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Abstract Background: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD. Methods: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed. Results: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD. Conclusion: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence.
Resumen Introducción: Las infecciones relacionadas con catéteres venosos centrales son unas de las infecciones asociadas a la atención de salud con mayor relevancia epidemiológica. La técnica aséptica «no tocar¼ es una práctica estandarizada que se utiliza para prevenir estas infecciones. En un hospital pediátrico, la tasa de infecciones relacionadas con catéteres venosos centrales fue de 1.92/1000 días de catéter. Sin embargo, en una de las unidades la tasa fue de 5.7/1000 días de catéter. Método: Se capacitaron enfermeras en la técnica aséptica «no tocar¼. Para la implementación se cumplieron ciclos de planificar-hacer-estudiar-actuar (PHEA). Se realizaron seguimiento de la adherencia a la técnica y vigilancia epidemiológica. Resultados: Se logró una adherencia a la técnica aséptica «no tocar¼ del 95% después de seis ciclos. La higiene de manos y la limpieza general alcanzaron un 100% de cumplimiento. La desinfección de los puertos y la recolección de material alcanzaron la menor adherencia, con un 76.2% y un 84.7%, respectivamente. La tasa de infecciones relacionadas con catéteres venosos centrales disminuyó de 5.7 a 1.26 por 1000 días de catéter. Conclusiones: La implementación de la técnica aséptica «no tocar¼ ayudó en la reducción de infecciones relacionadas con catéteres venosos centrales. La capacitación y el seguimiento continuo son clave para mantener el cumplimiento de la técnica.
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BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD. METHODS: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed. RESULTS: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD. CONCLUSION: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence.
INTRODUCCIÓN: Las infecciones relacionadas con catéteres venosos centrales son unas de las infecciones asociadas a la atención de salud con mayor relevancia epidemiológica. La técnica aséptica «no tocar¼ es una práctica estandarizada que se utiliza para prevenir estas infecciones. En un hospital pediátrico, la tasa de infecciones relacionadas con catéteres venosos centrales fue de 1.92/1000 días de catéter. Sin embargo, en una de las unidades la tasa fue de 5.7/1000 días de catéter. MÉTODO: Se capacitaron enfermeras en la técnica aséptica «no tocar¼. Para la implementación se cumplieron ciclos de planificar-hacer-estudiar-actuar (PHEA). Se realizaron seguimiento de la adherencia a la técnica y vigilancia epidemiológica. RESULTADOS: Se logró una adherencia a la técnica aséptica «no tocar¼ del 95% después de seis ciclos. La higiene de manos y la limpieza general alcanzaron un 100% de cumplimiento. La desinfección de los puertos y la recolección de material alcanzaron la menor adherencia, con un 76.2% y un 84.7%, respectivamente. La tasa de infecciones relacionadas con catéteres venosos centrales disminuyó de 5.7 a 1.26 por 1000 días de catéter. CONCLUSIONES: La implementación de la técnica aséptica «no tocar¼ ayudó en la reducción de infecciones relacionadas con catéteres venosos centrales. La capacitación y el seguimiento continuo son clave para mantener el cumplimiento de la técnica.
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Infecções Relacionadas a Cateter , Cateterismo Venoso Central , Infecção Hospitalar , Fidelidade a Diretrizes , Hospitais Pediátricos , Humanos , Infecções Relacionadas a Cateter/prevenção & controle , Infecções Relacionadas a Cateter/epidemiologia , Infecção Hospitalar/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Higiene das Mãos/normas , Higiene das Mãos/métodos , Criança , Assepsia/métodos , Desinfecção/métodosRESUMO
The tomato (Licopersicon esculentum Mill.) is considered to be one of the products with the highest demand due to its nutritional value; however, it is susceptible to infection by fungi during its pre- and postharvest stages. In this research, three commercial products (1% Citrocover, 1% Citro 80, and 0.002% Microdyn) and two coatings based on 1.0% chitosan/0.1% lime or 0.1% orange essential oils were evaluated in vitro and on Saladette tomatoes that were previously inoculated with four postharvest fungi. The application of the commercial citrus-based product Citrocover was highly effective in reducing the in vitro development of Aspergillus flavus, Fusarium oxysporum, and Colletotrichum gloeosporioides, but not Rhizopus stolonifer. The sanitizer Microdyn promoted infections with most fungi. Citrus-based products were effective in reducing infections with A. flavus in the tomatoes during storage. Overall, mycotoxin production was very low for all treatments. The use of commercial citrus-based products and coatings did not alter the weight loss, firmness, or total soluble solid contents of the treated tomatoes. The changes observed were, rather, associated with the normal ripening process of Saladette tomatoes. The commercial citrus-based products satisfactorily controlled the in vitro growth of the fungi Aspergillus flavus, Fusarium oxysporum, and Colletotrichum gloeosporioides.
