[Molecular characterization of Listeria monocytogenes isolates from human and food sources in Argentina, 2018-2023]. / Caracterización molecular de aislamientos de Listeria monocytogenes de origen humano y alimentario en Argentina, 2018-2023.

Human listeriosis is an infectious disease caused by Listeria monocytogenes. The invasive form of this disease leads to a high rate of hospitalizations and fatality. The main mode of transmission is through contaminated ready-to-eat foods such as dairy, vegetables and meat products. The knowledge of the diversity and population dynamics of isolates collected from human and food sources is essential for the detection of clusters and the identification of common sites of infection. The aim of this study was the molecular characterization of L. monocytogenes isolates in Argentina. We sequenced a total of 63 isolates, 35 from human and 28 from food sources, collected between 2018 and 2023. Our genomic study divided the isolates into two lineages, four serogroups, 17 sequence types and 15 clonal complexes (CCs). The hypervirulent clone CC1 (lineage I; serogroup IVb) predominated in human and food samples. The phylogenomic analysis showed a high and possible epidemiological relationship between isolates from human and/or food sources, suggesting the presence of transmission chains in our country. These findings highlight the need to strengthen genomic surveillance of L. monocytogenes in Argentina. The identification of geographic distribution and characteristics of predominant and emerging clones from human and food sources might help to focus action plans and public health policies better directed at the control and prevention of listeriosis.

Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. / Vigilancia epidemiológica en los últimos 4 años del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea: situación actual y tendencias.

BACKGROUND: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.

Implications for biological invasion of non-native plants for sale in the world's largest online market.

Internet trade is increasingly recognized as a dispersal pathway of non-native plant species that is difficult to monitor. We sought to identify non-native flora present in the Chinese online market, the largest e-commerce market globally, and to decipher the effect of existing trade regulations, among other variables, on e-trading patterns and to inform policy. We used a comprehensive list of 811 non-native plant species in China present in 1 of the 3 phases of the invasion continuum (i.e., introduced, naturalized, and invasive). The price, propagule types, and quantities of the species offered for sale were retrieved from 9 online stores, including 2 of the largest platforms. Over 30% of the non-native species were offered for sale in the online marketplaces; invasive non-native species dominated the list (45.53%). No significant price difference was observed across the non-native species of the 3 invasion categories. Among the 5 propagule types, a significantly higher number of non-native species were offered for sale as seeds. The regression models and path analyses consistently revealed a direct positive effect of the number of uses and species' minimum residence time and an indirect effect of biogeography on the pattern of trade in non-native plant species when minimal phylogenetic signal was detected. A review of the existing phytosanitary regulations in China revealed their inadequacy in managing e-trading of non-native plant species. To address the problem, we propose integration of a standardized risk assessment framework that considers perceptions of stakeholders and is adaptable based on continuous surveillance of the trade network. If implemented successfully, the measures could provide a template for other countries to strengthen trading regulations for non-native plant species and take proactive management measures.

La venta de plantas no nativas en el mercado virtual más grande y sus implicaciones para la invasión biológica Resumen El mercado virtual en internet se reconoce cada vez más como una vía de dispersión de especies vegetales no nativas difícil de controlar. Intentamos identificar la flora no nativa presente en el mercado virtual chino, el mayor mercado de comercio electrónico del mundo, para descifrar el efecto de las regulaciones comerciales vigentes, entre otras variables, en los patrones de comercio electrónico e informar a las políticas. Utilizamos una lista integral de 811 especies de plantas no nativas de China presentes en una de las tres fases de invasión (es decir, introducidas, naturalizadas o invasoras). El precio, los tipos de propágulos y las cantidades de las especies puestas a la venta se recuperaron de nueve tiendas en línea, incluidas dos de las mayores plataformas. Más del 30% de las especies no nativas se pusieron a la venta en los mercados en línea; las especies no nativas invasoras dominaron esta lista (45,53%). No se observaron diferencias significativas de precio entre las especies no nativas en las tres categorías de invasión. Entre los cinco tipos de propágulos, se puso a la venta un número significativamente mayor de especies no nativas en forma de semillas. Los modelos de regresión y los análisis de trayectoria revelaron un efecto positivo directo y constante del número de usos y del tiempo mínimo de residencia de las especies y un efecto indirecto de la biogeografía sobre el patrón de comercio de especies vegetales no nativas cuando se detectó una señal filogenética mínima. Una revisión de la normativa fitosanitaria vigente en China reveló su insuficiencia para gestionar el comercio electrónico de las especies vegetales no nativas. Para abordar el problema, proponemos la integración de un marco normalizado de evaluación de riesgos que tenga en cuenta las percepciones de los actores y sea adaptable en función de la vigilancia continua de la red comercial. Si se aplican con éxito, las medidas podrían servir de modelo para que otros países refuercen la normativa sobre comercio de especies vegetales no nativas y adopten medidas proactivas de gestión.

Eliminating morbidity caused by neglected tropical diseases by 2030.

