Complete Genome Sequences of Two Lytic Phages of Salmonella enterica Isolated from Wastewater in Ecuador.

Salmonella enterica is one of the most common causes of foodborne diseases. Bacteriophages provide an option to reduce the presence of Salmonella. Here, we describe the isolation of two lytic Salmonella bacteriophages. The complete genomes were annotated and show similarity to that of the lytic phage NBSal001, in the Drexlerviridae family.

Nontyphoidal Salmonella in Food from Latin America: A Systematic Review.

In Latin America, nontyphoidal Salmonella (NTS) is one of the most important etiological agents of foodborne infections; it can survive in soil, water, and food even after processing. Here, we aimed to perform a systematic review by collecting data on the prevalence, serotypes, and antimicrobial resistance (AMR) of NTS isolated from different food products in Latin America, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Out of 1766 studies screened, 244 reports from 13 Latin American countries were eligible. Among these, 182 reported NTS prevalence, 87 reported NTS serotypes, and 83 reported serotypes with AMR patterns. The NTS prevalence ranged from 0.005% to 93.3%, regardless of country and food. Meat showed the highest NTS prevalence. Enteritidis, Typhimurium, and Derby were the most frequently observed serotypes in different food products. The serotypes Enteritidis, Typhimurium, and Infantis, isolated from animal products, showed the highest AMR rate. The presence of NTS in fruits and vegetables, which are generally consumed raw or as ready-to-eat food, indicates a high risk of salmonellosis from consuming these foods. Thus, the reduction of this pathogen in the food chain requires a One Health approach, involving good agricultural and manufacturing practices, low antimicrobial use, and proper waste management.

Salmonella grows massively and aerobically in chicken faecal matter.

The use of wastewater for irrigation and animal manure as fertilizer can cause transmission of intestinal pathogens, conditions frequently observed in low- and middle-income countries (LMICs). Here, we tested the ability of Salmonella to grow in the faecal matter. We inoculated freshly isolated Salmonella strains (from chickens) in chicken faecal matter and incubated for 1 to 12 days, under aerobic and anaerobic conditions. We found that both Salmonella and Escherichia coli multiplied massively in faecal matter outside a host and significantly higher in aerobic conditions. Our results have critical implications in waste management, as we demonstrate that aerobic treatments may not be the best to reduce the number of Salmonella in the environment.

Comportamiento de la preeclampsia con agravamiento en gestantes o puérperas en Mayarí / Incidence of Severe Worsening Preeclampsia in Pregnant or Postpartum Women in Mayarí

Introducción: la preeclampsia representa un riesgo para la madre y el producto de la concepción. Objetivo: determinar el comportamiento de la preeclampsia con agravamiento en la sala de cuidados perinatales de la maternidad municipal. Métodos: durante enero-diciembre de 2013 en el Hospital General Universitario Mártires de Mayarí de la provincia Holguín se realizó un estudio de serie de casos en 44 pacientes que ingresaron en la Sala de Cuidados Perinatales con diagnóstico de preeclampsia con agravamiento. Se utilizaron estadígrafos como el porcentaje, la media y la desviación estándar; el Chi cuadrado para probar hipótesis de independencia. Resultados: los pacientes con diagnóstico de preeclampsia con agravamiento entre los 20 y 25 años representaron el 43,18%. El tiempo de gestación que predominó fue de 37 semanas y más con el 50%; el parto distócico representó el 90,9%; los recién nacidos pretérminos representaron el 43,47%. Conclusiones: el mayor número de casos con preeclampsia con agravamiento estuvo en pacientes entre 20 y 25 años. La vía del parto abdominal (cesárea) fue la predominante relacionándose con un número importante de embarazos pretérminos; en los resultados perinatales el indicador más afectado fue la prematuridad y el bajo peso al nacer con sus complicaciones.

