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1.
Int Urogynecol J ; 35(7): 1347-1362, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38861007

RESUMEN

INTRODUCTION AND HYPOTHESIS: The aim of this article is to present a systematic literature review focused on microbiome diversity in women experiencing pelvic floor dysfunction. METHODS: Utilizing PubMed/MedLine and Scopus, 25 pertinent studies were meticulously selected for this review. RESULTS: A key theme identified is the potential of microbiomes as diagnostic tools. The findings consistently highlight Lactobacillus as recurrent microbiota. Additionally, Gardnerella, Streptococcus, Prevotella, Aerococcus, Staphylococcus, Proteus, and Bifidobacterium species were frequently observed. This suggests the influential role of these microorganisms in shaping female urological and reproductive health. A deeper understanding of these predominant bacterial genera could offer invaluable insights into healthy physiological states and various disorders. The complex relationship between microbial compositions and diverse health conditions paves the way for novel diagnostic and therapeutic approaches. As we further explore the complexities of microbiomes, their role becomes increasingly crucial in transforming women's health care. CONCLUSIONS: These findings emphasize the need for personalized care, integrating the microbiome into a comprehensive health assessment and treatment framework. This review lays the groundwork for future medical strategies where the microbiome is a pivotal element in both preventive and therapeutic care.


Asunto(s)
Microbiota , Trastornos del Suelo Pélvico , Humanos , Femenino , Trastornos del Suelo Pélvico/microbiología , Lactobacillus , Vagina/microbiología , Genitales Femeninos/microbiología
2.
Eur J Public Health ; 34(1): 52-58, 2024 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-37793003

RESUMEN

BACKGROUND: The 'WHO-ASPHER Roadmap to Professionalizing the Public Health Workforce in the European Region' provides recommendations for strategic and systematic workforce planning around professionalization levers including: (i) competencies, (ii) training and education, (iii) formal organization, (iv) professional credentialing and (v) code of ethics and professional conduct as well as taxonomy and enumeration. It was based on a literature review till 2016. This scoping review aims to explore how the professionalization was documented in the literature between 2016 and 2022. METHODS: Following the Joanna Briggs Institute guidelines, we searched Medline via PubMed, Web of Science, ERIC via EBSCO and Google Scholar and included studies on professionalization levers. Four critical appraisal tools were used to assess qualitative, quantitative, mixed methods studies and grey literature. The PRISMA Extension for Scoping Reviews (PRISMA-ScR) was used for reporting. RESULTS: Eleven articles included in this review spanned 61 countries, targeting undergraduate, master's, doctoral degrees and continuing professional development. Most of these documents were reviews. About half provided a definition of the public health workforce; more than half covered the taxonomy and included information about competences, but the use of frameworks was sporadic and inconsistent. Formal organization and the necessity of a code of conduct for the public health workforce were acknowledged in only two studies. CONCLUSIONS: In spite of some efforts to professionalize the public health workforce, this process is fragmented and not fully recognized and supported. There is an urgent need to engage policymakers and stakeholders to prioritize investments in strengthening the public health workforce worldwide.


Asunto(s)
Fuerza Laboral en Salud , Salud Pública , Humanos , Recursos Humanos , Estudiantes
3.
BMC Med Res Methodol ; 23(1): 55, 2023 02 27.
Artículo en Inglés | MEDLINE | ID: mdl-36849911

RESUMEN

Safe and effective vaccines are crucial for the control of Covid-19 and to protect individuals at higher risk of severe disease. The test-negative design is a popular option for evaluating the effectiveness of Covid-19 vaccines. However, the findings could be biased by several factors, including imperfect sensitivity and/or specificity of the test used for diagnosing the SARS-Cov-2 infection. We propose a simple Bayesian modeling approach for estimating vaccine effectiveness that is robust even when the diagnostic test is imperfect. We use simulation studies to demonstrate the robustness of our method to misclassification bias and illustrate the utility of our approach using real-world examples.