The objective of this manuscript is to provide selective examples of the work of the Pan American Health Organization/World Health Organization (PAHO/WHO) Collaborating Centre for Research and Training in Parasite Epidemiology and Control which contribute to the WHO goal of eliminating neglected tropical diseases by 2030. This PAHO/WHO CC specifically aligns its activities with the Sustainable Development Goals and with the goals outlined in the WHO Road Map for Neglected Tropical Diseases 2021-2030. Its role is to contribute to advancing global action on NTDs, primarily through policy development and knowledge translation. Three important projects have recently been completed: 1. Finalizing the Monitoring and Evaluation Framework for the NTD Road Map (published May 2021; this PAHO/WHO CC was a member of the working group); 2. Developing new guidelines for the preventive chemotherapy of Taenia solium taeniasis (published September 2021; this PAHO/WHO CC was co-Chair; and 3. Formulating a policy brief on deworming for adolescent girls and women of reproductive age (published January 2022; this PAHO/WHO CC is co-lead). These projects are the result of the integration of expertise and experience from multiple partners, including from PAHO and WHO (where both organizations provided key leadership), this PAHO/WHO CC, government ministries, civil society organizations and universities, among others. In conclusion, this PAHO/WHO CC contributes timely guidance to country-led evidence-informed public health policy, to cost-effective program implementation and to the identification of priority research topics - all focused, ultimately, on eliminating NTD-attributable morbidity by 2030.

El objetivo de este artículo es proporcionar ejemplos seleccionados de la labor del centro colaborador de investigación y capacitación en epidemiología y control de parásitos de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), que contribuye al objetivo de la OMS de eliminar las enfermedades tropicales desatendidas para el 2030. Este centro colaborador de la OPS/OMS alinea sus actividades específicamente con los Objetivos de Desarrollo Sostenible y con los objetivos descritos en la Hoja de ruta sobre enfermedades tropicales desatendidas 2021-2030 de la OMS. Su función es contribuir al avance de las medidas mundiales sobre las enfermedades tropicales desatendidas, principalmente mediante la elaboración de políticas y la traducción de conocimiento. Recientemente se han completado tres proyectos importantes: 1) finalización del marco de seguimiento y evaluación de la Hoja de ruta sobre enfermedades tropicales desatendidas (publicado en mayo del 2021; este centro colaborador de la OPS/OMS formó parte del grupo de trabajo); 2) elaboración de nuevas directrices para la quimioterapia preventiva de la teniasis por Taenia solium (publicado en septiembre del 2021; este centro colaborador fue copresidente); y 3) formulación de un informe de políticas sobre la desparasitación de las adolescentes y las mujeres en edad reproductiva (publicado en enero del 2022; este centro colaborador fue coautor). Estos proyectos son el resultado de la integración del conocimiento y la experiencia de múltiples asociados, como la OPS y la OMS (ambas organizaciones ofrecieron un liderazgo clave), este centro colaborador de la OPS/OMS, así como varios ministerios gubernamentales, organizaciones de la sociedad civil y universidades, entre otros. En conclusión, este centro colaborador de la OPS/OMS ofrece orientaciones oportunas para las políticas de salud pública basadas en la evidencia lideradas por los países, la ejecución de programas costo-efectivos y la determinación de los temas de investigación prioritarios, todo ello destinado, en última instancia, a eliminar la morbilidad atribuible a las enfermedades tropicales desatendidas para el 2030.

O objetivo deste manuscrito é fornecer exemplos seletivos do trabalho do Centro Colaborador de Pesquisa e Treinamento em Epidemiologia e Controle de Parasitos da Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) que contribuem para a meta da OMS de eliminar até 2030 as doenças tropicais negligenciadas. Este CC da OPAS/OMS alinha especificamente suas atividades com os Objetivos de Desenvolvimento Sustentável e com as metas delineadas no Roteiro da OMS para Doenças Tropicais Negligenciadas 2021-2030. Seu papel é contribuir para o avanço da ação global contra doenças tropicais negligenciadas, principalmente por meio do desenvolvimento de políticas e da tradução de conhecimentos. Três importantes projetos foram concluídos recentemente: 1. Finalização da Estrutura de Monitoramento e Avaliação do Roteiro para as DTN (publicada em maio de 2021 ­ este CC da OPAS/OMS foi membro do grupo de trabalho); 2. Desenvolvimento de novas diretrizes para a quimioprofilaxia da teníase por Taenia solium (publicado em setembro de 2021 ­ este CC da OPAS/OMS foi copresidente); e 3. Formulação de orientação para políticas de desparasitação para adolescentes e mulheres em idade reprodutiva (publicado em janeiro de 2022 ­ este CC da OPAS/OMS foi cogestor). Esses projetos são o resultado da integração de conhecimentos e experiência de múltiplos parceiros, incluindo a OPAS e a OMS (onde ambas as organizações forneceram liderança essencial), este CC da OPAS/OMS, ministérios governamentais, organizações da sociedade civil e universidades, entre outros. Em suma, este CC da OPAS/OMS contribui com orientações oportunas para uma política de saúde pública liderada pelos países e informada com base em evidências, para a implementação de programas com boa relação custo-benefício e para a identificação de tópicos prioritários de pesquisa ­ todos focados, em última análise, na eliminação da morbidade atribuível às DTN até 2030.

Surveillance of Shiga toxin-producing Escherichia coli associated bloody diarrhea in Argentina.

