Fecal shedding of Campylobacter jejuni and Campylobacter coli among feral pigs in Texas.

The population and range of feral pigs in the United States are rapidly expanding, yet key knowledge gaps exist regarding their role in the ecology and transmission of foodborne pathogens. Our objectives were to estimate the prevalence of Campylobacter jejuni and Campylobacter coli shedding among feral pigs throughout Texas and to identify risk factors for positive status. Faecal samples were collected from feral pigs in Texas from February 2014 through May 2015, and target organisms were detected using PCR assays. The prevalence of C. jejuni shedding was 1.6% (6/370), and the prevalence of C. coli shedding was 3.5% (13/370). C. coli shedding was significantly more common (p = .008) among female pigs than among male pigs. Feral pigs may represent a source of human campylobacteriosis.

Faecal Campylobacter shedding among dogs in animal shelters across Texas.

Epidemiologic studies on faecal Campylobacter shedding among dogs in the United States have been limited, despite evidence that the incidence of human campylobacteriosis has increased over the last decade. Our objectives were to estimate the prevalence of faecal Campylobacter shedding among shelter dogs in Texas, to estimate the specific prevalence of Campylobacter jejuni and Campylobacter coli shedding, and to identify risk factors for Campylobacter-positive status. Using a cross-sectional study design, we collected faecal samples from dogs in six animal shelters across Texas between May and December, 2014. Quantitative PCR protocols were used to detect Campylobacter in samples and to specifically identify C. jejuni and C. coli. The prevalence of faecal Campylobacter shedding among sampled dogs was 75.7% (140/185). Prevalence varied significantly by shelter (p = .03), ranging from 57% to 93%. There was a marginal association (p = .06) between abnormal faecal consistency and positive Campylobacter status, after controlling for shelter as a random effect. However, approximately 70% of Campylobacter-positive dogs had grossly normal faeces. Campylobacter prevalence did not vary significantly by age group or sex. The prevalence of C. jejuni-positive samples was 5.4% (10/185), but C. coli was not detected in any samples. Dogs are a potential source of zoonotic Campylobacter transmission.

Identification of a Plasmid-Mediated Quinolone Resistance Gene in Salmonella Isolates from Texas Dairy Farm Environmental Samples.

A recent increase in plasmid-mediated quinolone resistance (PMQR) has been detected among Salmonella isolated from humans in the United States, and it is necessary to determine the sources of human infection. We had previously isolated Salmonella from dairy farm environmental samples collected in Texas, and isolates were tested for anti-microbial susceptibility. Two isolates, serotyped as Salmonella Muenster, showed the discordant pattern of nalidixic acid susceptibility and intermediate susceptibility to ciprofloxacin. For this project, whole-genome sequencing of both isolates was performed to detect genes associated with quinolone resistance. The plasmid-mediated qnrB19 gene and IncR plasmid type were identified in both isolates. To our knowledge, this is the first report of PMQR in Salmonella isolated from food animals or agricultural environments in the United States.

Evaluation of Faecal Salmonella Shedding Among Dogs at Seven Animal Shelters across Texas.

Estimates of prevalence of faecal Salmonella shedding among dogs in the United States have varied widely. Surveillance among shelter dogs has been limited, although dogs in animal shelters may be at elevated risk of Salmonella infection because of their previous exposure history as well as factors inherent to shelter environments. Our objectives were to estimate the prevalence of Salmonella shedding among shelter dogs across Texas, to identify risk factors for shedding and to characterize the isolates. Using a repeated cross-sectional study design, we collected faecal samples from dogs on two or three visits to each of seven Texas animal shelters between May 2013 and December 2014. Standard bacteriologic culture methods were used to isolate Salmonella from samples, and isolates were characterized via serotyping and anti-microbial susceptibility testing. The prevalence of faecal Salmonella shedding among sampled dogs was 4.9% (27/554), and within-shelter prevalence ranged from 1.9% to 8.3%. There was a marginal association (P = 0.09) between watery faecal samples and positive Salmonella status, as estimated by a logistic regression model that controlled for shelter as a random effect. However, over 60% of Salmonella-positive dogs had grossly normal faeces. Salmonella prevalence did not vary significantly by age group or sex. The most common serovars were Newport (22%) and Javiana (15%), both of which were widespread among shelters. Resistance to anti-microbial agents was uncommon. The prevalence of faecal Salmonella shedding among shelter dogs in Texas appears to be comparable to that seen among pet dogs in general.

Prevalence and Characterization of Salmonella Isolated from Feral Pigs Throughout Texas.

