Determination of the seroprevalence of Leptospira spp. and the main serovars circulating in cattle in the province of Manabí, Ecuador. / Determinación de la seroprevalencia de Leptospira spp. y los principales serovares circulantes en el ganado bovino en la provincia de Manabí, Ecuador.

Leptospirosis is a transmissible zoonotic disease caused by pathogenic strains of the genus Leptospira. Clinical signs in cattle are fever, haematuria, haemoglobinuria, meningitis, abortion, birth of weak calves and infertility; in the most severe cases, it can cause death to the animal. The few studies conducted in Ecuador, and in particular the province of Manabí, have revealed varying prevalence rates, ranging from 35.8% to 75%. The objective of this study is to determine the seroprevalence of leptospirosis in cattle and to ascertain the main serovars circulating in the province of Manabí. A cross-sectional epidemiological study was conducted from November 2015 to March 2016, for which seven cantons were selected at random and a total of 854 animals from 67 herds were investigated. The samples were processed in the laboratories of the Animal Diagnostics Directorate of the Ecuadorian Agency for Agriculture Quality Assurance (AGROCALIDAD) in Tumbaco, using the microscopic agglutination test. The sera were analysed to check whether they contained any of the eight serovars of Leptospira interrogans circulating most frequently in the country: Canicola, Hardjo, Pomona, Icterohaemorrhagiae, Grippotyphosa, Wolffi, Bratislava and Copenhageni. Overall seroprevalence at herd level was 97.01%, with the most common serovars being Pomona, Icterohaemorrhagiae, Grippotyphosa, Bratislava and Canicola. It was concluded that there is high seroprevalence at herd level in the province of Manabí.

La leptospirose est une maladie zoonotique infecto-contagieuse causée par des souches pathogènes du genre Leptospira. Chez les bovins, le tableau clinique de la maladie se caractérise par de la fièvre, une hématurie, une hémoglobinurie, une méningite, des cas d'avortement ou la naissance de veaux faibles et une infertilité ; dans les cas les plus graves, la maladie peut provoquer la mort de l'animal. En Équateur et plus précisément dans la province de Manabí, les rares études effectuées jusqu'à ce jour ont rapporté des taux de prévalence allant de 35,8 % à 75 %. Les auteurs présentent les résultats d'une étude visant à déterminer la prévalence sérologique de la leptospirose dans le cheptel bovin de la province de Manabí ainsi que les principaux sérovars présents. Une enquête épidémiologique transversale a été conduite de novembre 2015 à mars 2016 dans sept cantons choisis de manière aléatoire. Au total, 854 animaux appartenant à 67 élevages ont été testés. Les prélèvement ont été préparés par les laboratoires de la Direction du diagnostic vétérinaire de l'Agence équatorienne de la qualité agricole (AGROCALIDAD) de Tumbaco et soumis à une épreuve d'agglutination microscopique afin de déterminer s'ils contenaient l'un ou plusieurs des huit sérovars de Leptospira interrogans présents dans le pays, à savoir Canicola, Hardjo, Pomona, Icterohaemorrhagiae, Grippotyphosa, Wolffi, Bratislava et Copenhageni. La séroprévalence globale au niveau des troupeaux était de 97,01 %, les sérovars les plus fréquents étant Pomona, Icterohaemorrhagiae, Grippotyphosa, Bratislava et Canicola. Les auteurs en concluent que la séroprévalence au niveau des troupeaux est élevée dans la province de Manabí.

La leptospirosis es una enfermedad zoonótica infectocontagiosa causada por cepas patógenas del género Leptospira. En el ganado bovino, clínicamente se caracteriza por fiebre, hematuria, hemoglobinuria, meningitis, abortos y/o nacimiento de animales débiles e infertilidad, y, en los casos más graves, puede provocar la muerte de los animales. En Ecuador, y en concreto en la provincia de Manabí, los escasos estudios realizados denotan prevalencias variables, que van del 35,8% al 75%. El objetivo del presente estudio es determinar la seroprevalencia de la leptospirosis en el ganado bovino y conocer los principales serovares circulantes en la provincia de Manabí. Se realizó un estudio epidemiológico de tipo transversal en el período comprendido entre noviembre de 2015 y marzo de 2016, para el cual se seleccionaron siete cantones al azar y se investigaron un total 854 animales pertenecientes a 67 hatos. Las muestras se procesaron en los Laboratorios de la Dirección de Diagnóstico Animal de la Agencia Ecuatoriana para la Calidad del Agro (AGROCALIDAD) de Tumbaco utilizando la técnica de aglutinación microscópica, y los sueros se analizaron para comprobar si contenían cada uno de los ocho serovares de Leptospira interrogans de mayor circulación en el país: Canicola, Hardjo, Pomona, Icterohaemorrhagiae, Grippotyphosa, Wolffi, Bratislava y Copenhageni. La seroprevalencia general a nivel de hatos fue del 97,01%, siendo los más frecuentes los serovares Pomona, Icterohaemorrhagiae, Grippotyphosa, Bratislava y Canicola. Se llegó a la conclusión de que en la provincia de Manabí existe una alta seroprevalencia a nivel de hatos.