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In this study, we report the carbapenemase-encoding genes and colistin resistance in Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa in the second year of the COVID-19 pandemic. Clinical isolates included carbapenem-resistant K. pneumoniae, carbapenem-resistant E. coli, carbapenem-resistant A. baumannii, and carbapenem-resistant P. aeruginosa. Carbapenemase-encoding genes were detected by PCR. Carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli isolates were analyzed using the Rapid Polymyxin NP assay. mcr genes were screened by PCR. Pulsed-field gel electrophoresis and whole-genome sequencing were performed on representative isolates. A total of 80 carbapenem-resistant E. coli, 103 carbapenem-resistant K. pneumoniae, 284 carbapenem-resistant A. baumannii, and 129 carbapenem-resistant P. aeruginosa isolates were recovered. All carbapenem-resistant E. coli and carbapenem-resistant K. pneumoniae isolates were included for further analysis. A selection of carbapenem-resistant A. baumannii and carbapenem-resistant P. aeruginosa strains was further analyzed (86 carbapenem-resistant A. baumannii and 82 carbapenem-resistant P. aeruginosa). Among carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli isolates, the most frequent gene was blaNDM (86/103 [83.5%] and 72/80 [90%], respectively). For carbapenem-resistant A. baumannii, the most frequently detected gene was blaOXA-40 (52/86, 60.5%), and for carbapenem-resistant P. aeruginosa, was blaVIM (19/82, 23.2%). For carbapenem-resistant A. baumannii, five indistinguishable pulsotypes were detected. Circulation of K. pneumoniae New Delhi metallo-ß-lactamase (NDM) and E. coli NDM was detected in Mexico. High virulence sequence types (STs), such as K. pneumoniae ST307, E. coli ST167, P. aeruginosa ST111, and A. baumannii ST2, were detected. Among K. pneumoniae isolates, 18/101 (17.8%) were positive for the Polymyxin NP test (two, 11.0% positive for the mcr-1 gene, and one, 5.6% with disruption of the mgrB gene). All E. coli isolates were negative for the Polymyxin NP test. In conclusion, K. pneumoniae NDM and E. coli NDM were detected in Mexico, with the circulation of highly virulent STs. These results are relevant in clinical practice to guide antibiotic therapies considering the molecular mechanisms of resistance to carbapenems.
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COVID-19 , Colistina , Humanos , Colistina/farmacologia , Antibacterianos/farmacologia , Escherichia coli/genética , México/epidemiologia , Pandemias , Farmacorresistência Bacteriana/genética , Testes de Sensibilidade Microbiana , COVID-19/epidemiologia , beta-Lactamases/genética , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Bactérias Gram-Negativas , Klebsiella pneumoniae , Pseudomonas aeruginosa/genéticaRESUMO
BACKGROUND: Visceral adiposity index (VAI) has been identified as a cardiometabolic risk marker in children and adolescents which reflects abdominal fat distribution. The aim of the present study was to evaluated the predictive capacity of VAI, a body shape index (ABSI), atherogenic index of plasma (AIP), and triglycerides and glucose index (TyG index) compared with classical anthropometric measurements to discriminate metabolic syndrome (MetS). METHODS: This retrospective study included 1372 individuals. Anthropometric, clinical, and biochemical measurements were used to screen the prevalence of MetS components and to calculate VAI, ABSI, TyG index, and AIP. RESULTS: The discriminatory capacity among the variables was assessed by the area under the receiver operating characteristic (ROC) curve (AUC). VAI was the variable with the highest AUC with 0.932 CI 95% (0.917-0.948), followed by AIP with 0.914 CI 95% (0.897-0.931), and TyG index with 0.889 CI 95% (0.871-0.908). CONCLUSION: VAI is a promising tool to identify MetS in the late adolescence setting. Among the novel adiposity indexes VAI, AIP, TyG index are able to determine MetS presence, while ABSI is not capable.
