Biotic and abiotic factors shape the microbiota of wild-caught populations of the arbovirus vector Culicoides imicola.

Biting midges of the genus Culicoides are known vectors of arboviruses affecting human and animal health. However, little is known about Culicoides imicola microbiota and its influence on this insect's biology. In this study, the impact of biotic and abiotic factors on C. imicola microbiota was characterized using shotgun-metagenomic sequencing of whole-body DNA samples. Wild-caught C. imicola adult nulliparous females were sampled in two locations from Sicily, Italy. The climatic variables of temperature and soil moisture from both localities were recorded together with potential host bloodmeal sources. Shared core microbiome among C. imicola populations included Pseudomonas, Escherichia, Halomonas, Candidatus Zinderia, Propionibacterium, and Schizosaccharomyces. Specific and unique taxa were also found in C. imicola from each location, highlighting similarities and differences in microbiome composition between the two populations. DNA and protein identification showed differences in host preferences between the two populations, with Homo sapiens and Canis lupus familiaris L. being the preferred bloodmeal source in both locations. A principal component analysis showed that the combined effect of host preferences (H. sapiens) and local soil moisture factors shape the microbiome composition of wild-caught populations of C. imicola. These results contribute to characterizing the role of the microbiome in insect adaptation and its utility in predicting geographic expansion of Culicoides species with potential implications for the control of vector-borne diseases.

Pasture flock chicken cecal microbiome responses to prebiotics and plum fiber feed amendments.

When prebiotics and other fermentation substrates are delivered to animals as feed supplements, the typical goal is to improve weight gain and feed conversion. In this work, we examined pasture flock chicken cecal contents using next generation sequencing (NGS) to identify and understand the composition of the microbiome when prebiotics and fermentation substrates were supplemented. We generated 16S rRNA sequencing data for 120 separate cecal samples from groups of chickens receiving one of 3 prebiotics or fiber feed additives. The data indicated that respective feed additives enrich for specific bacterial community members and modulate the diversity of the microbiome. We applied synthetic learning in microbial ecology (SLiME) analysis to interpret 16S rRNA microbial community data and identify specific bacterial operational taxonomic units (OTU) that are predictive of the particular feed additives used in these experiments. The results suggest that feed can influence microbiome composition in a predictable way, and thus diet may have indirect effects on weight gain and feed conversion through the microbiome.

Venous leg ulcer in the context of chronic venous disease.

OBJECTIVES: Chronic venous disease (CVD) is a frequent disorder with a high socioeconomic impact. Little is known about the possible differences between healed ulcer (C5 group) and active ulcer (C6 group) in terms of disease severity and quality of life (QoL). Our aim was to determine the possible differences in severity disease and QoL between the C5-C6 and C1 (control) group. METHODS: Data from a national, multicentre, observational and cross-sectional study (n = 1598) were used to compare three groups of CVD: C1 (n = 243), C5 (n = 136) and C6 (n = 70). CVD severity was assessed with the Venous Clinical Severity Score (VCSS) and QoL with the Short Form 12 Health Survey (SF-12) and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). RESULTS: Patients with active ulcers had a higher mean total VCSS than patients with healed ulcers (P < 0.05). Both SF-12 and CIVIQ-20 QoL questionnaires indicated a poorer QoL in patients with ulcers than in those with C1 (P < 0.05). Compared with the C5 group, patients with active ulcers (C6) had lower QoL scores, but the differences were not statistically significant. CONCLUSIONS: Patients with venous leg ulcers (C5-C6) are associated with high severity and poor QoL. However, the healing of a leg ulcer did not contribute to improvement of QoL.

Quality of life in patients with chronic venous disease: influence of the socio-demographical and clinical factors.

