Mapping PTSD, depression, and anxiety: A network analysis of co-occurring symptoms in treatment-seeking first responders.

First responders are at high risk for a range of co-occurring mental health conditions due to their repeated exposure to traumatic events. When first responders present for treatment, their complex presentation of symptoms including posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) can prove challenging to differentiate for clinical purposes. Network analysis provides a means to identify the nuanced associations between the symptoms of these conditions and to identify groups of related symptoms. In this study, a treatment-seeking sample of first responders (N = 432) completed self-report measures of PTSD, depression, and GAD. Network analysis was used to identify symptom clusters within the sample. Our cross-sectional data yielded six empirically distinct communities: depression symptoms, GAD symptoms, and four communities comprising PTSD symptoms - intrusion and avoidance; irritability and aggression; negative affect; and arousal and sleep. Network associations underscore the heterogeneity of PTSD and also highlight overlapping and diverging symptoms of depression and GAD. These findings are discussed within the context of existing research on first responders, and recommendations for further study and treatment interventions are provided.

Network analysis of posttraumatic stress disorder in a treatment-seeking sample of US firefighters and emergency medical technicians.

BACKGROUND: First responders, including firefighters and emergency medical technicians (EMTs), are under extreme stress from repeated exposure to potentially traumatic events. To optimize treatment for this population, it is critical to understand how the various posttraumatic stress disorder (PTSD) symptom factors are associated with one another so these relations may be targeted in treatment. METHOD: Using a sample of treatment-seeking firefighters/EMTs (N = 342), we conducted a partial correlation network analysis of the eight-factor model. A Bayesian directed acyclic graph (DAG) was used to estimate causal associations between clusters. RESULTS: Approximately 37 % of the sample screened positive for probable PTSD. Internal re-experiencing and external re-experiencing had the strongest edges. In the DAG, internal re-experiencing was the parent node and was potentially predictive of external re-experiencing, negative affect, dysphoric arousal, and avoidance. LIMITATIONS: Data were drawn from a treatment-seeking sample that may not generalize to all firefighters/EMTs. CONCLUSIONS: The current findings are consistent with prior research suggesting re-experiencing plays a critical role in developing and maintaining PTSD symptoms. Future research should investigate non-treatment-seeking first responders, as well as EMTs and firefighters as individual populations.

Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of Veterans.

OBJECTIVE: Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA. METHODS: We used a treatment-seeking sample of veterans ( N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7). RESULTS: The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression measure was a two-factor structure, cognitive-affective, and somatic depression. The measure of generalized anxiety was a unidimensional model. LIMITATIONS: Follow-up studies should validate these measures on nontreatment-seeking discharged veterans. CONCLUSIONS: We interpret these findings within the veteran scholarship and explore clinical implications for providers.

Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of First Responders.

OBJECTIVE: First responders (FRs) commonly present for treatment with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no FR study has validated these measures on a treatment-seeking sample. METHODS: Confirmatory factor analysis was utilized to validate measures that assess these constructs (Posttraumatic Stress Disorder Checklist for DSM-5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7) on a treatment-seeking sample of FRs ( N = 390). RESULTS: The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting factor model of the depression measure was a two-factor structure, cognitive-affective and somatic depression. Lastly, generalized anxiety was a unidimensional construct. LIMITATIONS: Follow-up studies should validate these measures on each FR subtype. CONCLUSION: We position these findings within the FR literature, review clinical implications for providers, and offer recommendations for future research.

Predictors of Suicide and Differences in Attachment Styles and Resilience Among Treatment-Seeking First-Responder Subtypes.

OBJECTIVE: To identify the predictors of suicide for firefighters (FFs), emergency medical technicians (EMTs), and law enforcement officers (LEOs). METHODS: We used baseline data from FFs/EMTs (n = 69) and LEOs (n = 81) to investigate the unique predictors for both first-responder subtypes. We conducted confirmatory factor analysis on validated assessments of posttraumatic stress disorder (PTSD) and depression. Measures of attachment, resilience, PTSD, depression, generalized anxiety, trauma history, and substance use were the independent variables in two backward stepwise regressions predicting suicide. RESULTS: Substance use and somatic depression were significant predictors for LEOs, whereas affective depression, anhedonia, externalizing behaviors, trauma history, and generalized anxiety were significant predictors for FFs/EMTs. LIMITATIONS: These data are cross-sectional and should be modeled longitudinally over the course of treatment. CONCLUSION: Separate constructs influence suicide for LEOs and FFs/EMTs.

