Clinical characteristics and use of antibiotics in a group of patients with snake bites in Colombia.

Introduction: Millions of snake bites occur worldwide each year. Clinical practice guidelines generally do not recommend the use of prophylactic antibiotics. Objective: To determine the sociodemographic, clinical, and pharmacological variables and the use of antibiotics in a group of patients with snake bites in Colombia. Methods: A retrospective cross-sectional study was carried out. Patients affiliated with a Colombian health insurer who presented with snake bites between 2015 and 2022 were included. The cases were identified from the National Public Health Surveillance System. Sociodemographic, clinical and pharmacological variables were identified. Descriptive and bivariate analyses were performed. Results: A total of 643 patients were analyzed, with a median age of 30.8 years, and 74.7% were men. The most frequently identified genus of snake was Bothrops (88.8%), and most incidents were classified as mild ophidian accidents (61.6%). A total of 59.7% of patients received snake antivenom. A total of 13.8% and 2.2% of the patients had cellulitis or abscesses, respectively. A total of 63.5% received antibiotics (50.6% for prophylaxis and 12.9% for treatment), especially cephalexin (25.9%), and most of the antibiotic management was considered inappropriate (91.7%). Conclusion: Most patients with snake bites received antibiotics, especially for prophylactic purposes, a clinical behavior that goes against current evidence. The use of antibiotics with an unsuitable spectrum for the microorganisms that are usually found in the wounds of these patients is frequent. The development of local clinical practice guidelines is required to help reduce the overprescription of antibiotics, as the excessive use of antimicrobials is the main determinant of antimicrobial resistance.

A Cadaveric Study Using Computed Tomography for Measuring the Ocular Bulb and Scleral Skeleton of the Atlantic Puffin (Aves, Alcidae, Fratercula arctica).

Imaging diagnosis plays a fundamental role in avian medicine. However, there are few publications regarding its use in ophthalmology. Seabirds, in particular, present a peculiar ecology since their lives take place in very diverse environments: the aquatic, the terrestrial, and the aerial. This fact implies a series of adaptations at a visual level that are necessary for adequate interaction with the environment. Therefore, knowledge of eye particularities is of great importance for the scientific community since it allows us to deepen our understanding of the ocular anatomy and biology of these animals, which are increasingly present in veterinary and wildlife centers. In our study, we performed a morphometric analysis of the ocular bulb and its internal structures in the puffin (Fratercula arctica) using advanced imaging techniques such as CT.

Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia

Introduction. Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care. Objective. To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medellín, Colombia. Materials and methods. This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics. Results. In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (± 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%). The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%). During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%. Conclusion. Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate.

Introducción. La cirrosis hace parte de las diez primeras causas de muerte en el hemisferio occidental y acarrea un importante costo en salud. Objetivo. Describir las características sociodemográficas, clínicas y de laboratorio, de los pacientes mayores de 18 años que recibieron atención por descompensación aguda de la cirrosis en los servicios de urgencias de tres centros de alta complejidad en Medellín, Colombia. Materiales y métodos. Se trata de un estudio observacional de cohorte. Los resultados se analizaron mediante medidas de frecuencia, y se representaron en tablas y gráficas. Resultados. En total, en 576 registros clínicos se cumplieron los criterios de inclusión; se incluyeron 287 para el análisis. El 58,9 % fueron hombres, con edad promedio de 64 (± 13,5) años. Las causas más frecuentes de cirrosis fueron: ingestión de alcohol (47,7 %), criptogénica o inespecífica (29,6 %) y enfermedad por hígado graso no alcohólico (9,1 %). Los principales motivos de consulta fueron: presencia de edemas, ascitis o ambas (34,1 %), sospecha de hemorragia digestiva (26,5 %), dolor abdominal (14,3 %) y alteración del estado mental (13,9 %). Los diagnósticos de complicación aguda más frecuentes fueron ascitis (45,6 %), hemorragia digestiva por várices esofágicas (25,4 %), encefalopatía hepática (23,0 %) y peritonitis bacteriana espontánea (5,2 %). El 56,1 % de los pacientes recibió antibióticos; el 24,0 %, albúmina humana; el 24,0 % medicamentos, y el 27,5 % hemoderivados. En el 21,3 % de los casos, se requirió hospitalización en la unidad de cuidados intensivos o en la de cuidados intermedios. Se registraron 53 decesos, para una mortalidad del 18,5 %. Conclusiones. Los pacientes que consultan a los servicios de urgencias por una descompensación aguda de la cirrosis demandan una gran cantidad de recursos, frecuentemente presentan complicaciones asociadas, requieren manejo en unidades de cuidado crítico y evidencian una alta tasa de mortalidad.

Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia. / Caracterización de los pacientes con cirrosis agudamente descompensada que consultaron a diferentes servicios de urgencias de alta complejidad en Medellín, Colombia

INTRODUCTION: Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care. OBJECTIVE: To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medellín, Colombia. MATERIALS AND METHODS: This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics. RESULTS: In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (± 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%). The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%). During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%. CONCLUSION: Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate.

Introducción. La cirrosis hace parte de las diez primeras causas de muerte en el hemisferio occidental y acarrea un importante costo en salud. Objetivo. Describir las características sociodemográficas, clínicas y de laboratorio, de los pacientes mayores de 18 años que recibieron atención por descompensación aguda de la cirrosis en los servicios de urgencias de tres centros de alta complejidad en Medellín, Colombia. Materiales y métodos. Se trata de un estudio observacional de cohorte. Los resultados se analizaron mediante medidas de frecuencia, y se representaron en tablas y gráficas. Resultados. En total, en 576 registros clínicos se cumplieron los criterios de inclusión; se incluyeron 287 para el análisis. El 58,9 % fueron hombres, con edad promedio de 64 (±13,5) años. Las causas más frecuentes de cirrosis fueron: ingestión de alcohol (47,7 %), criptogénica o inespecífica (29,6 %) y enfermedad por hígado graso no alcohólico (9,1 %). Los principales motivos de consulta fueron: presencia de edemas, ascitis o ambas (34,1 %), sospecha de hemorragia digestiva (26,5 %), dolor abdominal (14,3 %) y alteración del estado mental (13,9 %). Los diagnósticos de complicación aguda más frecuentes fueron ascitis (45,6 %), hemorragia digestiva por várices esofágicas (25,4 %), encefalopatía hepática (23,0 %) y peritonitis bacteriana espontánea (5,2 %). El 56,1 % de los pacientes recibió antibióticos; el 24,0 %, albúmina humana; el 24,0 % medicamentos, y el 27,5 % hemoderivados. En el 21,3 % de los casos, se requirió hospitalización en la unidad de cuidados intensivos o en la de cuidados intermedios. Se registraron 53 decesos, para una mortalidad del 18,5 %. Conclusiones. Los pacientes que consultan a los servicios de urgencias por una descompensación aguda de la cirrosis demandan una gran cantidad de recursos, frecuentemente presentan complicaciones asociadas, requieren manejo en unidades de cuidado crítico y evidencian una alta tasa de mortalidad.

The Monitoring of Mycoplasma gallisepticum Minimum Inhibitory Concentrations during the Last Decade (2010-2020) Seems to Reveal a Comeback of Susceptibility to Macrolides, Tiamulin, and Lincomycin.