Feral pigs are one of the most abundant free-roaming ungulates in the United States, yet their role in the ecology and transmission of foodborne pathogens is poorly understood. Our objectives were to estimate the prevalence of Salmonella shedding among feral pigs throughout Texas, to identify risk factors for infection, and to characterize the isolates. Faecal samples were collected from feral pigs in Texas from June 2013 through May 2015. Standard bacteriologic culture methods were used to isolate Salmonella from samples, and isolates were characterized via serotyping and anti-microbial susceptibility testing. The prevalence of faecal Salmonella shedding among sampled pigs was 43.9% (194/442), with positive pigs originating from 50 counties. Pigs sampled during fall and summer were significantly more likely to be shedding Salmonella than pigs sampled during winter. High serovar diversity was evident among the isolates, and many of the detected serovars are leading causes of human salmonellosis. The most common serovars were Montevideo (10.0%), Newport (9.1%), and Give (8.2%). Resistance to anti-microbial agents was rare. The burgeoning feral pig population in the United States may represent an emerging threat to food safety.

Subtype analysis of Salmonella isolated from subclinically infected dairy cattle and dairy farm environments reveals the presence of both human- and bovine-associated subtypes.

While it is well established that clinically ill livestock represent a reservoir of Salmonella, the importance of subclinical shedders as sources of human salmonellosis is less well defined. The aims of this study were to assess the subtype diversity of Salmonella in healthy dairy cattle and farm environments and to compare the subtypes isolated from these sources with the Salmonella subtypes associated with clinical human cases in the same geographic area. A total of 1349 Salmonella isolates from subclinical dairy cattle and farm environments (46 farms) were initially characterized by traditional or molecular serotyping and tested for antimicrobial susceptibility. A set of 381 representative isolates was selected for further characterization by pulsed-field gel electrophoresis (PFGE); these isolates represented unique combinations of sampling date, serovar, antimicrobial resistance pattern, farm of origin, and source, to avoid overrepresentation of subtypes that were re-isolated from a given source. These 381 isolates represented 26 Salmonella serovars; the most common serovars were Cerro [(38.8%, 148/381) isolated from 21 farms], Kentucky [16.3%; 10 farms], Typhimurium [9.4%; 7 farms], Newport [7.6%; 8 farms], and Anatum [6.3%; 6 farms]. Among the 381 isolates, 90 (23.6%) were resistant to between 1 and 11 antimicrobial agents, representing 50 different antimicrobial resistance patterns. Overall, 61 XbaI-PFGE types were detected among these 381 isolates, indicating considerable Salmonella diversity on dairy farms. Fourteen PFGE types, representing 12 serovars, exactly matched PFGE types from human isolates, suggesting that subclinically infected dairy cattle could be sources of human disease-associated Salmonella.

Salmonella Cerro isolated over the past twenty years from various sources in the US represent a single predominant pulsed-field gel electrophoresis type.

Salmonella Cerro prevalence in US dairy cattle has increased significantly during the past decade. Comparison of 237 Salmonella isolates collected from various human and animal sources between 1986 and 2009 using pulsed-field gel electrophoresis, antimicrobial resistance typing, and spvA screening, showed very limited genetic diversity, indicating clonality of this serotype. Improved subtyping methods are clearly needed to analyze the potential emergence of this serotype. Our results thus emphasize the critical importance of population-based pathogen surveillance for the detection and characterization of potentially emerging pathogens, and caution to critically evaluate the adequacy of diagnostic tests for a given study population and diagnostic application.

The prevalence of multidrug resistance is higher among bovine than human Salmonella enterica serotype Newport, Typhimurium, and 4,5,12:i:- isolates in the United States but differs by serotype and geographic region.

Salmonella represents an important zoonotic pathogen worldwide, but the transmission dynamics between humans and animals as well as within animal populations are incompletely understood. We characterized Salmonella isolates from cattle and humans in two geographic regions of the United States, the Pacific Northwest and the Northeast, using three common subtyping methods (pulsed-field gel electrophoresis [PFGE], multilocus variable number of tandem repeat analysis [MLVA], and multilocus sequence typing [MLST]). In addition, we analyzed the distribution of antimicrobial resistance among human and cattle Salmonella isolates from the two study areas and characterized Salmonella persistence on individual dairy farms. For both Salmonella enterica subsp. enterica serotypes Newport and Typhimurium, we found multidrug resistance to be significantly associated with bovine origin of isolates, with the odds of multidrug resistance for Newport isolates from cattle approximately 18 times higher than for Newport isolates from humans. Isolates from the Northwest were significantly more likely to be multidrug resistant than those from the Northeast, and susceptible and resistant isolates appeared to represent distinct Salmonella subtypes. We detected evidence for strain diversification during Salmonella persistence on farms, which included changes in antimicrobial resistance as well as genetic changes manifested in PFGE and MLVA pattern shifts. While discriminatory power was serotype dependent, the combination of PFGE data with either MLVA or resistance typing data consistently allowed for improved subtype discrimination. Our results are consistent with the idea that cattle are an important reservoir of multidrug-resistant Salmonella infections in humans. In addition, the study provides evidence for the value of including antimicrobial resistance data in epidemiological investigations and highlights the benefits and potential problems of combining subtyping methods.