Asunto(s)
COVID-19 , Humanos , COVID-19/prevención & control , Vacunas contra la COVID-19 , Teorema de Bayes , Eficacia de las Vacunas , SARS-CoV-2
4.
BMC Med Res Methodol ; 22(1): 91, 2022 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-35369874

RESUMEN

BACKGROUND: Tests have false positive or false negative results, which, if not properly accounted for, may provide misleading apparent prevalence estimates based on the observed rate of positive tests and not the true disease prevalence estimates. Methods to estimate the true prevalence of disease, adjusting for the sensitivity and the specificity of the diagnostic tests are available and can be applied, though, such procedures can be cumbersome to researchers with or without a solid statistical background. This manuscript introduces a web-based application that integrates statistical methods for Bayesian inference of true disease prevalence based on prior elicitation for the accuracy of the diagnostic tests. This tool allows practitioners to simultaneously analyse and visualize results while using interactive sliders and output prior/posterior plots. METHODS - IMPLEMENTATION: Three methods for prevalence prior elicitation and four core families of Bayesian methods have been combined and incorporated in this web tool. |tPRiors| user interface has been developed with R and Shiny and may be freely accessed on-line. RESULTS: |tPRiors| allows researchers to use preloaded data or upload their own datasets and perform analysis on either single or multiple population groups clusters, allowing, if needed, for excess zero prevalence. The final report is exported in raw parts either as.rdata or.png files and can be further analysed. We utilize a real multiple-population and a toy single-population dataset to demonstrate the robustness and capabilities of |tPRiors|. CONCLUSIONS: We expect |tPRiors| to be helpful for researchers interested in true disease prevalence estimation and who are keen on accounting for prior information. |tPRiors| acts both as a statistical tool and a simplified step-by-step statistical framework that facilitates the use of complex Bayesian methods. The application of |tPRiors| is expected to aid standardization of practices in the field of Bayesian modelling on subject and multiple group-based true prevalence estimation.


Asunto(s)
Programas Informáticos , Teorema de Bayes , Humanos , Prevalencia , Estándares de Referencia
5.
BMC Vet Res ; 18(1): 47, 2022 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-35042530

RESUMEN

BACKGROUND: This study aimed to screen the sera of goats and sheep from flocks suspected of Mycobacterium avium subsp. paratuberculosis (MAP) infection by a newly standardized Mce-truncated ELISA (Mt-ELISA) kit for the detection of antibodies against MAP. Four diagnostic applied tests were evaluated including Indigenous plate-ELISA (IP-ELISA), Mt-ELISA, fecal Polymerase Chain Reaction (f-PCR) and fecal culture (FC). MATERIALS AND METHODS: Assuming the absence of a gold standard, latent-class models in a Bayesian framework were used to estimate the diagnostic accuracy of the four tests for MAP. RESULTS: Mt-ELISA had higher Sensitivity (Se) in sheep (posterior median: 0.68 (95% Probability Interval (PI): 0.43-0.95), while IP-ELISA recorded the highest Se in goats as 0.83 (95% PI, 0.61-0.97). The f-PCR Se estimate slightly differed between species [sheep 0.36 (0.19-0.58), goats 0.19 (0.08-0.35)], while the Se of FC was similar between species [sheep 0.29 (0.15-0.51), goats 0.27 (0.13-0.45)]. The specificity estimates for all tests were high, close to unity, and similar between species. CONCLUSION: Overall, the results showed that the Mt-ELISA method can be used for MAP detection in small ruminants' flocks.


Asunto(s)
Enfermedades de las Cabras , Mycobacterium avium subsp. paratuberculosis , Paratuberculosis , Enfermedades de las Ovejas , Animales , Teorema de Bayes , Ensayo de Inmunoadsorción Enzimática/veterinaria , Heces , Enfermedades de las Cabras/diagnóstico , Cabras , Paratuberculosis/diagnóstico , Sensibilidad y Especificidad , Ovinos , Enfermedades de las Ovejas/diagnóstico
6.
Am J Epidemiol ; 190(8): 1689-1695, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-33823529

