Influence of individual or group housing of newborn calves on rotavirus and coronavirus infection during the first 2 months of life.

Bovine rotavirus A (RVA) and bovine coronavirus (CoV) are the two main viral enteropathogens associated with neonatal calf diarrhea. The aim of the present work was to study the impact of group and individual housing systems in the epidemiology of RVA and CoV infection. Eleven calves reared in individual housing (FA) and nine calves in group housing (FB) were monitored during the first 7 weeks of life. Stool and serum samples were screened for RVA and CoV antigens by ELISA. IgG1 antibodies (Ab) to both antigens were also measured. From the 160 fecal samples collected, the proportion of positive samples to RVA and CoV was significantly higher in FB (23.6%) than in FA (9%) (p = 0.03). The geometric mean of colostral IgG1 Ab titers to CoV and RVA in FA (IgG1 anti-CoV 1024 and anti-RVA 1782.9) was lower than in FB (IgG1 anti-CoV 10,321.2 and anti-RVA 4096) at birth. Calves less than 2 weeks of life from FB had a higher risk of being infected by RVA (OR = 4.9; p = 0.01) and CoV (OR = 17.15; p = 0.01) than calves from FA. The obtained results showed that there was higher RVA and CoV shedding in group-housed calves than in individual-housed animals.

[Functional immunoassays in the setting of infectious risk and immunosuppressive therapy of non-HIV immunocompromised patients]. / Place des tests immunitaires fonctionnels dans la prise en charge du risque infectieux et de la gestion des thérapies immunosuppressives chez les patients immunodéprimés non-VIH.

The holistic approach of the human immune system is based on the study of its components collectively driving a functional response to an immunogenic stimulus. To appreciate a specific immune dysfunction, a condition is mimicked ex vivo and the immune response induced is assessed. The application field of such assays are broad and expanding, from the diagnosis of primary and secondary immunodeficiencies, immunotherapy for cancer to the management of patients at-risk for infections and vaccination. These assays are immune monitoring tools that may contribute to a personalised and precision medicine. The purpose of this review is to describe immune functional assays available in the setting of non-HIV acquired immune deficiency. First, we will address the use of theses assays in the diagnosis of opportunistic infections such as viral reactivation. Secondly, we will report the usefulness of these assays to assess vaccine efficacy and to manage immunosuppressive therapies.

Influence of electrodes on the 448 kHz electric currents created by radiofrequency: A finite element study.

Radiofrequency is a technology used in physical rehabilitation by physicians and physiotherapists for more than fifteen years, although there exist doubts on how it works. Indiba is a particular method that applies a voltage difference of 448 KHz between two electrodes, creating an electric current between them. These electrodes are an active one that is placed on different areas of the body and a passive one that is left on the same position during the treatment. There are two different types of active electrodes: the capacitive one and the resistive one. In this paper, it has been studied how the different electrodes affect the current density inside the body and thus how they affect the efficacy of the treatment. It shows how finite element calculations should help physicians in order to better understand its behavior and improve the treatments.

Egg yolk IgY antibodies: A therapeutic intervention against group A rotavirus in calves.

Bovine group A rotavirus (RVA) is considered the major cause of diarrhea in intensively reared neonatal calves. Chicken egg yolk antibodies (IgY) are efficient in protecting neonatal calves from RVA diarrhea; however, the value of this intervention in calves once diarrhea has appeared is unclear. The aim of the present study was to evaluate the application of RVA-specific IgY as a passive treatment in those cases. The experimental groups were: G1=RVA-specific IgY treatment; G2=no Ab treatment; and G3=colostrum deprived+no Ab treatment. IgY treatment significantly reduced virus shedding, diarrhea duration and severity compared to G2 and G3 calves. However, it caused a partial suppression of systemic Ab responses to RVA that could be associated with less severe diarrhea. The oral treatment with IgY for 7days was associated with significantly higher antibody secreting cell responses in the calves compared with other groups of animals.