AIM: Chronic venous disease (CVD) is a well-defined and known disorder which impact on related-health quality of life (QoL). However, individuals factors which determinate quality of life on CVD are not well defined. The purposes of this study were to describe the QoL in patients with CVD and examine socio-demographical and clinical factors which influence QoL METHODS: One thousand five hundred sixty patients with CVD were evaluated. We calculated for each patient two disease-specific severity scores: The "C" grade (clinical) of the CEAP classification and the Venous Clinical Severity Score (VCSS). Additionally, two QoL questionnaires were recorded: Short-Form Health Survey (SF-12) and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). Two multivariate logistic regression analyses (SF-12 and CIVIQ-20 model) were conducted to determine whether demographic and clinical variables were independently associated with QoL. RESULTS: Both QoL questionnaires indicated that the QoL decreased significantly (P<0.05) as the C grade of CEAP increased. Each increase of 0.10 in VCSS score represented 2% worsening in QoL as measured by CIVIQ-20. Three factors were strongly associated with poor QoL on SF-12: increasing age, prior superficial venous thrombosis (SVT) or prior deep venous thrombosis. In the specific disease CIVIQ-20 questionnaire three factors (higher age, prior SVT and higher weight) were strongly associated with decrease QoL. CONCLUSION: Increasing disease severity by VCSS is associated with reductions in QoL. Subgroup analysis indicates that there are several significant individual determinants of worsening QoL.

A colibacillosis outbreak in farmed red-legged partridges (Alectoris rufa).

Colibacillosis in different forms is responsible for significant economic losses in the poultry industry worldwide. Escherichia coli strains frequently implicated in poultry disease are designated as avian pathogenic E. coli (APEC). Natural infections and disease due to APEC have been described in wild birds, but not as yet in red-legged partridges. During an outbreak in an experimental partridge farm, 23 of 43 1-day-old chicks belonging to the same batch died. Putative APEC strains were detected and isolated both in cloacal swabs and in tissues originating from the same individuals and from different birds showing similar clinical signs. This is the first study that identifies APEC strains linked to a colibacillosis outbreak in farmed red-legged partridges, and also confirms the importance of farmed partridges as fecal carriers and potential spreaders of APEC.

Prevalence of Shiga toxin-producing Escherichia coli, Salmonella spp. and Campylobacter spp. in large game animals intended for consumption: relationship with management practices and livestock influence.

Although wild ruminants have been identified as reservoirs of Shiga-toxin producing Escherichia coli (STEC), little information is available concerning the role of Salmonella spp. and Campylobacter spp. in large game species. We evaluated the presence of these pathogens in faeces (N=574) and carcasses (N=585) sampled from red deer (N=295), wild boar (N=333) and other ungulates (fallow deer, mouflon) (N=9). Animal sampling was done in situ from 33 hunting estates during two hunting seasons. Salmonella spp. and Campylobacter spp. strains associated with human campylobacteriosis were infrequently detected indicating that both pathogens had a limited zoonotic risk in our study area. The overall STEC prevalence in animals was 21% (134/637), being significantly higher in faeces from red deer (90 out of 264). A total of 58 isolates were serotyped. Serotypes O146:H- and O27:H30 were the most frequent in red deer and the majority of isolates from red deer and wild boar were from serotypes previously found in STEC strains associated with human infection, including the serotype O157:H7. The STEC prevalence in red deer faeces was significantly higher with the presence of livestock (p<0, 01) where high densities of red deer (p<0.001) were present. To the best of our knowledge, this is the first study reporting the occurrence of Salmonella spp. and STEC in carcasses of large game animals. Furthermore, this study confirmed by pulsed-field gel electrophoresis (PFGE) that cross contamination of STEC during carcass dressing occurred, implying the likelihood of these pathogens entering into the food chain.