In Argentina, hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC-HUS) infection is endemic, and reliable data about prevalence and risk factors have been available since 2000. However, information about STEC-associated bloody diarrhea (BD) is limited. A prospective study was performed during the period October 2018-June 2019 in seven tertiary-hospitals and 18 referral units from different regions, aiming to determine (i) the frequency of STEC-positive BD cases in 714 children aged 1-9 years of age and (ii) the rate of progression of bloody diarrhea to HUS. The number and regional distribution of STEC-HUS cases in the same hospitals and during the same period were also assessed. Twenty-nine (4.1%) of the BD patients were STEC-positive, as determined by the Shiga Toxin Quik Chek (STQC) test and/or the multiplex polymerase chain reaction (mPCR) assay. The highest frequencies were found in the Southern region (Neuquén, 8.7%; Bahía Blanca, 7.9%), in children between 12 and 23 month of age (8.8%), during summertime. Four (13.8%) cases progressed to HUS, three to nine days after diarrhea onset. Twenty-seven STEC-HUS in children under 5 years of age (77.8%) were enrolled, 51.9% were female; 44% were Stx-positive by STQC and all by mPCR. The most common serotypes were O157:H7 and O145:H28 and the prevalent genotypes, both among BD and HUS cases, were stx2a-only or -associated. Considering the endemic behavior of HUS and its high incidence, these data show that the rate of STEC-positive cases is low among BD patients. However, the early recognition of STEC-positive cases is important for patient monitoring and initiation of supportive treatment.

Laboratory surveillance of invasive Haemophilus influenzae disease in Argentina, 2011-2019.

The incorporation of Haemophilus influenzae type b (Hib) vaccine into the Argentine National Immunization Program in 1998 resulted in a dramatic decrease in the incidence of invasive disease due to this serotype. We assessed 1405 H. influenzae (Hi) isolates causing invasive infections referred to the National Reference Laboratory between 2011 and 2019. Non-encapsulated Hi were the most common strains (44.5%), followed by types b (41.1%) and a (10.0%). Significant increase in the proportion of type b was observed, from 31.2% in 2011, to 50% in 2015, correlating with the peak incidence rate, later decreasing to 33.6% by 2019. We compared the genetic relationship between clones circulating during the period of increased Hib incidence (2011-2015) and those of the prevaccination-transition period (1997-1998). Four pulsotypes predominated in both periods, G, M, P and K, G being the most common. Multi-locus sequence typing revealed that the 4 pulsotypes belonged to ST6, or one of its simple or double locus variants. Isolates from fully vaccinated individuals did not differ from those of the rest of the population studied. After ruling out aspects associated with emergence of specific clones, we concluded that factors such as low booster coverage rates, delayed vaccination schedules and use of different vaccines may have contributed to the reemergence of Hib infections.

A quantitative global review of species population monitoring.

Species monitoring, defined here as the repeated, systematic collection of data to detect long-term changes in the populations of wild species, is a vital component of conservation practice and policy. We created a database of nearly 1200 schemes, ranging in start date from 1800 to 2018, to review spatial, temporal, taxonomic, and methodological patterns in global species monitoring. We identified monitoring schemes through standardized web searches, an online survey of stakeholders, in-depth national searches in a sample of countries, and a review of global biodiversity databases. We estimated the total global number of monitoring schemes operating at 3300-15,000. Since 2000, there has been a sharp increase in the number of new schemes being initiated in lower- and middle-income countries and in megadiverse countries, but a decrease in high-income countries. The total number of monitoring schemes in a country and its per capita gross domestic product were strongly, positively correlated. Schemes that were active in 2018 had been running for an average of 21 years in high-income countries, compared with 13 years in middle-income countries and 10 years in low-income countries. In high-income countries, over one-half of monitoring schemes received government funding, but this was less than one-quarter in low-income countries. Data collection was undertaken partly or wholly by volunteers in 37% of schemes, and such schemes covered significantly more sites and species than those undertaken by professionals alone. Birds were by far the most widely monitored taxonomic group, accounting for around half of all schemes, but this bias declined over time. Monitoring in most taxonomic groups remains sparse and uncoordinated, and most of the data generated are elusive and unlikely to feed into wider biodiversity conservation processes. These shortcomings could be addressed by, for example, creating an open global meta-database of biodiversity monitoring schemes and enhancing capacity for species monitoring in countries with high biodiversity. Article impact statement: Species population monitoring for conservation purposes remains strongly biased toward a few vertebrate taxa in wealthier countries.