RESUMEN

Our objective was to estimate the diagnostic accuracy of real-time polymerase chain reaction (RT-PCR) and lateral flow immunoassay (LFIA) tests for coronavirus disease 2019 (COVID-19), depending on the time after symptom onset. Based on the cross-classified results of RT-PCR and LFIA, we used Bayesian latent-class models, which do not require a gold standard for the evaluation of diagnostics. Data were extracted from studies that evaluated LFIA (immunoglobulin G (IgG) and/or immunoglobulin M (IgM)) assays using RT-PCR as the reference method. The sensitivity of RT-PCR was 0.68 (95% probability interval (PrI): 0.63, 0.73). IgG/M sensitivity was 0.32 (95% PrI :0.23; 0.41) for the first week and increased steadily. It was 0.75 (95% PrI: 0.67; 0.83) and 0.93 (95% PrI: 0.88; 0.97) for the second and third weeks after symptom onset, respectively. Both tests had a high to absolute specificity, with higher point median estimates for RT-PCR specificity and narrower probability intervals. The specificity of RT-PCR was 0.99 (95% PrI: 0.98; 1.00). and the specificity of IgG/IgM was 0.97 (95% PrI: 0.92, 1.00), 0.98 (95% PrI: 0.95, 1.00) and 0.98 (95% PrI: 0.94, 1.00) for the first, second, and third weeks after symptom onset. The diagnostic accuracy of LFIA varies with time after symptom onset. Bayesian latent-class models provide a valid and efficient alternative for evaluating the rapidly evolving diagnostics for COVID-19, under various clinical settings and different risk profiles.


Asunto(s)
Prueba de Ácido Nucleico para COVID-19/estadística & datos numéricos , Prueba Serológica para COVID-19/estadística & datos numéricos , COVID-19/diagnóstico , Inmunoensayo/estadística & datos numéricos , Reacción en Cadena en Tiempo Real de la Polimerasa/estadística & datos numéricos , Anticuerpos Antivirales/sangre , Teorema de Bayes , COVID-19/inmunología , Humanos , Análisis de Clases Latentes , SARS-CoV-2/genética , SARS-CoV-2/inmunología , Sensibilidad y Especificidad , Factores de Tiempo
7.
Foodborne Pathog Dis ; 18(12): 823-840, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34491108

RESUMEN

Toxoplasmosis, due to Toxoplasma gondii, is a parasitic disease with global importance. Among livestock, chronic T. gondii infection has been reported in higher rates in pigs and small ruminants, but with subclinical infections in case commonly encountered in pigs. Seroprevalence in the global pig population ranges according to the age or species of pigs, geographical distribution, production programs, and systems. Generally, T. gondii infections are noticed in low prevalence rates in conventional pig farms with high hygiene standards. In contrast, higher prevalence is common on free-ranging farms, outdoor or backyard small pig fams, as well as in farmed or hunted wild boars. The T. gondii average worldwide seroprevalence in pigs is reported to be 13% in Europe, 21% in Africa, 25% in North America, 21% in Asia, and 23% in South America. Human toxoplasmosis outbreaks have been correlated with the consumption of raw or undercooked meat, especially from infected pigs or wild boars, as well as of contaminated drinking water. The risk of infection in processed pork products is lower compared with fresh pork, as meat processing can reduce or inactivate T. gondii tissue cysts. Hence, the prevalence of T. gondii in the pig population may be a useful indicator of the risk of human toxoplasmosis associated with the consumption of pork products. The lack of obligatory screening methods at farm level for the detection of antibodies in farmed animals or the viable T. gondii in carcasses at slaughterhouse level increases the risk of contaminated pork or meat products. For this reason, the application of biosecurity and surveillance programs at farm level is very important to prevent a T. gondii infection.


Asunto(s)
Enfermedades de los Porcinos , Toxoplasma , Toxoplasmosis Animal , Animales , Anticuerpos Antiprotozoarios , Bioaseguramiento , Salud Pública , Estudios Seroepidemiológicos , Porcinos , Enfermedades de los Porcinos/epidemiología , Toxoplasmosis Animal/epidemiología
8.
BMC Vet Res ; 15(1): 198, 2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31196162