Determinantes de la gravedad en la insuficiencia venosa crónica. Estudio C-VIVES / Determining factors of the severity of chronic venous insufficiency. C-VIVES study

Introducción: La evaluación de la insuficiencia venosa crónica (IVC) puede medirse mediante escalas de gravedad venosa. Sin embargo, los factores individuales que la condicionan no están bien descritos. El objetivo del estudio es conocer las características sociodemográficas y clínicas de una muestra de pacientes portadores de IVC para permitir la búsqueda de los factores que incrementan la gravedad de la misma. Material y método: Estudio promovido por la Sociedad Española de Angiología y Cirugía Vascular en colaboración con otras sociedades científicas españolas sobre 1.560 pacientes con IVC y a los que se han aplicado 2 instrumentos: clasificación clínica CEAP y Venous Clinical Severity Score (VCSS). Resultados: La distribución de pacientes por estadios clínicos fue: C0, 3,3%; C1, 15,6%; C2, 21,0%, C3, 22,9%; C4, 23,6%; C5, 8,7%; C6, 4,5%. La puntuación VCSS para toda la cohorte fue de 0,89 ± 0,53, siendo superior a la media en 4 de los 10 atributos medidos: dolor (1,59 ± 0,75), venas varicosas (1,80 ± 0,74), edema (1,40 ± 0,89), y pigmentación (1,05 ± 0,98). A mayor CEAP le corresponde mayor puntuación VCSS. En el análisis por subgrupos destacan como factores de gravedad el género, varón, edad, peso, sedentarismo, antecedentes personales y familiares de enfermedad venosa. En el análisis de regresión múltiple, los determinantes fundamentales de gravedad son: 1) edad; 2) antecedente de trombosis venosa superficial o profunda, y 3) peso del paciente. Conclusiones: Existe una relación positiva entre CEAP y VCSS. El análisis por subgrupos define factores fuertes y débiles de gravedad, que quedan clarificados mediante regresión múltiple(AU)

Introduction: Chronic venous insufficiency (CVI) can be evaluated using venous clinical severity scores. However, the individual factors that may lead to this condition have not been well described. The objective of this study is to analyse the sociodemographic and clinical characteristics of sample of patients who suffer from CVI in order determine the factors that increase the severity of their condition. Material and method: A study, promoted by the Spanish Society of Angiology and Vascular Surgery in collaboration with other scientific societies, was conducted on 1,560 patients with CVI using two measurement tools: CEAP (clinical grade, etiology, anatomy, pathophysiology) classification and Venous Clinical Severity Score (VCSS). Results: The patient distribution by clinical status (C0 to C5) was: C0: 3.3%; C1: 15.6%; C2: 21.0%, C3: 22.9%; C4: 23.6%; C5: 8.7%; C6: 4.5%. The VCSS score for the whole cohort was 0.89 ± 0.53, being greater than the mean in four of the ten measurements attributed to: pain (1.59 ± 0.75), varicose veins (1.80 ± 0.74), oedema (1.40 ± 0.89), and pigmentation (1.05 ± 0.98). A higher CEAP corresponded to a higher VCSS. In the analysis by subgroups, the risk severity factors were associated with, being male, weight, being sedentary, personal and family history of venous disease. In the multiple regression analysis, the main determining factors were: 1) age; 2) history of superficial of deep venous thrombosis; and 3) patient weight. Conclusions: There is a positive relationship between CEAP and VCSS. The analysis by sub-groups defines strong and weak factors of severity, that are made clear using multiple regression analysis(AU)

Next-generation sequencing: the future of molecular genetics in poultry production and food safety.