Differences in Resilience and Mental Health Symptoms Among US First Responders With Secure and Insecure Attachment.

OBJECTIVE: This observational study aimed to determine whether attachment style predicted first responders' mental health and resilience. METHOD: Data were from a treatment-seeking sample of first responders ( N = 237). Each participant completed six assessments measuring attachment, resilience, generalized anxiety, depression, suicidality, and posttraumatic stress disorder. RESULTS: On the attachment assessment, 25.3% were categorized as secure, 19.0% as dismissive, 25.3% as preoccupied, and 30.4% as fearfully attached. As predicted, securely attached participants had the lowest scores for generalized anxiety, depression, suicidality, and posttraumatic stress disorder and the highest scores on the resiliency measure, followed by dismissive, preoccupied, and fearfully attached participants. LIMITATIONS: These data are cross-sectional and causality cannot be inferred. CONCLUSIONS: Results highlight the importance of the study of attachment to psychotherapy and mental health treatment with first responders.

Estudio descriptivo del proceso de preparación de sistemas personalizados de dosificación en una farmacia comunitaria rural / A descriptive study on the provision of multi compartmental compliance aids in a rural community pharmacy

Introducción: el aumento de patologías crónicas en edades avanzadas conlleva un elevado grado de polimedicación, entendido como el consumo simul-táneo de cinco o más medicamentos. La polimedi-cación aumenta el riesgo de problemas relaciona-dos con los medicamentos (PRM). Puede provocar la aparición de resultados negativos asociados a la medicación y una disminución en la adherencia terapéutica, que se acentúa en el ámbito rural don-de la población está especialmente envejecida. Los sistemas personalizados de dosificación (SPD) son una buena herramienta para solventar esta situa-ción. Su preparación se basa en procedimientos normalizados de trabajo (PNT) y documentos de buenas prácticas.Método: hemos realizado una adaptación de un PNT incidiendo en puntos clave como el estudio detallado de la farmacoterapia y la posibilidad de fraccionamiento y reacondicionamiento, incluyendo una revisión del uso de la medicación y la realiza-ción de un estado de situación. Con la información obtenida, hemos valorado la existencia de PRM.Resultados: de los pacientes adscritos al servicio, la mayoría eran mujeres mayores de 75 años y polimedicadas. Las patologías más prevalentes fueron hipertensión arterial, hipercolesterolemia y diabetes. Casi el 80% de los pacientes tenían al menos una pauta irregular en sus tratamientos. Menos del 5% de formas farmacéuticas no pudie-ron ser finalmente reacondicionadas. Se detectaron 77 PRM, destacando el aumento de probabilidad de efectos adversos por asociación de fármacos. La adherencia se incrementó del 28.2% al 79.5% después de seis meses.Conclusiones: la preparación de SPD es un servi-cio complejo, sistemático e individualizado que ha permitido una mejora sustancial en la adherencia. (AU)

Introduction: the high prevalence of chronic di-seases in older ages frequently leads to the simul-taneous intake of five or more drugs, a condition known as polymedication. This results in a higher risk of drug-related problems, which can cause negative outcomes associated with medication and a decrease in therapeutic adherence. This fact is noteworthy in rural areas where the population is particularly aged. Compliance aids system, elabo-rated according to specific working protocols and standards, can be a suitable tool to address this issue.Method: we have adapted our regional working pro-tocol by focusing on the analysis of the pharmaco-therapy, pharmaceutical dosage form splitting and stability, including and initial medication review and assessment of the patient. Medication and drug-re-lated problems were also assessed according to this procedure.Results: most of the ascribed patients were poly-medicated women over 75 years of age. Hyper-tension, hypercholesterolemia, and diabetes were found to be the most prevalent pathologies, while 80% of the patients were taking, at least, one drug at irregular dosing intervals. Less than 5% of the prescribed dosage forms were not suitable for reconditioning in compliance aids systems. We detected 77 drug-related problems, adverse drug reactions being the most frequently recorded. The-rapeutic adherence increased from 28.2% to 79.5% after six months.Conclusions: compliance aids system elaboration is a complex process, which should be individuali-zed for each patient. These devices may be useful to improve therapeutic adherence in polymedicated aged patients. (AU)

Network analysis of distress, suicidality, and resilience in a treatment seeking sample of first responders.