Tromboprofilaxis farmacológica en paciente crítico y la acumulación de heparinas de bajo peso molecular / Drug thromboprophylaxis in critical patients and the accumulation of low molecular weight heparins

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Aneurisma de tronco braquiocefálico encontrado previo a traqueostomía percutánea / Brachycephalic trunk aneurysm found before percutaneous tracheotomy

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Study of knowledge about bovine brucellosis among people involved in the cattle supply chain in the province of Manabí, Ecuador. / Estudio del nivel de conocimiento de la brucelosis bovina entre personas vinculadas a la cadena de producción bovina en la provincia de Manabí, Ecuador.

A cross-sectional study was conducted to determine the level of knowledge about brucellosis among livestock farmers and their families, veterinary personnel, food processors and other people involved in the cattle supply chain in the province of Manabí. A voluntary, open-ended survey of participants was conducted in seven cantons in Manabí province selected at random: Bolívar, Chone, El Carmen, Jama, Junín, Sucre and Tosagua. Of the 500 people who responded to the survey, only 30% said they knew the disease. Greater knowledge about the disease was observed among people with a higher educational level, veterinarians, livestock farmers/traders and men. For all the aspects surveyed, only a small percentage of respondents (ranging from 0.6% to 30.2%) indicated that they had knowledge of that aspect of the disease. Only 29.8% of the respondents stated that they knew the clinical signs of the disease in cattle, which could jeopardise the brucellosis surveillance system. Only 7.6% of respondents knew the measures for reducing the risk of contracting brucellosis, leading to widespread high-risk practices when working with animals. The conclusion is that there is a low level of knowledge about the disease among people involved in the cattle supply chain in the province under study.

Une enquête transversale a été menée en vue de déterminer le niveau de connaissances sur la brucellose parmi les éleveurs et leurs familles, le personnel vétérinaire, les entreprises de transformation des aliments et d'autres personnels travaillant en lien avec la filière bovine dans la province de Manabí (Équateur). Les participants volontaires de sept cantons de la province choisis au hasard (Chone, El Carmen, Sucre, Jama, Bolívar, Tosagua et Junín), ont répondu à un questionnaire ouvert. Parmi les 500 personnes interrogées, 30 % seulement ont déclaré connaître la maladie. Le niveau de connaissance de la maladie était proportionnellement plus élevé chez les personnes possédant un bon niveau d'instruction, chez les vétérinaires et chez les éleveurs commerciaux, ainsi que chez les hommes. Le niveau de connaissance était bas pour l'ensemble des aspects étudiés, oscillant entre 0,6 et 30,2 % suivant les aspects. Seuls 29,8 % des participants ont déclaré connaître les signes cliniques de la maladie chez les bovins, ce qui compromet l'efficacité du système de surveillance de la brucellose. Au total, 7,6 % seulement des personnes interrogées connaissaient les mesures permettant de réduire les risques de contracter la brucellose, ce qui se traduit par une fréquence élevée de pratiques à haut risque dans le travail avec les animaux. L'étude conclut à un niveau faible de connaissance de la brucellose chez les personnels liées à la filière bovine dans la région étudiée.

Se realizó un estudio transversal con el objetivo de determinar el nivel de conocimiento de la brucelosis entre los ganaderos y sus familias, el personal veterinario, los procesadores de alimentos y demás personal vinculado a la cadena de producción bovina de la provincia de Manabí. Se realizó a los participantes una encuesta abierta de carácter voluntario en siete cantones de la provincia seleccionados al azar: Chone, El Carmen, Sucre, Jama, Bolívar, Tosagua y Junín. De los 500 encuestados, solo el 30% respondió que conocía la enfermedad. Se observó un mayor conocimiento de la misma en las personas de mayor nivel educacional, en los veterinarios y ganaderos que realizan actividades comerciales, así como entre los varones. Se halló un bajo nivel de conocimientos respecto a todos los aspectos encuestados, que osciló entre el 0,6 y el 30,2%. Solo el 29,8% de los participantes indicó que conocía los signos clínicos de la enfermedad en el ganado bovino, lo cual puede dar al traste con el sistema de vigilancia de la misma. Solo el 7,6% de los encuestados conocía las medidas para reducir el riesgo de contraer brucelosis, lo cual se manifiesta con la alta frecuencia de prácticas de alto riesgo en el trabajo con los animales. Se concluye que existe un bajo nivel de conocimiento de la enfermedad entre las personas vinculadas a la cadena de producción bovina en la provincia estudiada.