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Síndrome Metabólica , Adolescente , Criança , Humanos , Adulto Jovem , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Adiposidade , Estudos Retrospectivos , Circunferência da Cintura , Antropometria , Obesidade Abdominal/epidemiologia , Triglicerídeos , Índice de Massa Corporal , Gordura Intra-Abdominal/metabolismoRESUMO
Introduction: Introduction: when peripheral tissues don't respond well to insulin action, it is defined as insulin resistance (IR). Many methods and indices are available for the estimation of IR, among them the homeostasis model assessment of insulin resistance (HOMA-IR) involves fasting plasma glucose and insulin. Nevertheless, the TyG index has a methodological advantage over the HOMA-IR because it requires only measurements provided by routine laboratory tests. Aim: distribution asessment of the HOMA-IR and TyG indexes in the sample. Also, to determine the predictive capacity of HOMA-IR, using TyG cutoff point as IR-positive diagnostic test. Materials and methods: a cross-sectional analytical study with 1686 participants aged 18 to 21 years from the state of San Luis Potosí, Mexico. Anthropometric assessment involves variables of weight and height. Fasting glucose, insulin and triglyceride concentrations were quantified. In addition, a questionnaire was carried out to know the hereditary family history and the presence of noncommunicable diseases (NCDs). Student's t-test was used to assess the differences in mean statistics between males and females. A receiver operating characteristic (ROC) curve was applied to examine the potential of HOMA-IR to identify IR. Results: 56 % of the study adolescents were females and 44 % were males; mean BMI was 22.62 ± 3.21 kg/m2. In the total sample mean serum glucose, insulin, and triglyceride concentrations were 89.48 ± 9.84 mg/dL, 6.26 ± 5.04 µU/mL, and 95.64 ± 55.78 mg/dL, respectively. A prevalence of 28.2 % of IR was determined, evaluated with the cut-off points for the TyG index. Subsequently, Receiver Operator Curves (ROC) were performed to evaluate the predictive capacity of HOMA-IR. The most outstanding cut-off value was 1.08 for the HOMA-IR index, reaching a sensitivity of 66 % and a specificity of 53 %. The prevalence of HOMA-IR greater than or equal to 1.18 was 47 % in the total population, 19.3 % in males and 28.5 % in females Conclusions: HOMA-IR and TyG can be useful diagnostic parameters for the assessment of IR in late adolescence. To provide a health guide for IR, we propose that a HOMA-IR target value ≤ 1.08 should be considered.
Introducción: Introducción: cuando los tejidos periféricos tienen una incapacidad para responder a la acción de la insulina se denomina resistencia a la insulina (RI). Existen diferentes métodos para la identificación de la RI; uno de estos es el índice HOMA-IR, que utiliza los parámetros de laboratorio, glucosa e insulina en ayunas. El índice triglicéridos y glucosa (TyG) presenta la ventaja de solo necesitar análisis de laboratorio de rutina. Objetivo: evaluación de la distribución de los índices HOMA-IR y TyG en la población, así como determinar la capacidad predictiva del índice HOMA-IR utilizando el TyG como prueba diagnóstica para la RI. Materiales y métodos: estudio analítico transversal con 1686 participantes de 18 a 21 años del estado de San Luis Potosí. Se tomaron variables antropométricas de peso y talla y se cuantificó la concentración de glucosa, insulina y triglicéridos en ayuno. Además, se realizó un cuestionario para conocer los antecedentes heredofamiliares y la presencia de enfermedades no transmisibles (ENT). Para la comparación entre mujeres y hombres se realizó una prueba de la t de Student y se realizaron curvas operador receptor (COR) para determinar los valores de corte del HOMA-IR. Resultados: el 56 % de la población fueron mujeres y el 44 % hombres; la media del IMC fue de 22,62 ± 3,21 kg/m2. En la población total de estudio, la media de la concentración sérica de glucosa, insulina y triglicéridos fue de 89,48 ± 9,84 mg/dL, 6,26 ± 5,04 µU/mL y 95,64 ± 55,78 mg/dL, respectivamente. Se determinó una prevalencia del 28,2 % de la RI evaluada con los puntos de corte para el índice TyG. Posteriormente se realizaron curvas operador receptor (COR) para evaluar la capacidad predictiva del HOMA-IR. El valor de corte más destacado fue de 1,08 para el índice HOMA-IR, alcanzando una sensibilidad del 66 % y una especificidad del 53 %. La prevalencia del HOMA-IR mayor o igual a 1,18 fue del 47 % en la población total, del 19,3 % en los hombres y del 28,5 % en las mujeres. Conclusiones: los índices HOMA-IR y TyG pueden ser parámetros de utilidad diagnóstica para la valoración de la RI en la adolescencia tardía. Con el objetivo de brindar una guía de salud para la RI, proponemos que se debe considerar como objetivo un valor de HOMA-IR ≤ 1,08.
