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RATIONALE: Understanding the migration of marine animals is hindered by the limitations of traditional tracking methods. It is therefore crucial to develop alternative methods. Stable isotope-based tracking has proven useful for this task, although it requires detailed isoscapes in the focal area. Here, we present predator-based isoscapes of the coastal zone of the Patagonian Shelf Large Marine Ecosystem (PSLME), which offers a novel tool for geolocation. METHODS: Whole-blood samples from breeding Magellanic penguins nesting at 11 colonies were used to create δ15N and δ13C isoscapes. Isotopic values were assigned to random positions inside their corresponding foraging area. Spatial analysis and data interpolation resulted in δ15N and δ13C isoscapes for the coastal zone of the PSLME, which were validated through cross-validation. RESULTS: The isoscapes mean standard error ranged from 0.05 to 0.41 for δ15N and from 0.07 to 0.3 for δ13C, similar to the error range of the mass spectrometer used for measuring isotope ratios. Predictive surfaces reflected the latitudinal trends, with δ13C and δ15N values increasing northwards. δ13C values showed a strong latitudinal gradient, while δ15N values had two distinct domains, with higher values in the north. The error surface indicated the highest certainty within 130 km from the shore and within the reported Magellanic penguin foraging areas. CONCLUSIONS: Both isoscapes revealed strong spatial variation. The δ13C isoscape showed a latitudinal gradient, consistent with patterns in other oceans. The δ15N isoscape clearly separated northern and southern colonies, likely influenced by nitrogen sources. The error obtained fell within the measurement error ranges, adding credibility to the models.
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Isótopos de Carbono , Isótopos de Nitrogênio , Spheniscidae , Animais , Spheniscidae/sangue , Isótopos de Nitrogênio/sangue , Isótopos de Nitrogênio/análise , Isótopos de Carbono/análise , Isótopos de Carbono/sangue , Espectrometria de Massas/métodos , Migração Animal , EcossistemaRESUMO
BACKGROUND: Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy. Preoperative factors are limited and controversial. This study aims to identify associated factors related to this complication in the Colombian population. METHODS: A retrospective review of a prospectively collected database was conducted. All patients over 18 years of age who underwent pancreaticoduodenectomy were included. Associations with DGE syndrome were evaluated with logistic regression analysis, Odds ratio, and b-coefficient were provided when appropriate. RESULTS: 205 patients were included. Male patients constituted 54.15% (n = 111). 53 patients (25.85%) were diagnosed with DGE syndrome. Smoking habit (OR 17.58 p 0.00 95% CI 7.62-40.51), hydromorphone use > 0.6 mg/daily (OR 11.04 p 0.03 95% CI 1.26-96.66), bilirubin levels > 6 mg/dL (OR 2.51 p 0.02 95% CI 1.12-5.61), and pancreatic fistula type B (OR 2.72 p 0.02 CI 1.74-10.00). DISCUSSION: Smoking history, opioid use (hydromorphone > 0.6 mg/Daily), type B pancreatic fistula, and bilirubin levels > 6 mg/dL should be considered as risk factors for DGE.
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Esvaziamento Gástrico , Pancreaticoduodenectomia , Complicações Pós-Operatórias , Humanos , Pancreaticoduodenectomia/efeitos adversos , Masculino , Fatores de Risco , Estudos Retrospectivos , Feminino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Pessoa de Meia-Idade , Esvaziamento Gástrico/fisiologia , Idoso , Gastroparesia/etiologia , Gastroparesia/epidemiologia , Fumar/efeitos adversos , Fístula Pancreática/etiologia , Fístula Pancreática/epidemiologia , Adulto , Bilirrubina/sangue , Analgésicos Opioides/administração & dosagemRESUMO
Methicillin-resistant Staphylococcus aureus (MRSA) constitutes an important cause for concern in the field of public health, and the role of the food chain in the transmission of this pathogen and in antimicrobial resistance (AMR) has not yet been defined. The objectives of this work were to isolate and characterize coagulase-positive Staphylococcus (CoPS) and coagulase-negative Staphylococcus (CoNS), particularly S. aureus, from school dining rooms located in Argentina. From 95 samples that were obtained from handlers, inert surfaces, food, and air in 10 establishments, 30 Staphylococcus strains were isolated. Four isolates were S. aureus, and the remaining ones (N = 26) belonged to 11 coagulase-negative species (CoNS). The isolates were tested for susceptibility to nine antibiotics. The presence of genes encoding toxins (luk-PV, sea, seb, sec, sed, and see), adhesins (icaA, icaD), and genes that confer resistance to methicillin (mecA) and vancomycin (vanA) was investigated. The resistance rates measured for penicillin, cefoxitin, gentamicin, vancomycin, erythromycin, clindamycin, levofloxacin, trimethoprim-sulfamethoxazole, and tetracycline were 73%, 30%, 13%, 3%, 33%, 17%, 13%, 7%, and 7% of the isolates, respectively. Seventeen AMR profiles were detected, and 11 isolates were multidrug resistant (MDR). Seven methicillin-resistant Staphylococcus isolates were detected in the hands of handlers from four establishments, two of them were MRSA. Two S. aureus isolates presented icaA and icaD, another one, only icaD. The gene vanA was found in two isolates. In relation to S. aureus, resistance to vancomycin but not to gentamicin was detected. School feeding plays a key role in the nutrition of children, and the consumption of food contaminated with MRSA and vancomycin-resistant S. aureus (VRSA) can be a serious threat to health. In particular, it was detected that the handlers were the source of MRSA, VRSA, MR-CoNS (methicillin-resistant coagulase-negative Staphylococcus), and MDR isolates. The results obtained indicate that the vigilance of this pathogen in school dining rooms should be extreme.
