Viability of Moniliophthora roreri on Cocoa Beans Under Microfermentation and Long-Term Survival on Carrier Materials.

The viability of Moniliophthora roreri inoculum was evaluated during the microfermentation process of diseased and healthy pulp-seed masses and on a range of carrier materials: aluminum, cloth, glass, paper, plastic, raffia, and rubber tire. Fungal survival was assessed before the microfermentation (0 h) and every 24 to 96 h by the growth of colonies in potato-dextrose-agar (PDA) and sporulation in seed shells. Colonies of M. roreri and sporulation on seed shells were observed from seeds not submitted to microfermentation. No growth was recovered from diseased cocoa beans after 48 h under the microfermentation. The viability of M. roreri spores recovered from carrier materials was evaluated at 7, 15, 30, 45, and 100 days after inoculation (DAI) by collecting spores and plating them on Sabouraud dextrose yeast extract agar amended with chloramphenicol (50 mg l1). The viability was determined by counting germinated and ungerminated spores under a light microscope (40×) after incubating in a moist chamber at 26 ± 2°C for 72 h. Spores maintained long-term viability on all tested carrier materials toward the end of the experiment (overall 26%) with significant differences (<0.05) among them. Maximum spore viability occurred at 7 and 15 DAI, with cloth and plastic carrier materials considered at high risk of acting as vehicles for the fungal spread. Mathematical models of spore viability over time were fit to the data using the Bayesian information criterion. Findings confirmed the importance of the fermentation process to hamper M. roreri growth and the potential of carrier materials for fungal dispersal.

First report of Trypanosoma vivax infection in sheep from Nicaragua.

In Central America, outbreaks of trypanosomiasis by Trypanosoma vivax have been recorded only in cattle. This is the first report of an outbreak of trypanosomiasis by T. vivax in 30 Pelibuey sheep (2 to 7 years old, male and female) from Nicaragua, which occurred in 2009. Clinical signs included fever, apathy, pale mucous membranes, weakness, progressive weight loss, and sudden death. Infection by T. vivax was detected in 22 (73.3%) sheep by blood smear analysis and/or PCR. Trypanosomes were morphologically identified in 11 (36.7%) blood smear samples, whereas 17 (85%) of the 20 samples subjected to PCR were positive for T. vivax. Eighteen (81.8%) of the 22 infected sheep presented a packed red cell volume (PCV) lower than 25%. Upon diagnosis, the treated animals were clinically recovered and no parasites could be observed in subsequent examinations. Tabanids were potential mechanical vectors of T. vivax in the farm. This is the first report of T. vivax in Nicaragua and for the first time this haemoparasite is recorded in sheep in Central America.

Incidencia de infección de la herida quirúrgica en pacientes con apendicitis complicada manejada con cierre primario o tardío de la herida / Incidence of surgical wound infection in patients with complicated appendicitis managed with primary or delayed wound closure

El cierre tardío de la herida quirúrgica suele estar recomendado para pacientes con apendicitis complicada. Sin embargo condiciona un mayor dolor y prolonga la estancia hospitalaria. El cierre tardío actualmente se considera controversial. Objetivo Comparar la incidencia de infección del sitio quirúrgico (ISQ) existente con el cierre primario (CP) y tardío (CT) de la herida en pacientes con apendicitis aguda complicada (perforada o necrótica). Diseño Estudio prospectivo de cohortes. Lugar y sujetos 276 pacientes (138 con CP y 138 con CT de la herida) que fueron sometidos a una apendicectomía en los hospitales Eugenio Espejo, Pablo Arturo Suárez, Enrique Garcés y Gustavo Domínguez, entre mayo y septiembre de 2011. Mediciones principales Los pacientes fueron seguidos hasta un mes luego de la cirugía. El desenlace principal fue la incidencia de ISQ. En ambos grupos se revisaron los expedientes clínicos y se entrevistó a los pacientes para identificar los casos de ISQ. Se calculó el riesgo relativo de ISQ. Resultados La edad media de los pacientes fue 33.5 años (rango 6 a 83 años). Las infecciones de herida ocurrieron en 49 pacientes (17.8%; IC95%= 13.6% - 22.7%), sin diferencias entre hombres y mujeres (16.7% vs. 18.8%; p=ns). Los pacientes con apendicitis perforada tuvieron una mayor incidencia de ISQ que aquellos con apendicitis necrosada (24.6% vs. 10.9%; p<0.01). La tasa de ISQ fue 20.3% (IC95%= 13.9% - 28.0%) y 15.3% (IC95%= 9.7% - 22.5%) en los grupos CP y CT respectivamente, pero esta diferencia no fue signifcativa. El riesgo relativo de ISQ no se asoció estadísticamente con el CP (RR= 1.33; IC95%= 0.80 ­ 2.23; p=ns). La incisión media (laparotomía) se asoció con mayor riesgo de ISQ (RR= 2.76; IC95%= 1.67 ­ 4.55; p<0.001). Conclusiones El cierre primario de la herida puede ser preferible para el manejo de la apendicitis complicada, porque no se asocia con un incremento de riesgo en la infección del sitio quirúrgico al compararlo con el cierre tardío y puede ser una opción más conveniente para el paciente.