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Resistência à Insulina , Insulinas , Masculino , Feminino , Humanos , Adolescente , Glucose , Triglicerídeos , Glicemia , Estudos Transversais , México , Biomarcadores , HomeostaseRESUMO
Recent multidrug resistance in Pseudomonas aeruginosa has favoured the adaptation and dissemination of worldwide high-risk strains. In June 2018, 15 P. aeruginosa strains isolated from patients and a contaminated multi-dose meropenem vial were characterized to assess their association to an outbreak in a Mexican paediatric hospital. The strains were characterized by antibiotic susceptibility profiling, virulence factors' production, and biofilm formation. The clonal relationship among isolates was determined with pulse-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) sequencing. Repressor genes for the MexAB-OprM efflux pump were sequenced for haplotype identification. Of the strains, 60% were profiled as extensively drug-resistant (XDR), 33% as multidrug-resistant (MDR), and 6.6% were classified as sensitive (S). All strains presented intermediate resistance to colistin, and 80% were sensitive to aztreonam. Pyoverdine was the most produced virulence factor. The PFGE technique was performed for the identification of the outbreak, revealing eight strains with the same electrophoretic pattern. ST235 and ten new sequence types (STs) were identified, all closely related to ST233. ST3241 predominated in 26.66% of the strains. Twenty-five synonymous and seventeen nonsynonymous substitutions were identified in the regulatory genes of the MexAB-OprM efflux pump, and nalC was the most variable gene. Six different haplotypes were identified. Strains from the outbreak were metallo-ß-lactamases and phylogenetically related to the high-risk clone ST233.
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Mexico's obesity rates are alarming, and experts project drastic increases in the next thirty years. There is growing interest in understanding how remote acculturation and globalization processes influence health behaviors. The present study used focus group data from a central state, San Luis Potosí, in Mexico to explore mothers' perspectives on factors that influence family mealtime routines. Thematic analysis was used to identify barriers and facilitators to healthy mealtime routines and diet within families. Twenty-one mothers participated in the focus groups; 76% were full-time stay at home mothers, the majority were low-income (65%), and fewer than half reached a high school education. Three major themes emerged: (1) mothers do most of the visible work involving mealtime routines; (2) family meals are different today, and globalization is a contributing factor; and (3) family mealtimes are shifting to weekend events. Empowering mothers to negotiate diet with family members to build healthy routines, navigate challenges due to changing environments, and set family boundaries around technology use during mealtimes should be taken into consideration when promoting healthy behaviors with Mexican families.
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The fungus Aspergillus flavus causes serious damage to maize grains and its by-products, such as tortilla. Currently, animal and plant derivatives, such as chitosan and propolis, and plant extract residues, respectively, are employed as alternatives of synthetic fungicides. The objective of this research was to evaluate the efficacy of several formulations based on propolis-chitosan-pine resin extract on the in vitro growth of A. flavus, the growth of maize grain plantlets and the quality of stored tortillas at 4 and 28 °C. The most outstanding formulation was that based on 59.7% chitosan + 20% propolis nanoparticles + 20% pine resin extract nanoparticles; since the in vitro conidia germination of A. flavus did not occur, disease incidence on grains was 25-30% and in tortillas, 0% infection was recorded, along with low aflatoxin production (1.0 ppb). The grain germination and seedling growth were markedly reduced by the nanocoating application. The percentage weight loss and color of tortillas were more affected by this coating compared to the control, and the rollability fell within the scale of non-ruptured at 4 °C and partially ruptured at 28 °C. The next step is to evaluate the toxicity of this formulation.