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Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Criança , Humanos , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus , Coagulase/genética , Vancomicina , Argentina , Infecções Estafilocócicas/epidemiologia , Testes de Sensibilidade Microbiana , Staphylococcus/genética , Antibacterianos/farmacologia , Instituições Acadêmicas , GentamicinasRESUMO
Shiga toxin-producing Escherichia coli (STEC) are foodborne pathogens causing severe diseases. The ability of STEC to produce disease is associated with Shiga toxin (Stx) production. We investigated the occurrence of STEC on bovine and pork carcasses and walls of trucks where they were transported, and we characterized virulence genes and serotypes of STEC strains. We compared the whole genomic sequencing of a STEC O157:H7 strain isolated from a bovine carcass in this work and a STEC O157:H7 strain isolated from a child with HUS, both isolated in 2019. We studied the relationship between these isolates and others collected in the database. The results show a 40% of STEC and two different serogroups were identified (O130 and O157). STEC O157:H7 were isolated from bovine carcasses and harbored stx2, eae, ehxA, katP, espP, stcE, ECSP_0242/1773/2687/2870/2872/3286/3620 and were classified as lineage I/II. In STEC non-O157 isolates, three isolates were isolated from bovine carcasses and harbored the serogroup O130 and one strain isolated from pork carcasses was O-non-typeable. All STEC non-O157 harbored sxt1 gene. The analysis from the whole genome showed that both STEC O157:H7 strains belonged to the hypervirulent clade 8, ST11, phylogroup E, carried the allele tir 255 T > A T, and they were not clonal. The analysis of information allows us to conclude that the STEC strains circulate in pork and bovine carcasses arriving in transport. This situation represents a risk for the consumers and the need to implement an integrated STEC control in the food chain.
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Infecções por Escherichia coli , Escherichia coli O157 , Proteínas de Escherichia coli , Carne de Porco , Carne Vermelha , Escherichia coli Shiga Toxigênica , Criança , Animais , Bovinos , Humanos , Suínos , Escherichia coli Shiga Toxigênica/genética , Proteínas de Escherichia coli/genética , Escherichia coli O157/genética , Infecções por Escherichia coli/veterináriaRESUMO
PURPOSE: Thoracic endovascular aortic repair (TEVAR) has been described to be superior to an open surgical approach, and previous studies have found superiority in TEVAR by reducing overall morbidity and mortality rates. This study aimed to describe the outcomes of TEVAR for patients with thoracic aortic disease at a high complexity. MATERIALS AND METHODS: Descriptive study, developed by a retrospective review of a prospectively collected database. Patients aged above 18 years who underwent TEVAR between 2012 and 2022 were included. Patient demographics, perioperative data, surgical outcomes, morbidity, and mortality were described. Statistical and multivariate analyses were made. Statistical significance was reached when p values were <0.05. RESULTS: A total of 66 patients were included. Male patients were 60.61% and the mean age was 69.24 years. Associated aortic diseases were aneurysms (68.18%), ulcer-related (4.55%), intramural-related hematoma (7.58%), trauma-related pathology (1.52%), and aortic dissection (30.30%). The mean hospital stay was 18.10 days, and intensive care unit was required for 98.48%. At 30 days, the mortality rate was 10.61% and the reintervention rate was 21.21%. Increased intraoperative blood loss (p=0.001) and male sex (p=0.04) showed statistical relationship with mortality. Underweight patients have 6.7 and 11.4 times more risk of complications and endoleak compared with higher body mass index values (p=0.04, 95% confidence interval [CI]=0.82-7.21) and (p=0.02, 95% CI=1.31-12.57), respectively. CONCLUSION: Thoracic endovascular aortic repair seems to be a feasible option for patients with thoracic aortic pathologies, with adequate rates of mortality and morbidity. Underweight patients seem to have an increased risk of overall morbidity and increased risk for endoleak. Further prospective studies are needed to prove our results. CLINICAL IMPACT: Obesity and BMI are widely studied in the surgical literature. According to our study, there is a paradox regarding the outcomes of patients treated with TEVAR in terms of postoperative complications and mortality related to the body mass index. And shouldn't be considered as a high-risk feature in terms of postoperative morbidity and mortality in this procedure.