The era of molecular biology and automation of the Sanger chain-terminator sequencing method has led to discovery and advances in diagnostics and biotechnology. The Sanger methodology dominated research for over 2 decades, leading to significant accomplishments and technological improvements in DNA sequencing. Next-generation high-throughput sequencing (HT-NGS) technologies were developed subsequently to overcome the limitations of this first generation technology that include higher speed, less labor, and lowered cost. Various platforms developed include sequencing-by-synthesis 454 Life Sciences, Illumina (Solexa) sequencing, SOLiD sequencing (among others), and the Ion Torrent semiconductor sequencing technologies that use different detection principles. As technology advances, progress made toward third generation sequencing technologies are being reported, which include Nanopore Sequencing and real-time monitoring of PCR activity through fluorescent resonant energy transfer. The advantages of these technologies include scalability, simplicity, with increasing DNA polymerase performance and yields, being less error prone, and even more economically feasible with the eventual goal of obtaining real-time results. These technologies can be directly applied to improve poultry production and enhance food safety. For example, sequence-based (determination of the gut microbial community, genes for metabolic pathways, or presence of plasmids) and function-based (screening for function such as antibiotic resistance, or vitamin production) metagenomic analysis can be carried out. Gut microbialflora/communities of poultry can be sequenced to determine the changes that affect health and disease along with efficacy of methods to control pathogenic growth. Thus, the purpose of this review is to provide an overview of the principles of these current technologies and their potential application to improve poultry production and food safety as well as public health.

Detection and characterization of Shiga toxin-producing Escherichia coli in game meat and ready-to-eat meat products.

A total of 142 samples of game meat and ready-to-eat meat products from red deer and wild boar were analysed in order to assess the presence of Shiga toxin-producing Escherichia coli (STEC). Shiga-toxin encoding genes (stx genes) were detected by PCR in 36 (25.4%) of the samples and STEC was isolated from 8 (5.6%) of the same samples. None of the samples tested positive for E. coli O157:H7. Four different serotypes were found among the 8 STEC isolates, with serotype O27:H30 being predominant (62.5%, 5/8). The PCR assay indicated the presence of the stx2 gene in all of the STEC isolates and further subtyping resulted in detection of three different subtypes: stx2a, stx2b and stx2g. The only stx1-positive isolate was further subtyped as stx1c. The ehxA gene was detected in 3 (37.5%) of the isolates and none of them contained the eae gene. All STEC isolates were sensitive to the 13 antibiotics tested. Some isolates possessed serotypes and virulence gene profiles previously associated with STEC infections in humans. The isolation of a STEC strain carrying the stx2a subtype from a ready-to-eat meat product from deer suggests the role of these products as a potential source of STEC infections in humans.

Chronic venous disease in Spain: doctor-patient correlation.

AIM: The present study aimed to demonstrate how the quality of life (QoL) perceived by patients with chronic venous disease (CVD) is correlated with the severity of their disease objectively assessed by primary care physician. MATERIAL AND METHODS: A total of 1560 patients with CVD were evaluated using four measurement instruments: CEAP clinical classification, Venous Clinical Severity Score (VCSS), SF-12 Health Survey and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). Statistical correlations between these tools were analysed using Spearman's coefficient. RESULTS: Patients were distributed in C0, 58 (3.7%); C1, 243 (15.6%); C2, 328 (21.0%); C3, 357 (22.9%); C4, 368 (23.6%); C5, 136 (8.7%); and C6, 70 (4.5%). The VCSS score for the whole cohort was 0.89 ± 0.53. The correlation between CEAP and VCSS was moderately strong (r = 0.69). The overall QoL scores measured by SF and CIVIQ were 56.84 ± 19.63 and 65.11 ± 14.35, respectively. The correlation between the two QoL questionnaires was very strong (r = 0.81). The correlations of the SF and CIVIQ with the VCSS were moderately strong (r = -0.47 and -0.48). The correlations between QoL questionnaires and CEAP were moderate and lower than those with VSCC. CONCLUSIONS: While there is correlation between VCSS, CEAP, modified CIVIQ and venous ultrasound findings, subgroup analysis indicates that this correlation is driven by different components of VCSS compared with the other venous assessment tools. Patients' opinions about their disease are correlated with those assessed by primary care physicians.

