Development of a quantitative risk assessment of bovine viral diarrhea virus and bovine herpesvirus-1 introduction in dairy cattle herds to improve biosecurity.

A quantitative risk assessment model was developed to estimate the annual probability of introducing bovine viral diarrhea virus (BVDV) and bovine herpesvirus 1 (BoHV-1) at the farm level through animal movements. Data from 2017 official animal movements, biosecurity questionnaires, scientific literature, and expert opinion from field veterinarians were taken into consideration for model input parameters. Purchasing or introducing cattle, rearing replacement heifers offsite, showing cattle at competitions, sharing transport vehicles with other herds, and transporting cattle in vehicles that have not been cleaned and disinfected were considered in the model. The annual probability of introducing BVDV or BoHV-1 through infected animals was very heterogeneous between farms. The median likelihoods of BVDV and BoHV-1introduction were 12 and 9%, respectively. Farms that purchased cattle from within their region (i.e., local movements) and shared transport with other farms had a higher probability for BVDV and BoHV-1 introduction. This model can be a useful tool to support decision-making on biosecurity measures that should be prioritized to reduce the probability of introduction of these 2 diseases in dairy herds.

Short communication: Risk factors associated with Mycobacterium avium ssp. paratuberculosis introduction into dairy herds in Galicia, northwestern Spain.

This study assessed potential risk factors associated with introduction of Mycobacterium avium ssp. paratuberculosis (MAP) into dairy cattle herds in the Galicia region, northwestern Spain. The study was carried out with data collected from 93 dairies enrolled in a voluntary MAP control program. Information on potential risk factors was obtained through personal interviews with the farmers and veterinarians in charge of the control program of each farm. In addition, blood samples were taken annually over 2 years from cows on the farms in the program, and analyzed with a commercial ELISA to detect antibodies to MAP. Fecal samples of all ELISA-positive cows were analyzed using PCR. Based on χ2 test and Fisher's exact test, purchase practices, shared manure truck, shared materials, and visitors per month who contacted animals were found to be significantly associated with farm MAP infection status. Multiple logistic regression indicated that purchase practices and herd size (included as a potential confounder) are the variables that best predict MAP status.

Quantitative risk assessment of introduction of BVDV and BoHV-1 through indirect contacts based on implemented biosecurity measures in dairy farms of Spain.

A stochastic quantitative risk assessment model was developed to estimate the annual probability of introduction of bovine viral diarrhea virus (BVDV) and bovine herpesvirus 1 (BoHV-1) on 127 dairy farms through indirect contacts. Vehicles transporting calves, cattle to slaughterhouse, dead animals, and mixture of feed, as well as visits by veterinarians and hoof trimmers, farm workers and contacts with neighbors were considered in the model. Data from biosecurity questionnaires of each farm, scientific literature and expert opinion from field veterinarians, animal vehicle drivers, hoof trimmers and personnel from rendering transport companies were used to estimate values for input parameters. Results showed that the annual probability of introducing BVDV or BoHV-1 through indirect contacts was very heterogeneous. The overall distribution of median values for each farm ranged from 0.5 to 14.6% and from 1.0 to 24.9% for BVDV and BoHV-1, respectively. The model identified that providing protective clothing and boots to visits, not allowing the animal vehicle driver to come into contact with animals present on the farm and ensuring that calf vehicles arrived empty, were the measures with the highest impact on the probability of infection for most farms. This model could be a useful tool to show the impact of the measures to farmers and veterinarians, thus increasing their awareness on biosecurity. In addition, it could support decision making on which measures should be prioritized in dairy cattle herds to reduce the probability of introduction of diseases.

[Analysis of good animal husbandry practices and their epidemiological application]. / Análisis de las buenas prácticas ganaderas y su aplicación epidemiológica.