Programa multicéntrico para la atención integral del recién nacido con agresión hipóxico-isquémica perinatal (ARAHIP) / Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)

INTRODUCCIÓN: El recién nacido con indicadores de potencial evento hipóxico-isquémico perinatal precisa de una atención integral que detecte precozmente si necesita tratamiento con hipotermia y el control de los factores agravantes del da˜no cerebral en las primeras 6 h de vida. PACIENTES Y MÉTODOS: Aplicación de un programa prospectivo de ámbito poblacional que ordena y sistematiza la atención durante las primeras 6 h de vida en los ≥ 35 semanas nacidos con indicadores de agresión hipóxico-isquémica perinatal. El programa involucra 12 hospitales (91.217 m2), 7 de nivel asistencial i-ii y 5 de nivel III. Se establecen 4 protocolos: a) detección del recién nacido con potencial agresión hipóxico-isquémica; b) vigilancia de la repercusión neurológica y en otros órganos; c) control y tratamiento de complicaciones, y d) vigilancia y acciones durante el transporte. RESULTADOS: Entre junio del 2011 y junio del 2013, de 32.325 recién nacidos ≥ 35 semanas, 213 cumplieron criterios de potencial agresión hipóxico-isquémica perinatal (7,4 por 1.000). El 92% siguió la monitorización establecida en el programa; 33 recién nacidos tuvieron encefalopatía hipóxico-isquémica moderada-grave (1 por 1.000) y 31/33 (94%) recibieron tratamiento con hipotermia. CONCLUSIONES: El programa Atención integral al Recién nacido con Agresión Hipóxico-Isquémica Perinatal ha permitido ofrecer atención integral al recién nacido con indicadores de agresión hipóxico-isquémica perinatal. Se han controlado factores comórbidos agravantes de la lesión cerebral y se han detectado aquellos con encefalopatía hipóxico-isquémica moderadagrave, permitiendo iniciar la hipotermia dentro de las primeras 6 h de vida. Programas de ámbito poblacional son cruciales para disminuir la morbimortalidad asociada a la encefalopatía hipóxico-isquémica

INTRODUCTION: Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment. PATIENTS AND METHODS: The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m2); two level I centers, five level II centers, and five level III hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport. RESULTS: From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%). CONCLUSIONS: The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy

[Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)]. / Programa multicéntrico para la atención integral del recién nacido con agresión hipóxico-isquémica perinatal (ARAHIP).

INTRODUCTION: Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment. PATIENTS AND METHODS: The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m(2)); two level i centers, five level ii centers, and five level iii hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport. RESULTS: From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%). CONCLUSIONS: The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy.

Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: a multicentre, randomised, blinded, controlled and non-inferiority trial.

BACKGROUND: Acute ankle sprains are common and activity limiting injuries, and topical diclofenac gel has proven efficacy in alleviating pain and restoring function. This trial aimed to compare a topical natural agent, Traumeel with topical diclofenac gel (1%) in the management of acute ankle sprain. METHODS: This prospective, multicentre, randomised, blinded, active-control and non-inferiority study involved 449 physically active adults sustaining unilateral grade 1 or 2 ankle sprain within the past 24 h. Participants were randomised to receive 2 g of Traumeel ointment (T-O) (n = 152) or Traumeel gel (T-G) (n = 150) or diclofenac gel (D-G) (n = 147), administered topically to the ankle three times a day for 14 days, with 6-weeks follow up. RESULTS: Day 7 median percentage reductions in Visual Analogue Scale pain score were 60.6%, 71.1% and 68.9% for the T-O, T-G and D-G groups, respectively. Total pain relief was reported by 12 (8.5%), 7 (5.0%) and 8 (5.9%) participants in each group, respectively. Median improvements in Foot and Ankle Ability Measure Activities of Daily Living subscale score were 26.2, 26.2 and 25.0 points for T-O, T-G and D-G groups, respectively. Mann-Whitney effect sizes and lower bound confidence intervals demonstrated non-inferiority of Traumeel vs. diclofenac for reducing pain and functional improvement. At 6 weeks, participants reported total pain relief and normal functioning. Adverse events (n = 43) were reported by 31/447 participants (6.9%). Treatments were equally well tolerated. CONCLUSIONS: T-O and T-G decreased pain and improved joint function to the same extent as D-G in acute ankle sprain, and were well tolerated.