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INTRODUCTION: Anisakiasis is a human parasitic disease caused by the consumption of raw fish or shellfish containing larvae of the Anisakidae family. It is currently considered an emerging disease of public health interest. OBJECTIVE: To identify the presence of larvae of the Anisakidae family in samples of frozen raw fish fillets intended for human consumption in markets in Medellín and its metropolitan area in Antioquia, Colombia. MATERIALS AND METHODS: A cross-sectional study was carried out, in which larvae of the Anisakidae family were detected and identified in frozen raw fish fillets from three representative markets in Medellín and its metropolitan area. A total of 384 ready for consumption fillets were analyzed (197 sawfish, 137 salmon, 37 tuna, and 13 hake), using the pressing and ultraviolet light method. Taxonomic keys were used to identify the collected parasites and to establish its genus. Conventional PCR and Sanger sequencing was performed to determine the species. RESULTS: Four larvae were found in 4 of the 384 (1.04%) fillets (CI95% 1.04 ± 1.01%). The species of fish in which the larvae were found was sawfish (Scomberomorus spp.) and the genus and species of the larvae was established as Anisakis pegreffii. CONCLUSIONS: According to the study, the presence of Anisakis parasites in frozen raw fish fillets in the influence area is evident.
Introducción. La anisakiasis es una infección producida por parásitos de la familia Anisakidae, transmitida a los humanos por el consumo de pescado o mariscos crudos. En la actualidad, se considera una enfermedad emergente de interés en salud pública. Objetivo. Identificar la presencia de larvas de la familia Anisakidae en muestras de filetes de pescado crudo congelado destinados a consumo humano, en mercados de Medellín y su área metropolitana en Antioquia (Colombia). Materiales y métodos. Se realizó un estudio transversal, en el cual se buscó la presencia de larvas de la familia Anisakidae en filetes de pescado crudo congelado de tres mercados representativos de Medellín y su área metropolitana. Se analizaron 384 filetes listos para el consumo (197 sierras, 137 salmones, 37 atunes y 13 merluzas). Cada filete fue analizado mediante el método de prensado y luz ultravioleta. Los parásitos recolectados se identificaron a partir de claves taxonómicas para establecer el género, así como PCR convencional y posterior secuenciación Sanger, para determinar la especie. Resultados. Se encontraron 4 larvas en 4 de los 384 filetes (1,04 %) (IC95% 1,04 ± 1,01 %). Las larvas encontradas fueron identificadas como Anisakis pegreffi y el tipo de pescado en el cual se encontraron fue la sierra (Scomberomorus spp.). Conclusiones. De acuerdo con el estudio realizado, se evidencia la presencia de parásitos anisákidos en filetes de pescado crudo congelado en el área de influencia.
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Anisaquíase , Anisakis , Parasitos , Animais , Humanos , Estudos Transversais , Anisaquíase/veterinária , Peixes/parasitologia , LarvaRESUMO
BACKGROUND: Chronic pancreatitis is an inflammatory disease characterized by irreversible morphological changes due to chronic pancreatic fibrosis. The treatment goals are to relieve pain, preserve function, and prevent further pathological consequences. Endoscopic treatment, surgery, or both are options for untreatable pain or suspected malignancy. Frey procedure is a reasonable surgical intervention because of its hybrid character, combining resection and drainage. Unfortunately, there is limited information about the outcomes of this procedure in Latin America, and few cases described in Colombia. This study aims to describe the experience of a pancreatic surgery reference center in the management of patients undergoing Frey's surgery for chronic pancreatitis. METHODS: A retrospective review of a prospectively collected database of patients who underwent a Frey procedure due to chronic pancreatitis between January 2014 to February 2022 in a hospital in Bogotá, Colombia, was made. A demographic, clinical, and postoperative outcome description was performed. Mann-Whitney Willcoxon test was performed between operative variables and long-term outcomes. RESULTS: Eighteen patients met the inclusion criteria. 55.5% of patients were male. Chronic pancreatitis etiology in most cases (83.3% n = 15) was idiopathic. The median duration of symptoms and chronic pancreatitis diagnosis before surgery was 6.15 months (IQR 5;97). Overall morbidity was 38.88%. One patient died at 30 days of follow-up. The median follow-up time was 42.5 (IQR 19;65 months). The median pain reduction was 3 points according to the visual analog score. Six patients were diagnosed with malignant conditions after surgery (mean 27.8 ± 7.5 months). Wirsung's duct size was statistically related with malignancy presentation after Frey's procedure (Z = 2.54; P = 0.01). CONCLUSION: According to our data, Frey's procedure remains safe and feasible, with acceptable outcomes in terms of pain relief and pancreatic function. The study confirms the importance of a longstanding follow-up due to an inherent risk of pancreatic malignancy. Our data suggest that pancreatic duct size could be related with the malignancy diagnosis after Frey's procedure; however, further prospective studies with a larger sample size would be helpful to confirm these results.