A comparative analysis was made of 229 technical specifications for 33 good animal husbandry practices relating to 10 spheres defined by two international organisations and Chile's Agriculture and Livestock Service (SAG) with the aim of establishing epidemiological indicators and assessing the impact of applying the indicators to disease prevention, control and eradication programmes. The information compiled was analysed using frequency charts and comparative tables. The analysis revealed that 11 good animal husbandry practices and 65 technical specifications could be applied directly to prevention and control programmes. The specifications for good animal husbandry practices did not include assessment systems based on the estimation of epidemiological indicators of morbidity and mortality. An assessment was made of the records from 292 family livestock farms in southern Chile enrolled in the PABCO official certification programme for livestock establishments for the purpose of promoting good animal husbandry practices. Even though more than 90% of the establishments were found to use

[Control of arterial hypertension by means of a regimen of hemodialysis on alternate days (HDAA or EODD: "Every Other Day Dialysis") versus 2 conventional regiments of 4 and 5 hours per session 3 times a week with 72 hours without sessions during the weekends]. / Control de la hipertensión arterial mediante el esquema de hemodiálisis en días alternos (HDDA o EODD: "Every Other Day Dialysis") versus dos esquemas convencionales de 4 y 5 horas por sesión tres veces a la semana con 72 horas de fin de semana sin sesiones.

An increase in the frequency of hemodialysis sessions improves control of extracellular volume and blood hypertension and consequently reduces the mortality related to cardiovascular aetiology in hemodialysis patients.We report the evolution of the blood hypertension depending on the need for antihypertensive drugs in a group of 38 prevalent patients that were included in a every-other-day dialysis schedule (EODD), and compare it with the results in two other groups of prevalent patients that were dialyzed in conventional, previously employed schedules without week-end sessions 4 hours x 3 x week and 5 hours x 3 x week. All three groups received hemodialysis treatment for more than 6 months.A 68% (26/38) of the patients received antihypertensive treatment at the beginning the EODD schedule and, after 16 months, only 7.9% (3/38) of them required antihypertensive treatment (p < 0.001) with reduction in two of the three remanent patients; hypertension control in those 25 patients took an average of 100 +/- 15 days. The final frequency of hypertension in EODD was lower (p < 0.002) than the frequency registered in the 84 prevalent patients in 4h x 3 x week schedule, and also lower (p = 0.065) than the frequency of the 56 prevalent patients in 5h x 3 x week schedule. There is a significant difference (p < 0,05) between EODD and 4h x 3 x week schedule as regards average figures of: increase in weight, decrease in dry-weight, blood pressure levels and hypotension incidence. EODD also produced better results than 5h x 3 x week schedule in this regard although statistics did not reflect it. The results using the every-other-day hemodialysis schedule support previous experiences(Lecce, Columbia) which achieved a good control of the dry-weight by means of suppressing the volume overload gained during the weekend and consequently obtaining adequate ultrafiltration rates and high reduction both of the hypertension and of the symptoms of intolerance to hemodialysis, which are so frequent in conventional schedules with 72 hours without hemodialysis sessions.

Identification of the Photoreceptor Transcriptional Co-Repressor SAMD11 as Novel Cause of Autosomal Recessive Retinitis Pigmentosa.

Retinitis pigmentosa (RP), the most frequent form of inherited retinal dystrophy is characterized by progressive photoreceptor degeneration. Many genes have been implicated in RP development, but several others remain to be identified. Using a combination of homozygosity mapping, whole-exome and targeted next-generation sequencing, we found a novel homozygous nonsense mutation in SAMD11 in five individuals diagnosed with adult-onset RP from two unrelated consanguineous Spanish families. SAMD11 is ortholog to the mouse major retinal SAM domain (mr-s) protein that is implicated in CRX-mediated transcriptional regulation in the retina. Accordingly, protein-protein network analysis revealed a significant interaction of SAMD11 with CRX. Immunoblotting analysis confirmed strong expression of SAMD11 in human retina. Immunolocalization studies revealed SAMD11 was detected in the three nuclear layers of the human retina and interestingly differential expression between cone and rod photoreceptors was observed. Our study strongly implicates SAMD11 as novel cause of RP playing an important role in the pathogenesis of human degeneration of photoreceptors.

