Hookworm Infection in South American Fur Seal ( Arctocephalus australis) Pups.

Tissues of South American fur seal pups naturally infected with hookworms ( Uncinaria sp) were examined. Hookworm infection was found in nearly all pups examined (132/140, 94%), and hookworm enteritis with secondary bacteremia was considered the cause of death in 46 (35%) pups. Common findings in these pups included severe hemorrhagic enteritis and numerous (mean intensity = 761.8) hookworms in the jejunum. Hookworms were recovered from the abdominal cavity in 12 of 55 pups (22%) examined through peritoneal wash; these pups had an average of 1343.3 intestinal hookworms and marked fibrinohemorrhagic peritonitis. In all pups that died as a consequence of hookworm infection, the intestinal villi were short, blunt, and fused, and there were variable numbers of free and intrahistiocytic gram-negative bacteria in submucosal hookworm feeding tracks, mesenteric lymph nodes, spleen, blood vessels, and liver sinusoids. Pups that died of causes unrelated to the hookworm infection (trauma) had hookworm feeding tracks confined to the apical portions of the mucosa, and moderate to marked catarrhal eosinophilic enteritis. The number of hookworms was negatively correlated with intestinal villous length and number of leukocytes in the intestine. Pups with hookworm peritoneal penetration had nematodes with little or no blood in the hookworm intestine, suggesting that lack of food for the nematode could be associated with peritoneal penetration. Findings suggest that the initial burden of larval infection, the level of the host tissue response, or a combination determine the number of nematodes in the intestine, the severity of hookworm tissue damage, and pup mortality.

[Effects on cognitive processes of dual-task training in people with Parkinson's disease: a systematic review]. / Efectos sobre los procesos cognitivos del entrenamiento basado en doble tarea en personas con enfermedad de Parkinson: una revisión sistemática.

INTRODUCTION: Dual-tasking is a non-pharmacological intervention in people with neurodegenerative conditions, and is used in Parkinson's disease (PD), primarily to enhance motor performance. The aim of this review is to compile the current evidence on how dual-task training affects cognitive processes in people with PD. MATERIAL AND METHODS: A systematic review was undertaken, applying PRISMA guidelines, which included articles obtained from the PubMed, Web of Science, Science Direct and Springer Link databases. Methodological quality was assessed using PEDro and ROBINS-I. RESULTS: Twelve articles met the inclusion and exclusion criteria: nine of them were randomized controlled trials, and the remaining three were non-randomized studies. Improvements in attention and executive functions were identified, although the diversity of approaches and duration means that reaching definitive conclusions is difficult. CONCLUSIONS: Increased research and standardized intervention programmes are essential. Longitudinal and randomized controlled studies in representative samples which provide conclusions that are applicable to other contexts are also important.

TITLE: Efectos sobre los procesos cognitivos del entrenamiento basado en doble tarea en personas con enfermedad de Parkinson: una revisión sistemática.Introducción. La doble tarea es una intervención no farmacológica en personas con condiciones neurodegenerativas, utilizada en la enfermedad de Parkinson (EP), principalmente para favorecer el desempeño motor. El objetivo de esta revisión es reunir la evidencia actual sobre cómo el entrenamiento de doble tarea afecta a los procesos cognitivos en personas que presenten EP. Material y métodos. Se desarrolló una revisión sistemática, aplicando las directrices de PRISMA, incluyendo artículos obtenidos en las bases de datos de PubMed, Web of Science, Science Direct y Springer Link. La calidad metodológica se evaluó mediante PEDro y ROBINS-I. Resultados. Doce artículos cumplieron con los criterios de inclusión y exclusión: nueve de ellos corresponden a ensayos controlados aleatorizados y los tres restantes fueron estudios no aleatorizados. Se identificaron mejoras en la atención y las funciones ejecutivas, aunque la diversidad en enfoques y duración dificulta llegar a conclusiones definitivas. Conclusiones. Es crucial expandir la investigación, estandarizando los programas de intervención. Del mismo modo, es importante llevar a cabo estudios longitudinales y controlados aleatorizados en muestras representativas que permitan llegar a conclusiones aplicables a otros contextos.