Introduction: preeclampsia is a risk for the mother and the result of the conception. Objective: determinate the behavior of severe preeclampsia in the Perinatal Care Unit of the municipality. Method: a case series study was performed in 44 patients admitted to the Perinatal Care Ward with a diagnosis of worsening preeclampsia, during January to December 2013 at General University Hospital of Mayarí Holguin province. They used stadigraphs as the percentage, the mean and standard deviation as well as Chi square for testing hypothesis of independence. Results: patients diagnosed with worsening preeclampsia between 20 and 25 accounted for 43.18%. The gestation period that prevailed was 37 weeks and more with 50%; the dystocia accounted for 90.9%; preterm infants accounted for 43.47%. Conclusions: the highest number of cases with worsening preeclampsia was in patients between 20 and 25 years. The way of abdominal delivery (C-section) was the predominant interacting with a large number of preterm pregnancies; in perinatal outcomes, prematurity and low birth weight infants with complications represented the most affected indicator.

Scarlet fever: A not so typical exanthematous pharyngotonsillitis (based on 171 cases) / Escarlatina: una faringoamigdalitis exantemática no tan típica (a propósito de 171 casos)

AIM: To describe the age, signs and clinical symptoms of children with scarlet fever at the present time, and to check whether they are equivalent to those with traditional streptococcal pharyngotonsillitis. Study DESIGN: An observational, retrospective study was conducted on the clinical records of 5500 children aged from 0 to 15 years attending a primary health care center. A record was made of the percentage of the cases in which signs and symptoms appear and the Centor score was calculated. Microbiological diagnosis of the disease was made using the rapid antigen-detection test or traditional culture. RESULTS: A total of 171 out of 252 scarlet fever diagnoses were microbiologically verified in 158 PATIENTS: The median age was 3.8 years (interquartile range: 2.91-4.78), with the majority (57%) under the age of 4 years. There was fever in 89% of the processes (95% CI: 84-94%), with a temperature of >38°C in 73% (95% CI: 65-80%), enlarged lymph nodes in 70% (95% CI: 58-82%), absence of cough in 73% (95% CI: 65-80%), and tonsillar exudate in only 24% (95% CI: 17-31%). The Centor score (n=105) was ≤2 points in 86% (95% CI: 79-92%). The only difference regarding age is that episodes in patients under the age of 4 years old have significantly higher fever (>38°C) than the older ones (80% versus 63%. OR 3.13; 95% CI: 1.46-6.71). CONCLUSIONS: Scarlet fever pharyngotonsillitis differs from the traditional streptococcal pharyngotonsillitis, and its evaluation using clinical prediction rules such as Centor or McIsaac is questionable. The main diagnostic key must certainly be rash, regardless of patient age

OBJETIVO: Describir la edad, signos y síntomas clínicos de niños con escarlatina en la actualidad y comprobar si corresponden a los de la clásica faringoamigdalitis estreptocócica. Diseño del estudio: Estudio observacional, retrospectivo, sobre registros clínicos (5.500 niños de 0 a 15 años pertenecientes a un centro de atención primaria). Porcentaje de casos en los que aparecen los signos y síntomas y cálculo del escore de Centor. Diagnóstico microbiológico realizado mediante test rápido de detección de antígeno o cultivo tradicional. RESULTADOS: De 252 diagnósticos de escarlatina se confirmaron microbiológicamente 171, en 158 pacientes. La mediana de la edad fue de 3,8 años (rango intercuartílico: 2,9-4,8), la mayoría (57%) menores de 4 años. Hubo fiebre en un 89% de episodios (IC 95: 84 a 94%), mayor de 38°C en el 73% (IC 95: 65 a 80%), adenopatías en un 70% (IC 95%: 58 a 82%), ausencia de tos en un 73% (IC 95: 65 a 80%), y exudado amigdalar sólo en un 24% (IC 95: 17 a 31%). El escore de Centor (n=105) fue ≤ 2 puntos en un 86% (IC 95: 79 a 92%). Los niños <4 años tienen significativamente más fiebre (> de 38°C) que los mayores (80% frente a 63%. OR 3,13; IC 95: 1,46 a 6,71). CONCLUSIÓN: La faringoamigdalitis de la escarlatina difiere de la clásica estreptocócica y ha de ser cuestionada su valoración a través de reglas de predicción como las de Centor o McIsaac. La clave diagnóstica principal continúa siendo la erupción cutánea independientemente de la edad del paciente

Comportamiento de la preeclampsia con agravamiento en gestantes o puérperas en Mayarí / Incidence of Severe Worsening Preeclampsia in Pregnant or Postpartum Women in Mayarí