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Pancreatopatias , Pancreatite Crônica , Humanos , Masculino , Feminino , Estudos Prospectivos , Pancreatite Crônica/cirurgia , Pâncreas , DorRESUMO
Background: Acute pancreatitis is one of the most common gastrointestinal diseases. Approximately 20% of the patients develop peripancreatic collections. Step-up management it's now the best approach with less rate of morbidity and mortality compared with open or minimally invasive surgery. Percutaneous management could reach a success rate between 50 and 76%. Our study shows the outcomes of trans-gastric versus transabdominal percutaneous drainage in cases of acute peripancreatic fluid infected collections in the absence of interventionist endoscopy. Methods: A retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent percutaneous drainage between January 2010-December 2021 were included. Analysis and description of outcomes such as mortality, complications, and avoidance of surgical procedures was performed. Results: 18 patients underwent percutaneous drainage. 66.67% of patients were male. Mean age was 52.55 ± 22.06 years. Mean weight was 74.43 ± 15.25 kg. Mean size of peripancreatic collections 118.4 ± 49.12 mm. Wall-off necrosis was present in 33.33%. Trans-gastric approach was performed in 50% of the cases, the rest was trans-abdominal. No mortality was evidenced after 30 days of follow up. After trans-gastric percutaneous drainage, all patients avoided surgical open or laparoscopic procedure. Conclusion: Standardized step-up approach shows increased rates of success in percutaneous drainage of peripancreatic collections. Our case series shows a high rate of success in terms of avoidance any surgical procedure with no mortality after trans-abdominal and trans-gastric percutaneous drainage. Nevertheless, further prospective studies with higher sample size are needed.
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We aimed to compare the genetic diversity existing in VTEC O157:H7 strains isolated from cases of human disease from Argentina and Chile. For it, 76 strains were studied in relation to the distribution of genes encoding virulence factors and subtyped by lineage-specific polymorphisms (LSPA-6), and phylogroups assignment. Our results show the almost exclusive circulation of VTEC O157:H7 isolates belonging to lineage I/II, associated with hypervirulent strains, and to the phylogroup E and, on the other hand, genetic diversity present among Argentinean and Chilean strains analyzed, mainly in relation to putative virulence determinants and nle profiles.
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Infecções por Escherichia coli , Escherichia coli O157 , Argentina , Chile , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/genética , Humanos , Fatores de Virulência/genéticaRESUMO
El objetivo del presente estudio es presentar una revisión de la literatura disponible, que permita abordar de forma ordenada la evidencia actual con respecto a la organización de un servicio de cirugía ortopédica y traumatología durante la pandemia por covid-19, el manejo de los pacientes y las medidas de protección para el personal de salud involucrado. Se realizó una búsqueda de literatura en bases de datos (PUBMED y Scielo), instituciones gubernamentales de salud y sociedades científicas. Los autores seleccionaron los artículos que consideraron pertinentes para la presente revisión. Se plantean recomendaciones para los distintos escenarios de la práctica ortopédica: consulta externa, hospitalización, cirugía (electiva y de urgencias) y urgencias; así como recomendaciones específicas para algunas subespecialidades (cirugía de columna, cirugía de mano y ortopedia pediátrica).
In this study, we review current evidence on how to organize an orthopaedic's department during the covid-19 pandemic, how to manage patients and how to protect health personnel. We executed these search in PUBMED, Scielo, government health agencies and scientific associations databases. We selected articles based on relevance. We made recommendations for different scenarios of orthopedic practice: outpatient clinic, inpatient care, surgery (elective and emergency) and emergency department. We also made recommendatios for some orthopaedic subspecialties, including spinal surgery, hand surgery and pediatric orthopaedics.