Efectos sobre los procesos cognitivos del entrenamiento basado en doble tarea en personas con enfermedad de Parkinson: una revisión sistemática / Effects on cognitive processes of dual-task training in people with Parkinson’s disease: a systematic review

Introducción: La doble tarea es una intervención no farmacológica en personas con condiciones neurodegenerativas, utilizada en la enfermedad de Parkinson (EP), principalmente para favorecer el desempeño motor. El objetivo de esta revisión es reunir la evidencia actual sobre cómo el entrenamiento de doble tarea afecta a los procesos cognitivos en personas que presenten EP. Material y métodos. Se desarrolló una revisión sistemática, aplicando las directrices de PRISMA, incluyendo artículos obtenidos en las bases de datos de PubMed, Web of Science, Science Direct y Springer Link. La calidad metodológica se evaluó mediante PEDro y ROBINS-I. Resultados: Doce artículos cumplieron con los criterios de inclusión y exclusión: nueve de ellos corresponden a ensayos controlados aleatorizados y los tres restantes fueron estudios no aleatorizados. Se identificaron mejoras en la atención y las funciones ejecutivas, aunque la diversidad en enfoques y duración dificulta llegar a conclusiones definitivas. Conclusiones: Es crucial expandir la investigación, estandarizando los programas de intervención. Del mismo modo, es importante llevar a cabo estudios longitudinales y controlados aleatorizados en muestras representativas que permitan llegar a conclusiones aplicables a otros contextos.(AU)

Introduction: Dual-tasking is a non-pharmacological intervention in people with neurodegenerative conditions, and is used in Parkinson’s disease (PD), primarily to enhance motor performance. The aim of this review is to compile the current evidence on how dual-task training affects cognitive processes in people with PD. Material and methods: A systematic review was undertaken, applying PRISMA guidelines, which included articles obtained from the PubMed, Web of Science, Science Direct and Springer Link databases. Methodological quality was assessed using PEDro and ROBINS-I. Results: Twelve articles met the inclusion and exclusion criteria: nine of them were randomized controlled trials, and the remaining three were non-randomized studies. Improvements in attention and executive functions were identified, although the diversity of approaches and duration means that reaching definitive conclusions is difficult. Conclusions: Increased research and standardized intervention programmes are essential. Longitudinal and randomized controlled studies in representative samples which provide conclusions that are applicable to other contexts are also important.(AU)

Pathological Findings in Wild Rats (Rattus rattus) Captured at Guafo Island, Northern Chilean Patagonia.

The black rat (Rattus rattus) is an invasive species and potential reservoir of significant pathogens of man, domestic animals and wildlife. During the 2012-2014 austral summers, 201 black rats were captured and examined on the uninhabited Guafo Island, in Northern Chilean Patagonia (43.593029°S, 74.713481°W). The mite Ornithonyssus bacoti caused lymphoplasmacytic and eosinophilic dermatitis in all infected rats (105/210, 52%), but no skin lesions were observed in rats infected with Nosopsyllus spp. and Plocopsylla spp. fleas. Eighty-eight rats (44%) had mild lymphoplasmacytic and eosinophilic enterocolitis and 61 of these rats were infected with the nematode Heterakis spumosa. In the liver, 63 animals (31%) had areas of necrosis with histiocytic and eosinophilic inflammation associated with multiple Calodium hepaticum eggs, and in 15 cases there was co-infection with several Taenia taeniaeformis strobilocerci. Mild interstitial lymphoplasmacytic sialadenitis with intranuclear inclusion bodies, suggesting cytomegalovirus infection, was observed in 28 rats (15%). In the lung, alveolar histiocytosis (69 rats, 34%) and perivascular lymphocytic infiltrates (46 rats, 23%) were the most common findings. There was mild to moderate lymphoplasmacytic interstitial nephritis in 52 rats (26%) and in 15% of these cases Leptospira spp. antigen was detected in the distal renal tubules. Some of the diseases of black rats on Guafo Island are likely to play a role in rat population dynamics. The endemic Guafo Island long-clawed mole mouse (Geoxus lafkenche), sea lions and fur seals may be at risk for infection by some of these rat pathogens.

European recommendations for the management of healthcare workers occupationally exposed to hepatitis B virus and hepatitis C virus.

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, >or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBc IgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs >or=50 mUI/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs >or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected.

European recommendations for the management of healthcare workers occupationally exposed to hepatitis B virus and hepatitis C virus.

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, >10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBc IgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs >50 mUI/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs >10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected.

Effects of flower dimorphism and light environment on arbuscular mycorrhizal colonisation in a cleistogamous herb.