Una Revisión Global Cuantitativa del Monitoreo Poblacional de Especies Resumen El monitoreo de especies, definido aquí como la recolección sistemática y repetida de datos para detectar cambios a largo plazo en las poblaciones de las especies silvestres, es un componente vital de la práctica y las políticas de la conservación. Generamos una base de datos de casi 1,200 esquemas, con un rango de fecha de inicio desde 1800 hasta 2018, para revisar los patrones espaciales, temporales, taxonómicos y metodológicos en el monitoreo global de especies. Identificamos los esquemas de monitoreo por medio de búsquedas estandarizadas en línea, una encuesta digital realizada a los actores, búsquedas a profundidad en una muestra de países y en una revisión global de las bases de datos sobre la biodiversidad. Estimamos el número total mundial de esquemas funcionales de monitoreo entre 3,300 y 15,000. Desde el 2000, ha habido un fuerte aumento en el número de esquemas nuevos que han iniciado en países de bajo o mediano ingreso y en países megadiversos, pero una disminución en los países de alto ingreso. El número total de esquemas de monitoreo en un país y su producto interno bruto per cápita tuvieron una correlación sólida y positiva. Los esquemas que estaban activos en 2018 lo habían estado en un promedio de 21 años en los países de alto ingreso, comparado con un promedio de 13 años en los países de mediano ingreso y de 10 años en los países de bajo ingreso. En los países de alto ingreso, más de la mitad de los esquemas de monitoreo recibieron financiamiento del gobierno, comparado con menos de un cuarto de los esquemas en los países de bajo ingreso. La recolección de datos se realizó parcial o totalmente por voluntarios en 37% de los esquemas, y dichos esquemas cubrieron significativamente más sitios y especies que aquellos realizados sólo por profesionales. Las aves fueron por mucho el grupo taxonómico más monitoreado, comprendiendo casi la mitad de todos los esquemas, pero este sesgo declinó con el tiempo. El monitoreo en la mayoría de los grupos taxonómicos todavía es disperso y descoordinado, y la mayoría de los datos generados son vagos y tienen poca probabilidad de alimentar procesos más amplios de conservación de biodiversidad. Estas deficiencias podrían abordarse, por ejemplo, creando una meta-base de datos globales abiertos de los esquemas de monitoreo de la biodiversidad y mejorando la capacidad para el monitoreo de especies en los países con alta biodiversidad.

Post-polypectomy colonoscopy surveillance: Can we improve the diagnostic yield?

Although adenomas and serrated polyps are the preneoplastic lesions of colorectal cancer, only few of them will eventually progress to cancer. This review provides a comprehensive overview of the present and future of post-polypectomy colonoscopy surveillance. Post-polypectomy surveillance guidelines have recently been updated and all share the aim towards more selective and less frequent surveillance. We have examined these current guidelines and compared the recommendations of each of them. To improve the diagnostic yield of post-polypectomy surveillance it is important to find predictors of metachronous polyps that better identify high-risk individuals of developing advanced neoplasia. For this reason, we have also conducted a literature review of the molecular biomarkers of metachronous advanced colorectal polyps. Finally, we have discussed future directions of post-polypectomy surveillance and identified possible strategies to improve the use of endoscopic resources with the COVID-19 pandemic.

[Impact of an active surveillance program and infection control measures on the incidence of carbapenem-resistant gram-negative bacilli in an intensive care unit]. / Impacto de un programa de vigilancia activa y medidas de control de infecciones sobre la incidencia de bacilos gram negativos resistentes a carbapenems en una unidad de cuidados intensivos.

Hospital-acquired infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB) have been increasingly reported worldwide and are associated with high rates of mortality especially in intensive care units(ICUs). Early identification through rectal surveillance cultures and implementation of infection control measures(ICM) including contact precautions, staff education on cleaning and hand hygiene may reduce the spread of these microorganisms. The aim of this work was to assess the impact of enhanced ICM on CRGNB colonization and to describe the molecular epidemiology of these bacteria in a polyvalent ICU in a tertiary level hospital. A prospective study including audits and active surveillance culture program, with molecular characterization, was conducted before and after the implementation of prevention programs and infection control measures. Microbiological screening was performed in chromogenic media; PCR targeting ß-lactamases genes (blaKPC, blaNDM, blaVIM and blaOXA-48, blaSHV and blaCTX-M), molecular typing by PFGE; and MLST in K. pneumoniae were performed. CRGNB colonization was reduced from 16.92% to 9.67% upon implementing the infection control measures. In K. pneumoniae the most frequent carbapenemase type was KPC-2 associated with SHV-2 and CTX-M-15, and was disseminated in various STs (ST17, ST13, ST2256, ST353); there was no persistence of particular clones and virulence factors showed no association with hypervirulence. IMP-1 carbapenemase predominated in A. baumannii and the PFGE analysis individualized 3 clusters, assuming that the dissemination in the ICU was clonal. The early detection of patients colonized with CRBGN by using epidemiological surveillance cultures and the implementation of prophylactic measures are key to reducing the incidence of these microorganisms.

Threats of illegal, unregulated, and unreported fishing to biodiversity and food security in the Republic of the Congo.

Illegal, unregulated, and unreported (IUU) fishing poses a major threat to effective management of marine resources, affecting biodiversity and communities dependent on these coastal resources. Spatiotemporal patterns of industrial fisheries in developing countries are often poorly understood, and global efforts to describe spatial patterns of fishing vessel activity are currently based on automatic identification system (AIS) data. However, AIS is often not a legal requirement on fishing vessels, likely resulting in underestimates of the scale and distribution of legal and illegal fishing activity, which could have significant ramifications for targeted enforcement efforts and the management of fisheries resources. To help address this knowledge gap, we analyzed 3 years of vessel monitoring system (VMS) data in partnership with the national fisheries department in the Republic of the Congo to describe the behavior of national and distant-water industrial fleets operating in these waters. We found that the spatial footprint of the industrial fisheries fleet encompassed over one-quarter of the Exclusive Economic Zone. On average, 73% of fishing activity took place on the continental shelf (waters shallower than 200 m). Our findings highlight that VMS is not acting as a deterrent or being effectively used as a proactive management tool. As much as 33% (13% on average) of fishing effort occurred in prohibited areas set aside to protect biodiversity, including artisanal fisheries resources, and the distant-water fleet responsible for as much as 84% of this illegal activity. Given the growth in industrial and distant-water fleets across the region, as well as low levels of management and enforcement, these findings highlight that there is an urgent need for the global community to help strengthen regional and national capacity to analyze national scale data sets if efforts to combat IUU fishing are to be effective.