Epilepsia postraumática, evaluación de los criterios de causalidad. A propósito de un caso / Posttraumatic epilepsy and its differential diagnosis in impairment evaluation. Case report

Objetivo: Se presenta un caso de valoración pericial de nexo de causalidad en una epilepsia postraumática, entre un traumatismo craneoencefálico (TCE) ocurrido cuatro años antes y una agresión con resultado de lesiones leves, en un varón de 21 años, consumidor ocasional de alcohol, cannabis y cocaína. El objetivo de este artículo es el análisis de los criterios médico-legales aplicables al caso y la correcta evaluación del estado anterior del paciente. La valoración pericial resulta afectada por la complejidad de los mecanismos desencadenados en el TCE, por la intervención de otros factores que pueden contribuir a la aparición de epilepsia, y por la existencia de una extensa literatura sobre el tema, en muchos casos con hallazgos dispares y contradictorios. Conclusiones: En el presente caso, evaluados los criterios de causalidad, la epilepsia se considera secundaria al TCE sufrido cuatro años antes (AU)

Introduction: This report shows a case of posttraumatic epilepsy related to head injury four years ago and aggression with result in mild injury, in a 21-year-old male, alcohol, cannabis and cocaine user. The aim of this report is to review the expert evaluation of the link between head injury or aggression and posttraumatic epilepsy by the analysis of the causal relationship factors and the influence of previously existing pathology. The expert evaluation is awkward and difficult to deal with, because of the different mechanisms of Traumatic Brain Injury (TBI) and other factors that could lead to epilepsy. Also the extensive bibliography on the subject is controversial. Conclusions: In this case the posttraumatic epilepsy can be reasonably linked to the TBI that had been undergone 4 years ago (AU)

Milk supplemented with immune colostrum: protection against rotavirus diarrhea and modulatory effect on the systemic and mucosal antibody responses in calves experimentally challenged with bovine rotavirus.

Group A bovine rotavirus (BRV) is the major cause of neonatal calf diarrhea worldwide. As a preventive strategy, we evaluated the protection and immunomodulation in two groups of BRV-inoculated calves. All calves received control colostrum (CC; VN=65,536; IgG(1)=16,384) prior to gut closure followed by the milk supplemented with immune colostrum (VN=1,048,576; IgG(1)=262,144), twice a day, for 14 days. Calves received milk supplemented with 0.8% immune colostrum [(Gp 1) VN=16,384; IgG(1)=4096] or milk supplemented with 0.4% immune colostrum [(Gp 2) VN=1024; IgG(1)=1024]. Calves receiving CC or colostrum deprived calves (CD) fed antibody (Ab) free milk served as controls (Gp 3 and 4). Calves were inoculated with virulent BRV IND at 2 days of age. Group 1 calves (milk IgG(1) 4096) showed 80% protection against BRV diarrhea and significantly reduced virus shedding. At 21 post-inoculation days (PID), the antibody secreting cell (ASC) responses of Gp 1 calves were limited mainly to duodenal and jejunal lamina propria (LP) with limited or no responses in systemic sites (spleen and PBL) and mesenteric lymph nodes. The profile of serum and fecal Ab responses as well as the ASC responses was also modulated by the presence of passive IgG(1) Abs and probably other colostrum components, toward higher titers of IgA Ab in serum and feces and a greater number of IgA ASC in the proximal intestine, reflecting positive modulation by colostrum toward this isotype associated with optimal protection of the intestinal mucosa. After challenge, at PID 21, all calves in Gp 1 and 2 were fully protected against diarrhea and only 1 of 5 calves in Gp 1 shed virus asymptomatically, indicating that the passive Ab treatment for 14 days was effective in protecting most of the animals after a first and a second virus exposure. The final outcome was a positive modulation of the mucosal immune responses and a high protection rate against diarrhea and virus shedding during the period of peak susceptibility to BRV infection.

Nexo causal de neumotórax asociado con acupuntura. A propósito de un caso / Pneumothorax related to acupuncture therapy. A case report of pneumothorax

Se describe el caso de un paciente sometido a tratamiento con acupuntura y electroestimulación que sufrió un cuadro de neumotórax al terminar una de las sesiones. Se trata de un varón de 26 años, diagnosticado de fractura tercio distal del radio derecho tratado quirúrgicamente. En su evolución presentó algodistrofia de la muñeca y la mano derechas, fue sometido a tratamiento con acupuntura y electroestimulación y presentó, al terminar una de las sesiones, un neumotórax derecho. El interés que presenta este caso es la valoración pericial del nexo causal entre el neumotórax y el tratamiento con acupuntura, mediante el análisis de los criterios de causalidad médico-legal aplicables al caso. Aunque los efectos adversos graves debidos a la acupuntura son raros y la literatura médica no proporciona adecuados datos relacionados con la incidencia de tales complicaciones, la mayoría de los autores atribuyen el neumotórax, en general, a un error del terapeuta y no a los riesgos específicos de la acupuntura

