Vigilancia epidemiológica del virus Occidental del Nilo en las llanuras orientales de Colombia / Epidemiological surveillance of West Nile virus in the Eastern Plains of Colombia

RESUMEN Objetivo. Identificar la presencia del virus del Oeste del Nilo en equinos y mosquitos en ocho municipios del departamento del Meta. Materiales y métodos. La investigación contó con el aval del Comité de bioética de la Universidad de los Llanos. Se analizaron mediante pruebas serológicas y moleculares 613 muestras de equinos criollos y de raza cuarto de milla, destinados a actividades deportivas y de trabajo, con un rango de edad de 2 a 15 años, en los transectos: Villavicencio-Restrepo-Cumaral, San Martín - Castilla la Nueva-Granada y Puerto López-Puerto Gaitán, analizados en 62 pool y 213 mosquitos. Los pool de sueros de equinos y mosquitos fueron analizados por ELISA y PCR. Resultados. No se encontraron animales seropositivos mediante la prueba de ELISA y las pruebas moleculares también fueron negativas. Conclusiones. Aunque en este estudio no se evidenció la presencia de anticuerpos IgM por la técnica de Elisa y las pruebas moleculares (RT-PCR) también fueron negativas para circulación viral, en los municipios objeto de estudio, es importante indicar que la detección molecular en sueros, requiere unos niveles de viremia representativos y que el animal se encuentre en la fase aguda de la enfermedad. Aunque es posible que la población equina se mantenga libre de contacto con el virus, se debe mantener la vigilancia epidemiológica frente a este importante patógeno para la salud humana, especialmente por la presentación de brotes de otros virus zoonóticos como la Encefalitis Equina del Este y Encefalitis Equina Venezolana en los departamentos del Meta y Casanare, contiguo a este.

ABSTRACT Objective. Identify the presence of West Nile virus in horses and mosquitoes in eight municipalities of the department of Meta. Materials and methods. The research was supported by the Bioethics Committee of the University of Los Llanos. 613 samples of Creole and quarter-mile equine horses, intended for sports and work activities, with an age range of 2 to 15 years, were analyzed using serological and molecular tests in the transects: Villavicencio-Restrepo-Cumaral, San Martín- Castilla la Nueva-Granada and Puerto López-Puerto Gaitán, analyzed in 62 pools and 213 mosquitoes. The pool of sera of horses and mosquitoes were analyzed by ELISA and PCR. Results. No seropositive animals were found by the ELISA test and molecular tests were also negative. Conclusions. Although in this study the presence of IgM antibodies was not evidenced by the Elisa technique, and molecular tests (RT-PCR) were also negative for viral circulation, in the municipalities under study, it is important to indicate that the molecular detection in sera, it requires representative levels of viremia and that the animal is in the acute phase of the disease. Although it is possible that the equine population remains free of contact with the virus, epidemiological surveillance should be maintained against this important pathogen for human health, especially due to the outbreak of other zoonotic viruses such as Eastern Equine Encephalitis and Encephalitis Venezuelan Equine in the departments of Meta and Casanare, adjacent to this.

Conocimiento de las preferencias de los pacientes terminales en los hospitales públicos de la Región de Murcia / Advanced knowledge of patient preferences for end-of-life care in national health service hospitals of the Murcia Region