Amenazas de la Pesca Ilegal, No Regulada y No Reportada para la Biodiversidad y la Seguridad Alimentaria en la República del Congo Resumen La pesca ilegal, no regulada y no reportada (INN) representa una amenaza importante para el manejo efectivo de los recursos marinos, lo que afecta a la biodiversidad y a las comunidades que dependen de estos recursos costeros. Los patrones espaciotemporales de las pesquerías industriales en los países en desarrollo a menudo están poco comprendidas, y los esfuerzos globales para describir los patrones espaciales de la actividad de los navíos pesqueros actualmente están basados en los datos del sistema automático de identificación (SAI). Sin embargo, el SAI no es siempre un requerimiento legal en los navíos pesqueros, lo que probablemente resulta en valores subestimados de la escala y la distribución de la actividad pesquera legal e ilegal, lo que podría tener ramificaciones significativas para los esfuerzos enfocados de aplicación de la ley y para el manejo de los recursos de las pesquerías. Para ayudar a completar este vacío en el conocimiento, analizamos tres años de datos del sistema de monitoreo de navíos (SMN) en asociación con el departamento nacional de pesquerías de la República del Congo para describir el comportamiento de las flotas industriales nacionales y de altura que operan en estas aguas. Descubrimos que la huella espacial de la flota de pesquerías industriales abarcó más de un cuarto de la Zona Económica Exclusiva. En promedio, el 73% de la actividad pesquera se realizó en el talud continental (aguas con una profundidad menor a 200 m). Nuestros descubrimientos resaltan que el SMN no está actuando como un disuasivo o no se está usando efectivamente como una herramienta proactiva de manejo. Un máximo del 33% (13% en promedio) de los esfuerzos de pesca ocurrieron en áreas prohibidas apartadas para proteger a la biodiversidad, incluyendo los recursos para la pesca artesanal, con el 84% de la responsabilidad de esta actividad ilegal cayendo sobre las flotas de altura. Dado el crecimiento de flotas industriales y de altura en la región, así como los bajos niveles de manejo y aplicación de la ley, estos resultados resaltan la necesidad urgente que existe para que la comunidad global ayude a fortalecer la capacidad regional y nacional para analizar los conjuntos de datos de escala nacional si se espera que los esfuerzos para combatir la pesca INN sean efectivos.

Baseline prevalence and type distribution of Human papillomavirus in sexually active non-vaccinated adolescent girls from Argentina.

In 2011, Argentina launched a government-funded national Human papillomavirus (HPV) immunization program incorporating a bivalent HPV vaccine, with a 0-1-6-month schedule, for girls 11 years of age, born after January 2000. Monitoring the changes of HPV infection prevalence among young women has been proposed as an endpoint for early assessment of HPV vaccination programs. However, the data on HPV prevalence at young ages are very limited. The aim of this work was to determine the prevalence of HPV infection and type-specific distribution in sexually active 15-17-year-old non-vaccinated girls. Cervical samples from 1073 adolescents were collected for HPV detection and genotyping using the BSGP5+/GP6+PCR-reverse line blot (RLB) assay. Out of 957 specimens analyzed, 56.3% were positive for any HPV type; 42.2% harbored at least one high-risk HPV (HR-HPV) type and 30.8% low-risk HPV (LR-HPV) types. Multiple and single infections were identified in 36.3% and 20.0% of the samples respectively. The 6 most common HR-HPV types were HPV16 (11.1%), HPV52 (10.8%), HPV56 (8.3%), HPV51 (7.4%), HPV58 (7.3%) and HPV31 (7.1%). The prevalence of HR-HPV-16/18 was 15.2%. In conclusion, results confirm that HPV (particularly HR-types) are very common among sexually active adolescents, and prevalence rises quickly after their sexual debut. Our HPV type-specific prevalence baseline may be used to monitor post-vaccinal longitudinal changes in Argentina.

[Intensified epidemiological surveillance of arbovirosis: First case of native dengue fever in Catalonia (Spain), Northern Metropolitan Area of Barcelona, 2018-2019]. / Vigilancia epidemiológica intensificada de arbovirosis: primer caso de dengue autóctono en Cataluña (España), zona Metropolitana Norte de Barcelona, 2018-2019.