[Benefits of every other day dialysis (EODD) without rest for 72 hours in patients with symptomatic cardiovascular disease]. / Beneficios de la hemodiálisis en días alternos sin descanso de 72 horas (EODD: every other day dialysis) en pacientes con enfermedad cardiovascular sintomática.

With the purpose to improve the clinical situation of nine hemodialysis patients who suffer from severe cardiovascular disease and are highly symptomatic after weekends without dialysis because of fluid overload, their dialysis schedule was changed from 5 hours in 3 sessions per week to 4 hours every other day sessions (EODD), avoiding 72 hours of interdialitic weekend period. In each patient, during 38 sessions previous to starting the EODD (stage 1: 3 months) and the 38 sessions in EODD, which followed the first month of this dialysis regime (stage 2), the frequency of the next incidences was registered (ratio in 348 sessions, in every stage, of this patients group): presence of dysnea and/or hypertension pre dialysis session, pre or intra dialysis angor, emergency sessions with hypotension and sessions without achieving predetermined dry-weight. During the EODD stage, sessions, with dysena, hypertension and pre or intra dialysis angor were reduced in 80% (p < 0.001); the incidence of sessions with hypotensive episode or sessions without achieving dry-weight decreased in a third. All patients experimented a considerable improvement in their clinical situation. In addition, the whole group reduced dry-weight and later regained it without presenting symptoms which had motivated EODD schedule. EODD schedule improves the clinical situation in patients with cardiopathy who would not do so when following previous schedule (which includes 48 hours without dialysis).

[Systemic arterial hypertension in primary chronic glomerulonephritis: prevalence and its influence on the renal prognosis]. / Hipertensión arterial en las glomerulonefritis primarias crónicas biopsiadas: prevalencia e influencia en el pronóstico renal.

UNLABELLED: Nowadays, glomerulonephritis is one of the most common causes of End-stage Renal Disease and starting point of dialysis in Spain. Several factors may influence negatively in this prognosis; among them, we may show up the systemic arterial hypertension. Though its prevalence in the glomerulonephritis is considered higher than in other nephropathies, with variations among series, probably due to difference in ages, in geographical areas, in histological types, in time on evolution of the nephritis ... and because it is difficult to distinguish if the hypertension is a consequence of the nephritis or a consequence of the renal failure that can be present in several cases. In the same way, its negative influence in the renal prognosis may be influenced more by this renal failure, which can be its cause when it is quite severe, than by the hypertension itself. Our aims were to analyse, on the one hand the prevalence of hypertension in the 394 patients diagnosed of primary glomerulonephritis by means of a renal biopsy during two decades in the Bay of Cadiz, as well as its influence in the renal prognosis since the moment of the diagnosis, even with the absence of severe renal failure. We gathered demographic, clinical, analytical and histological data, as well as the situation of the renal function and the survival period of it at the end of each patient study. For the analysis prognosis and renal survival, Kaplan-Meier curves and the long-rank test were used. Of the 394 patients, 247 are men and 147 are women, with an average age of 36.7 +/- 17.7 years old. The global prevalence of hypertension was 39%, with a higher frequency in older patients. The gathered rate of renal survival for hypertensive patients was 54%, 28%, 20% and 4% at 5, 10, 15 and 20 years respectively; while for non-hypertensive patients, it was 83%, 75%, 66% and 62% for the same periods of time (p < 0.001). This worse tendency for hypertensive patients is observed too in each particular histological type, especially in the IgA nephropathy and membranous nephropathy. These results were the same for the patients who did not have severe renal failure in the moment of the biopsy. CONCLUSIONS: Hypertension is a common fact in the primary glomerulonephritis, which also conditions, in an important way, the renal prognosis itself in a long term, from the moment of diagnosis and even before the existence of a significant renal failure.

