ABSTRACT
Background and Aim: Extensive cattle rearing is a major source of economy for the inhabitants of the Amazon region of Peru. Milk and meat production is generally affected by the prevalence of various parasites, including hepatic and gastrointestinal parasites, as these products provide ideal conditions for parasitic growth. This poses a serious public health threat. This study aimed to estimate the prevalence, coinfection, and risk factors associated with the liver fluke (Fasciola hepatica) and other gastrointestinal parasites in cattle from the Amazon region of Peru. Materials and Methods: Fecal samples obtained from 1450 bovine specimens were analyzed using flotation and sedimentation methods to identify parasites, including Eimeria spp., strongyle-type eggs (STEs), and F. hepatica. We collected information about the specimens, including age, sex, origin, breed, category, frequency of deworming, farm size, herd size, water sources, and rearing system by conducting simple inspections and interviewing owners. The data obtained were statistically evaluated using the Chi-square test (p < 0.05) to determine the association between the qualitative variables. We also calculated the odds ratio at a 95% confidence interval to identify the risk factors. Results: We observed that F. hepatica, Eimeria spp., and STEs were 45.6%, 39.8%, and 35.3% prevalent, respectively. We found risk factors related to distomatosis in the animals from Huambo, where the drinking water sources are mainly streams, ditches, and rivers, while the specimens from Valle Chico were predisposed to coccidiosis. Further, the risk factors related to the presence of STEs in feces were age (61-90 months), origin (Valle Chico), herd size (<50 animals), and type of extensive rearing. Furthermore, significant coinfection was observed between Eimeria spp. and STEs. Conclusion: The high percentages of parasites in cattle observed were related to epidemiological factors, such as the origin of the sample, water sources, age, herd size, and extensive breeding. Similarly, the presence of STEs was a risk factor for contracting coccidiosis. Our future goals include investigating these parasites using a larger sample size and identifying more risk factors using more sensitive and specific diagnostic tests.
ABSTRACT
El tratamiento del infarto agudo de miocardio ha evolucionado notablemente en las últimas tres décadas. Actualmente están establecidas con total nitidez las ventajas del tratamiento de reperfusión en cuanto a reducción de la morbimortalidad en una enfermedad tan prevalente en los países desarrollados. Si las diferentes opciones de reperfusión, farmacológica o mecánica, se aplican y especialmente si es precozmente desde el inicio de los síntomas, la mortalidad del infarto de miocardio puede ser inferior al 5%, cifra impensable hace tan sólo unos años. La intervención coronaria percutánea primaria es el método de reperfusión ideal. Sin embargo, desde una visión comunitaria y a la vista de la extensión del territorio y los tiempos de acceso desde el inicio de los síntomas al contacto con el sistema sanitario, así como al centro intervencionista, la reperfusión farmacológica y el traslado simultáneo para realizar intervención coronaria percutánea de rescate, si procediera, pueden ser una opción complementaria, con resultados no inferiores a los de la intervención coronaria percutánea primaria, en caso de que se la considerara como única opción. Navarra es una comunidad relativamente extensa (10.391 km2 ), con tres centros hospitalarios públicos: un centro con unidad coronaria y cardiología intervencionista, en el Complejo Hospitalario de Navarra en Pamplona, y dos hospitales comarcales, Estella y Tudela, ubicados a 50 y 90 km del centro intervencionista. Estratégicamente, el objetivo es reperfundir al mayor número de pacientes que presenten un infarto de miocardio con elevación del ST. Si es en el área de Pamplona-Pamplona Norte, siempre intervención coronaria percutánea primaria; si es en los dependientes de los hospitales comarcales de Estella y Tudela, estrategia invasiva o farmacoinvasiva en función de la suma de tiempos desde el inicio de los síntomas hasta el contacto con el sistema sanitario, más el tiempo teórico de traslado al centro intervencionista de Pamplona. Este tipo de estrategia combinada, con protocolos bien definidos, en una comunidad como la de Navarra, con peculiaridades urbanas y rurales, se muestra muy eficiente y su modelo, dentro de las dificultades, es de aplicación sencilla (AU)
The treatment of acute myocardial infarction has advanced considerably over the last three decades. Today, the benefits of reperfusion therapy are abundantly clear: it can reduce morbidity and mortality in a disease that has a very high prevalence in developed countries. If the various reperfusion treatments are used early after symptom onset, mortality due to myocardial infarction may be less than 5%, a level that was unthinkable just a few years ago. Primary percutaneous coronary intervention is the ideal reperfusion method. However, for the community as a whole in a region where distances are large and there may be a lengthy delay between symptom onset and hospital admission, pharmacological reperfusion with simultaneous transport for rescue percutaneous coronary intervention, if warranted, may be an alternative, and outcomes are not inferior to those of primary percutaneous coronary intervention when this is the only option. In the region of Navarre in Spain, a relatively extensive area (i.e. 10391 km2 ) is covered by three public hospitals: the Complejo Hospitalario de Navarra in Pamplona and two district hospitals in Estella and Tudela, located 50 km and 90 km, respectively, from the interventional cardiology service in Pamplona. Strategically, the goal is to provide reperfusion therapy for the maximum possible number of patients with ST-elevation myocardial infarction. Primary percutaneous coronary intervention is always performed in patients from the area around Pamplona and North Pamplona. In areas served by the district hospitals in Estella and Tudela, either invasive treatment or the combination of pharmacological and invasive therapy may be used depending on the sum total of the time between symptom onset and first contact with the health system plus the theoretical transfer time to the interventional cardiology service in Pamplona. The use of this combination treatment strategy, based on well-defined protocols, in a region like Navarre, which is characterized a mixture of urban and rural communities, appears to be very effective and, within its limitations, the program was simple to implement (AU)
Subject(s)
Humans , Myocardial Infarction/surgery , Percutaneous Coronary Intervention/methods , Myocardial Revascularization/methods , Acute Coronary Syndrome/surgery , Models, Organizational , Community Networks , Myocardial Ischemia/epidemiologyABSTRACT
BACKGROUND: A Mediterranean dietary pattern has been associated with a reduced risk of coronary heart disease, as well as a reduction of oxidative stress, but studies indicating possible interactions between food intake and inflammatory mediators production at specific sites are lacking. AIM OF THE STUDY: To assess the relationship between Mediterranean diet consumption and inflammatory related molecules production in coronary vessels. METHODS: A previously reported Mediterranean-diet score was computed summing-up the quintiles of eight dietary components from a validated food frequency questionnaire in 24 patients with unstable angina. Tumor necrosis factor (TNF-alpha) and vascular cell adhesion molecule (VCAM-1) concentrations were measured in coronary sinus blood. RESULTS: Both biomarkers showed an inverse association with the Mediterraneandiet score. The association between VCAM-1 and the Mediterranean-diet score had an adjusted beta coefficient of -35.1 ng/ml (95% coefficient interval, CI: -63.5 to -6.7). The adjusted beta coefficient using TNF-alpha as the dependent variable was -41.6 pg/ml (95 % CI: -76.2 to -7.1). The consumption of olive oil as a single item showed a significant inverse association, and a Mediterranean-diet score excluding olive oil was also inversely associated with TNF-alpha and VCAM-1 serum levels in coronary venous blood. CONCLUSIONS: Adherence to a Mediterranean dietary pattern may protect against coronary artery wall production of inflammatory mediators. This finding could provide a novel mechanistic explanation for the recognized lower coronary risk associated with a Mediterranean diet.