OBJECTIVE: To evaluate the results obtained by a surveillance network on arbovirosis composed by doctors and nurses located at hospitals and Primary Care trained in their identification, diagnostic confirmation and clinical management. LOCATION: North Metropolitan Area of Barcelona (1,400,000 inhabitants; Catalonia; Spain) during a calendar year. PARTICIPANTS: Seven Primary Care and 10 hospital physicians plus 4 Primary Care nurses. TYPE OF STUDY: A prospective observational study. MAIN MEASUREMENTS: Demographic, epidemiological (autochthonous/imported, suspect/probable/confirmed case) and healthcare variables (symptoms, serological profile, viral period) were defined. RESULTS: Of the 34 patients identified, 26 (76.5%) met study criteria. Among them, any arbovirosis was confirmed in 14 (53.8%): 13 dengue plus 1chikungunya fever. There were no cases of Zika fever. There was a history of travel to endemic areas 23 (88.4%), but not in 3cases (11.6%) in which the possibility of an indigenous transmission was considered; of them, a case of dengue was confirmed. The estimated incidence of arbovirosis was 0.4 (95%CI: 0.33-0.51) cases ×10,000hab/year which, when compared to the estimated incidence in the same geographical area during the period 2009-2013 (0.19cases ×10,000hab/year; 95%CI: 0.07-0.31), a significant increase was found (P=.044). Patients within viremia period at the time of their first medical visit were 11 (42.3%). CONCLUSIONS: An intensified epidemiological surveillance program defined at Primary Care and hospital levels is able to detect significantly more cases of imported and autochthonous arbovirosis. Possibly we are witnessing an increase in the incidence of imported arbovirosis and, thus, measures aimed at their identification and confirmation should be reinforced.

Stepparents' Attachment Orientation, Parental Gatekeeping, and Stepparents' Affinity-Seeking with Stepchildren.

Remarried stepfamilies are a sizable portion of American families; in a 2011 Pew Center survey, 42% of respondents reported at least one stepfamily member. Family clinicians and researchers suggest that stepparents' ability to develop close bonds with stepchildren may be critical to the well-being of couple and family relationships. Using actor-partner interdependence models to analyze dyadic data from 291 heterosexual remarried stepfamily couples, we explored factors related to stepparents' efforts to befriend their stepchildren. Specifically, we evaluated how remarried parents' gatekeeping and stepparents' perceptions of their attachment orientations were associated with their own and their spouse's perceptions of stepparents' affinity-seeking behaviors. Securely attached stepparents and stepparents with anxious attachment orientations engaged more frequently in affinity behaviors than did stepparents with avoidant attachment orientations; there was no difference between securely attached and anxious stepparents. Stepparents' reports of parents' restrictive gatekeeping were strongly and negatively associated with both stepparents' and parents' reports of stepparent affinity-seeking (actor and partner effects). Parents' reports of their own restrictive gatekeeping were also negatively (but more weakly) associated with parents' reports of stepparent affinity-seeking. Implications for families, clinicians, and relationship researchers and theorists are discussed.

Las familias ensambladas con parejas que se vuelven a casar constituyen una parte considerable de las familias estadounidenses; en una encuesta del Pew de 2011, el 42% de los encuestados informaron tener por lo menos un familiar con familia ensamblada. Los especialistas en familia y los investigadores sugieren que la capacidad de los padrastros de desarrollar vínculos estrechos con los hijastros puede ser fundamental para el bienestar de las relaciones de pareja y familiares (Browning & Artlelt, 2012; Ganong, Coleman, Fine, & Martin, 1999). Mediante el uso de modelos de interdependencia actor-pareja para analizar los datos diádicos de 291 parejas heterosexuales de familias ensambladas con parejas que se volvieron a casar, analizamos los factores relacionados con los esfuerzos de los padrastros para hacerse amigos de sus hijastros. Específicamente, evaluamos cómo la vigilancia de los padres que volvieron a casarse y las percepciones de los padrastros de sus orientaciones de apego estuvieron asociados con sus propias percepciones y las de su cónyuge de las conductas de búsqueda de afinidad de los padrastros. Los padrastros con un vínculo de apego seguro y los padrastros con orientaciones de apego ansioso participaron con más frecuencia en conductas de afinidad que los padrastros con orientaciones de apego evasivo; no hubo diferencia entre los padrastros con vínculo de apego seguro y los de apego ansioso. Los informes de los padrastros de la vigilancia restrictiva de los padres estuvieron asociados estrechamente y negativamente con los informes de los padrastros y de los padres sobre la búsqueda de afinidad de los padrastros (efectos de la pareja y del actor). Los informes de los padres de su propia vigilancia restrictiva también estuvieron asociados negativamente (pero más levemente) con los informes de los padres sobre la búsqueda de afinidad de los padrastros. Se debaten las consecuencias para las familias, los médicos y los investigadores y teóricos de las relaciones.

Black Lives Matter: We are in the Same Storm but we are not in the Same Boat.

Black Lives Matter is a clarion call for racial equality and racial justice. With the arrival of Africans as slaves in 1619, a racial hierarchy was formed in the United States. However, slavery is commonly dismissed as that less than noble aspect of the United States' history without really confronting the legacies of racial inequality and racial injustice left in its wake. White supremacy, based on the myths of white superiority and Black inferiority, have obscured racial inequality and racial injustice, resulting in blaming the victims. Using Black Lives Matter as a platform, we focus on some key considerations for theory, research, education, training, and practice in clinical, community, and larger systems contexts. Broadly, we focus on Black Lives Matter, literally; Black dehumanization; historical oppression; healing; and implications for the field of family therapy. More specifically, we draw attention to health disparities, mass incarceration and aggressive policing, intergenerational racial trauma, restorative justice, and antiracist work.