Duración total de la ventilación en decúbito prono en pacientes con síndrome de distrés respiratorio agudo / Total duration of ventilation in the prone position in patients with acute respiratory distress syndrome

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Biocide tolerance in Salmonella from meats in Southern Spain.

Salmonella serovars sampled from meat products in Southern Spain (Andalucía) during the period 2002-2007 were analyzed in this study. The serovars most frequently detected (in order) were Typhimurium, Enteritidis, Derby, Anatum and Rissen. Isolates (n = 43) were tested for sensitivity to biocides, including the quaternary ammonium compounds benzalkonium chloride (BC), cetrimide (CT) and hexadecylpyridinium chloride (HDP), and the bisphenols triclosan (TC) and hexachlorophene (CF). The minimum inhibitory concentration (MIC) for the quaternary ammonium compounds was in the range of 25 to 50 mg/L for most isolates, although a few isolates required much higher concentrations, up to 250 mg/L. Bisphenols showed higher inhibitory activity, with a MIC of 2.5 to 25 mg/L. A few isolates showed a "non-wildtype" MIC for TC of up to 250 mg/L. These results indicate a low incidence of tolerance towards quaternary ammonium compounds and triclosan among Salmonella from meats and meat products.

Inactivation of Staphylococcus aureus in Oat and Soya Drinks by Enterocin AS-48 in Combination with Other Antimicrobials.

The presence of toxicogenic Staphylococcus aureus in foods and the dissemination of methicillin-resistant S. aureus (MRSA) in the food chain are matters of concern. In the present study, the circular bacteriocin enterocin AS-48, applied singly or in combination with phenolic compounds (carvacrol, eugenol, geraniol, and citral) or with 2-nitro-1-propanol (2NPOH), was investigated in the control of a cocktail made from 1 methicillin-sensitive and 1 MRSA strains inoculated on commercial oat and soya drinks. Enterocin AS-48 exhibited low bactericidal activity against staphylococci in the drinks investigated when applied singly. The combinations of sub-inhibitory concentrations of enterocin AS-48 (25 µg/mL) and phenolic compounds or 2NPOH caused complete inactivation of staphylococci in the drinks within 24 h of incubation at 22 °C. When tested in oat and soya drinks stored for 7 d at 10 °C, enterocin AS-48 (25 µg/mL) in combination with 2NPOH (5.5 mM) reduced viable counts rapidly in the case of oat drink (4.2 log cycles after 12 h) or slowly in soya drink (3.8 log cycles after 3 d). The same combined treatment applied on drinks stored at 22 °C achieved a fast inactivation of staphylococci within 12 to 24 h in both drinks, and no viable staphylococci were detected for up to 7 d of storage. Results from the study highlight the potential of enterocin AS-48 in combination with 2NPOH for inactivation of staphylococci.

Polyol specificity of recombinant Arabidopsis thaliana sorbitol dehydrogenase studied by enzyme kinetics and in silico modeling.

Polyols are enzymatically-produced plant compounds which can act as compatible solutes during periods of abiotic stress. Nicotinamide adenine dinucleotide(+)-dependent SORBITOL DEHYDROGENASE (SDH, E. C. 1.1.1.14) from Arabidopsis thaliana L. sorbitol dehydrogenase (AtSDH) is capable of oxidizing several polyols including sorbitol, ribitol, and xylitol. In the present study, enzymatic assays using recombinant AtSDH demonstrated a higher specificity constant for xylitol compared to sorbitol and ribitol, all of which are C2 (S) and C4 (R) polyols. Enzyme activity was reduced by preincubation with ethylenediaminetetraacetic acid, indicating a requirement for zinc ions. In humans, it has been proposed that sorbitol becomes part of a pentahedric coordination sphere of the catalytic zinc during the reaction mechanism. In order to determine the validity of this pentahedric coordination model in a plant SDH, homology modeling, and Molecular Dynamics simulations of AtSDH ternary complexes with the three polyols were performed using crystal structures of human and Bemisia argentifolii (Genn.) (Hemiptera: Aleyrodidae) SDHs as scaffolds. The results indicate that the differences in interaction with structural water molecules correlate very well with the observed enzymatic parameters, validate the proposed pentahedric coordination of the catalytic zinc ion in a plant SDH, and provide an explanation for why AtSDH shows a preference for polyols with a chirality of C2 (S) and C4 (R).

Multilocus sequence typing and antimicrobial resistance in Enterococcus faecium isolates from fresh produce.