RESUMEN

Paratuberculosis, a chronic disease affecting ruminant livestock, is caused by Mycobacterium avium subsp. paratuberculosis (MAP). It has direct and indirect economic costs, impacts animal welfare and arouses public health concerns. In a survey of 48 countries we found paratuberculosis to be very common in livestock. In about half the countries more than 20% of herds and flocks were infected with MAP. Most countries had large ruminant populations (millions), several types of farmed ruminants, multiple husbandry systems and tens of thousands of individual farms, creating challenges for disease control. In addition, numerous species of free-living wildlife were infected. Paratuberculosis was notifiable in most countries, but formal control programs were present in only 22 countries. Generally, these were the more highly developed countries with advanced veterinary services. Of the countries without a formal control program for paratuberculosis, 76% were in South and Central America, Asia and Africa while 20% were in Europe. Control programs were justified most commonly on animal health grounds, but protecting market access and public health were other factors. Prevalence reduction was the major objective in most countries, but Norway and Sweden aimed to eradicate the disease, so surveillance and response were their major objectives. Government funding was involved in about two thirds of countries, but operations tended to be funded by farmers and their organizations and not by government alone. The majority of countries (60%) had voluntary control programs. Generally, programs were supported by incentives for joining, financial compensation and/or penalties for non-participation. Performance indicators, structure, leadership, practices and tools used in control programs are also presented. Securing funding for long-term control activities was a widespread problem. Control programs were reported to be successful in 16 (73%) of the 22 countries. Recommendations are made for future control programs, including a primary goal of establishing an international code for paratuberculosis, leading to universal acknowledgment of the principles and methods of control in relation to endemic and transboundary disease. An holistic approach across all ruminant livestock industries and long-term commitment is required for control of paratuberculosis.


Asunto(s)
Paratuberculosis/epidemiología , Paratuberculosis/prevención & control , Crianza de Animales Domésticos , Animales , Animales Salvajes/microbiología , Notificación de Enfermedades/normas , Incidencia , Mycobacterium avium subsp. paratuberculosis/aislamiento & purificación , Paratuberculosis/economía , Rumiantes/microbiología
10.
Vet Anaesth Analg ; 42(6): 608-13, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25819160

RESUMEN

OBJECTIVE: Τo evaluate the antiemetic effect of butorphanol (BUT) when co-administered with dexmedetomidine (DEX) in cats. STUDY DESIGN: Double-blind, randomized controlled cross-over experimental study. ANIMALS: Fourteen purpose-bred healthy Domestic Short Hair cats, seven females and seven males, aged median (range) 14-84 (78) months and weighing 1.7-5.5 (4.0) kg. METHODS: Each cat received five different treatment protocols intramuscularly (IM): (A) 25 µg kg(-1) DEX; (B) 20 µg kg(-1) DEX and 0.2 mg kg(-1) BUT; (C) 20 µg kg(-1) DEX and 0.1 mg kg(-1) BUT; (D) 25 µg kg(-1) DEX and 0.2 mg kg(-1) BUT; and (E) 20 µg kg(-1) DEX. Episodes of emesis, incidence and severity of nausea, and time to lateral recumbency were recorded for a period of 8 minutes after treatment administration, and the sedation was scored at the end of this period. The Friedman test and the Cochran's Q-test were used to analyse the data. Significance was evaluated at the 5% level. RESULTS: The proportion of cats that vomited was significantly lower with the treatment protocols that included BUT (B, C and D) compared with the protocols that included only DEX (A and E). The proportion of cats that had nausea was significantly higher with the protocols that included only DEX (A and E) compared with protocols B and D. Time to lateral recumbency (p=0.09) and sedation score (p=0.07) was not statistically different between the treatment protocols. CONCLUSIONS AND CLINICAL RELEVANCE: Butorphanol can be used to prevent emesis and reduce the incidence and the severity of nausea caused by DEX in cats. It seems that the combination of BUT and DEX is very useful not only when emesis could result in serious complications, but also to provide comfort and well-being in cats sedated for minor procedures.