Introducción: la preeclampsia representa un riesgo para la madre y el producto de la concepción.Objetivo: determinar el comportamiento de la preeclampsia con agravamiento en la sala de cuidados perinatales de la maternidad municipal.Métodos: durante enero-diciembre de 2013 en el Hospital General Universitario Mártires de Mayarí de la provincia Holguín se realizó un estudio de serie de casos en 44 pacientes que ingresaron en la Sala de Cuidados Perinatales con diagnóstico de preeclampsia con agravamiento. Se utilizaron estadígrafos como el porcentaje, la media y la desviación estándar; el Chi cuadrado para probar hipótesis de independencia.Resultados: los pacientes con diagnóstico de preeclampsia con agravamiento entre los 20 y 25 años representaron el 43,18%. El tiempo de gestación que predominó fue de 37 semanas y más con el 50%; el parto distócico representó el 90,9%; los recién nacidos pretérminos representaron el 43,47%.Conclusiones: el mayor número de casos con preeclampsia con agravamiento estuvo en pacientes entre 20 y 25 años. La vía del parto abdominal (cesárea) fue la predominante relacionándose con un número importante de embarazos pretérminos; en los resultados perinatales el indicador más afectado fue la prematuridad y el bajo peso al nacer con sus complicaciones.(AU)

Introduction: preeclampsia is a risk for the mother and the result of the conception.Objective: determinate the behavior of severe preeclampsia in the Perinatal Care Unit of the municipality.Method: a case series study was performed in 44 patients admitted to the Perinatal Care Ward with a diagnosis of worsening preeclampsia, during January to December 2013 at General University Hospital of Mayarí Holguin province. They used stadigraphs as the percentage, the mean and standard deviation as well as Chi square for testing hypothesis of independence.Results: patients diagnosed with worsening preeclampsia between 20 and 25 accounted for 43.18%. The gestation period that prevailed was 37 weeks and more with 50%; the dystocia accounted for 90.9%; preterm infants accounted for 43.47%.Conclusions: the highest number of cases with worsening preeclampsia was in patients between 20 and 25 years. The way of abdominal delivery (C-section) was the predominant interacting with a large number of preterm pregnancies; in perinatal outcomes, prematurity and low birth weight infants with complications represented the most affected indicator.

Scarlet fever: A not so typical exanthematous pharyngotonsillitis (based on 171 cases).

AIM: To describe the age, signs and clinical symptoms of children with scarlet fever at the present time, and to check whether they are equivalent to those with traditional streptococcal pharyngotonsillitis. STUDY DESIGN: An observational, retrospective study was conducted on the clinical records of 5500 children aged from 0 to 15 years attending a primary health care center. A record was made of the percentage of the cases in which signs and symptoms appear and the Centor score was calculated. Microbiological diagnosis of the disease was made using the rapid antigen-detection test or traditional culture. RESULTS: A total of 171 out of 252 scarlet fever diagnoses were microbiologically verified in 158 patients. The median age was 3.8 years (interquartile range: 2.91-4.78), with the majority (57%) under the age of 4 years. There was fever in 89% of the processes (95% CI: 84-94%), with a temperature of >38°C in 73% (95% CI: 65-80%), enlarged lymph nodes in 70% (95% CI: 58-82%), absence of cough in 73% (95% CI: 65-80%), and tonsillar exudate in only 24% (95% CI: 17-31%). The Centor score (n=105) was ≤2 points in 86% (95% CI: 79-92%). The only difference regarding age is that episodes in patients under the age of 4 years old have significantly higher fever (>38°C) than the older ones (80% versus 63%. OR 3.13; 95% CI: 1.46-6.71). CONCLUSION: Scarlet fever pharyngotonsillitis differs from the traditional streptococcal pharyngotonsillitis, and its evaluation using clinical prediction rules such as Centor or McIsaac is questionable. The main diagnostic key must certainly be rash, regardless of patient age.

Parastomal hernia-repair using mesh and an open technique.