El movimiento Black Lives Matter (Las vidas de los negros son importantes) es un llamamiento a la igualdad y la justicia racial. Con la llegada de los africanos como esclavos en el año 1619, se formó una jerarquía racial en los Estados Unidos. Sin embargo, la esclavitud generalmente se desestima como el aspecto menos noble de la historia de los Estados Unidos sin afrontar realmente los legados de desigualdad e injusticia raciales que dejó. La supremacía blanca, basada en los mitos de la superioridad blanca y la inferioridad negra, han ocultado la desigualdad y la injusticia raciales, lo cual condujo a la culpabilización de las víctimas. Utilizando el movimiento Black Lives Matter como plataforma, nos centramos en algunas consideraciones clave para la teoría, la investigación, la educación, la capacitación y la práctica en contextos clínicos, comunitarios y en sistemas más grandes. En líneas generales, nos centramos en Black Lives Matter, literalmente; en la deshumanización de los negros, la opresión histórica, la recuperación, y las consecuencias para el área de la terapia familiar. Más específicamente, visibilizamos las desigualdades sanitarias, el encarcelamiento masivo y la vigilancia policial agresiva, el trauma racial intergeneracional, la justicia reparadora y la labor antirracista.

An Stx-EAEC O59:NM[H19] strain isolated from a hemolytic uremic syndrome case in Argentina.

Shiga toxin-producing Escherichia coli (STEC) are a heterogeneous group of foodborne pathogens causing a broad spectrum of human disease, from uncomplicated diarrhea to hemolytic uremic syndrome (HUS). In this study, we report an HUS case associated with an O59:NM[H19] strain, harboring stx2a, iha, lpfAO26, lpfAO113 genes associated with STEC, and aatA, aap, pic, sigA, agg4A genes associated with enteroaggregative E. coli (EAEC), named Stx-EAEC. The strain showed low toxicity on Vero cells, and was resistant to streptomycin and trimethoprim/sulfonamides. The child carried the bacteria for more than 100 days. Since the large outbreak associated with Stx-EAEC O104:H4, many strains with similar profiles have been described. In Germany, an O59:NM[H19] strain, with comparable characteristics to the Argentine strain, was isolated from a bloody diarrhea case. In Argentina, this is the first report of an HUS case associated with a Stx-EAEC infection, and represents a new challenge for the surveillance system.

Aedes aegypti, the dengue fever mosquito in Mexico City. Early invasion and its potential risks.

INTRODUCTION: Mexico City has no endemic presence of Aedes aegypti, and it is therefore free of vector-borne diseases, such as dengue fever, Zika and chikungunya. However, evidence has shown the presence of Aedes aegypti eggs in the city since 2015. OBJECTIVE: To report the constant and increasing presence of Aedes aegypti eggs in Mexico City from 2015 to 2018. METHODS: Surveillance was carried out using ovitraps. Eggs were counted and hatched in order to determine the species. RESULTS: From 2015 to 2018, 378 organisms were identified as Ae. aegypti. In total, 76 Aedes aegypti-positive ovitraps were collected at 50 different places in 11 boroughs of the city. Northeastern Mexico City was the area with the highest number of positive traps. CONCLUSIONS: The results may be indicating a period of early colonization and the probable existence of cryptic colonies of the mosquito; Mexico City could be at risk of experiencing vector-borne epidemics.

INTRODUCCIÓN: La Ciudad de México no tiene presencia endémica de Aedes aegypti, por lo que está libre de enfermedades transmitidas por vector como dengue, Zika y chikunguña. Sin embargo, existe evidencia de la presencia de huevecillos en la urbe desde 2015. OBJETIVO: Reportar la presencia constante y en aumento de huevecillos de Aedes aegypti en la Ciudad de México de 2015 a 2018. MÉTODO: Se realizó vigilancia a través de ovitrampas; se contabilizaron y eclosionaron huevecillos para determinar la especie. RESULTADOS: De 2015 a 2018 fueron identificados 378 organismos como Aedes aegypti. En total fueron colectadas 76 ovitrampas positivas a Aedes aegypti en 50 sitios distintos de 11 alcaldías. El noreste de la Ciudad de México fue el área con mayor positividad. CONCLUSIONES: Los resultados pueden estar indicando un periodo de colonización incipiente y la probable la existencia de colonias crípticas del mosquito, por lo que la Ciudad de México podría estar en riesgo de presentar epidemias de enfermedades transmitidas por vector.

Endoscopic surveillance after colonic polyps and colorrectal cancer resection. 2018 update. / Vigilancia tras resección de pólipos de colon y de cáncer colorrectal. Actualización 2018.