Seroprevalence and risk factors associated to Neospora caninum in dairy cattle herds in the municipality of Pasto, Colombia / Seroprevalencia y factores de riesgo asociados a Neospora caninum en ganado lechero en el municipio de Pasto, Colombia

Objective. To determine seroprevalence and risk factors associated to Neospora caninum in non-vaccinated dairy cattle against infectious agents of reproductive syndrome in the municipality of Pasto, Colombia. Materials and methods. Farms over 2527 meters over sea level were selected, a total of 238 serum samples of Holstein cows were collected and analyzed using the indirect ELISA test to determine N. caninum seropositivity. An epidemiological survey was realized in each herd which included variables related to health and management measures of cattle. A multivariate analysis of binary logistic regression was used with a confidence interval of 95% (p<0.05) using SPSS19® program. Results. The estimated prevalence of N. caninum was 76.9%. The risk factors associated to neosporosis infection in the analyzed farms are as follows: residues of abortions generally left outdoors and not buried (OR 3.81, 95% CI 1.5 - 9.6); dogs fed with leftovers (OR 15.44 IC 95% 1.94-123.22) and bulls allowed to mate with cows (OR 19.68, 95% CI 2.34 - 165.52). Conclusions. The high prevalence of N. caninum and the low abortion rate in dairy herds of the municipality of Pasto corroborated no existence of the disease in all animals serologically positive, but it did suggest that at some point in their lives they were exposed to N. caninum. From the identified risk factors in this study, recommendations can be provided for an effective control of reproductive diseases like Neosporosis present in this region.

Objetivo. Determinar la seropositividad de N. caninum en bovinos no vacunados contra el síndrome reproductivo y los factores de riesgo asociados a la presentación de esta enfermedad en los hatos lecheros del municipio de Pasto, Nariño. Materiales y métodos. Se seleccionaron fincas sobre los 2527 msnm. Se analizaron muestras de suero de 238 vacas Holstein mediante la prueba de ELISA indirecta para determinar la seropositividad a N. caninum y se realizó una encuesta epidemiológica incluyendo variables sobre el ganado como: medidas sanitarias y de manejo. Se realizó un análisis multivariado mediante regresión logística binaria con un intervalo de confianza del 95% (p<0.05) utilizando el programa SPSS19®. Resultados. La prevalencia estimada para N. caninum fue de 76.9%. Los factores de riesgo asociados a Neosporosis en las fincas estudiadas son los residuos de abortos, que no se entierran y se dejan a la intemperie (OR 5.49; IC 95% 1.7-17.7), alimentar los perros con desperdicios (OR 15.44 IC 95% 1.94-123.22) y la monta directa (OR 14.62 IC 95% 1.55-137.53). Conclusiones. La elevada prevalencia de N. caninum y la tasas bajas de abortos en el municipio de Pasto, confirma que la enfermedad no se presenta en todos los animales positivos serológicamente, pero sugiere que en algún momento de su vida fueron expuestos al agente causal. A partir de los factores de riesgo identificados en este trabajo se pueden establecer recomendaciones para un control efectivo de enfermedades reproductivas como la Neosporosis presentes en la región.

Factores de riesgo asociados a aborto bovino en la cuenca lechera del departamento de Nariño / Risk factors associated with bovine abortion in a dairy región in the department of Nariño

Objetivo. Identificar los factores asociados al aumento en la probabilidad de ocurrencia del aborto bovino, permitiendo la implementación de programas de control efectivos. Materiales y métodos. Se trabajó con una prevalencia superior al 5% según datos obtenidos por Colácteos en el 2003 de la cuenca lechera. Los factores de riesgo asociados a la presentación de aborto se agruparon en agentes etiológicos de origen infeccioso y de origen no infeccioso. Para la identificación de los factores de riesgo se analizó la información para los años 2006-2007, obtenida de registro que reportan la presentación de abortos en fincas de la cuenca lechera. Los datos insuficientes se complementaron con la aplicación de una encuesta paracada finca que incluyó las variables consideradas como factores de riesgo. El diseño para identificar los factores correspondió a un estudio de casos y controles, donde se calculó el Odds Ratio para cada variable en estudio y se validó con el modelo de regresión logística multivariado. Resultados. Se encontró en las variables, ausencia de sistemas de drenaje con un OR 4.42(P 0.006) y la ausencia de pozo séptico con OR 5.59(P 0.033).Conclusiones. Los abortos se presentan con mayor frecuencia en vacas adultas entre el segundo y cuarto parto, durante el último tercio de la gestación y en los primeros 5 meses del año. Los factores de riesgo asociados a la presentación de aborto fueron la ausencia de sistemas de drenaje y de pozo séptico para el manejo de aguas residuales y aguas lluvias.