Criterios de derivación entre niveles asistenciales de pacientes con patología vascular. Documento de consenso semFYC-SEACV / Criteria for between-care-level referrals of patients with vascular disease. semFYC-SEACV consensus document

La Sociedad Española de Medicina Familiar y Comunitaria (semFYC) y la Sociedad Española de Angiología y Cirugía Vascular (SEACV) han elaborado, mediante un grupo de trabajo conjunto, un documento de derivación entre niveles asistenciales de los pacientes con las principales patologías vasculares: enfermedad arterial periférica, insuficiencia venosa y pie diabético. Se han definido las responsabilidades y habilidades requeridas de cada nivel asistencial y también los criterios de derivación mutua, así como los de priorización. La elaboración de este documento consensuado pretende aportar una herramienta eficiente que asegure la continuidad en la asistencia sanitaria, respetando siempre las particularidades y necesidades específicas de cada zona sanitaria(AU)

The Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of Angiology and Vascular Surgery (SEACV), through a Joint Working Group, have prepared a document on between care-level referrals of patients with the main vascular diseases; peripheral arterial disease, venous insufficiency, and diabetic foot. The responsibilities and skills required at each care level have been defined, as well as the criteria for mutual referral and how to prioritise them. The preparation of this consensus document attempt to provide an efficient tool that may ensure the continuity of health care, always respecting the specific characteristics and needs of each health care area(AU)

Performance of immunochromatographic and ELISA tests for detecting fallow deer infected with Mycobacterium bovis.

Fallow deer (Dama dama) are widely distributed as natural or naturalised populations, as well as in game parks and deer farms. We used 157 fallow deer sampled in populations considered to be Mycobacterium tuberculosis complex (MTC) free and 73 Mycobacterium bovis-infected fallow deer confirmed postmortem by culture to evaluate the diagnostic performance of two tests for the detection of anti-mycobacterial antibodies: the dual path platform (DPP) VetTB assay and the bovine purified protein derivative (bPPD) ELISA. We also compared their sensitivity with that of the skin test, analyzed the effect of haemolysis degree on the antibody detection and described the relationship between the test readings and presence/absence of gross tuberculosis (TB) compatible lesions. Sensitivity of bPPD ELISA was 51% at a specificity of 96%. Depending on the cut-off value selected, the sensitivity of DPP VetTB ranged from 62 to 71%, while its specificity was 88-95%. In the subgroup of M. bovis-infected deer for which the skin test data were available (33 of 73); this method detected 76% of culture-positive animals, although the specificity of the intradermal test was not determined in this study. When the DPP VetTB and skin test data were combined, the resulting sensitivity obtained in this sub-group of M. bovis-infected deer increased to 97%. Gross pathology identified TB compatible lesions (TBL) in 89% culture-confirmed fallow deer. The infected animals with visible lesions had significantly higher readings in the DPP VetTB, but not in the bPPD ELISA. Only high levels of haemolysis decreased antibody test sensitivity and this effect was more evident for the bPPD ELISA. The results allowed inferring a number of management recommendations for rapid detection of MTC infection in live fallow deer and in surveys on hunter-harvested cervids.

Prevención de la enfermedad tromboembólica venosa en pacientes ambulatorios con patología médica / Prevention of venous thromboembolic disease in outpatients with medical conditions

La enfermedad tromboembólica venosa (ETEV), que comprende la trombosis venosa profunda y la tromboembolia pulmonar, constituye un problema de salud por su alta incidencia, morbimortalidad y costes sociosanitarios. El mejor tratamiento es la profilaxis de ésta. Aunque la clase sanitaria ha asumido mayoritariamente la instauración de la profilaxis en el paciente quirúrgico o traumatológico, no ha ocurrido lo mismo en el paciente con patología médica, tanto hospitalizado como ambulatorio. El paciente con patología médica presenta ETEV de forma más frecuente y más grave que el quirúrgico o el traumatológico cuando no se instaura la profilaxis adecuada. La correcta estratificación del riesgo que presenta este tipo de sujeto nos inducirá a instaurar la prevención más idónea para la ETEV. En la valoración de riesgo, la guía PRETEMED ha aportado la descripción de los factores de riesgo de ETEV relacionados con el paciente con patología médica, definiendo unas recomendaciones sobre la instauración de la profilaxis en este tipo de pacientes hospitalizados o ambulatorios (AU)