There is limited scientific evidence available to stratify the risk of developing metachronous colorectal cancer after resection of colonic polyps and to determine surveillance intervals and is mostly based on observational studies. However, while awaiting further evidence, the criteria of endoscopic follow-up needs to be unified in our setting. Therefore, the Spanish Association of Gastroenterology, the Spanish Society of Family and Community Medicine, the Spanish Society of Digestive Endoscopy, and the Colorectal Cancer Screening Group of the Spanish Society of Epidemiology, have written this consensus document, which is included in chapter 10 of the "Clinical Practice Guideline for Diagnosis and Prevention of Colorectal Cancer. 2018 Update". Important developments will also be presented as regards the previous edition published in 2009. First of all, situations that require and do not require endoscopic surveillance are established, and the need of endoscopic surveillance of individuals who do not present a special risk of metachronous colon cancer is eliminated. Secondly, endoscopic surveillance recommendations are established in individuals with serrated polyps. Finally, unlike the previous edition, endoscopic surveillance recommendations are given in patients operated on for colorectal cancer. At the same time, it represents an advance on the European guideline for quality assurance in colorectal cancer screening, since it eliminates the division between intermediate risk group and high risk group, which means the elimination of a considerable proportion of colonoscopies of early surveillance. Finally, clear recommendations are given on the absence of need for follow-up in the low risk group, for which the European guidelines maintained some ambiguity.

Adherence to follow-up in high-risk adenoma patients diagnosed by, and excluded from the Barcelona colorectal cancer screening programme. / Adherencia al seguimiento de las personas con adenoma de alto riesgo diagnosticadas y excluidas del Programa de detección precoz de cáncer de colon y recto de Barcelona.

INTRODUCTION: Colorectal cancer screening programmes have been shown to reduce incidence and mortality. High-risk adenomas (HRA) are the most frequently diagnosed lesions in these programmes, and these patients are referred to a specialist. However, few studies have evaluated the adherence of HRA patients to the recommended endoscopic follow-up. OBJECTIVES: To analyse follow-up adherence and duration in patients diagnosed with HRA in a screening programme. METHODS: Retrospective cohort study of patients diagnosed with HRA within one of the participating hospitals of the colorectal cancer screening programme of Barcelona, during the first round of the programme (2010-2011). The follow-up period was 75.5 months. Descriptive analyses, logistic regression and survival models were performed. RESULTS: 602 patients were included in the study, 66.6% of which were men. The adherence rate was 83.7% (n=504). Follow-up colonoscopy was performed within the recommended time (36±6months) in 57.7%, with a mean follow-up of 34 months. The Cox regression only showed differences at the socioeconomic level, with a lower adherence rate in the most deprived quintile (HR 0.70; 95% CI, 0.53-0.93). CONCLUSIONS: Compared to previous studies, the follow-up adherence rate is considered to be acceptable. However, follow-up was not performed within the recommended time frame in a high proportion of cases. There is a need to further explore the reasons leading to lower follow-up adherence in the most deprived socioeconomic group and to increase the equity of the programme beyond participation.

[Decrease in the incidence of chickenpox in the Community of Madrid after universal childhood immunization. Years 2001-2015]. / Descenso de la incidencia de la varicela en la Comunidad de Madrid tras la vacunación infantil universal. Años 2001-2015.

OBJECTIVE: Varicella vaccine was recommended in the Community of Madrid (CM) at 15months of age between November 2006 and December 2013. The objective was to describe the impact of vaccination on the incidence of varicella in the CM during the period 2001-2015. DESIGN: A descriptive study of cases of varicella reported to the Sentinel Physician Network of the CM and the cases recorded in the Minimum Basic Data Set at hospital discharge was carried out. Total incidence of cases and of hospital admissions were calculated, as well as specific incidence by age and sex. RESULTS: The incidence was 94.0% lower between 2012 and 2013 than between 2001 and 2003. Between 2014 and 2015 the incidence was 61.8% higher than between 2012 and 2013. The highest incidence was observed in children aged 0 to 4years except for 2010-2014, which was exceeded by the incidence in children aged 5 to 9. The trend in hospital admissions was also decreasing, with the highest incidence in children aged 0 to 1year, followed by 1-4years. CONCLUSIONS: There has been a significant decrease in the incidence of cases and of hospital admissions by varicella in all age groups after the recommendation to vaccinate at 15months of age, which is compatible with the effectiveness of a dose and its ability to produce immunity group. The withdrawal of this recommendation between 2014 and 2015 has led to an increase in the incidence.

Dengue data and surveillance in Tanzania: a systematic literature review.

OBJECTIVE: Although there is evidence that dengue virus is circulating in Tanzania, the country lacks a dengue surveillance system. Consequently, the true estimate of dengue seroprevalence, as well as the incidence in the population, the frequency and magnitude of outbreaks is unknown. This study therefore sought to systematically review available dengue data from Tanzania. METHODS: The systematic review was conducted and reported using the PRISMA tool. Five databases (PubMed, Embase, Web of Science, WHOLIS and Google Scholar) were searched for articles using various keywords on the illness, data and geographical location. Identified articles were assessed for inclusion based on predefined eligibility criteria. Data were extracted from included articles, analysed and reported. RESULTS: Based on the 10 seroprevalence studies in defined populations with estimates of acute confirmed infections that were included in the review, the estimated seroprevalence of past dengue infection in Tanzania ranged from 50.6% in a health facility-based study to 11% in a population-based study. Acute confirmed infections of dengue were estimated to be as high as 38.2% of suspected cases. Only one study reported on an outbreak. CONCLUSIONS: It is evident that dengue needs to become part of regular disease surveillance in Tanzania. Control measures need to be instituted with a focus on building human resource capacity and integrating dengue control measures in ongoing health programmes, for both preventive and curative interventions. Systematic reviews are valuable in assessing health issues when surveillance data are not available.