An operational evaluation of the Community Oral Rehydration Units in Peru.

Since 1984, in Latin America donor agencies and national governments have extensively supported the implementation of the Community Oral Rehydration Units (CORUs) in an attempt to increase the access to oral rehydration therapy and improve the case management of diarrhoea at the community level. This study surveyed 40 CORUs in two regions of Peru to assess their operation, the number of patients with diarrhoea attended, and the knowledge of volunteers in charge. The results show that CORUs were mainly implemented close to existing health centres; the median of case load was 2.0 patients in the preceding month; and the volunteers' knowledge of case management was principally deficient in the diagnosis of hydration status, dietary management and in preventive measures. This lack of knowledge was replicated by professionals at the supervising health centres. Despite the fact that CORUs have been functioning for around four years, they exhibit numerous deficiencies which prevent them from fulfilling their objectives. A global review of the whole CORU strategy is called for.

PIP: In Peru, an evaluation of 20 health centers and 40 community oral rehydration units (CORUs) in southern Lima and the Sullana region (northern Peru) was done to determine the number of diarrhea cases attended by CORUs, the knowledge of the volunteers in charge, and the quality of care provided by these services. Data were collected during April-May 1991, in the middle of the cholera epidemic in Peru. 80% of health centers and 79% of CORUs had oral rehydration salts (ORS) available. 63% of these health centers stored the ORS sachets appropriately compared to just 48% of the CORUs. Health professionals caring for diarrhea cases at health centers included auxiliaries (40%), physicians (34%), and nurses (17%). Most of the CORUs (61%) were in an urban area. Urban CORUs were closer to the nearest health center than rural CORUs (1 vs. 3 km; p = 0.003). The close proximity of urban CORUs to health centers works against the CORU strategy to improve coverage of diarrhea cases and access to ORS. Almost all diarrhea cases at the CORUs had no signs of dehydration, but most received ORS solution anyhow. In fact, only 10% of CORU volunteers and 7% of health workers at the centers looked for key signs of dehydration. A CORU volunteer even referred such a case (a child) to the next level. 85% of volunteers knew how to manage complications, while just 55% of health professionals did. Few volunteers and health professionals recommended breast feeding during a diarrhea episode (38% and 41%, respectively). About 25% of both groups knew about proper dietary management. The low knowledge levels suggest failures in training activities. Only 48% of CORUs received supervision from health center based health professionals the during the last month. CORUs did not maintain records of CORU activities (e.g., number of ORS sachets distributed) which made it difficult to monitor and evaluate the performance of CORUs.

Effectiveness of two methods of advising mothers on infant feeding and dietetic management of diarrhoea at an outpatient clinic in Peru.

The effectiveness of two educational intervention programmes in promoting infant feeding practices was assessed among mothers of small children attending a hospital's Oral Rehydration Unit in Peru. One group of mothers received 5 min of counselling and a recipe pamphlet. The other group received the same counselling plus a 20-min cooking demonstration. Both interventions had a statistically significant (p < 0.05) impact on maternal knowledge and practices; differences between the impact of the two practices were negligible. After merging both groups into a single sample, it was observed that changes over time were significantly large (p < 0.05). Knowledge rates were 27.6% before the intervention, 73.7% 2 days later and 75% 30 days later. The corresponding figures for practices were 2.6%, 58.3% and 37.5% respectively. We conclude that when place, time and message are adequately chosen, a simple method may be an effective way of good communication. We suggest that a larger implementation trial would be useful before starting larger infant feeding programmes.

A 3-year follow-up of HCV-RNA viraemia in haemodialysis patients.