Asunto(s)
Analgésicos no Narcóticos/efectos adversos , Antieméticos/uso terapéutico , Butorfanol/uso terapéutico , Enfermedades de los Gatos/inducido químicamente , Dexmedetomidina/efectos adversos , Vómitos/veterinaria , Animales , Antieméticos/administración & dosificación , Butorfanol/administración & dosificación , Enfermedades de los Gatos/epidemiología , Gatos , Estudios Cruzados , Método Doble Ciego , Femenino , Incidencia , Masculino , Vómitos/inducido químicamente , Vómitos/epidemiología , Vómitos/prevención & control
11.
Zoonoses Public Health ; 71(2): 170-177, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37974512

RESUMEN

AIMS AND METHODS: Brucellosis is worldwide one of the most prevalent zoonotic diseases with serious public health hazard affecting domestic livestock and causing economic losses. Objective of this study is to estimate the true prevalence of brucellosis in livestock, specifically cattle, sheep, goats and camels, using a novel Bayesian latent class model, adjusting for the imperfect sensitivity and specificity of the applied tests, where the second test was restricted only to first test-positive samples. RESULTS: Brucellosis seems more prevalent in goats and sheep, while the posterior medians and 95% probability intervals (95% PI) for the average true prevalence for sheep, goats, cattle and camels are 18% (4%-43%), 19% (7%-37%), 16% (5%-34%) and 18% (1%-48%) respectively. CONCLUSIONS: The study results indicate that brucellosis is highly endemic in Iran and crucial steps are needed to control and raise awareness about the high public health concern of the disease.


Asunto(s)
Brucelosis , Enfermedades de los Bovinos , Enfermedades de las Cabras , Enfermedades de las Ovejas , Animales , Bovinos , Ovinos , Camelus , Cabras , Teorema de Bayes , Prevalencia , Irán/epidemiología , Brucelosis/epidemiología , Brucelosis/veterinaria , Ganado , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Cabras/epidemiología , Enfermedades de los Bovinos/epidemiología
12.
J Clin Epidemiol ; 168: 111267, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38307216

RESUMEN

OBJECTIVES: Assessing the accuracy of serological tests for SARS-CoV-2 was challenging due to the lack of a gold standard. This study aimed to estimate the accuracy of SARS-CoV-2-specific serological tests using Bayesian latent class models (BLCM) and compare methods with and without a gold standard. STUDY DESIGN AND SETTING: In this study, we analyzed 356 samples-254 positives, ie, from individuals with a previous SARS-CoV-2 infection diagnosis, and 102 negatives, ie, prepandemic samples-using six different rapid serological tests and one laboratory assay. A BLCM was employed to concurrently estimate the sensitivity and specificity of all serological tests for the immunoglobulin (Ig) M and IgG antibodies specific for SARS-CoV-2. Noninformative priors were used. A sensitivity analysis was conducted considering three methods: 1) reverse transcription-polymerase chain reaction test (RT-PCR) as the gold standard, 2) BLCM with RT-PCR as an imperfect gold standard, and 3) frequentist latent class model (LCM). All analyses used software R version 4.3.0, and BLCM were fitted using package runjags using the software JAGS (Just Another Gibbs Sampler). RESULTS: The BLCM-derived sensitivity for IgM varied from 10.7% [95% credibility interval (CrI):1.9-24.6] to 96.9% (95% CrI: 91.0-100.0), with specificities ranging from 48.3% (95% CrI: 39.0-57.6) to 98.9% (95% CrI: 96.2-100.0). Sensitivity for IgG varied between 76.9% (95% CrI: 68.2-84.7) and 99.1% (95% CrI: 96.1-100.0), and specificity ranged from 49.9% (95% CrI: 19.4-95.8) to 99.3% (95% CrI: 97.2-100.0). LCM results were comparable to BLCM. Considering the RT-PCR as a gold standard underestimated the tests' sensitivity, particularly for IgM. CONCLUSION: BLCM-derived results deviated from those using a gold standard, which underestimated the tests' characteristics, particularly sensitivity. Although Bayesian and frequentist LCM approaches yielded comparable results, BLCM had the benefit of enabling credibility interval computation even when sample power is limited.