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Aflatoxinas , Quitosana , Própole , Aflatoxinas/análise , Aspergillus flavus , Quitosana/análise , Quitosana/farmacologia , Grão Comestível/química , Extratos Vegetais/farmacologia , Própole/farmacologia , Zea mays/químicaRESUMO
The phylogeny of Tomarus Erichson, 1847 (Coleoptera: Scarabaeidae: Dynastinae: Pentodontini) was explored by parsimony using morphological characters to approach its taxonomic and nomenclature problems. The genus was not supported as a monophyletic group, and the recovered lineages did not match at all any of the previously known classifications. Three different lineages and six monophyletic groups were recovered, which could be treated as independent genera. However, the classification proposed here is as conservative as possible concerning to the creation of many new names and generic taxa. Thus, four genera are now recognized: Euligyrus Casey, 1915 new status (2 species), Ligyrus Burmeister, 1847 revised status (18 species, including Oxygrylius Casey, 1915 new synonymy), Proculigyrus new genus (1 species), and Tomarus Erichson, 1847 revised status (18 species). Three subgenera are recognized for the genus Ligyrus: Anagrylius Casey, 1915 revised status (2 species), Ligyrodes Casey, 1915 revised status (3 species), and Ligyrus revised status (13 species). A complete taxonomic treatment is presented for each genus, including descriptions, keys, and occurrence maps. A revised status is presented for the following species: Ligyrus (Ligyrus) nasutus (Burmeister, 1847), T. amazonicus (Arrow, 1914), and T. gyas Erichson, 1848. Lectotypes are designated for Bothynus neglectus LeConte, 1847, L. amazonicus Arrow, 1914, L. bryanti Rivers, 1891, Scarabeus fossor Latreille, 1813, S. relictus Say, 1825 T. gyas, T. maimon Erichson, 1847, and some synonyms of L. sallaei Bates, 1888 (Ligyrodes propinquus Casey, 1915 and Ligyrodes aztecus Casey, 1915), S. gibbosus DeGeer, 1774 (Bothynus morio LeConte, 1847, L. californicus Casey, 1909, and L. spissipes Casey, 1909), S. relictus (Ligyrodes parviceps Casey, 1915 and Ligyrodes quadripennis Casey, 1915), and S. bituberculatus Palisot de Beauvois, 1811 (Ligyrus maximus Arrow, 1913 and Ligyrus latus Arrow, 1914). Ligyrus patagonus Steinheil, 1874 is a new synonym for L. rubripes Boheman, 1858. Type species are designated for the synonyms Grylius Casey, 1915 and Ligyrellus Casey, 1915. New combinations (new combination) are presented for: Euligyrus ebenus (De Geer, 1774), E. similis (Endrödi, 1968), Ligyrus (Anagrylius) moroni (López-García & Deloya, 2019), L. (Ligyrus) paranaensis (López-García & Deloya, 2019), L. (Ligyrus) peninsularis (Casey, 1915), L. (Ligyrus) spinipenis (Neita & Ratcliffe 2017), and Tomarus amazonicus. Ligyrus (Ligyrus) allonasutus new species is described to include populations of T. nasutus from western Mexico to Panama. Phylogenetic and taxonomic value of mouthparts, elytro-tergal stridulatory apparatus, and male genitalia is discussed along with a description of the biogeographic patterns of distribution for each genus.
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Aracnídeos , Besouros , Gorgulhos , Masculino , Animais , FilogeniaRESUMO
Aspergillus flavus affects fresh and dry fruit and vegetable products, and its toxic metabolites, namely aflatoxins, cause serious damage in humans. The objective of this research study was to evaluate the effect of commercial natural products as well as edible and nanostructured chitosan coatings on the development of A. flavus and on the production of aflatoxins in vitro and in tomato. Treatments were as follows: chitosan 1%, chitosan coating, chitosan nanostructured coating, Citrocover 1% (citrus seed extract), Resinadher 0.5% (pine resin extract), mancozeb 2%, and water. The variables were as follows: halo inhibition, spore production, and aflatoxins content. In fruit, the following were evaluated: disease incidence, mycelial growth, and aflatoxin production. An ANOVA (Tukey: p < 0.05) was used. In vitro results showed that Citrocover and Resinadher reduced sporulation (0.2 and 0.9 × 105 spores mL-1, respectively), while chitosan inhibited the production of aflatoxins. With Resinadher and Citrocover, tomato fruit had the lowest incidence, mycelial growth, and aflatoxin production with corresponding values of 0%, 0.0 cm2, and 0.95 ppb, respectively, and 7%, 0.2 cm2, and 1.77 ppb, respectively. The use of Citrocover and Resinadher could be a viable alternative to decrease the development of A. flavus in tomato fruit.