Although it is known that floral dimorphism contributes to the maintenance of mixed breeding systems, the consequences of producing progeny of a contrasting genetic background and seeds with differential resource allocation has been practically ignored regarding establishment of belowground organisms-plant interactions. This article evaluates the combined effect of floral dimorphism with cross type and light environment on interactions between Ruellia nudiflora and arbuscular mycorrhizal fungi (AMF). R. nudiflora produces cleistogamous (CL) flowers that exhibit obligate self-pollination and chasmogamous (CH) flowers with facultative self- (CHs) or cross- (CHc) pollination. We evaluated the establishment of the plant-AMF interaction in progeny derived from each floral type, under two light conditions (shaded versus open). We established different scenarios depending on the existence of inbreeding depression (ID) and whether the differential resource allocation (DRA) to CH and CL flowers affected the R. nudiflora-AMF interaction. We predicted that under shaded light conditions there might be an intensification of ID, having a negative effect on AMF colonisation. The percentages of hyphae and vesicles in the harvested roots was significantly higher in the shaded plants (F ≥ 4.11, P < 0.05), while progeny of CHc and CHs presented a higher percentage of hyphae and vesicle colonisation compared to CL progeny (F = 15.26, P < 0.01). The results show that DRA to CH flowers and light availability both determines the establishment of R. nudiflora-AMF interaction. The results also suggest that even under stressful light conditions, endogamy does not affect this interaction, which may explain the success of R. nudiflora as an invasive species.

[Changes in epidemiological pattern of methicillin-resistant Staphylococcus aureus infections in a tertiary hospital. Experience of 5 years]. / Cambios en los patrones epidemiológicos de la infección por Staphylococcus aureus resistente a la meticilina en un hospital de tercer nivel. Experiencia de 5 años.

OBJECTIVE: To describe the demographic pattern and tendency of the infections by MRSA between 1992 and 1997. DESIGN AND METHODS: Descriptive study of the infections by MRSA in a tertiary-care hospital. RESULTS: 267 MRSA infections, 131 infections were included within 58 buds and 136 cases isolated form. The more affected services were Internal Medicine, Urology, Neurology, Vascular surgery and intensive care unit. A tendency was observed to the increase in > 65 years cases and in medical services. CONCLUSIONS: The increase of elderly cases in medical services and > 65 years carriers in their nose could translate the existent situation in the community.

[Time-series analysis applied to nosocomial infection]. / Análisis de series temporales aplicado a la infección nosocomial.

BACKGROUND: In this study we introduce a new view of hospital infection, to apply time series techniques to it. Our objective is to complement hospital infection's epidemiological surveillance by means of obtaining alert and alarm thresholds that make easy to the epidemiologist the decision of intervention, in case they are exceeded. METHODS: We have used the classic time series analysis described by Rumeau-Rouquette, and ARIMA (Autoregresive Integrated Moving Average) models developed by Box and Jenkins. The study focus on three hospital units: one intensive care, one long term care and one surgical unit. The nosocomial infection intervals have been calculated with a 68% (1SD) and 95% (2SD) confidence levels. RESULTS: We detect an ascending general trend in the last two units, without the detection of seasonal variations. Two ARIMA (1, 0, 0) models we obtained for surgery and long term care, discarding other better adjusted models, more complex and difficult to obtain, but with no real advantage in prediction power. Confidence intervals were calculated with both methods. We did not find general trend and seasonal variations for intensive care unit. No model was considered valid, because of its high random component. The nosocomial infection intervals have been calculated with mean +/- 1SD and mean +/- 2SD. CONCLUSIONS: We think that more precise knowledge of hospital infection, with a high random component in our study, can be in addition useful to assign priority to human and material resources.

[Costs of accidental punctures in hospital health personnel]. / Costes de las inoculaciones accidentales en personal sanitario de un hospital.

OBJECTIVES: The aim of this study was to calculate the average cost of each hepatitis B, C and HIV follow-up carried out in the health personnel that have suffered an exposure to blood and body fluids and to estimate the cost for each of the different types of sources as well as to identify the items that account for the main part of the cost. METHODS: A cost analysis was carried out. The post-exposure programme was modelled in a decision tree combining probabilities (percentage of each type of source in dependence of its positivity for the three viruses and immunization state of the health personnel against hepatitis B) and monetary costs (pesetas from 1994). Costs included: salaries, laboratory, chemist, energy, cleaning, telephone, medical and office equipment, amortization and lost productivity. A sensitivity analysis was carried out with the real fulfillment of the programme. RESULTS: The average cost was 39,564 ptas. (29,750 ptas. applying the sensitivity analysis), with a range from 86,864 ptas. (source positive for the three viruses and injured subject not immunized) to 23,074 ptas. (source negative for the three viruses). If the source was hepatitis B positive, the average cost was 86,093 ptas. when the injured subject was not immunized and 53,232 ptas. if he was immunized. Serologic tests account for the main part of the cost (range from 72.8% to 87.7%). CONCLUSIONS: High cost suggests an appropriate risk evaluation in order to avoid unnecessary follow-ups. The model used allows to know the cost of each potentially avoided episode and it could be used for any hospital in order to make an economical evaluation of new preventive devices.