Asunto(s)
COVID-19 , Humanos , COVID-19/diagnóstico , SARS-CoV-2 , Análisis de Clases Latentes , Teorema de Bayes , Pruebas Serológicas/métodos , Sensibilidad y Especificidad , Inmunoglobulina G , Inmunoglobulina M , Prueba de COVID-19
13.
Prev Vet Med ; 224: 106133, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38340463

RESUMEN

The prevalence of an infectious disease of animals living in separate groups (e.g. herds) is naturally analyzed using a Bayesian hierarchical latent class model. We propose an extension to this methodology by including subgroup level prevalence measures within the groups of animals. As an application illustrating the merits of our methodology, we reassessed the prevalence of bovine paratuberculosis (PTBC) infection in Hungarian commercial dairy farms. Our aim was to consolidate previous findings using a large amount of recent data and priors based on historical data. To model the subgroup level infection prevalence within animal groups, we considered correlated prevalences following beta distributions derived from independent normally distributed random herd effects. In the application, infection status of herds was handled as latent classes, multiparous and primiparous cows as within-herd subgroups. The novel methodology allows us to estimate both the mean and median conditional within-herd true prevalence (CWHP) related to each animal subgroup as well as other measures characterizing the interrelation of subgroups. The results of the application aligned with the findings of the former PTBC study, while the more recent and considerably larger dataset and the use of historical priors increased the reliability of the results. The STAN and JAGS codes of the application are available in Supplementary material.


Asunto(s)
Enfermedades de los Bovinos , Mycobacterium avium subsp. paratuberculosis , Paratuberculosis , Femenino , Bovinos , Animales , Paratuberculosis/epidemiología , Prevalencia , Teorema de Bayes , Reproducibilidad de los Resultados , Enfermedades de los Bovinos/epidemiología , Industria Lechera , Ensayo de Inmunoadsorción Enzimática/veterinaria
14.
JBI Evid Synth ; 22(3): 406-412, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38475898

RESUMEN

The pursuit of conclusive evidence related to an unanswered foreground (decision-making) question has been the driving factor behind multiple ongoing and planned randomized controlled trials as well as meta-analyses. However, a fundamental challenge lies in establishing robust methods for ascertaining whether a collection of synthesized trials has yielded a definitive answer to that foreground question through the process of meta-analysis. This article explores the evolution of methods that attempt to address this challenge. These methods have primarily focused on defining and measuring the sufficiency and stability of evidence within a meta-analytic context. Cumulative meta-analysis and trial sequential analysis are the tools currently used, but they both come with limitations and challenges. We further discuss methods aimed at evaluating the evolution of effects over time more directly, such as the recursive cumulative meta-analysis. The latter method can be considered a better alternative, as it serves to demonstrate whether there is a true underlying treatment effect to which the meta-analysis is converging. However, recursive cumulative meta-analysis falls short of a specific indicator that establishes whether convergence has been reached. We coin the term exit for a meta-analysis where convergence can be demonstrated. Developing methods to determine the exit status of a meta-analysis is the next priority in research synthesis methods, as it will indicate that the research journey has concluded on a particular foreground question with no expectation of a different result with the addition of future trials.


Asunto(s)
Metaanálisis como Asunto , Proyectos de Investigación
15.
Vet Sci ; 11(4)2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38668408

RESUMEN

Due to the increasing risk of extreme events caused by climate change (i.e., floods, fires and hurricanes) or wars, European veterinary public health may need some improvement. Utilizing a mix of qualitative (participatory observation) and quantitative methods (Internet mining), we analyzed the Greek media's responses to the millennial flood in Thessaly (September 2023), focusing on animal health (including wild, companion animals and livestock) and public sentiment towards epizootic/epidemic threats. The study revealed a gap in crisis management plans regarding veterinary-related issues, emphasizing the need for comprehensive emergency response strategies. Our findings show how (i) the lay referral system is projecting the perception of epidemic threats into the population; (ii) the emotional load of images of animal carcasses is misused by media creators aiming for a big audience; and (iii) pets' owners are creating online communities for the searching and treatment of their pets. Our results stress the importance of integrating crisis communication in consecutive phases of the discourse, such as the following: (i) weather change; (ii) acute flood; (iii) recovery; and (iv) outbreaks, into veterinary practices to better prepare for such disasters.