INTRODUCTION: First responders are routinely and regularly exposed to traumatic events that can clinically manifest with a symptom constellation of posttraumatic stress disorder (PTSD), generalized anxiety, depression, and suicidality. METHODS: We used network analysis to examine baseline data from treatment seeking first responders (n = 308) to examine the interrelatedness of those constructs, including a measure of resilience. We estimated two models: a regularized partial correlation network and a Bayesian Directed Acyclic Graph (DAG). RESULTS: The models reveal converging evidence highlighting the central role of negative alterations in cognitions and mood PTSD cluster along with affective depression. These nodes did not significantly differ, though they were among the strongest in the partial correlation network and shared the most variance with the other nodes. The DAG results suggested that the negative alterations in cognitions and mood PTSD cluster predicted downstream constructs of affective depression; intrusion, hyperarousal, and avoidance PTSD clusters; and resilience. Only resilience and affective depression exhibited direct effects on suicidality. Both somatic depression and suicidality were endogenous endpoints in the DAG. Resilience exhibited an inverse path to suicide. However, resilience was relatively independent of the other constructs in the models and the DAG suggested that it was a consequence of PTSD related distress. LIMITATIONS: The data is cross-sectional in nature that should be followed up in longitudinal studies. CONCLUSION: Findings are discussed in respect to the role of distress and emotional dysregulation as common factors underlying a broad range of internalizing problems.

Affective Depression Mediates PTSD to Suicide in a Sample of Treatment-Seeking First Responders.

OBJECTIVE: The aim of this study was to examine the associations of comorbid posttraumatic stress disorder (PTSD), affective or somatic depression, and suicide among first responders (FRs). METHOD: We used baseline data from FRs ( N = 232) who sought services at a nonprofit mental health agency specializing in treating trauma exposed FRs. We conducted two PROCESS simple mediation models with PTSD as the predictor, affective depression and somatic depression as the mediators, and suicidality as the dependent variable. RESULTS: Affective depression significantly mediated the relationship between PTSD and suicidality, whereas somatic depression did not. The direct effect of PTSD on suicidality was not significant. LIMITATIONS: These data are cross-sectional and should be followed up with longitudinal analyses across the course of treatment. CONCLUSIONS: To reduce suicide risk, it is recommended that clinicians target affective depression instead of PTSD symptoms.

Differences in Suicidality in Non-Treatment-Seeking and Treatment-Seeking Law Enforcement Officers: A Cross-sectional Study.

OBJECTIVE: Law enforcement officers (LEOs) are exposed to high levels of occupational trauma and face added stress from heightened public scrutiny and COVID-19, which may result in suicide. It is crucial to understand differences between LEOs who seek treatment and those who do not. METHOD: We compared LEOs from the same greater metropolitan area who sought treatment with those who did not. Participants completed validated measures assessing posttraumatic stress disorder, generalized anxiety, depression, and suicidality. RESULTS: The treatment-seeking sample scores were higher on all standardized assessments. Bivariate logistic regression results indicated that the non-treatment-seeking sample's odds of experiencing suicidality were 1.76 times the odds for the treatment seeking sample. Conclusions: This suggests that many LEOs experiencing suicidality may not be seeking treatment and highlights the role that posttraumatic stress disorder may play in determining whether LEOs seek treatment or not.

Effect of an Arthrobotrys musiformis (Fungi: Orbiliales) culture filtrate on the population of gastrointestinal parasitic nematode eggs in faeces of grazing lambs.