Fundamento. Los cuidados terminales no deseados son un evento adverso evitable y sujeto a normativa legal. Una de las recomendaciones para la seguridad del paciente del National Quality Forum (NQF) es «Asegurar el conocimiento de preferencias del paciente para cuidados terminales». Nuestro objetivo es valorar el cumplimiento de esta recomendación y qué factores sociolaborales se asocian a él en los hospitales públicos de la Región de Murcia. Métodos. Estudio transversal en 8 hospitales. Medimos indicadores de estructura (existencia y características de los protocolos sobre instrucciones previas) y proceso (frecuencia con que se indagan las preferencias de pacientes terminales), construidos según la recomendación del NQF. El indicador de proceso se mide mediante un cuestionario distribuido a una muestra representativa de profesionales (n=3.141). Realizamos un análisis descriptivo de resultados de ambos indicadores. La asociación de variables sociolaborales con la indagación de preferencias del paciente (variable dependiente) se analiza mediante regresión logística. Resultados. Uno de los 8 hospitales tenía protocolo válido. El 12% (IC del 95%, 9,4-14,6) de los profesionales (n=607) respondió que en su servicio siempre se indagan las preferencias de los pacientes terminales. La existencia de protocolo se asoció significativamente (odds ratio [OR] = 18,1; IC del 95%, 2,28-143,83) a la respuesta positiva, y trabajar en servicios quirúrgicos (OR=0,15; IC del 95%, 0,04-0,65) a una respuesta negativa. Conclusiones. Se observa un escaso cumplimiento de la recomendación del NQF, evidenciado por una escasa protocolización sobre instrucciones previas y la baja frecuencia de consulta a pacientes terminales sobre sus preferencias. La implantación de protocolos puede ayudar a mejorar esta situación que es significativamente peor en servicios quirúrgicos(AU)

Background and objective. Provision of unwanted end-of-life care is an adverse event that can be avoided and is regulated by law. One of the Safe Practices recommended by the National Quality Forum (NQF) is «Ensure that patient preferences regarding end-of-life care are known». Our objective is to assess compliance with this recommendation, and the associated socio-professional factors, in the National Health Service hospitals in the Murcia Region (Spain). Methods. Cross-sectional study in 8 hospitals. We measured structure (existence and characteristics of guidelines about advance directives) and process (frequency with which healthcare providers enquire about the preferences of terminally ill patients) indicators, constructed according to the NQF recommendation. The process indicator was measured using a questionnaire distributed to a sample of clinical personnel (n=3141). A descriptive analysis of the results was performed. The association of socio-professional variables with asking patient's preferences (dependent variable) was analysed using multivariate logistic regression. Results. One of the eight assessed hospitals has valid guidelines. Only 12% of professionals (n=607), (95% confidence interval [CI], 9.4-14.6), responded that they always enquire about the preferences of terminally ill patients in their departments. The existence of guidelines is significantly associated with this response (odds ratio [OR]=18.1; 95% CI, 2.28-143.83) and working in surgical departments with a negative response (OR=0.15; 95% CI, 0.04-0.65). Conclusions. There is a very low compliance with the NQF recommendation, evidenced by the lack of guidelines and the low frequency in which terminally ill patients are asked about their preferences for life-sustaining treatment. Implementation of guidelines may help to improve this situation, which is significantly worse in surgical services(AU)

[Advanced knowledge of patient preferences for end-of-life care in national health service hospitals of the Murcia Region]. / Conocimiento de las preferencias de los pacientes terminales en los hospitales públicos de la Región de Murcia.

BACKGROUND AND OBJECTIVE: Provision of unwanted end-of-life care is an adverse event that can be avoided and is regulated by law. One of the Safe Practices recommended by the National Quality Forum (NQF) is "Ensure that patient preferences regarding end-of-life care are known". Our objective is to assess compliance with this recommendation, and the associated socio-professional factors, in the National Health Service hospitals in the Murcia Region (Spain). METHODS: Cross-sectional study in 8 hospitals. We measured structure (existence and characteristics of guidelines about advance directives) and process (frequency with which healthcare providers enquire about the preferences of terminally ill patients) indicators, constructed according to the NQF recommendation. The process indicator was measured using a questionnaire distributed to a sample of clinical personnel (n=3141). A descriptive analysis of the results was performed. The association of socio-professional variables with asking patient's preferences (dependent variable) was analysed using multivariate logistic regression. RESULTS: One of the eight assessed hospitals has valid guidelines. Only 12% of professionals (n=607), (95% confidence interval [CI], 9.4-14.6), responded that they always enquire about the preferences of terminally ill patients in their departments. The existence of guidelines is significantly associated with this response (odds ratio [OR]=18.1; 95% CI, 2.28-143.83) and working in surgical departments with a negative response (OR=0.15; 95% CI, 0.04-0.65). CONCLUSIONS: There is a very low compliance with the NQF recommendation, evidenced by the lack of guidelines and the low frequency in which terminally ill patients are asked about their preferences for life-sustaining treatment. Implementation of guidelines may help to improve this situation, which is significantly worse in surgical services.