Venous thromboembolic disease (VTED), that includes deep venous thrombosis and pulmonary thromboemolism, constitutes a health problem due to its high incidence, morbidity-mortality and socio-health care costs. The best treatment is its prophylaxis. Although the health care class has most assumed the establishment of prophylaxis in the surgical or trauma patient, the same has not occurred in the hospitalized patient or out-patient with a medical condition. The patient with a medical condition has VTED more frequently and more severely than the surgical or trauma patient when adequate prophylaxis is not established. Correct staging of the risk presented by this type of subject will lead us to establish the best prevention for VTED. In the evaluation of risk, the PRETEMED guide has provided the description of the risk factors of VTED related with the medical patient, defining some recommendations on the establishment of the prophylaxis in this type of hospitalized patient or out-patient (AU)

[Brain natriuretic peptide in primary care: diagnostic value in heart failure]. / Péptido cerebral natriurético en atención primaria: valor diagnóstico en la insuficiencia cardíaca.

OBJECTIVE: To determine the validity and usefulness of brain natriuretic peptide (BNP) for diagnosing left ventricular dysfunction (LVD). DESIGN: Prospective, descriptive, multi-centred study to validate the diagnostic test. SETTING: Primary care centres in the Community of Madrid, Spain. PARTICIPANTS: Consecutive sample of patients at high risk of presenting with LVD. INTERVENTIONS: Data will be gathered from anamnesis, physical examination, ECG, and chest x-ray to find the risk factor(s) for LVD and the presence or absence of symptoms of congestive heart failure according to the Framingham scale. BNP will be determined at PC clinics in all patients who meet the inclusion criteria, using the "triage BNP test." All patients included in the study will be referred to an echocardiography service for an echocardiogram, which will be the gold standard test. Two independent cardiologists will evaluate the echocardiograph without knowing the BNP values. MAIN MEASUREMENTS: BNP concentrations will be compared against the kind and degree of LVD. ROC curves analysis will test the capacity of BNP to diagnose LVD. Optimal sensitivity and specificity value will be calculated by means of the position on the curve resulting from the minimum distance at the cut-off point for best sensitivity and specificity. Then, sensitivity, specificity, and positive and negative predictive values will be calculated. DISCUSSION: BNP can complement the information provided by other diagnostic tests. It should be included as an important factor in the taking of clinical-therapeutic decisions.

Prevención, detección y diagnóstico clínico de la insuficiencia cardíaca en atención primaria

La insuficiencia cardíaca es un importante problema de salúd pública que afecta a una proporción creciente de la población, sobre todo personas mayores, generando una gran morbimortalidad y un elevado coste sociosanitario, frente al que es preciso adoptar estrategias preventivas adecuadas (AU)

[The coverage and quality of the follow-up in the prenatal care at a health center]. / Cobertura y calidad del seguimiento de la atención prenatal en un centro de salud.

OBJECTIVE: To discover the recruitment and follow-up coverage of Prenatal Care in Parla Health Center, derivation causes and quality control of follow-up. DESIGN: Descriptive and retrospective study. PATIENTS: We obtained 445 newborns (from May 1991 to April 1992) in pediatric records of Health Center, and encountered 412 women records (93%). MEASUREMENTS AND MAIN RESULTS: We measured general practitioner coverage, obstetric derivation and causes, and audit of 23 quality markers selected. General practitioner diagnosed pregnancy in 142 cases (32%). Of them, 63 were derivated at the beginning, 19 at the following-up, and 60 cases (13.5% of total newborns known) were completed in primary care. In these, 19 of 23 quality markers were fulfilled over 80%. CONCLUSIONS: We emphasized the poor capacity of primary care for recruiting pregnancies in the moment (most of them went straight to obstetric), and the excellent results of quality control markers. These situations can be as similar as many others Health Centers in urban areas. Coordination with Reference Obstetric Services is necessary as a strategy to increased the coverage of these programs.