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Humanos , COVID-19 , Pacientes , TraumatologiaRESUMO
Shiga toxin-producing Escherichia coli (STEC) is a zoonotic foodborne pathogen associated with hemolytic uremic syndrome (HUS) that vary in their ability to cause disease in humans. STEC represents a serious problem for public health and Argentina is the country with the highest HUS incidence worldwide. Non-LEE effector (nle) genes, present on pathogenicity islands (PAIs), encode translocated substrates of the type III secretion system (T3SS), which could have an important role in STEC virulence. Particularly, nleB is one of the main effector genes proposed as a virulence marker that is involved in the action of T3SS during the STEC infection. NleB inhibits the inflammatory response of the host cell allowing the bacteria to persist in the first stage of the infection. In order to identify the potential risk of STEC strains for public health, the aim of this study was to evaluate and compare basal nleB transcription of 24 STEC strains belonging to 10 serotypes isolated from cattle, food and patients. The results showed differences in nleB transcription among strains. Some non-O157:H7 strains presented transcription levels above the control, an O157:H7 HUS-producing strain. On the other hand, no significant differences were found in basal transcription levels associated with origin or serotype but differences were found between HUS and non-HUS strains. These differences in nleB transcription may be of importance in STEC pathogenesis and could help to differentiate high and low virulence STEC strains.
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Relato de caso: Relatar um caso de canal acessório do Canalis Sinuosos, localizado por palatino à raiz do dente 21 que, na radiografia panorâmica, foi observada como uma área radiolúcida sobreposta aos terços médio-apical dente 21, indicando reabsorção radicular, sendo indispensável uma investigação acurada por tomografia computadorizada de feixe cônico (TCFC). Conclusão: A TCFC se mostrou eficiente na identificação do Canalis Sinuosos em relação à radiografia panorâmica, possibilitando um correto diagnóstico para o caso.
Case report: This report describes a case of Canalis sinuosus accessory canal, lingually to the root of the tooth 21, that was observed on panoramic radiograph as a radiolucent area superimposed over the middle and apical thirds, indicating root resorption. However, cone-beam computed tomography (CBCT) recommended for an accurated diagnosis of the case disclose the presence of this anatomic variation. Conclusion: CBCT was more accurate in detection of Canalis sinuosus than panoramic radiography.
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Nervo Maxilar , Tomografia Computadorizada de Feixe Cônico , Variação AnatômicaRESUMO
Shiga toxin-producing Escherichia coli (STEC) are important foodborne pathogens that can cause severe disease. The ability to adhere to epithelial cells is an important virulence trait and pathogenicity islands (PAIs) play an important role. Recently, researchers identified a member of the Heat-resistant agglutinin family and characterized this antigen named Hemagglutinin from Shiga toxin-producing E. coli (Hes). More importantly, they showed that hes and other genes such as iha, pagC and agn43 were integrated in each of the four modules present in the new PAI named Locus of Adhesion and Autoaggregation (LAA) whose presence is associated with severe disease linked to with LEE-negatives STEC. The distribution of LAA among STEC strains isolates from different origins between 2000 and 2015 from cattle, the farm environment, and food and harboring diverse virulence was investigated. The STEC strains were characterized by PCR to detect three modules of LAA and agn43 (as marker of module IV), and phylogenetic groups were determined. LAA was found in 46% of LEE-negative STEC corresponding to serogroups O91, O174, O113, O171, O178, O130 and others. The presence of this PAI is associated with strains harboring stx2 (56%) and belonging to phylogroup B1 (91%). LAA is a novel pathogenicity island associated with strains isolated from Hemolytic Uremic Syndrome cases. Therefore, the results of this study contribute to a better understanding regarding the pathogenicity of this emergent subset of STEC strains harboring LAA as a predictor of virulence of LEE-negative STEC strains.
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Proteínas de Escherichia coli/genética , Ilhas Genômicas/genética , Fosfoproteínas/genética , Sorotipagem , Escherichia coli Shiga Toxigênica/genética , Fatores de Virulência/genética , Adesinas de Escherichia coli/genética , Animais , Animais Domésticos , Argentina , Proteínas de Bactérias/genética , Bovinos , Análise por Conglomerados , Escherichia coli/genética , Escherichia coli/patogenicidade , Infecções por Escherichia coli/veterinária , Marcadores Genéticos , Genoma Bacteriano , Hemaglutininas , Filogenia , Toxina Shiga I/genética , Toxina Shiga II/genética , VirulênciaRESUMO
We wish to make the following correction to the paper by Soledad-Cadona et al.[...].
