A systematic review of worldwide data on tinea capitis: analysis of the last 20 years.

Dermatophyte infections are the most common fungal infections in humans; among them, tinea capitis (TC) - the most contagious fungal infection - is caused by anthropophilic, zoophilic and geophilic dermatophytes. The purpose of this systematic review was to determine the different aetiological variants involved in TC and the overall epidemiology of the causes of this infection in the last two decades. We searched the MEDLINE (PubMed) and Embase databases for articles published from July 2000 to August 2019 using the following search terms: 'Tinea capitis', 'Africa', 'America', 'Asia', 'Europe', 'Oceania', and the names of the countries on each continent. The flow of information through the different phases in this systematic review was depicted using a PRISMA flow diagram, which mapped the number of records identified, included and excluded, and the reasons for exclusion. Our findings indicate that the frequency of different aetiologic agents of TC in the reported studies varied globally, from 0.4-87.7% in Africa, 0.2-74.0% in North America, 0.0-91.2% in Eastern Asia, 0.0-69.0% in Eastern Europe and 2.9-86.4% in Oceania. Microsporum canis is the most frequent reported zoophilic agent worldwide, while Trichophyton violaceum and Trichophyton tonsurans are the predominant anthropophilic agents. Over time, the frequency of these latter fungal infections has increased globally, and these fungi have become the major species globally. Anthropophilic transmission - the most prevalent type of transmission - could be explained by two factors: (i) the socioeconomic status of affected countries and population groups with associated risk factors and (ii) movement of populations importing new causes of infection to areas where they had not been encountered previously. We observed that intercontinental migration and travel; globalization; environmental, climatic and ecological changes; and accelerated evolution of health technologies may influence the observed epidemiological changes and, consequently, contributed to the variations in the global status of TC.

Tibolone prevents oxidation and ameliorates cholinergic deficit induced by ozone exposure in the male rat hippocampus.

Oxidative stress is related to the development of central nervous system diseases involving memory processes. Cholinergic system and memory processes are disrupted by ozone exposure. In rats, ozone induces motor disturbances and memory deficits as well as biochemical changes in brain regions related to memory processes. In this work, we analyzed the effect of chronic tibolone (TIB) administration in central nervous system, specifically the content of choline acetyltransferase, acetylcholinesterase, acetylcholine and oxidative stress markers in the hippocampus of male rats exposed to ozone. Our results reveal a neuroprotective effect of TIB treatment on neuronal damage induced by chronic ozone exposure. Furthermore, we suggest that TIB can prevent memory deficits by providing a protective effect against oxidative stress and the cholinergic system disruption induced by ozone exposure. Together, these findings present a potential neuroprotective effect of TIB in processes linked to memory deficits induced by aging or neurodegenerative diseases.

Effect of natural exogenous antioxidants on aging and on neurodegenerative diseases.

Aging and neurodegenerative diseases share oxidative stress cell damage and depletion of endogenous antioxidants as mechanisms of injury, phenomena that are occurring at different rates in each process. Nevertheless, as the central nervous system (CNS) consists largely of lipids and has a poor catalase activity, a low amount of superoxide dismutase and is rich in iron, its cellular components are damaged easily by overproduction of free radicals in any of these physiological or pathological conditions. Thus, antioxidants are needed to prevent the formation and to oppose the free radicals damage to DNA, lipids, proteins, and other biomolecules. Due to endogenous antioxidant defenses are inadequate to prevent damage completely, different efforts have been undertaken in order to increase the use of natural antioxidants and to develop antioxidants that might ameliorate neural injury by oxidative stress. In this context, natural antioxidants like flavonoids (quercetin, curcumin, luteolin and catechins), magnolol and honokiol are showing to be the efficient inhibitors of the oxidative process and seem to be a better therapeutic option than the traditional ones (vitamins C and E, and ß-carotene) in various models of aging and injury in vitro and in vivo conditions. Thus, the goal of the present review is to discuss the molecular basis, mechanisms of action, functions, and targets of flavonoids, magnolol, honokiol and traditional antioxidants with the aim of obtaining better results when they are prescribed on aging and neurodegenerative diseases.

Cancer screening in Spain.

OBJECTIVE: To describe the current status of breast, colorectal and cervical cancer screening in Spain. METHODOLOGY: The situation was analysed on the basis of data drawn from surveys conducted in each autonomous region (Comunidad Autónoma). RESULTS: Currently, breast cancer screening coverage is 100%. In 2007, overall participation was 67.0% with an adherence of 91.2%. The detection rate was 3.4 per thousand, 15.1% intraductal and 30% invasive <1 cm in diameter, with 65% showing axilary node negative. Colorectal cancer screening had been implemented in six regions (4.5% of the target population). Participation ranged from 17.2% to 42.3%, with positive test percentages ranging from 1.7 per thousand (guaiac) to 9.5% (immunological). The invasive cancer detection rate was 1.7 per thousand (guaiac) and 3.4 per thousand (immunological). In most cases, cervical cancer screening was undertaken opportunistically, with an estimated coverage of 69.0%. CONCLUSIONS: In Spain, cancer screening is being conducted in accordance with national and international recommendations. The fact that screening programmes are operated as a network has led to a high degree of consensus as to the methodology and information systems to be used to enable joint evaluation.