This study assessed the anthelmintic activity of the oral administration of a free-spore culture filtrate of the nematophagous fungus (NF) Arthrobotrys musiformis (M-10) on gastrointestinal parasitic nematodes (GIN) in naturally infected lambs. The fungus was grown on potato-dextrose agar plates (PDA) and transferred to a fermented rice medium (FRM). After 40-day incubation the total amount of FRM with the growing fungi was transferred to a flask shaker with distilled water for a 24 h period. The fungus was centrifuged and filtered. Three groups of six naturally-infected lambs (>1000 epg) each were treated once as follows: Group 1) 63.8 mg/kg A. musiformis culture filtrate (CF) (per os); Group 2) Levamisole 7.5 mg/ml (intramuscularly), Group 3) 15 ml of distilled water (per os). Faecal samples were individually collected on days -2, 0, 2, 4, 6, 8 and 10 after treatment. For each experimental group, mean egg shedding was calculated and transformed (log 10 [epg + 1]). Means between the fungal filtrate group and the negative control were analysed using a T-Student Test. The faecal egg count reduction test (FECRT) was performed in groups treated with CF and Levamisole in relation to the control group (water) were 36.8-57.4% and 89-95.4%, respectively., although due to the difference between groups, no statistical significance was found (p > 0.05). The use of A. musiformis CF appears to be a good alternative treatment, although, more studies should be performed to establish the use of these fungal products as potential tools for GIN control.

Un nuevo método no invasivo en la valoración integral de la fibrilación auricular por tomografía cardíaca / A novel, non-invasive, integral imaging assessment in atrial fibrillation by cardiac tomography

Resumen Objetivo: Analizar la utilidad clínica y la viabilidad de la tomografía cardíaca multidetector (TCMD) en la valoración de pacientes con fibrilación auricular (FA). Material y métodos: Estudio prospectivo de casos y controles en 84 sujetos (54 con FA y 30 controles). La morfología de la orejuela izquierda (OI) se clasificó en cactus, ala de pollo, manga de viento y coliflor. La presencia de trombo en la OI, el antecedente de accidente cerebrovascular y la escala CHA2DS2-VASc se compararon con parámetros obtenidos por TCMD. Resultados: La fracción de expulsión de la aurícula izquierda (FEAI) y la fracción de expulsión de la orejuela izquierda (FEOI) fueron más bajas en los individuos con FA (p < 0.001). El volumen indexado de la aurícula izquierda (VIAI) fue mayor en los pacientes con FA (p < 0.001). Se observó una correlación inversa entre la FEAI y el VIAI (r = -0.38, p < 0.001). La morfología tipo coliflor fue la más frecuente en enfermos con FA, mientras que la de tipo cactus predominó en los controles. La de tipo coliflor fue la más relacionada con presencia de trombos (p < 0.01), así como una calificación CHA2DS2-VASc alta. La velocidad de flujo fue menor en los pacientes con FA (p < 0.001). Conclusión: La TCMD es un método novedoso y no invasivo para una valoración integral en la FA. Los resultados de este estudio podrían mejorar la precisión, la utilidad clínica y el análisis de estratificación del riesgo en la FA. Los autores proponen incluir este nuevo método en la valoración integral del riesgo tromboembólico en pacientes con FA.

Abstract Objective: To analyze the clinical utility and feasibility of the multidetector cardiac tomography (MDCT) in multi-parametric imaging assessment in atrial fibrillation (AF) patients. Material and methods: Prospective case-control study in 84 subjects (54 AF subjects and 30 healthy subjects). Left atrial appendage (LAA) morphology was classified as: cactus, chicken wing, wind sock, cauliflower. Intra-cardiac thrombus, stroke history and CHA2DS2-VASC scale were compared to cardiac MDCT atrial imaging assessment. Results: Left atrial ejection fraction (LAEF) and LAA ejection fraction (LAAEF) were lower in AF subjects (p < 0.001), left atrial volume index (LAVI) was higher in AF subjects (p < 0.001). An inverse correlation between LAEF and LAVI was found (r = −0.38, p < 0.001). Cauliflower LAA morphology frequency was higher in AF subjects, whereas cactus LAA morphology frequency was higher in controls. Cauliflower LAA morphology was associated with thrombus presence (p < 0.01) as well as a higher CHA2DS2-VASc score. Flow velocity were lower in AF subject compared to controls (p < 0.001). Conclusion: MDCT is a novel, non-invasive, worldwide available method for an integral assessment in AF. Our results could improve precision, clinical utility and risk stratification analysis in AF. Our proposal is to include this new method into the global cardiovascular and thrombotic risk assessment in AF patients.

[A novel, non-invasive, integral imaging assessment in atrial fibrillation by cardiac tomography]. / Un nuevo método no invasivo en la valoración integral de la fibrilación auricular por tomografía cardíaca.