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Shiga toxin-producing Escherichia coli (STEC) are foodborne pathogens associated with outbreaks and hemolytic-uremic syndrome. Cattle and meat foods are the main reservoir and infection source, respectively. Pathogenicity islands (PAIs) play an important role in STEC pathogenicity, and non-locus of the enterocyte effacement(LEE) effector (nle) genes present on them encode translocated substrates of the type III secretion system. A molecular risk assessment based on the evaluation of the nle content has been used to predict which STEC strains pose a risk to humans. The goal was to investigate the distribution of the PAIs OI (O-island)-36 (nleB2, nleC, nleH1-1, nleD), OI-57 (nleG2-3, nleG5-2, nleG6-2), OI-71 (nleA, nleF, nleG, nleG2-1, nleG9, nleH1-2) and OI-122 (ent/espL2, nleB, nleE, Z4321, Z4326, Z4332, Z4333) among 204 clinical, food and animal isolates belonging to 52 non-O157:H7 serotypes. Differences in the frequencies of genetic markers and a wide spectrum of PAI virulence profiles were found. In most LEE-negative strains, only module 1 (Z4321) of OI-122 was present. However, some unusual eae-negative strains were detected, which carried other PAI genes. The cluster analysis, excluding isolates that presented no genes, defined two major groups: eae-negative (determined as seropathotypes (SPTs) D, E or without determination, isolated from cattle or food) and eae-positive (mostly identified as SPTs B, C, or not determined).
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BACKGROUND & OBJECTIVES: : The presence of Babesia spp in humans, bovine cattle and ticks (the transmitting vector) has not been well characterized in Colombia. Babesia infection in humans can be overlooked due to similarity of the disease symptoms with malaria specially in the regions where malaria is endemic. The aim of the present work was to study the frequency of Babesia infection in humans, bovines and ticks in a malaria endemic region of Colombia, and explore the possible relationship of infection with host and the environmental factors. METHODS: : A cross-sectional study was carried out between August 2014 and March 2015 to determine the frequency of B. bovis and B. bigemina infection in a sample of 300 humans involved in cattle raising, in 202 bovines; and in 515 ticks obtained from these subjects, using molecular (PCR), microscopic and serological methods. In addition, the demographic, ecological and zootechnical factors associated with the presence of Babesia, were explored. RESULTS: : In the bovine population, the prevalence of infection was 14.4% (29/202); the highest risk of infection was found in cattle under nine months of age (OR = 23.9, CI 8.10-94.30, p = 0.0). In humans, a prevalence of 2% (6/300) was found; four of these six cases were positive for B. bovis. Self-report of fever in the last seven days in the positive cases was found to be associated with Babesia infection (Incidence rate ratio = 9.08; CI 1.34-61.10, p = 0.02). The frequency of B. bigemina infection in the collected ticks was 18.5% (30/162). INTERPRETATION & CONCLUSION: : The study established the presence of Babesia spp in humans, bovines and ticks. The most prevalent species responsible for babesiosis in humans and bovines was B. bovis, while B. bigemina was the species most frequently found in the tick population. The results contribute to the knowledge of the epidemiology of babesiosis in the country and can provide guidelines for the epidemiological surveillance of this non-malarial febrile illness in humans as well as cattle.
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Babesia/isolamento & purificação , Babesiose/epidemiologia , Doenças Endêmicas/estatística & dados numéricos , Malária/epidemiologia , Carrapatos/parasitologia , Adulto , Animais , Bovinos , Colômbia/epidemiologia , Estudos Transversais , DNA de Protozoário/genética , Vetores de Doenças , Meio Ambiente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Infestações por Carrapato/epidemiologiaRESUMO
The aim of this study was to investigate the prevalence of diarrheagenic E. coli strains in vegetables from the humid Pampa region, Argentina, and to determine the occurrence of serotypes and virulence genes in the isolates. A total of 373 fresh vegetable samples obtained from 41 different geographical points were examined. E. coli was detected in 38.6% of the samples. Ten isolates could be obtained from 14 samples presumptively positive for diarrheagenic E. coli: 8 were identified as atypical Enteropathogenic E. coli (aEPEC) and 2 as Verocytotoxigenic E. coli (VTEC). Lettuce and beet were the vegetables most frequently contaminated with pathogenic E. coli. The isolates belonged to serotypes O1:H7, O28:H19, O39:H40, O86:H31, O132:H8, O139:H20, O178:H7 and O178:H19, some of which reportedly have caused human illness, and one isolate resulted non typeable. Taking into account the distribution of 16 nle genes, 7 profiles were detected. On the other hand, all tested isolates harbored the gene encoding for the adhesin HcpA. Other adhesion related genes were also identified: ecpA and elfA were detected in 90%, lpfA0113 in 60%, and ehaA in 50% of the isolates meanwhile ihaA was only observed in O178:H19 isolate. This VTEC isolate harbored, also, Cdt-V toxin and megaplasmid encoding genes such as espP, subA and epeA and exhibited a strong cytotoxic effect. These data is the first molecular E. coli report that confirms the presence of E. coli pathotypes circulating among vegetables in Argentina. Genetic characterization showed that in addition to eae or vtx genes, isolates obtained from vegetables harbored genes encoding other toxins, adhesins, and components related to the type III secretion system that could contribute to their virulence. In conclusion, this research shows that vegetables in Argentina may be the source of VTEC and EPEC infections in the community and therefore, they should be considered as vehicles for transmission of these potentially pathogenic bacteria.
