ABSTRACT
Porcine reproductive and respiratory syndrome virus (PRRSV) causes significant economic losses to the swine industry worldwide. While PRRSV has been endemic in North America since 1989, it was not until 1999 that the virus was first described in South America. Notably, recently an increased number of PRRSV outbreaks have been reported in South American countries. However, epidemiological information related to these outbreaks is limited and the genetic characteristics of the PRRSV strains circulating in the region are poorly understood. In this study, we describe the genetic analyses of PRRSV strains associated with severe PRRS outbreaks in Peru. Samples originating from 14 farms located in two Departments in Peru (Lima and Arequipa), were subjected to RT-PCR amplification of the PRRSV ORF5 gene and sequencing followed by restriction fragment length polymorphism (RFLP) analysis. Results demonstrated the circulation of PRRSV-2 in Peru. Notably ORF5 RFLP typing revealed that 15 (75%) of the PRRSV strains detected in this study belong to the RFLP 1-7-4 type. Phylogenetic analysis showed that the Peruvian strains are closely related to the highly virulent PRRSV 1-7-4 strains that emerged in the US in 2013-2014. Results here indicate the presence of highly virulent PRRSV 1-7-4 strains in Peru and provide important information on the geographical distribution of PRRSV, confirming the recent geographical expansion of this important swine pathogen towards South America.
Subject(s)
Disease Outbreaks/veterinary , Porcine Reproductive and Respiratory Syndrome/virology , Porcine respiratory and reproductive syndrome virus/isolation & purification , Animals , Farms , Female , Geography , Male , Peru/epidemiology , Phylogeny , Polymorphism, Restriction Fragment Length , Porcine respiratory and reproductive syndrome virus/genetics , Porcine respiratory and reproductive syndrome virus/pathogenicity , Real-Time Polymerase Chain Reaction/veterinary , Swine , Viral Envelope Proteins/geneticsABSTRACT
OBJECTIVE: The objective of our work is to use a surgical series to analyse the validity of elastography in evaluating the malignancy of thyroid nodules and multinodular goitres. PATIENTS AND METHODS: The study examined 156 patients, 134 women (85·9%) and 22 men (14·1%), who underwent surgery for nodular thyroid disease between October 2008, and November 2010. The average age of the patients was 52 years (±14·42). Thirty-six patients (23·1%) presented with a single nodule, and 120 (76·9%) exhibited multinodular goitres. Prior to surgical intervention, all patients underwent colour eco-elastography using a qualitative five-point ordinal scale for nodule classifications. Test results were analysed using a receiver operating characteristic (ROC) curve, and an anatomical pathologic examination of surgical specimens was used as a gold standard diagnostic tool for comparison. RESULTS: Of the 192 nodules analysed, 28 (14·6%) were malignant. Using elastography data, an ROC curve was obtained with an area under the curve of 0·662 (±0·060) and a 95% confidence interval (CI 95%) between 0·545 and 0·779 (P = 0·006). By establishing a cut-off point that classified thyroid nodules with an elastographic value greater than or equal to 3 as malignant, we achieved a sensitivity of 75%, specificity of 45·73%, positive predictive value of 19·1% and negative predictive value of 91%. The positive and negative likelihood ratios were 1·38 and 0·55, respectively. CONCLUSIONS: Ultrasound elastography can provide information regarding malignancy risk in thyroid nodules and multinodular goitres. However, the sensitivity and specificity values obtained in our study are below those reported by other groups, a finding that calls into question the current clinical utility of ultrasound elastography.