Objetivo: Analizar la utilidad clínica y la viabilidad de la tomografía cardíaca multidetector (TCMD) en la valoración de pacientes con fibrilación auricular (FA). Material y métodos: Estudio prospectivo de casos y controles en 84 sujetos (54 con FA y 30 controles). La morfología de la orejuela izquierda (OI) se clasificó en cactus, ala de pollo, manga de viento y coliflor. La presencia de trombo en la OI, el antecedente de accidente cerebrovascular y la escala CHA2DS2-VASc se compararon con parámetros obtenidos por TCMD. Resultados: La fracción de expulsión de la aurícula izquierda (FEAI) y la fracción de expulsión de la orejuela izquierda (FEOI) fueron más bajas en los individuos con FA (p < 0.001). El volumen indexado de la aurícula izquierda (VIAI) fue mayor en los pacientes con FA (p < 0.001). Se observó una correlación inversa entre la FEAI y el VIAI (r = -0.38, p < 0.001). La morfología tipo coliflor fue la más frecuente en enfermos con FA, mientras que la de tipo cactus predominó en los controles. La de tipo coliflor fue la más relacionada con presencia de trombos (p < 0.01), así como una calificación CHA2DS2-VASc alta. La velocidad de flujo fue menor en los pacientes con FA (p < 0.001). Conclusión: La TCMD es un método novedoso y no invasivo para una valoración integral en la FA. Los resultados de este estudio podrían mejorar la precisión, la utilidad clínica y el análisis de estratificación del riesgo en la FA. Los autores proponen incluir este nuevo método en la valoración integral del riesgo tromboembólico en pacientes con FA.

Mejora de la cobertura de vacunación frente a la gripe estacional desde la farmacia comunitaria: impacto de una intervención piloto / Improving flu vaccination coverage from community pharmacy: Pilot intervention study

INTRODUCCIÓN: la vacunación es el modo más eficaz para prevenir la gripe estacional. En España las coberturas son bajas en todos los grupos de población. Nuestro objetivo es comprobar si la intervención del farmacéutico comunitario puede incrementar las tasas de vacunación e identificar las variables que influyen sobre ellas. MATERIAL Y MÉTODOS: estudio cuasi experimental pre-post intervención en tres grupos de riesgo (GR): mayores de 65 años (M), alto riesgo de sufrir complicaciones (C) y que pueden transmitir la infección (T). Se determinan las tasas de vacunación pre y postintervención (dos campañas) y el efecto de diversas variables sobre la posibilidad de vacunarse. RESULTADOS: han sido entrevistados 74 pacientes, 58  % mujeres, entre 33 y 90 años. Tasa de vacunación previa a la intervención: 58  %. Porcentajes por GR: 69  % M, 62  % C y 47  % T. Se identifican 31 pacientes de riesgo sin historial de vacunación. Tasa de vacunación tras la intervención: 74  % en campaña 17/18 y 66  % en 18/19. La vacunación se relaciona con grado de conocimiento del proceso, existencia de historia de vacunación previa y edad superior a 65 años. DISCUSIÓN: las tasas de vacunación antes de la intervención son similares a las publicadas a nivel regional y nacional. Las tasas incrementadas alcanzadas (74  % y 66  %) se aproximan a los niveles propuestos por la Unión Europea (UE) y la Organización Mundial de la Salud (OMS). El mayor aumento en los grupos C y T puede ser relevante en comunidades cerradas donde las medidas higiénicas son de capital importancia

INTRODUCTION: Vaccinating population is the most effective method of preventing flu and its consequences although in Spain coverage rates remain low. Our objective is to assess whether community pharmacist intervention can increase vaccination coverage of risk population and to identify factors influencing rates. MATERIAL AND METHODS: Pre-post cuasi experimental study including three high risk population groups: aged 65 and above (M), having any risk chronic illness (C) or transmitting patients (T). Coverage was measured before and twice (two vaccination campaigns) after intervention and the effect of different factors on having the vaccine were estimated. RESULTS: 74 patients, 58  % women, aged between 33 and 90 were interviewed. Vaccination coverage before intervention: 58  %. Rates found by risk group: 69  % M, 62  % C y 47  % T. 31 risk patients with no vaccination history were identified. Global post-intervention vaccination coverage: 74  % in 17/18 vaccination campaign and 66  % in 18/19. Flu awareness, vaccination in previous seasons and being aged above 65 showed statistically significant effect on vaccination rate. DISCUSSION: Pre-intervention rates were similar to those published for our region and country. Post-intervention rates (74 and 66  %) are close to EU and WHO vaccination goals. The higher coverage increase was achieved for C and T groups: this can be relevant in closed communities where hygiene measures are of importance. CONCLUSIONS: A simple intervention conducted at our community pharmacy resulted in a significant increase of the flu vaccination rate in several population risk groups