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Diarreia/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/isolamento & purificação , Contaminação de Alimentos/análise , Verduras/microbiologia , Adesinas Bacterianas/genética , Adesinas Bacterianas/metabolismo , Argentina , Escherichia coli/classificação , Escherichia coli/genética , Escherichia coli/metabolismo , Proteínas de Escherichia coli/genética , Proteínas de Escherichia coli/metabolismo , Humanos , Sorogrupo , Sorotipagem , Fatores de Virulência/genética , Fatores de Virulência/metabolismoRESUMO
Dentistry is interested in identifying and controlling adverse events, understood as involuntary injuries to the patient during dental care. The aim of this study was to analyze the adverse events reported to the Office of the Clinical Director at the School of Dentistry at Pontificia Universidad Javeriana (Colombia) during 2011-2012. It was an observational, descriptive study that evaluated 227 dental clinical records of patients who filed a complaint with the Office of the Clinical Director. Of these, 43 were adverse events and were used as the basis for this study. Of the 16,060 patients who received care during 2011 - 2012, 0.26% (43) filed a complaint involving an adverse event, of which 97.7 % were considered preventable. Most of these (76.18%, n= 32) occurred during clinical management of treatments in different specialties, 9.5% (4) were the result of deficient external dental laboratory quality, and 14.32% (6) were due to failure in document management, soft tissue injury, misdiagnosis and swallowing foreign objects. Of the patients involved, 65.2% (28) received care from postgraduate students, with the highest number of cases in the Oral Rehabilitation speciality. The occurrence of adverse events during dental care, indicates the need for information about their origin in order to establish protection barriers and prevent their incidence, particularly in the educational area under the student dental clinic service model.
En odontología existe interés por identificar y controlar los eventos adversos, entendidos como las lesiones no voluntarias que ocurren durante la atención odontológica. El objetivo de este estudio fue analizar los eventos adversos reportados a Dirección de Clínicas de la Facultad de Odontología de la Pontificia Universidad Javeriana durante el periodo 2011-2012. Se realizó un estudio observacional descriptivo para el que se evaluaron 227 historias clínicas de pacientes que reportaron una queja a la Dirección de Clínicas, de las cuales en 43 se evidenció la presencia de eventos adversos, a partir de las cuales se registró la información analizada en este estudio. De los 16.060 pacientes atendidos durante el periodo 2011 y 2012, el 0,26% (43) formularon alguna queja que resultó en un evento adverso, de los cuales el 97,7 % se consideraron prevenibles. El mayor porcentaje 76,18 % (32) se presentó durante la gestión clínica de tratamientos en diferentes áreas. El 9,5 % (4), se debieron a fallas en la calidad del trabajo del laboratorio externo; el 14,32% (6) correspondió a eventos generados por fallas en la gestión documental, lesiones de tejidos blandos, fallas de diagnóstico y deglución de objetos extraños. El 65,2 % (28) de los pacientes fueron atendidos por estudiantes de posgrado, con el mayor número de casos en la especialidad de Rehabilitación Oral. La presentación de eventos adversos durante el proceso de atención en odontología, es indicador de la necesidad de conocer su origen para establecer barreras de protección y prevenir su incidencia, especialmente en el área formativa bajo el modelo de atención docencia servicio.