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Resumen Introducción: Los gramnegativos continúan siendo los causantes de infecciones asociadas a la atención a la salud (IAAS). Material y métodos:: Analizamos la resistencia antimicrobiana de patógenos durante el 2013 vs. 2018 y lo comparamos con lo publicado en 2006 vs. 2012. Resultados: Identificamos nueve patógenos gramnegativos, de un total de 404 aislamientos, con una prevalencia en 2013 (N = 227 [0.22]) vs. 2018 (N = 177 [0.17]) y una incidencia por egresos (6,607 en el 2013 y 7,778 en el 2018) del 3.4 y 2.2% respectivamente. Destacaron tres patógenos: Klebsiella pneumoniae (129 [31.93%]), Pseudomonas aeruginosa (85 [21.03%]) y Escherichia coli (80 [19.80%]). Estos, llamados patógenos ESKAPE-E, prevalecieron como causantes de IAAS. Identificamos un aumento en los patrones de resistencia para muchos patógenos en 2018. Conclusión: La multirresistencia a patógenos ESKAPE-E es un serio problema de salud pública, por carecer de alternativas terapéuticas para enfrentar este reto. Los mapas de resistencia bacteriana ayudan en la prescripción antibiótica.
Abstract Background: Gram-negatives continue to be the cause of infections associated with health care (HCAI). Material and methods: We analyzed the antimicrobial resistance of pathogens during 2013 vs. 2018 and we compare it with what was published in 2006 vs. 2012. Results: We identified 9 gram-negative pathogens, out of a total of 404 isolates, with a prevalence in 2013 (N = 227 [0.22]) vs. 2018 (N = 177 [0.17]) and an incidence due to discharges (6,607 in 2013 and 7,778 in 2018) of 3.4 and 2.2%, respectively.Three pathogens stood out Klebsiella pneumoniae (129 [31.93%]), Pseudomonas aeruginosa (85 [21.03%]) and Escherichia coli (80 [19.80%]). These, called ESKAPE-E pathogens, prevailed as the cause of HCAI. We identified an increase in resistance patterns for many pathogens in 2018. Conclusion: Multi-resistance to ESKAPE-E pathogens is a serious public health problem, due to the lack of therapeutic alternatives to face this challenge. Bacterial resistance maps help in antibiotic prescription.
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INTRODUCTION: Background: the aim of this study was to investigate the association between birthweight, cardiovascular disease (CVD) risk factors, and depression in young Mexican adults. Methods: birthweight reports, family history of CVD and diabetes-related diseases, anthropometrics, serum lipid profile (total cholesterol [TC], triglycerides [TG], high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], and very-low density lipoprotein-cholesterol [VLDL-C]), and depressive symptoms were measured in 778 subjects of the UP-AMIGOS cohort study. To investigate the association between birthweight categories and CVD risk factors and depression, a one-way analysis of variance with post-hoc test was performed of quantitative variables, and ï£2 test for qualitative variables. Results: mean age was 17.8 years and 469 (60.3 %) of patients were female (n = 469, 60.3 %). The percentage of patients with low birthweight (LBW) was 8.1 % (n = 63), and 3.3 % (n = 26) reported high birthweight (HBW). Young adults with HBW were associated with elevated diastolic blood pressure (DBP), and high weight and body mass index (BMI) when compared to LBW subjects, the difference being statically significant (p < 0.05). Birthweight had no significant association with depression (p > 0.67). Conclusion: the findings from this population-based study revealed a positive relation between birthweight categories and some CVD risk factors. Depression was not related to birthweight.
INTRODUCCIÓN: Introducción: el objetivo de este estudio fue investigar la asociación entre el peso al nacer, los factores de riesgo de las enfermedades cardiovasculares (ECV) y la depresión en adultos mexicanos jóvenes. Métodos: se obtuvieron como variables el peso al nacer, los antecedentes heredofamiliares de ECV y diabetes, la antropometría, el perfil lipídico (colesterol total [CT], triglicéridos [TG], lipoproteína de alta densidad [C-HDL], lipoproteína de baja densidad [C-LDL] y lipoproteína de muy baja densidad [C-VLDL]) y los síntomas de depresión de 778 participantes del estudio de cohortes UP-AMIGOS. Se realizó un análisis de la varianza de 1 vía con pruebas post hoc para investigar la asociación entre las categorías de peso al nacer, riesgo ECV y depresión entre las variables cuantitativas; para las variables cualitativas se realizaron pruebas del ï£2. Resultados: la edad media fue de 17,8 años y 469 (60,3 %) de los participantes eran mujeres. El porcentaje de pacientes con bajo peso al nacer (BPN) fue del 8,1 % (n = 63) y el 3,3 % (n = 26) tenían elevado peso al nacer (EPN). Se encontró una asociación en el grupo de EPN con la elevación de la presión arterial diastólica (PAS), el peso y el índice de masa corporal (IMC) al compararlo con el grupo de BPN, con una diferencia significativa de p < 0,05. No se encontró ninguna asociación entre el peso al nacer y la depresión (p > 0,67). Conclusiones: se encontró una relación positiva entre las categorías de peso al nacer con algunos factores de riesgo de ECV. La depresión no se asoció con el peso al nacer según los resultados de este estudio poblacional.
