD) and 44 were controls. The statistical analysis was realized with the best distinctions to define the FTD group were: predominance of men (73% vs. 31% in AD), younger age of onset (65 years vs. 76 years in AD) Columbia Behavioral Scale more compromised (10 vs. 7 in AD and 1 in controls) and MMS inferior to controls (24 vs. 27) but superior to AD (24 vs. 20). These distinctions aid to better define the profile of patients with FTD, but also open a new questions which we expect to answer, soon, in a longitudinal study of this persons.