Assuntos
Assistência Odontológica , Erros Médicos/estatística & dados numéricos , Gestão de Riscos/estatística & dados numéricos , Faculdades de Odontologia , Adulto , Colômbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Verotoxin-producing E. coli (VTEC) O157:H7 is the dominant serotype isolated from patients with HUS and, Argentina has the highest rate of HUS in the world. Molecular typing had allowed to identify subpopulations related to the origin and virulence of O157:H7 strains. Our aim was to perform a genetic characterization of 43 O157:H7 strains isolated in Argentine mostly from cattle and humans in order to establish the potential public health risk. For it, we used a combination of molecular subtyping methods in order to identify clade 8_rhsA (C3468G), LSPA-6 and virulence profiles and, a cytotoxicity assay on Vero cell. All isolates carried the clade 8 SNP variant and 98% of them belonged to lineage I/II (2% lineage II). Isolates were grouped into eleven nle profiles, 46% were positive for all nle genes, while the remaining isolates, except two, showed incomplete OI-71, particularly lacked nleF. All isolates showed the plasmid profile ehxA-espP-katP-stcE and harbored ehaA, elfA, iha and lpfA variants lpfA1-3 and lpfA2-2 and, ECSP_0242. The frequencies of the remaining ECSP genes were 95% ECSP_2687, 88% ECSP_3286, 86% ECSP_3620, 53% ECSP_2870/2872 and 44% ECSP_1733. All O157:H7 strains, except the isolate identified as lineage II, were cytotoxic on Vero cells. Among Argentinean strains, most genetic markers occur at equal relative frequencies among clinical and bovine isolates, showing diversity mostly in nle genes profiles. The belonging of the isolates to hypervirulent clade 8 and lineage I/II, the high prevalence of nle and putative virulence factors genes, would allow assigning most O157:H7 strains of this region a high risk to public health.
Assuntos
Doenças dos Bovinos/microbiologia , Escherichia coli O157/fisiologia , Proteínas de Escherichia coli/genética , Síndrome Hemolítico-Urêmica/microbiologia , Toxinas Shiga/biossíntese , Animais , Argentina/epidemiologia , Aderência Bacteriana/genética , Bovinos , Doenças dos Bovinos/epidemiologia , Análise por Conglomerados , Escherichia coli O157/classificação , Genótipo , Síndrome Hemolítico-Urêmica/epidemiologia , Humanos , Fenótipo , Plasmídeos/genética , Virulência/genética , Fatores de Virulência/genéticaRESUMO
Dentistry is interested in identifying and controlling adverseevents, understood as involuntary injuries to the patient duringdental care. The aim of this study was to analyze the adverse eventsreported to the Office of the Clinical Director at the School ofDentistry at Pontificia Universidad Javeriana (Colombia) during20112012. It was an observational, descriptive study thatevaluated 227 dental clinical records of patients who filed acomplaint with the Office of the Clinical Director. Of these, 43were adverse events and were used as the basis for this study. Ofthe 16,060 patients who received care during 2011 2012, 0.26%(43) filed a complaint involving an adverse event, of which 97.7 %were considered preventable. Most of these (76.18%, n= 32)occurred during clinical management of treatments in differentspecialties, 9.5% (4) were the result of deficient external dentallaboratory quality, and 14.32% (6) were due to failure in documentmanagement, soft tissue injury, misdiagnosis and swallowingforeign objects. Of the patients involved, 65.2% (28) received carefrom postgraduate students, with the highest number of cases inthe Oral Rehabilitation speciality. The occurrence of adverseevents during dental care, indicates the need for information abouttheir origin in order to establish protection barriers and preventtheir incidence, particularly in the educational area under thestudent dental clinic service model.
En odontología existe interés por identificar y controlar loseventos adversos, entendidos como las lesiones no voluntarias que ocurren durante la atención odontológica. El objetivo de este estudio fue analizar los eventos adversos reportados a Dirección de Clínicas de la Facultad de Odontología de la Pontificia Universidad Javeriana durante el periodo 20112012.Se realizó un estudio observacional descriptivo para el que se evaluaron 227 historias clínicas de pacientes que reportar onuna queja a la Dirección de Clínicas, de las cuales en 43 se evidenció la presencia de eventos adversos, a partir de las cualesse registró la información analizada en este estudio. De los16.060 pacientes atendidos durante el periodo 2011 y 2012, el0,26% (43) formularon alguna queja que resultó en un evento adverso, de los cuales el 97,7 % se consideraron prevenibles. Elmayor porcentaje 76,18 % (32) se presentó durante la gestión clínica de tratamientos en diferentes áreas. El 9,5 % (4), sedebieron a fallas en la calidad del trabajo del laboratorio externo; el 14,32% (6) correspondió a eventos generados porfallas en la gestión documental, lesiones de tejidos blandos, fallas de diagnóstico y deglución de objetos extraños. El 65,2 %(28) de los pacientes fueron atendidos por estudiantes de posgrado, con el mayor número de casos en la especialidad de Rehabilitación Oral. La presentación de eventos adversos durante el proceso de atención en odontología, es indicador dela necesidad de conocer su origen para establecer barreras deprotección y prevenir su incidencia, especialmente en el área formativa bajo el modelo de atención docencia servicio.