INTRODUCTION: Parastomal hernia occurs in 35%-50% of patients who have had a stoma formed, whether for the digestive tract or the urinary tract. There are many repair techniques including primary repair and repair using different types of mesh prosthesis, and the surgical approach may be open or laparoscopic. However, all techniques suffer the disadvantage of a high index of hernia recurrence. PATIENTS AND METHODS: This study included 125 patients from the stoma clinic at our hospital. Hernia repair was performed on 25 of these patients who had a terminal colostomy because of either cancer or inflammatory disease. Preoperative colon preparation involved a cathartic, an evacuating enema, and antibiotic therapy in the preoperative period. The repair was conducted via an anterior approach, dissecting the skin around the stoma in the way a plastic surgeon handles an umbilical scar during abdominoplasty, in order to enter the hernia site. The hernial sac was left intact to form a bed on which to lay a lightweight polypropylene mesh, and this was then fixed to the deep face of the aponeurosis all around the stoma, with sutures placed in a U-shape with 1/0 or 2/0 non-absorbent material. The mesh was also fixed to the external surface of the colon with simple sutures of 3/0 polyglycocolic acid. A closed supra-aponeurotic drain was left in situ, and the skin was closed with 3/0 nylon. RESULTS: Of the corpus, 50 patients presented with parastomal hernia (40%), and 25 of them underwent surgery. These patients were followed for a period of 12 months, on average (range: 8-24 months). After operation, 2 patients (8%) experienced hernia recurrence and underwent further surgery to reinforce the abdominal wall with a new insertion of mesh prosthesis; 2 patients (8%) suffered surgical wound infection; and 2 patients (8%) developed a seroma. There was no rejection of the mesh, erosion of the colon, or fistula formation. CONCLUSIONS: Inserting a mesh prosthesis by this technique is a safe effective treatment for parastomal hernia, adding another option to the available repair solutions. Prospective and comparative studies are required to reinforce this study, and they should ideally include a greater number of patients in the study corpus.

Lactancia materna: seguimiento durante el puerperio / Maternal lactancy, follow up during puerperium

Se realizó un estudio prospectivo longitudinal, de investigación clínica, en el servicio de gineco-obstetricia del HGZ 6 de Cd. Valles S.L.P, del 01 de marzo al 15 de julio de 1995, 100 pacientes fueron evaluadas a las 24 h del puerperio dentro del hospital y a los 20 y 40 días en su domicilio, con la finalidad de determinar la continuidad en la lactancia materna, ya que todas egresaron del hospital lactando a su neonato y recibiendo capacitación acerca de las noblezas de la leche materna, 31 por ciento de los embarazos fue resultado por cesárea y 69 por parto normal. Se encontró una pérdida en la continuidad de 43 por ciento a los 20 días y de 44 por ciento a los 40 días, se evaluó además la incidencia de infecciones respiratorias y enterales en lo niños lactados de manera exclusiva y con fórmula artificial, esto no fue significativo estadísticamente (p> 0.5 por ciento). Se concluye que la distorción cultural y conductual acerca de los beneficios de la leche humana es aun patente y requiere revertirse a corto plazo, para reafirmar la vigencia de este recurso natural.

Actitudes en el personal de salud / Attitudes in the personnel of health

El presente trabajo fue realizado por el grupo de internas rotativas de enfermería que realizamos nuestras pasantías en los servicios de cirugía, unidad de cuidados intensivos,medicina interna, infectología, neonatología y centro obstétrico en el Hospital Enrique Garcés.Iniciamos una investigación participativa que desarrolló el proceso vivido en los servicios a través de la reconstrucción de nuestras vivencias, quedó así definida la temática del trabajo...

Informe asistencia técnica sobre el desarrollo de los servicios de salud (Versión preliminar) del 27 de noviembre al 29 de diciembre de 1986 / sss

La presente asistencia técnica tiene como referencias: Participación en la elaboración del Modelo de Regionalización de Salud. Participación en la elaboración del Modelo de Atención. Participación en la elaboración de los instrumentos de la organización del trabajo en el Area de Salud; a)Programa del Area de Salud b)Guía para el desarrollo de Actividades en el Sector; c)Boleta de censo de población. Analizar el curso de adiestramiento para la capacitación de los equipos de Dirección de las Areas de Salud; objeto de estudio, proyecto para la validación de modelos de Regionalización y Modelo de Atención