[Considerations on the concept of epilepsy]. / Acerca del concepto de epilepsia.

This leading article is written bearing in mind the disparities between different texts and studies on epilepsy. These concern the concept and the definition of epilepsy, although there is now little disparity in the classification of crises and syndromes. We also consider the increasing tendency to include other disorders with their own names and characteristics within the concept of epilepsy. Many of these disorders are also characterized by mental retardation, dementia and neurological deterioration. This contributes to maintain the sombre, ominous concept implicit in the world 'epilepsy' for centuries and is a major factor in the social discrimination of people with epilepsy. We suggest a concept and definition of the disorder differentiating it from epileptic crises and other processes.

[Etiological factors of epilepsy]. / Factores etiológicos de las epilepsias.

INTRODUCTION: The epilepsies are one of the main reasons for consultation and hospital admission in neurology. They may be caused by multiple factors. OBJECTIVES: To determine the types of epilepsy, their aetiology and the value of a clinical history in diagnosis of their cause. PATIENTS AND METHODS: We studied 96 epileptic patients aged over 15 years in the epilepsy clinic of the Hospital Dr. Carlos J. Finlay in La Habana, Cuba. On a questionnaire we recorded: family history, pre-, peri- and postnatal histories, clinical features of the crises and physical exploration. All had inter-ictal electroencephalograms, 62 had cranial CTs, 36 had MR studies and 8 had both types of imaging studies. We excluded acute metabolic disorders and cerebral tumours. RESULTS: There was a predominance of persons aged between 26 and 35 (78%) and 59.37% were men. Symptomatic epilepsy was seen in 51.4%, in 38.54% this was cryptogenic and in 10.41% idiopathic. Perinatal damage was present in 20.8%, head injury in 11.4%, febrile convulsion in 10.4%, meningoencephalitis in 8.3% and cardiovascular disease in 4.1%. CONCLUSIONS: The international classification of epilepsy permits our patients to be divided into groups. In most of them aetiological factors were detected after an interview and medical exploration.

Efecto de Justicia pectoralis sobre la conducta exploratoria en ratones / Efect of Justicia pectoralis about of exploratory behaviour in mice

Se estudió el efecto de extractos acuosos de Justicia pectoralis sobre la conducta exploratoria en ratones. Se encontró que las decocciones de la planta (verde y seca) y el liofilizado de la planta seca inhibieron la conducta exploratoria de forma dependiente de la dosis. Este efecto fue similar al de varios psicofármacos de referencia. Estos resultados sugieren la presencia en Justicia pectoralis de compuestos neuroactivos con propiedades sedantes

Justicia pectoralis no previne las convulciones inducidas por PTZ y PTX / Justicia pectoralis in not prevention of the comvulsions induced by PTZ and PTX

Se evaluan los efectos de extractos acuosos de Justicia pectoralis sobre las convulsiones inducidas por pentilentetrazol y picrotoxina en ratones. Se realizaron curvas dosis-efectos de estos agentes convulsivantes en ausencia y presencia de una decocción de la planta verde, de un liofilizado hidrosoluble de la planta seca y de un psicofármaco de referencia, diazepam. Se demostró que los extractos de Justicia pectoralis no protegen contra las convulsiones inducidas por los agentes convulsivantes a diferencia del diazepam. Los resultados indican que el posible efecto sedante de Justicia pectoralis no está relacionado con el mecanismo de acción de los ansiolíticos del tipo de las benzodiazepinas

Justicia pectoralis no previne las convulciones inducidas por PTZ y PTX / Justicia pectoralis in not prevention of the comvulsions induced by PTZ and PTX

Se evaluan los efectos de extractos acuosos de Justicia pectoralis sobre las convulsiones inducidas por pentilentetrazol y picrotoxina en ratones. Se realizaron curvas dosis-efectos de estos agentes convulsivantes en ausencia y presencia de una decocción de la planta verde, de un liofilizado hidrosoluble de la planta seca y de un psicofármaco de referencia, diazepam. Se demostró que los extractos de Justicia pectoralis no protegen contra las convulsiones inducidas por los agentes convulsivantes a diferencia del diazepam. Los resultados indican que el posible efecto sedante de Justicia pectoralis no está relacionado con el mecanismo de acción de los ansiolíticos del tipo de las benzodiazepinas (AU)

Efecto de Justicia pectoralis sobre la conducta exploratoria en ratones / Efect of Justicia pectoralis about of exploratory behaviour in mice