[Population estimates and conservation of felids (Carnivora: Felidae) in Northern Quintana Roo, Mexico]. / Estimación poblacional y conservación de felinos (Carnivora: Felidae) en el norte de Quintana Roo, México.

Wildlife density estimates provide an idea of the current state of populations, and in some cases, reflect the conservation status of ecosystems, essential aspects for effective management actions. In Mexico, several regions have been identified as high priority areas for the conservation of species that have some level of risk, like the Yucatan Peninsula (YP), where the country has the largest population of jaguars. However, little is known about the current status of threatened and endangered felids, which coexist in the Northeastern portion of the Peninsula. Our objective was to estimate the wild cats' density population over time at El Eden Ecological Reserve (EEER) and its surrounding areas. Camera trap surveys over four years (2008, 2010, 2011 and 2012) were conducted, and data were obtained with the use of capture-recapture models for closed populations (CAPTURE + MMDM or 1/2 MMDM), and the spatially explicit capture-recapture model (SPACECAP). The species studied were jaguar (Panthera onca), puma (Puma concolor), ocelot (Leopardus pardalis), jaguarundi (Puma yaguaroundi) and margay (Leopardus wiedii). Capture frequency was obtained for all five species and the density for three (individuals/100km2). The density estimated with The Mean Maximum Distance Moved (MMDM), CAPTURE, ranged from 1.2 to 2.6 for jaguars, from 1.7 to 4.3 for pumas and from 1.4 to 13.8 for ocelots. The density estimates in SPACECAP ranged from 0.7 to 3.6 for jaguars, from 1.8 to 5.2 for pumas and 2.1 to 5.1 for ocelots. Spatially explicit capture recapture (SECR) methods in SPACECAP were less likely to overestimate densities, making it a useful tool in the planning and decision making process for the conservation of these species. The Northeastern portion of the Yucatan Peninsula maintains high populations of cats, the EEER and its surrounding areas are valuable sites for the conservation of this group of predators. Rev. Biol.

Estimación poblacional y conservación de felinos (Carnivora: Felidae) en el norte de Quintana Roo, México / Population estimates and conservation of felids (Carnivora: Felidae) in Northern Quintana Roo, Mexico

Resumen:La estimación de la densidad de fauna silvestre permite tener una idea del estado de salud de las poblaciones y en algunos casos indica el estado de conservación de los ecosistemas. Los métodos de evaluación deben hacer estimaciones no sesgadas, ya que servirán de base para estrategias de conservación de especies clave. Algunas regiones en México han sido identificadas como áreas de alta prioridad para la conservación de especies con cierto nivel de riesgo, como es la Península de Yucatán (PY), donde prevalece la mayor población de jaguares en México. Sin embargo, poco se sabe acerca de la situación actual de los felinos amenazados y en peligro de extinción, como un grupo de especies que conviven en la parte noreste de la Península. Nuestro objetivo fue estimar la densidad de las poblaciones de felinos silvestres a mediano plazo en la Reserva Ecológica El Edén (EEER) y sus alrededores. Se llevaron a cabo muestreos con cámaras-trampa durante cuatro años (2008, 2010, 2011 y 2012), se usaron modelos de captura-recaptura para poblaciones cerradas (CAPTURA + MMDM o VMMDM) y un modelo de C-R espacial-mente explícito (CERC) por medio del paquete SPCACAP para realizar las estimaciones de densidad. Las especies estudiadas fueron: jaguar (Panthera onca),puma (Puma concolor),ocelote (Leopardus pardalis),jaguarundi (Puma yaguaroundi)y tigrillo (Leopardus wiedii).La frecuencia de captura se obtuvo para las cinco especies y la densidad para tres (individuos/100km2). La densidad estimada por medio de MMDM varió entre 1.2 y 2.6 para jaguares, pumas (1.7-4.3) y ocelotes (1.4-13.8). Las estimaciones de la densidad en SPACECAP variaron desde 0.7 hasta 3.6 para jaguares, de 1.8 a 5.2 para pumas y de 2.1 a 5.1 en ocelotes. El método de C-R espacialmente explícito (SECR, SPACECAP) tiene menos probabilidades de sobrestimar la densidad, lo que provee una herramienta útil en el proceso de planificación y toma de decisiones para la conservación de estas especies. La parte noreste de la Península de Yucatán mantiene poblaciones altas de felinos, la REEE y sus alrededores son clave para la conservación de este grupo de depredadores.