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Peso ao Nascer , Depressão/diagnóstico , Fatores de Risco de Doenças Cardíacas , Adolescente , Antropometria/métodos , Índice de Massa Corporal , Estudos de Coortes , Correlação de Dados , Depressão/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , México/epidemiologia , Adulto JovemRESUMO
Biodegradable alternatives for the control of Aspergillus flavus in fig fruit were tested with the application of coatings based on chitosan (CS) and propolis (P). To potentiate the fungicidal effect, nanoparticles of these two (CSNPs and PNPs) were also considered. The objectives of this research were to evaluate the effect of different formulations on: (a) the ripening process of the fig, (b) the incidence of A. flavus and the production of aflatoxins, and (c) the acceptance of the treated fruit by a panel. The nanostructured coatings did not influence the ripening process of the fruit during the 12 days of storage, however, the antioxidant activity increased by approximately 30% with the coating CS + PNPs + P. The figs treated with CS + CSNPs + PNPs + P, inhibited the growth of the fungus by about 20% to 30% under laboratory and semi-commercial conditions. For all treatments, the aflatoxin production was lower than 20 ppb compared to the control with values of c.a. 250 ppb. The sensory quality was acceptable among the panel. The edible coatings can be a non-toxic alternative for post-harvest preservation and the consumption of fig fruit. The next step will be its inclusion and evaluation at a commercial level in packing houses.
RESUMO
Several perceived barriers to healthy eating within the family (e.g., cost, lack of time, energy, accessibility) are documented. However, few studies have assessed Hispanic mothers' perceived barriers and strategies in implementing healthy eating changes in the family's meals. The primary goal of this qualitative study was to investigate Mexican and Puerto Rican mothers' barriers and strategies to creating healthy eating changes within the family at home. A sample of 46 Mexican-American and Puerto Rican mothers in California, Illinois, and Texas participated in this study. An average of 5 mothers participated in a focus group session in Spanish and completed a demographic survey. Focus group thematic analysis revealed that major barriers to implementing healthy eating changes within the family include child and spouse resistance as well as meal preparation time. The resistance mothers reported encountering magnify their meal preparation workload. Mothers shared that they sometimes prepared multiple meals in a single mealtime to please family members. Several strategies to promote healthy eating at home, including serving as role models, providing easy access to healthy food items at home, and not purchasing, or hiding, unhealthy food at home, were also discussed. The current study expands the existing literature by emphasizing the need to empower parents to make healthy changes within their family and the importance of taking fathers and children into account in programming so that the whole family is involved in making healthy changes.
Assuntos
Dieta Saudável , Mães , Criança , Família , Comportamento Alimentar , Feminino , Humanos , Illinois , Masculino , Refeições , Americanos Mexicanos , México , TexasRESUMO
OBJECTIVE: This study seeks to compare and contrast barriers to engage in physical activity (PA) among Latino parents in the USA and Mexico given different cultural and environmental contents. METHODS: Four bilingual and bicultural trained research assistants conducted focus groups in Mexico and the USA RESULTS: There were 33 total participants. Twenty-one mothers were married; most participants had not completed above a high school education. Most participants were full-time stay-at-home mothers (59%). Analyses revealed several topics of discussion related to beliefs and barriers that contributed to family PA engagement: (1) walking is the most common form of PA for families in both countries; (2) parents believe people of all ages and genders can and should be physically active, but there are differences in access, opportunity, and ability; (3) major barriers to engaging in PA are different for those living in Mexico (safety concerns) than in the USA (weather constraints). CONCLUSION: These findings have implications for behavioral interventions and understanding how environmental concerns impact Latino families trying to manage healthier lifestyles. Engaging community networks and resources can be a way to combat these barriers to promote PA in all contexts.