Se estudió el efecto de extractos acuosos de Justicia pectoralis sobre la conducta exploratoria en ratones. Se encontró que las decocciones de la planta (verde y seca) y el liofilizado de la planta seca inhibieron la conducta exploratoria de forma dependiente de la dosis. Este efecto fue similar al de varios psicofármacos de referencia. Estos resultados sugieren la presencia en Justicia pectoralis de compuestos neuroactivos con propiedades sedantes (AU)

Valoracion clinica, electroencefalografia y por potenciales evocados en la conmocion cerebral. Reporte preliminar. / Importance of clinical, electroencephalographic and by evoked potentials in brain concussion. Preliminary report

Se hizo un estudio prospectivo con 30 pacientes que tuvieron conmocion cerebral y con otras 20 personas como control ninguno de los cuales tenia antecedentes neurologicos. Se les hizo EEG y PEC cada seis meses con estudio clinico trimestral comprobando que cuando se observaron gran numero de asimetrias en los PEC en las primeras 24 horas, los sintomas fueron mas numerosos e intensos, con mayor probabilidad de presentar epilepsia,concluyendose que tienen valor pronostico

Granulomatosis de Wegener. Informe de un caso con lesiones oculares y revision de la literatura. / Wegener's granuloma. Report of a case with ocular lesions and literature review

Se presenta un caso con el diagnostico de granulomatosis de Wegener a forma limitada con toma ocular, se revisa la literatura y se evalua la terapeutica actual que ha mejorado considerablemente el pronostico de la entidad

Granulomatosis de Wegener. Informe de un caso con lesiones oculares y revision de la literatura. / Wegener's granuloa. Report of a case with ocular lesions and literature review

Se presenta un caso con el diagnostico de granulomatosis de Wegener a forma limitada con toma ocular, se revisa la literatura y se evalua la terapeutica actual que ha mejorado considerablemente el pronostico de la entidad

Valoracion clinica, electroencefalografia y por potenciales evocados en la conmocion cerebral. Reporte preliminar. / Iportance of clinical, electroencephalographic and by evoked potentials in brain concussion. Preliminary report

Se hizo un estudio prospectivo con 30 pacientes que tuvieron conmocion cerebral y con otras 20 personas como control ninguno de los cuales tenia antecedentes neurologicos. Se les hizo EEG y PEC cada seis meses con estudio clinico trimestral comprobando que cuando se observaron gran numero de asimetrias en los PEC en las primeras 24 horas, los sintomas fueron mas numerosos e intensos, con mayor probabilidad de presentar epilepsia,concluyendose que tienen valor pronostico

[Epilepsy: spidemiological study in a child population]. / La epilepsia: estudio epidemiológico en una población infantil.

The principal aims of this paper were to know the epidemiologic and clinical aspects of epilepsy in children and the use of an original methodology in the study of chronic illnesses. A survey was carried out through home calls by sampling an area in Havana City, Cuba; 14,445 children were studied. The sample was chosen at random by groups with proportional probabilities as to size, single stage. It was carried out by: --Detection of suspects by questioning. --Confirmation of suspects by means of a clinical exmination performed by specialists. Prevalence in children resulted in 7.5 epileptic children out of a thousand inhabitants. The lowest rate present was from 0 to 4 years of age (3.5) and the highest, from 10 to 14 (10). 39.4% of the cases had their first attack during the first year of lie. A highest rate was present was from 0 to 4 years of age (3.5) and the highest, from 10 to 14 (10). 39.4% of the cases had their first attack during the first year of life. A highest rate was present in the male sex (8.4 and lowest in females (6.5). Educational level was lower than the population's average; 37% did not attend classes, 87% of children showed generalized attacks, 48.1% were classified as having primary epilepsy (idiopathic) and 51.8% as organic (secondary). Some other clinical phenomena are also described, as well as aspects of medical care.

La docencia en el hospital / Teaching in the hospital

Se analizan algunas de las características del proceso enseñanza-aprendizaje en el hospital. Se señala la posición que ocupa el hospital dentro de la organización de salud, así como sus características; se destaca la gran importancia de la función docente y el porqué de esta importancia. Se hace referencia a las tendencias actuales del desarrollo hospitalario y se enumeran los niveles de docencia que existen en el hospital. Se analizan las relaciones entre profesores y alumnos en el proceso de enseñanza-aprendizaje y sus importantes implicaciones en el trabajo educativo y científico. Se realiza una breve revisión del aprendizaje y el comportamiento, la importancia de la educación y de la interrelación entre la teoría y la práctica y su respectiva importancia en el proceso de enseñanza-aprendizaje. Finalmente se analizan algunos aspectos de trascendencia en el enfoque clínico de los pacientes, que deben ser superados (AU)