A case-report of pneumothorax related to acupuncture therapy and electrostimulation is described. A 26-year-old male had an accident and as a result, a right distal radius fracture. After surgery, he developed algodystropy of the right wrist and hand and underwent treatment with acupuncture and electrostimulation. At the end of one of the sessions, he suffered an immediate right pneumothorax. The interest of this case is the expert evaluation of the causal connection between the pneumothorax and treatment with acupuncture by means of the analysis of the medical-legal causality criteria applicable to the case. Although serious adverse events due to acupuncture therapy are rare, the medical literature does not provide data about the incidence of such complications. The majority of the authors generally attribute the pneumothorax to an error by the therapist and not to the specific risks of the acupuncture

Conocimientos y opiniones de estudiantes de medicina de quinto año acerca de las medicinas alternativas y complementarias / Knowledge and opinions of fifth-year medical students about alternative and complementary medicines

Objetivos: Identificar conocimientos y opiniones de estudiantes Medicina acerca de las Medicinas Alternativas y Complementarias (MAC). Material y Métodos: Se aplicó una encuesta autoadministrada a 106 estudiantes de quinto año de Medicina de la Pontificia Universidad Católica de Chile en 2005. Esta encuesta incluyó estimadores de nivel de conocimientos, percepción de utilidad e interés por adquirir conocimientos sobre cuatro terapias: medicina mapuche, homeopatía, acupuntura y reiki. También incluyó una medición del nivel de acuerdo con doce afirmaciones generales sobre MAC. Resultados: La tasa de respuesta fue de 90,5%. El porcentaje de personas que desconocían o sólo reconocían el nombre de las distintas terapias fue variable: 11,3% para homeopatía, 19,8% para acupuntura, 54,1% para reiki y 55,2% para medicina mapuche. La mejor percepción sobre utilidad fue para la acupuntura (78,7% la considera útil o muy útil), siendo semejante para hombres y mujeres. Las otras terapias tuvieron fueron evaluadas como útiles principalmente por mujeres, con diferencias estadísticamente significativas. Se identificó un amplio interés por adquirir conocimientos generales sobre el tema. Las mujeres mostraron mayor acuerdo con las afirmaciones generales favorables hacia las MAC y mayor desacuerdo hacia las afirmaciones críticas. Discusión: Los estudiantes de Medicina presentan conocimientos limitados sobre las MAC, pero un elevado interés en el tema. Las mujeres tienen una actitud más favorable hacia las MAC que los hombres. (AU)

Effect of combined nutrients on biosurfactant produced by Pseudomonas putida.

This work investigated biosurfactant production by Pseudomonas putida in combined C/P, C/Ninorganic, C/Fe, C/Mg nutrient ratios and peptone concentration. Analysis of the 2(5-1) fractional factorial experimental design showed that only the C/Fe ratio had a significant (p<0.02) effect on biosurfactant production. The highest amount of biosurfactant was obtained at low C/Fe ratios, but net surface tension did not show significant differences. In addition, low amounts of peptone and the C/P-C/Mg nutrient ratios interaction significantly (p < 0.05) enhanced the biomass produced by P. putida. Analysis of biosurfactant by gas chromatography (GC) showed that the hydrophilic fraction was composed by rhamnose and the hydrophobic fraction, mainly by palmitic (C16), stearic (C18:0), oleic (C18:1) and linoleic (C18:2) fatty acids.