Performing a delayed primary wound closure is often recommended in patients with complicated appendicitis. Nevertheless it can result in increased pain as well as an extended hospital stay. Delayed primary wound closure remains controversial. Objective To compare the incidence of surgical wound infection (SWI) related with primary (PC) and delayed (DC) wound closure in patients with complicated (perforated or gangrenous) appendicitis. Design Prospective cohort study Subjects and setting 276 patients (138 with delayed closure and 138 whose wounds were primarily closed) who underwent appendectomy between May 2011 and September 2011 in four Ecuadorian hospitals (Eugenio Espejo, Pablo Arturo Suárez, Enrique Garcés and Gustavo Dominguez). Main measurements Patients had a follow-up until 30 days after surgery. The main outcome was the incidence of SWI. Hospital records were reviewed and patient's interviews were performed in both groups to identify cases of SWI. Relative risk of SWI was calculated. Results The median age of the patients was 33.5 years (range 6 to 83 years). Wound infections were observed in 49 patients (17.8%; 95%CI= 13.6% - 22.7%) without differences between males and females (16.7% vs. 18.8%; p=ns). Patients with perforated appendicitis had a higher incidence of SWI than those with gangrenous appendicitis (24.6% vs. 10.9%; p<0.01). The rate of SWI was 20.3% (95%CI= 13.9% - 28.0%) and 15.3% (95%CI= 9.7% - 22.5%) in the PC and DC groups, however this difference was not significant. Moreover, the relative risk of SWI with PC was not statistically signifcant (RR= 1.33; 95%CI= 0.80 ­ 2.23; p=ns). Midline laparotomy showed a higher risk for SWI (RR= 2.76; 95%CI= 1.67 ­ 4.55; p<0.001). Conclusion Primary wound closure may be preferable for complicated appendicitis because is not associated with an increased risk of incision infection when compared with delayed management and could be more convenient for patients.

Internal consistency of the Spanish health literacy test (TOFHLA-SPR) for Puerto Rico.

BACKGROUND: Low functional health literacy has been related to poor viral control, and lower levels of ART adherence in people living with HIV/AIDS. Research in functional health literacy among people living with HIV/AIDS in Puerto Rico (PR) is an unexplored area. The purpose of this paper is to describe how the full-length Spanish Version of the Test of Functional Health Literacy in Adults (TOFHLA-S) scale was adapted to PR. METHODS: Thirty participants (women = 16, men = 14) completed a basic demographic questionnaire, the TOFHLA-S and participated in an interview. Analyses were performed to examine the information provided by participants and the internal consistency of the TOFHLA-S. RESULTS: The mean age was 47.7 years (range 34-77). Thirty-seven percent had less than 12 years of formal schooling and 43% reported having education above high school. Changes suggested by participants included: increasing font size from 14 to 16 points for better readability and changes/simplification of several words in order to make them colloquial and comprehensible for the PR context. The reliability coefficient obtained for this scale was strong (estimated alpha = 0.95) however, differences were observed by subtype: numeracy (estimated alpha(num) = .819 vs. comprehension (estimated alpha =. 953). CONCLUSIONS: Based on this process, we have adapted the original version of the TOFHLA-S and the new version of the full-length TOFHLA-S, PR is now valid for further research and testing levels of functional health literacy in a larger sample in PR.