Abstract:Wildlife density estimates provide an idea of the current state of populations, and in some cases, reflect the conservation status of ecosystems, essential aspects for effective management actions. In Mexico, several regions have been identified as high priority areas for the conservation of species that have some level of risk, like the Yucatan Peninsula (YP), where the country has the largest population ofjaguars. However, little is known about the current status of threatened and endangered felids, which coexist in the Northeastern portion of the Peninsula. Our objective was to estimate the wild cats' density population over time at El Eden Ecological Reserve (EEER) and its surrounding areas. Camera trap surveys over four years (2008, 2010, 2011 and 2012) were conducted, and data were obtained with the use of capture-recapture models for closed populations (CAPTURE + MMDM or 'V MMDM), and the spatially explicit capture-recapture model (SPACECAP). The species studied were jaguar (Panthera onca),puma (Puma concolor),ocelot (Leopardus pardalis),jaguarundi (Puma yaguaroundi)and margay (Leopardus wiedii).Capture frequency was obtained for all five species and the density for three (individuals/100km2). The density estimated with The Mean Maximum Distance Moved (MMDM), CAPTURE, ranged from 1.2 to 2.6 for jaguars, from 1.7 to 4.3 for pumas and from 1.4 to 13.8 for ocelots. The density estimates in SPACECAP ranged from 0.7 to 3.6 for jaguars, from 1.8 to 5.2 for pumas and 2.1 to 5.1 for ocelots. Spatially explicit capture recapture (SECR) methods in SPACECAP were less likely to overestimate densities, making it a useful tool in the planning and decision making process for the conservation of these species. The Northeastern portion of the Yucatan Peninsula maintains high populations of cats, the EEER and its surrounding areas are valuable sites for the conservation of this group of predators.

Infecciones de transmisión sexual en mujeres de un establecimiento penitenciario de Lima, Perú / Sexually transmitted infections in women living in a prison in Lima, Peru

Con el objetivo de determinar la prevalencia de infecciones de transmisión sexual (ITS) en mujeres privadas de libertad del Establecimiento Penitenciario Chorrillos I en la ciudad de Lima, Perú, se realizó un estudio de tipo transversal que incluyó mediante un muestreo aleatorio simple a mujeres en edades entre los 18 a 54 años. En ellas se analizaron 180 muestras serológicas y 168 muestras de secreción cérvico vaginal. Los agentes etiológicos más prevalentes obtenidos a través de estas muestras fueron Chlamydia trachomatis en 42,3%, Gardnerella vaginalis en 24,4% y Trichomonas vaginalis en 10,1%; para muestras de suero fueron sífilis y VIH ambas en el 2,2%. Se concluye que existe una alta prevalencia de infecciones de transmisión sexual en mujeres privadas de libertad del Establecimiento Penitenciario Chorrillos I en la ciudad de Lima, Perú. Se debería establecer sistemas de tamizaje de rutina para el diagnóstico y tratamiento de las ITS dentro del sistema carcelario, e incluir a esta población en los programas de salud sexual y reproductiva.

In order to determine the prevalence of sexually transmitted infections (STI) in recluse women of Chorrillos Penitentiary I in the city of Lima, Peru, a cross-sectional study was performed, including a simple random sample of women between ages 18 and 54, from whom 180 serum samples and 168 samples of cervical and vaginal discharge were analyzed. The most prevalent etiologic agents identified from cervical and vaginal discharge samples were Chlamydia trachomatis in 42.3%, Gardnerella vaginalis in 24.4% and Trichomonas vaginalis in 10.1% and for serum samples the most prevalent were syphilis and HIV, both in 2.2%. We conclude that there is a high prevalence of sexually transmitted infections in recluse women of Chorrillos Penitentiary I in the city of Lima, Peru. There should be routine screenings established for diagnosis and treatment of STIs within the prison system and this population should be included in the sexual and reproductive health programs.