Mycoplasma gallisepticum (Mg) is a highly contagious avian pathogen responsible for significant economic losses for the poultry industry. In some circumstances, antimicrobial treatment is useful to contain clinical signs of Mg infection in birds. However, antimicrobial resistance emergence is now common among animal pathogens, becoming a worldwide health concern. The collection of minimum inhibitory concentration (MIC) data is fundamental for an appropriate antimicrobial use and for fighting antimicrobial resistance emergence. However, MIC data can only be generated in specialized laboratories, and therefore they are not regularly available. MICs of 67 non-vaccine-derived Mg isolates collected in Italy between 2010 and 2020 were obtained. Although 79.1% of the Mg isolates showed enrofloxacin MICs ≥ 8 µg/mL, a statistically significant trend toward low MICs of erythromycin, tylosin, tilmicosin, spiramycin, tiamulin, and lincomycin was observed, indicating a comeback to susceptibility of Mg toward these drugs. Doxycycline proved to be slightly more effective than oxytetracycline. The present study shows that Mg changed its susceptibility toward many of the drugs most commonly used for its containment over a ten-year period.

Kudoa sp. (Myxozoa, Multivalvulida): first report in five commercial fish species from the Canary Islands-FAO 34 (Macaronesia-Spain).

Kudoid myxozoans have been reported causing serious chronic problems in marine fisheries, by reducing the market value of infected fish through pathological damage to the host musculature. We report here the overall prevalence of a Kudoa species in 84/277 (30.3%) fishes from 20 different species of high commercial value captured between October 2011 and December 2013 from the United Nations Food and Agriculture Organization (FAO) 34 commercial fishing area, near the coast of the Canary Islands (Spain). Macroscopic examination showed myxozoan-like cysts in skeletal muscle from 5 of the 20 fish species examined, with the following prevalences: Pagellus acarne (86.7%), Pagellus erythrinus (46.5%), Serranus cabrilla (27.8%), Spondyliosoma cantharus (19.4%), and Sarpa salpa (28.6%). Infection intensity was determined based on spore counts following muscle tissue digestion. Morphometric studies to characterize the species and DNA sequence analysis results suggest that these infections are attributable to a Kudoa species closely related to Kudoa trachuri. This paper reports the first study on a multivalvulidan species to be identified from the Canary Islands. Furthermore, this is the first report of Kudoa parasites in all of the hosts mentioned above, with the exception of P. acarne.

Biochemical characterisation of some non fermenting, non arginine hydrolysing mycoplasmas of ruminants.

The pattern and kinetics of substrate oxidation by type and recent field strains of Mycoplasma agalactiae, Mycoplasma bovis, Mycoplasma bovigenitalium and Mycoplasma ovine/caprine serogroup 11 were investigated by measurement of oxygen uptake. Metabolism of a range of organic acids, sugars and alcohols was detected. All the test strains were unable to oxidise sugars, glycerol and the organic acids, fumarate, malate and alpha-ketoglutarate (1 mM). All strains oxidised organic acid l-lactate, 2-oxobutyrate and pyruvate and demonstrated the ability to oxidise alcohols, particularly isopropanol, which was oxidised at a high rate and high affinity (0.5 mol/mol isopropanol). Its oxidation was consistent with acetone formation, which may be of important in relation to pathogenicity. All strains oxidised similar substrates, however differences were observed between strains in terms of the relative rates and kinetic values for some substrates.

Conocimiento y medidas preventivas sobre SIDA en homosexuales no organizados en los distritos de San Martín de Porres, Santa Anita, Comas, Chorrillos, La Victoria - Rímac / Knowledge and preventive measures on AIDS in homosexuals nonorganized in the districts of San Martín de Porres, Santa Anita, Comas, Chorrillos, La Victoria - Rímac

En el grupo estudiado se ha encontrado que el grado de instrucción no influye significativamente en el nivel de conocimiento sobre el SIDA. Al relacionar las variables grado de instrucción y nivel socioeconómico, no se ha encontrado asociación estadísticamente significativa. La mayoría de la población encuestada utiliza el presente preservativo como barrera para evitar las enfermedades venéreas incluyendo el SIDA. A su vez el 64 por ciento solo practica relaciones sexuales anales, las cuales constituye factor de riesgo para adquirir la enfermedad del SIDA. La gran mayoría de homosexuales No-Organizados presentarón un conocimiento bajo antes de la charla educativa (18 por ciento) después de esta, el conocimiento fué alto (52 por ciento) debido al módulo educativo utilizado.