Rinoescleroma, una enfermedad rara en Chile: reporte de un caso clínico / Rhinoscleroma, a rare illness in Chile: report of a clinical case

Se presenta el primer caso publicado de rinoescleroma en un paciente chileno, con historia de tres años de evolución de obstrucción nasal izquierda que luego se hace bilateral. Es estudiado en el Policlínico de Otorrinolaringología del Hospital Barros Luco Trudeau, pesquisándose una masa en fosas nasales de aspecto polipoideo atípico. Mediante estudio histopatológico e infectológico se confirma el diagnóstico de rinoescleroma, con cultivo positivo para Klebsiella rhinoscleromatis. El paciente es tratado con moxifloxacino durante seis semanas previo a la cirugía endoscópica, efectuándose resección de la patología en ambas fosas nasales. Se trata con antibiótico durante seis semanas más, quedando, a los tres meses postcirugía, con leve obstrucción nasal a izquierda secundaria a una estenosis fibrosa de coana izquierda, residual a su patología.

Cultura y salud / Culture and Health

La salud y sus diferentes visiones: Construyendo interculturalidad desde la salud.- La concepción holística: Principios y conceptos.- Identidad: Un requisito básico para la convivencia entre culturas.- Raza y etnicidad: La discriminación y su impacto en la salud.- Los problemas de la salud: Desde las causas.- Las plantas medicinales: Una forma de percibir el efecto de las plantas desde una nueva dimensión.- Plantas medicinales: Sus usos y saberes.- La cultura y sua alimentación: Lo profundo de la comida, lo transformador de la nutrición.- El parto y el nacimiento: Un acontecimiento cálido, familiar y comunitario.- Relaciones de género: ¿Complementariedad?.- La cultura y el ejercicio de los derechos

aproximación al tratamiento nutricional de los errores innatos del metabolismo (y V) / approaches to the dietary treatment of inborn errors of metabolism (and V)

No disponible

Aproximación al tratamiento nutricional de los errores innatos del metabolismo (IV) / Approaches to the dietary treatment of inborn errors of metabolism (IV)

No disponible

Aproximación al tratamiento nutricional de los errores innatos del metabolismo (III) / Approaches to the dietary treatment of inborn errors of metabolism (III)

No disponibe (AU)

Aproximación al tratamiento nutricional de los errores innatos del metabolismo (II) / Approaches to the dietary treatment of inborn errors of metabolism (II)

El tratamiento nutricional de los errores innatos del metabolismo (EIM) constituye en la actualidad el pilar más importante en el manejo global de estas enfermedades. Nuestra intervención dietética no sólo debe intentar asegurar un adecuado crecimiento y desarrollo del niño sino que, al mismo tiempo, tenemos que programar un enfoque nutricional específico según el defecto metabólico del que se trate. En este artículo (segundo de cinco partes) y el siguiente abordamos los aspectos diatéticos y nutricionales de algunos de los trastornos más frecuentes que afectan el metabolismo de los aminoácidos (AU)

Aproximación al tratamiento nutricional de los errores innatos del metabolismo (I) / The dietary treatment of inborn errors of metabolism (I)

El tratamiento nutricional de los errores innatos del metabolismo constituye en la actualidad el pilar más importante en el manejo global de estas enfermedades. Las intervenciones dietéticas no sólo deben intentar asegurar un adecuado crecimiento y desarrollo del niño, sino que, al mismo tiempo, se debe programar un enfoque nutricional específico según el defecto metabólico del que se trate. En este artículo -primero de dos partes- se abordan los aspectos dietéticos y nutricionales del los trastornos más frecuentes que afectan al metabolismo de los hidratos de carbono y de las grasas (betaoxidación) (AU)

Cerebrospinal fluid levels of selenium in patients with Alzheimer's disease.

We compared CSF and serum selenium levels, measured by atomic absorption spectrophotometry, in 27 patients with Alzheimer's disease (AD) (13 females, 14 males, mean +/- SD age 73.6 +/- 7.4 years) without major clinical signs of undernutrition, and 34 matched controls (18 females, 16 males, mean +/- SD age 70.7 +/- 7.8 years). CSF and serum selenium levels did not differ significantly between AD-patient (11.4 +/- 7.8 ng/ml and 28.5 +/- 13.0 ng/ml, respectively) and control groups (13.3 +/- 7.0 ng/ml and 22.5 +/- 17.5 ng/ml). These values were not correlated with age, age at onset, duration of the disease, and scores of the MiniMental State Examination in the AD group. Weight and body mass index were significantly lower in AD patients than in controls. These results suggest that CSF selenium concentrations are apparently unrelated with the reported oxidative stress processes in patients with AD.