Assuntos
Atitude Frente a Saúde , Comparação Transcultural , Planejamento Ambiental , Exercício Físico/psicologia , Família/psicologia , Hispânico ou Latino/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores Socioeconômicos , Estados Unidos/etnologiaRESUMO
OBJECTIVE: To describe the methodology of a family-focused, culturally tailored program, Abriendo Caminos, for the prevention of excess weight gain in children. DESIGN: Randomized control trial with outcome assessment at pretest, posttest, and 6 months after intervention or abbreviated-attention control group. SETTING: Community setting across 5 sites (Illinois, California, Iowa, Texas, and Puerto Rico). PARTICIPANTS: Mexican American and Puerto Rican families (parent and 1 child aged 6-18 years). A sample size of 100 families (50 intervention and 50 control) per site (nâ¯=â¯500) will provide adequate power to detect intervention effects. INTERVENTION: Families will participate in 6 weekly, 2-hour group workshops on nutrition education through combined presentations and activities, family wellness, and physical activity. MAIN OUTCOME MEASURES: The primary outcome is prevention of excess weight gain in children; secondary outcomes include changes in child diet, specifically fruit, vegetable, and sugar-sweetened beverage consumption, and changes in parents' diets and improvement of family routines. Measures will be collected at baseline, postintervention, and 6 months after. ANALYSIS: Modeling to assess changes within and between experimental groups will be checked using standard methods including assessment of model fit, influence diagnostics, adjusted R2, and multicollinearity. Significance of effects will be examined using Type III tests.
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Dieta , Exercício Físico/fisiologia , Promoção da Saúde/métodos , Adolescente , Criança , Currículo , Feminino , Hispânico ou Latino , Humanos , Masculino , Obesidade Infantil/prevenção & controle , Porto Rico , Estados Unidos , Aumento de PesoRESUMO
We provided a taxonomic synopsis of the species of the genus Tomarus Erichson, 1847 (Coleoptera: Scarabaeidae: Dynastinae: Pentodontini) of Peru. Diagnosis, illustrations, photographs, and maps are presented for each species and a taxonomic key to known species in the country is also included.
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Besouros , Animais , PeruRESUMO
ABSTRACT Introduction: Systemic Lupus Erythematosus is a relatively frequent disease of universal distribution. Its incidence varies according to the characteristics of the studied population such as age, gender and ethno. It is a chronic and autoimmune disease, which cause is not clear at all. Objective: to characterize clinically and epidemiologically the patients with systemic lupus erythematosus. Methods: A descriptive investigation of 112 patients with diagnosis of systemic lupus erythematosus assisted at Arnaldo Milián Castro University Hospital was carried out from January 2008 to December 2017. Results: patients between 30 and 39 years of age were the most representative with a higher incidence in the female sex. High blood pressure prevailed as previous history and coffee as toxic habit. There was a higher affection of the osteomyoarticular system followed by skin and mucosa. The combination of Prednisone and Azathioprine was the most used treatment. Infections were the main cause of death. Conclusions: systemic Lupus Erythematosus is present with major frequency in female young patients, with a high risk of systemic affection as well as presenting a life-threatening evolution secondary to infections(AU)
Introducción: el lupus eritematoso sistémico, es una enfermedad relativamente frecuente y de distribución universal. La incidencia varía según las características de la población estudiada, como la edad, el género y la etnia. Es una enfermedad crónica y autoinmune, cuya causa no está esclarecida del todo. Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con lupus eritematoso sistémico. Métodos: se realizó una investigación descriptiva de 112 pacientes con diagnóstico de lupus eritematoso sistémico, atendidos en el Hospital Universitario Clínico Quirúrgico Arnaldo Milián Castro, entre enero del 2008 y diciembre del 2017. Resultados: los pacientes entre 30 y 39 años de edad fueron los más representativos, con mayor incidencia en el sexo femenino. Predominó la hipertensión arterial como antecedente patológico personal y el café como hábito tóxico. Existió mayor afectación del sistema osteomioarticular seguido por piel y mucosas. La combinación de prednisona y azatioprina fue el tratamiento más usado. La principal causa de muerte fueron las infecciones. Conclusiones: el lupus eritematoso sistémico se presenta con mayor frecuencia en pacientes jóvenes y del sexo femenino, con alto riesgo de afectación sistémica así como a presentar evolución tórpida secundaria a infecciones(AU)