[Classification of disposable medical plastics and search for alternatives without polyvinyl chloride in the Hospital Virgen de las Nieves (Granada, Spain)]. / Clasificación de materiales plásticos sanitarios desechables y búsqueda de alternativas sin policloruro de vinilo en el Hospital Virgen de las Nieves.

OBJECTIVES: To identify and classify disposable hospital products containing polyvinyl chloride (PVC), including the search and evaluation of cost-effective sustainable alternative products free of PVC. METHODS: A descriptive observational analysis was performed, after classifying the latest research in major databases, and disposable products that could contain PVC. These were divided into 5 groups: cannulas, catheters, tubes, bags, and equipment, purchased in the period 2008-2009, differentiating between the technical and economic assessment of the materials. RESULTS: In the analysis of the composition of 492 articles selected, 234 (47.5%) contained PVC, and 19.4% were considered PVC-free alternatives, with only 11.3% of these being economically viable. CONCLUSIONS: This study highlights the advantages of the classification of PVC products, by showing that safe and efficient alternatives exist for some product lines that are consistent with patient safety and quality in the work by doctors.

[The role of cancer registries in the planning of primary care. A special reference to the Calatayud health area]. / El papel de los registros de cáncer en la planificación de la asistencia primaria. Referencia especial al sector de salud de Calatayud.

The present study is based on the analysis of records concerning 2,123 cases of cancer registered between 1973 and 1982 in the Health Sector of Calatayud. We pretend to find out what sort of role is played by the gathered cancer information registries on the Community Health Diagnosis elaboration and, therefore, on the Primary Care Planning. An important loss of cases (23% in men and 13% in women) and a clear influence of socioeconomic factors concerning Epidemiology and even Cancer Care are remarked. Delay times of diagnosis are higher than on the other series: breast (17.4 months), skin (39.9 months), larynx (7.7 months). A preferential care about the improvement of the Sanitary Education of population, their accessibility to Sanitary System and medical praxis of the Primary Care professionals are proposed.

[Accidents with biological material in health care workers in 2 primary health care areas (1990-1999)]. / Accidentes con material biológico en trabajadores sanitarios de 2 áreas de atención primaria (1990-1999).

OBJECTIVE: To find out the exposures with biological material in health care workers in primary health care, registered in the biological accidents database from Preventive Medicine Service in Miguel Servet Universitary Hospital of Zaragoza. DESIGN: Descriptive study of a retrospective cohort. SITE: Primary health care, Areas II and V of Zaragoza.Participants. Workers in this areas, distributed by: physician, nursing staff, auxiliary, orderly, housekeeping staff, others. MEASUREMENTS AND MAIN RESULTS: Data of: workers, accident, serologic source, worker protection and vaccinal status of hepatitis B. The incidence of accidents was 26 (period 1997-1999). Most proportion of accidents were declared by nursing (78%). The highest occupational incidence was in auxiliary (63 ). In 90,1% of the cases, the accident was needlestick injury. The source was known in 67,7% of cases. The accidents occurred in hands in 96,8% of cases, and only one third of workers carried gloves. CONCLUSIONS: Results obtained are similar with previous studies about this event. We must insist on the need to declare these accidents, providing more information and accessibility for the declaration to worker. Moreover, we must insist on the correct application in the health care field of the standard precautions, because almost 50% of accidents are evitable, and to increase hepatitis B vaccination covertures.

[Epidemiology of brucellosis. Retrospective study of 246 hospital cases]. / Epidemiología de la brucelosis. Estudio retrospectivo de 246 casos hospitalarios.

246 cases of brucellosis registered by the Medicine Preventive Service of Miguel Servet Hospital for the period 1981-87 are retrospectively studied. It emphasizes the consumption of non controlled dairy products as the most frequent (54.5%) risk factor. A greater prevalence of professional and contact with cattle risk factors are observed in the male patients coming from rural areas.