The purpose of the present study was to determine the relatedness of Enterococcus faecium isolates from fresh produce to E. faecium strains from other sources by using multi-locus sequence typing (MLST) and to determine the antimicrobial resistance of the isolates. MLST analysis of 22 E. faecium isolates from fresh produce revealed 7 different sequence types (ST 22, ST 26, ST 43, ST 46, ST 55, ST 94 and ST 296). Most isolates belonged to ST 296 (40.9 %), followed by ST 94 (27.3 %). All isolates were sensitive to vancomycin and to imipenem, and only one was resistant to ampicillin (MIC 32 mg/l). However, all were resistant to cefotaxime and ceftazidine. E. faecium isolates from fresh produce were inhibited by quaternary compounds (benzalkonium chloride, cetrimide, hexadecylpyridinium chloride, didecyldimethylammonium bromide), biguanides (chlorhexidine), polyguanides [poly-(hexamethylene guanidinium) hydrochloride], bisphenols (triclosan, hexachlorophene) and biocidal solutions of P3 oxonia and P3 topax 66. Didecyldimethylammonium bromide and triclosan were the least effective biocides in growth inhibition, while hexadecylpyridinium chloride was the most effective. Results from MLST typing and antibiotic resistance suggest that the studied E. faecium isolates from fresh produce are not related to the clinically-relevant clonal complex CC17.

Pancreatitis aguda como presentación de un quiste del conducto biliar en el adulto: reporte caso / Acute pancreatitis as a presentation of bile duct cyst in adults: a case report

Paciente adulta se presentó en la sala de urgencias con un cuadro de pancreatitis aguda como complicación de un quiste del conducto biliar colédoco tipo IV, el cual fue diagnosticado por ultrasonograma abdominal durante su estancia intrahospitalaria. El diagnóstico de quiste de colédoco es más difícil en la edad adulta ya que los pacientes raramente se presentan con la triada clásica de dolor abdominal, masa palpable e ictericia, presentándose principalmente con alguna manifestación de vías biliares o pancreática benigna. Existen pocas publicaciones en Occidente acerca de este tópico. La importancia en cuanto al diagnóstico temprano, la clasificación del mismo y al tratamiento quirúrgico con la resección total del quiste radica en su alta incidencia hacia el desarrollo de colangiocarcinoma.

Modeling the healthcare assistance process for comorbidity patients compliant with prEN12967.

The increment of life expectancy in our society, and the consequent population ageing, anticipate that the health sector must face the challenges associated with a growing population group of elderly patients with numerous disorders, generally chronic. In this work we introduce a framework to support the communication and information management tasks involved in a coordinated care of this kind of patients. This framework has been developed in the European context, it is compliant with CEN's prEN12967, and follows ITU-T's ODP methodology, that facilitates its integration in any system following this standard.

The experience of deafened adults: implications for rehabilitative services.

This study explored the psychological and social effects of becoming deaf as an adolescent or adult and the adequacy of rehabilitation services offered to such individuals. Qualitative interviews were conducted with a sample of eight deafened adults in the Province of Ontario, Canada. The results indicated that medical interventions (for example, audiometric testing, hearingaidprovision, and cochlear implantation) were relied on exclusively as rehabilitation servicesfor the deafened adults. None of the study participants were referred to individual, family, or group counseling by their physicians or hearing health services providers, despite the many negative effects of becoming deaf that participants described. This gap in service makes it apparent that the rehabilitation system for adventitious deafness needs the involvement of counselors and social workers to better ensure that the psychosocial needs of clients are addressed.

Tratamiento médico con metotrexato del embarazo tubario no complicado / Medical treatment using methotrexate in uncomplicated tubal pregnancy

El embarazo ectópico es una patología común en el mundo occidental cuya incidencia ha aumentado en los últimos años. A pesar de ello la tasa de mortalidad ha disminuido en un 90 por ciento. Esto es el resultado de un diagnóstico precoz posible por la disponibilidad de radioinmunoanálisis sensitivos y específicos para gonodotrofina coriónica humana (B-hCG), ultrasonografía transvaginal de alta resolución, y la laparoscopia. El diagnóstico precoz permite el uso de opciones de tratamiento que preservan la trompa uterina. De hecho, en mujeres seleccionadas, la cirugía puede reemplazarse con el manejo médico. El metotrexato es el fármaco más usado, se ha utilizado en diferentes dosis y vías de administración. Se realizó un estudio prospectivo entre diciembre de 1996 y marzo del año 2000. Un total de 17 pacientes cumplieron los criterios para entrar al protocolo de manejo médico del embarazo ectópico. El éxito terapéutico se alcanzó en 12 pacientes (76,5 por ciento). Un 23,4 por ciento de las pacientes requirió una segunda dosis de metrotrexato. El tratamiento médico del embarazo ectópico no complicado con metotrexato es una alternativa terapéutica frente a un diagnóstico no invasivo de éste, seguro, con escasos efectos adversos, efectivo y de bajo costo, y eventualmente ambulatorio