Profilaxis antimicrobiana de la infección de localización quirúrgica: monodosis versus multidosis. Revisión sistemática de Ensayos Clínicos aleatorizados / No disponible

Objetivo: Valorar la evidencia científica acerca de la duración óptima de la profilaxis antimicrobiana quirúrgica. Material y Métodos: Revisión sistemática que incluye ensayos clínicos aleatorizados (ECAs) que comparan profilaxis antimicrobiana con monodosis prequirúrgica frente a profilaxis multidosis, publicados hasta Septiembre de 2004. Resultados: Se localizó una revisión sistemática publicada en 1998 que obtiene un OR de 1'04 con un Intervalo de Confianza (IC) al 95% [0'86-1'27] al comparar frecuencia de infección de localización quirúrgica en pacientes que reciben monodosis y multidosis. Tras esta revisión, se publicaron cuatro ECAs con los siguientes RR e IC al 95%: 2 [1'02-3'92], 0'51[0'10-2'65], 0'46[0'21-1'02] y 1'18[0'33-4'24]. Conclusiones: La administración de dosis adicionales de antimicrobiano posquirúrgicas no reduce la incidencia de infección de localización quirúrgica. No obstante, es preciso realizar nuevos ensayos clínicos para asentar esta evidencia en aquellas especialidades quirúrgicas con poca representación en los estudios realizados hasta ahora

Objective: To assess the scientific evidence about the optimum length for the antimicrobial prophylaxis in surgery. Methods: Systematic review including randomized clinical trials comparing single-dose preoperative prophylaxis with multiple-dose surgical prophylaxis, published until September 2004. Results: A systematic review published in 1998 was identified. The combined OR of surgical site infection for single versus multiple-dose prophylaxis was 1'04, 95% CI [0'86,1'27]. After this review another four trials were published with the following RR and CI 95%: 2 [1'02-3'92], 0'51 [0'10-2'65], 0'46 [0'21-l'02] and l'18[0'33-4'24]. Conclusions: Administration of postsurgery doses don't reduce the surgical site infection incidence. However, new trials are necessary to support this evidence in surgical disciplines with little participation in previous trials

Aeromonas jandaei and Aeromonas veronii dual infection of a human wound following aquatic exposure.

Exudate removed from an infection that developed below the left eye of a 10-year-old male following a previously inflicted wound after aquatic exposure was cultured and revealed two different Aeromonas spp. Further characterization showed that one strain was phenotypically identical to Aeromonas veronii, while the other strain was confirmed by DNA hybridization analysis to be Aeromonas jandaei sp. nov. This is the first report of these more recently described aeromonads, thus far rarely reported from clinical disease, occurring simultaneously in a human infection.

Group B streptococcal sepsis in adults and infants. Contrasts and comparisons.

Group B streptococcal infection may result in significant morbidity and mortality in both infants and adults. The experience with group B streptococcal disease was analyzed at one medical center over a ten-year period from 1975 to 1984. Streptococcus agalactiae bacteremia was observed in 29 adults and 26 infants, with an attack rate of 0.2 cases per 1000 adult admissions and 3.2 cases per 1000 live births, respectively. The majority of adult infections apparently occurred as a result of nosocomial acquisition and was associated with a high mortality rate of 38%. Risk factors for group B streptococcal sepsis in adults include diabetes mellitus, malignancy, and hepatic failure. The majority (73%) of neonatal cases occurred within seven days of birth and occurred in a setting of maternal fever, prolonged rupture of membranes, or prematurity. The mortality rate in infants was remarkably low at only 15%. Fatalities occurred in both adults and infants, despite appropriate antimicrobial therapy. Infection control strategies against group B streptococcus must address potential nosocomial dissemination in adults as well as vertical transmission in infants.

A hospital-wide outbreak of septicemia due to a few strains of Staphylococcus aureus.

During a 6-month period at Walter Reed Army Hospital the monthly attack rate of Staphylococcus aureus bacteremia increased to 3.8 +/- 0.5 (mean +/- SEM) from 2.5 +/- 0.2 cases per 1,000 dispositions for the previous 48 months (P less than 0.05). A predominant phage pattern, designated S, was found in 12 (39%) of 31 bacteremic isolates typed and another strain, delta, was associated with four catheter-related infections. Two other strains also accounted for infections. Patients with isolates of the S phage pattern had a higher mortality (59%) than patients with non-S isolates (37%). Thirty-eight per cent of S. aureus carriers among hospital personnel harbored S or delta strains. Limitation of intravascular devices, strict handwashing, and the use of gloves were associated with a significant decrease in the incidence of S. aureus bacteremia to 1.9 +/- 0.5/1,000 dispositions over the next 6 months (P less than 0.05). S and delta strains were reduced to 20% of these isolates despite their persistence in 32% of staphylococcal carriers upon reculture of personnel. We conclude that S. aureus persists as an important pathogen in the hospitals, and that phage typing S. aureus isolates remains an important tool in hospital epidemiology. The presence of multiple S. aureus strains causing this outbreak and the extent of their dissemination among patients and personnel reported here emphasizes the need to reevaluate strategies of nosocomial staphylococcal control.