Effect of exogenous ethylene on ACC content and ACC oxidase activity during ripening of Manila mangoes subjected to hot water treatment.

Mangoes (Mangifera indica L.) 'Manila' were subjected to the USDA-approved hot water treatment and then exposed to synthetic air mixtures containing 0.5, 0.75 or 1 ml l(-1) of ethylene for 6, 12 or 18 h at 25 degrees C, to induce accelerated ripening. After treatment the mangoes were allowed to ripen in air at 24-25 degrees C. The content of 1-aminocyclopropane-1-carboxylic acid (ACC) and ACC oxidase (ACO) activity increased in fruit treated with 0.5 and 0.75 ml l(-1) of ethylene for 6 or 12 h. Ethylene production was reduced in fruit treated with 1 ml l(-1) of ethylene. This was due to the decreased of ACC synthesis rather than to lower ACC oxidase activity. Treatment with 0.5 ml l(-1) of ethylene for 12 h was found best for accelerate ripening; fruits were fully ripened and edible 3 days after treatment, compared to 6-7 days for untreated mangoes.

Early redox changes during rat thymocyte apoptosis.

Methylprednisolone (glucocorticoid hormone, MPS), etoposide (epipodophyllotoxin inhibitor of a topoisomerase II), and thapsigargin (inhibitor of the endoplasmic reticular Ca2+-ATPase) were used as apoptosis-inducing agents in rat thymocytes. Early redox changes were determined during the early phase of induced apoptosis. The three agents induced apoptosis as assessed by DNA laddering after agarose gel electrophoresis and by quantitative DNA fragmentation. Intracellular H2O2 steadystate concentrations after 30 min of incubation were 40, 48, 25, and 75 nM for control and MPS-, etoposide-, and thapsigargin-treated thymocytes, respectively. After 30 min of MPS and thapsigargin exposure, increased DCFH oxidation was clear compared with control cells, but no increase in dichlorofluorescein (DCF) was observed in etoposide-treated thymocytes. DCF fluorescence correlated linearly with the intracellular H2O2 concentration after 30 min of incubation. The amounts of thiobarbituric acid-reactive substances produced after 3 h of incubation and expressed as pmol/mg protein were 105+/-23, 120+/-18, 350+/-17, and 98+/-24 pmol/mg protein for untreated and MPS-, thapsigargin-, and etoposide-treated thymocytes, respectively. Common and marked reductions in intracellular glutathione of 46, 73, 58, and 39% were observed after 2 h of incubation with MPS-, thapsigargin-, and etoposide-treated cells and in untreated cells, respectively. A simultaneous increase in oxidized glutathione, compared with untreated cells, was evident in MPS (66%) and was stronger in thapsigargin-exposed cells (250%). A 55% decrease in GSSG in etoposide-treated cells was found. It is concluded that redox changes occur during the early phase of induced apoptosis in rat thymocytes and are not always associated with an oxidative stress. Rather, this situation is closely related with the type of stimuli.

Epidemiologia de los tumores de ovario. / Epidemiology of ovarian tumors

Se efectuo un analisis epidemiologico de 522 casos de tumores de ovario atendidos en un periodo de ocho anos. Su frecuencia fue del 1.8 por ciento. El 86.4 por ciento fueron benignos y predominaron en la cuarta decada de la vida; los malignos, (13.6 por ciento) prevalecieron en la quinta y sexta decada. El dolor en hipogastrio y la hemorragia uterina anormal, fueron los sintomas mas frecuentes.De acuerdo a la estirpe histologica el mayor porcentaje fue para los de origen epitelial (70.l por ciento); de estos los mas frecuentes fueron cistadenoma seroso (45.9 por ciento) y cistadenocarcinoma seroso (4.7 por ciento)