Subject(s)
Elasticity Imaging Techniques , Goiter, Nodular/diagnostic imaging , Thyroid Neoplasms/diagnostic imaging , Thyroid Nodule/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle , Diagnosis, Differential , Female , Goiter, Nodular/diagnosis , Humans , Male , Middle Aged , Prospective Studies , ROC Curve , Reproducibility of Results , Risk Factors , Thyroid Neoplasms/diagnosis , Thyroid Nodule/diagnosis , Young AdultABSTRACT
Introducción: Analizamos nuestra experiencia y los resultados obtenidos con el uso del vacuum assisted closure (VAC®, KCI Clinic Spain SL) en el manejo del abdomen abierto. Material y métodos Revisamos de forma retrospectiva las laparostomías realizadas entre junio de 2006 y marzo de 2011 usando la terapia VAC® en el Hospital Xeral-Cíes de Vigo. Resultados Incluimos a 23 pacientes consecutivos (18 varones y 5 mujeres) en los que se usó el VAC® en un abdomen abierto por distintas indicaciones (traumatismo abdominal, peritonitis, pancreatitis, patología isquémica o síndrome compartimental abdominal). El VAC® precisó recambio una media de 3,1 veces por paciente (1-7), con una duración total media de la terapia de 14,8 días (2-43) hasta el cierre, lográndose el cierre primario en 18 de 21 pacientes (86%). La estancia media hospitalaria fue de 110,1 días (8-163) y 6 pacientes (26%) fallecieron durante el ingreso por problemas relacionados con su proceso de base. Siete casos (30%) presentaron complicaciones durante la terapia VAC®: 3 abscesos intraabdominales (13%), 4 fístulas o dehiscencias de suturas (17%) y 1 evisceración (4%).Conclusiones La terapia VAC® es de manejo sencillo con una aceptable tasa de complicaciones, particularmente la de fístulas intestinales, y una mortalidad reducida. De los diversos sistemas disponibles para el cierre diferido de un abdomen, el VAC® supone un progreso considerable en estos últimos años gracias a su material adaptable y sus numerosas ventajas. Posiblemente su uso aumentará en el futuro (AU)
Introduction: We analyse our experience and the results obtained with the use of vacuumassisted closure (VAC1, KCI Clinic Spain SL) in the management of open abdomen.Material and methods: We retrospectively reviewed the la parostomies performed between June 2006 and March 2011 using VAC1treatment in the Hospital Xeral-Cíes, Vigo. Results: We included 23 consecutive patients (18 males and 5 females) on whom the VAC1was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischemic disease or abdominal compartmental syndrome). The VAC1neededchanging a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%).The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC1 therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%).Conclusions: VAC1therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC1has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future (AU)
Subject(s)
Humans , Abdominal Wound Closure Techniques , Laparotomy/methods , Postoperative Complications , Abdominal Injuries/surgery , VacuumABSTRACT
INTRODUCTION: We analyse our experience and the results obtained with the use of vacuum assisted closure (VAC(®), KCI Clinic Spain SL) in the management of open abdomen. MATERIAL AND METHODS: We retrospectively reviewed the laparostomies performed between June 2006 and March 2011 using VAC(®) treatment in the Hospital Xeral-Cíes, Vigo. RESULTS: We included 23 consecutive patients (18 males and 5 females) on whom the VAC(®) was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischaemic disease or abdominal compartmental syndrome). The VAC(®) needed changing a mean of 3.1 times per patient (range 1-7), with total mean treatment duration of 14.8 days (2-43) until closure, primary closure being achieved in 18 out of 21 patients (86%). The mean hospital stay was 110.1 days (8-163) and 6 patients (26%) died during their hospital stay due to problems related to their underlying disease. Seven cases (30%) had complications during the VAC® therapy: 3 intra-abdominal abscesses (13%), 4 fistulas or suture dehiscence (17%), and 1 evisceration (4%). CONCLUSIONS: VAC(®) therapy is simple to manage, with an acceptable rate of complication, particularly of intestinal fistulas, and a reduced mortality. Of the various systems available for the deferred closure of the abdomen, the VAC(®) has made considerable progress in the past few years, mainly due to its adaptable material, and its numerous advantages. Its use will possibly increase in the future.
Subject(s)
Abdomen/surgery , Abdominal Wound Closure Techniques , Negative-Pressure Wound Therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Twenty-five BVDV strains, detected in serum from persistently infected cattle from Peru (n=15) and Chile (n=10) were genetically characterized. The phylogenetic analysis based on the 5' UTR showed that all 25 strains belonged to genotype 1. Twenty-three of the strains could further be subdivided into subtype 1b, and two out of ten Chilean strains into subtype 1a. In conclusion, in total 23 out of 25 strains analyzed were of genotype 1, subtype 1b. This is the predominant BVDV subtype in many countries all over the world, including USA. The close homology with previously described strains reflects the influence of livestock trade on the diversity of BVDV circulating within and between countries and continents. Peru and Chile have imported large numbers of cattle from USA and Europe, mostly with insufficient or lacking health documentation.
Um total de 25 isolados do vírus da diarréia viral bovina (BVDV), sendo 15 originarias do Peru e 10 do Chile foram sujeitas a caracterização genética. A árvore filogenética baseada na análise da região proximal não-codificante (5'UTR) do genoma viral demonstrou que as 25 estirpes pertencem ao genótipo 1 do vírus BVD. Vinte e três destas estirpes puderam adicionalmente ser subdivididas no subtipo 1b, enquanto duas das 10 estirpes isolados provenientes do Chile foram identificadas como pertencentes ao subtipo 1a. Em conclusão, 23 de um total de 25 isolados analisados pertencem ao genótipo 1, subtipo 1b. Este é o subtipo de BVDV predominante em muitos países do mundo, incluindo os EUA. A elevada similaridade genética com isolados descritos anteriormente em outras regiões do mundo realça o papel do comércio internacional de gado no estabelecimento de diversidade genética do vírus BVD. Tanto o Peru como o Chile têm historia de importação de grandes quantidades de gado dos Estados Unidos e da Europa, no entanto sem suficiente documentação comprovativa do estado sanitário no que concerne a esta virose.