Retrospective analysis of antimicrobial susceptibility trends (2000-2009) in Neisseria gonorrhoeae isolates from countries in Latin America and the Caribbean shows evolving resistance to ciprofloxacin, azithromycin and decreased susceptibility to ceftriaxone.

BACKGROUND: The emergence of resistance and treatment failures to third generation cephalosporins prompted the revitalization of the global Gonococcal Antimicrobial Surveillance Program (GASP) to ensure that information regarding trends of the antimicrobial susceptibility of Neisseria gonorrhoeae isolates is up-to-date. Accordingly, former and potential GASP participants in Latin America and the Caribbean were contacted to reinitiate the GASP network in the region and to undertake a retrospective analysis of the antimicrobial susceptibility of N. gonorrhoeae isolates between 2000 and 2009. METHODS: Eleven countries participated in this retrospective analysis reporting on the susceptibility of N. gonorrhoeae isolates to up to 6 antibiotics as well as national treatment guidelines over the period. Antimicrobial susceptibility determination was carried out using combination of agar dilution and disk diffusion (Clinical Laboratory and Standards Institute) or Etest. Antimicrobial susceptibility data from each country were aggregated and analyzed for antimicrobial resistance trends in the region. RESULTS: More than 11,400 N. gonorrhoeae isolates were tested for antimicrobial susceptibility: 6 countries tested N. gonorrhoeae over the entire period and 5 countries tested sporadically. Decreased susceptibility to ceftriaxone was reported from 1 country (7 isolates, MICs >0.25 µg/ml) in 2007. No resistance to spectinomycin was reported. From 2000 to 2009, aggregated ciprofloxacin resistance increased from 2% (19/784) to 31% (311/1015) in 9 countries and azithromycin resistance increased from 6% (39/646) to 23% (225/962) in 4/6 reporting countries. Overall, resistance to penicillin and tetracycline decreased from 35% (441/1241) to 26% (258/975) and from 60% (476/792) to 35% (323/931), respectively.In 2009, resistance to gentamicin (3%, 4/122), chloramphenicol (5%, 6/120), and ofloxacin (2%, 6/120) was reported from 1 country. CONCLUSIONS: The report of ceftriaxone-resistant isolates coupled with the emergence and spread of resistance to ciprofloxacin and azithromycin in Latin America and the Caribbean in the 2000s indicates the importance of active surveillance of N. gonorrhoeae antimicrobial susceptibility to determine antimicrobial resistance emerging trends so as to promptly inform and guide the development of effective treatment options for gonococcal infections.

The rat glomerular filtration barrier does not show negative charge selectivity.

OBJECTIVE: To characterize the effects of size, shape, and negative charge on the transport of macromolecules across the glomerular capillary wall by using the sieving curves (fractional clearance vs. solute molecular radii) of fluorescent polydispersed polysaccharide tracers. METHODS: Glomerular fractional clearances (FC) were measured with fluorescent neutral [isoelectric point (pI) = 7.3 +/- 0.2] and negatively charged (pI = 3.5 +/- 0.4) dextrans (DEX) in comparison with negatively charged (pI = 4.8 +/- 0.3) hydroxy ethyl starch (HES) and (pI = 4.6 +/- 0.1) bovine serum albumin (BSA) in Sprague-Dawley and Fischer 344/Brown Norway rats. FCs (n = 53) were measured by using the urinary clearance of (14)C-inulin to determine the glomerular filtration rate. The relative uptake of each fluorescent probe by endothelial and renal proximal tubule epithelial (LLC-PK(1)) cells, in vitro, was measured microscopically by using a cooled (-25 degrees C) CCD camera. RESULTS: The sieving curves for randomly coiled neutral and negatively charged DEX probes were identical. These FC values were 6-fold greater than those for HES and 200-fold above similarly sized fluorescent BSA. The polysaccharide probes did not show significant binding to serum proteins. The uptake of BSA by LLC-PK(1) cells was 20- to 100-fold greater than that for neutral or negatively charged macromolecules. CONCLUSIONS: These findings indicate that the rat glomerular filtration barrier restricts the transport of polysaccharide macromolecules as a function of their size and configuration but not negative charge.