BACKGROUND: Hepatitis C virus (HCV) infection in a population of haemodialysed patients was studied over a 3-year follow-up period in order to evaluate the changes in viral RNA, diversity of genotypes, and serological response to synthetic HCV peptides. METHODS: Twenty-eight (32.9%) patients with anti-HCV antibodies from a total of 85 patients assigned to a haemodialysis unit were studied. The serological response to immunopeptides was evaluated by immunoblotting, viral RNA in serum was detected using the polymerase chain reaction (RT-PCR), and genotyping was carried out by hybridization with probes fixed to nitrocellulose paper. RESULTS: Of the 28 haemodialysis patients who had anti-HCV antibodies, three (10.7%) were always RNA negative, six (21.4%) were always RNA positive, and 19 (67.8%) were variable RNA. There was an incomplete antibody response to non structural antigens in non-viraemic patients. Genotype was determined in 23 patients, and the other two could not be genotyped. The most common genotype was 1b (69.4%), followed by 1a (17.4%), and 2a, 3a, and 4a (each 4.4%). CONCLUSIONS: Haemodialysis patients, when followed up for a long time, frequently show an intermittent HCV viraemia state, suggesting that HCV cannot be evaluated adequately by isolated RNA determinations.

Detection of hepatitis G virus (HGV) RNA and antibodies to the HGV envelope protein E2 in a cohort of hemodialysis patients.

An analysis of the evolution of hepatitis G virus (HGV) infection markers was performed for a cohort of 58 hemodialyzed patients. During follow-up (4.88 +/- 0.42 years), a group of these patients cleared their antibodies against the envelope protein E2 with (4 of 29 cases; 13.8%) or without (9 of 29 cases; 31%) the reappearance of viremia. This finding implies a temporally limited protection in patients previously infected with HGV.

Embarazo ectópico ístmico-cervical en cicatriz de cesárea previa / Ectopic pregnancy within the scar of a previous cesarean of isthmic-cervical location

El embarazo localizado dentro de una cicatriz de cesárea previa es el menos frecuente de los embarazos ectópicos y no existe un tratamiento estándar. Se presenta el caso clínico de una paciente con embarazo ectópico ístmico-cervical sobre una cicatriz de cesárea. Se hospitaliza por el riesgo de ruptura uterina, evolucionó con invasión trofoblástica de la histerorrafia culminando en muerte embrionaria. No hubo complicaciones maternas. Se trató con metotrexato para evitar la progresión de la invasión trofoblástica, con buen resultado materno.

Determinación de la toxicidad retiniana de una mezcla de lidocaína: bupivacaína y hialuronidasa en conejos albinos de Nueva Zelanda / Determination of retina toxicity of a mixture of lidocaíne: bupivacaine and hialuronidase in albino rabbits of New Zealand

Con la finalidad de determinar la posible acción tóxica que pudiera producir sobre la integridad funcional y morfológica de la retina, la inyección de una mezcla de anestésicos (lidocaína 2 por ciento, bupivacaína 0,75 por ciento, hialuronidasa) en el globo ocular de conejos albinos de Nueva Zelanda, se utilizaron 12 conejos albinos a los cuales previa sedación con Clorhidrato de Ketamina se les realizó ERG, previo a la inyección, así como, 10 minutos y 4 horas posterior a la inyección, y estudio con microscopia de luz y electrónica posterior a la enucleación. Podemos infereir por lo observado que los cambios que se producen con la inyección de la mezcla utilizada en este estudio, ocasionan una alteración progresiva y más tardía que la observada con lidocaína o bupivacaína, donde apreciamos el inicio de la recuperación de la actividad electrorretinográfica a las cuatro (4) horas de realizada la inyección. Este efecto de alteración tardía y profunda producido con la mezcla podría deberse a la potenciación de la actividad del anestésico al ser administrado en forma combinada, aunado a la combinación de los mismos con la hialuronidasa. Las alteraciones observadas a la microscopia electrónica podrían sugerir la probable disrupción de la membrana limitante interna a nivel de las uniones de las células de MÜller con el paso de vítreo acumulándose en las capas más internas de la retina en forma de lagunas