16.
Travel Med Infect Dis ; 58: 102697, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38369074

RESUMEN

BACKGROUND: Rabies remains a deadly zoonotic disease, primarily prevalent in Eastern European countries, with a significant global burden in Asia and Africa. Post-exposure prophylaxis (PEP) is critical to prevent clinical rabies. Serbia, a country with a relatively low animal rabies incidence, has been implementing a 4-dose Essen PEP regimen for 13 years. This real-world study aimed to assess the effectiveness of the 4-dose Essen regimen, considering demographic and clinical factors, after WHO Category III exposure. METHOD: The study included 601 patients who received the 4-dose Essen PEP and 79 who received an additional 5th dose. RESULTS: Age emerged as a critical factor influencing seroconversion rates after the 4-dose regimen, with older individuals exhibiting lower RVNA titers. Logistic regression indicated a 3.18% decrease in seroconversion odds for each added year of age. The Cox proportional hazards mixed model highlighted age-related risks, with age groups 45-60 and 75-92 at the highest risk of non-seroconversion. Human Rabies Immune Globulin (HRIG) administration was associated with lower RVNA values after the 4-dose regimen, suggesting interference with vaccine immunogenicity among people who received larger doses of HRIG. CONCLUSIONS: This study provides valuable real-world evidence for rabies PEP in a non-homogeneous population with potential comorbidities. The results underscore the importance of optimizing PEP strategies, particularly in older individuals, and reconsidering HRIG dosing to improve seroconversion rates.


Asunto(s)
Vacunas Antirrábicas , Virus de la Rabia , Rabia , Animales , Humanos , Anciano , Rabia/epidemiología , Rabia/prevención & control , Profilaxis Posexposición , Serbia/epidemiología , Anticuerpos Antivirales
17.
Comp Immunol Microbiol Infect Dis ; 108: 102170, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38581930

RESUMEN

There is currently sparse information on the possible effect of long-term storage of serum specimens for the retrospective serodiagnosis of canine monocytic ehrlichiosis (CME). The aim of this study was to assess the agreement between the original serologic outcome and the results of a repeat indirect fluorescent antibody (IFA) assay for the detection of IgG antibodies against E. canis. A secondary aim was to compare the diagnostic performance of two commercially available point-of-care (POC) immunochromatographic (IC) assays. Archived serum samples originally tested as positive (n=66) or negative (n=19) for E. canis IgG antibodies and kept frozen at -20°C for a median of 22 years, were retrospectively examined by IFA and by two POC IC assays. Cohen's Kappa coefficient (0.748, p < 0.0001), indicated a substantial agreement between the original and repeat serologic testing results. An almost identical high sensitivity and moderate specificity were established for the two POC IC assays. Canine serum specimens on long-term storage may still be of value for seroepidemiologic surveys investigating the exposure to E. canis.


Asunto(s)
Enfermedades de los Perros , Ehrlichiosis , Perros , Animales , Ehrlichia canis , Estudios Retrospectivos , Estudios Seroepidemiológicos , Ehrlichiosis/diagnóstico , Ehrlichiosis/veterinaria , Anticuerpos Antibacterianos , Enfermedades de los Perros/diagnóstico , Inmunoglobulina G , Ehrlichia
18.
J Infect Public Health ; 17(3): 401-405, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38262075

RESUMEN

BACKGROUND & METHODS: This paper describes a pilot application of the Epidemic Volatility Index (EVI) to data from the pulmonary clinic of the University Hospital of Thessaly, Greece, for monitoring respiratory infections, COVID-19, and flu cases. EVI, a simple and easily implemented early warning method based on the volatility of newly reported cases, exhibited consistent and stable performance in detecting new waves of epidemics. The study highlights the importance of implementing early warning tools to address the effects of epidemics, including containment of outbreaks, timely intervention strategies, and resource allocation within real-world clinical settings as part of a broader public health strategy. RESULTS: The results presented in the figures demonstrate the association between successive early warnings and the onset of new waves, providing valuable insights for proactive decision-making. A web-based application enabling real-time monitoring and informed decision-making by healthcare professionals, public health officials, and policymakers was developed. CONCLUSIONS: This study emphasizes the significant role of early warning methods in managing epidemics and safeguarding public health. Future research may explore extensions and combinations of multiple warning systems for optimal outbreak interventions and application of the methods in the context of personalized medicine.


Asunto(s)
Epidemias , Humanos , Grecia/epidemiología , Epidemias/prevención & control , Brotes de Enfermedades/prevención & control , Salud Pública , Hospitales
19.
Comp Immunol Microbiol Infect Dis ; 112: 102225, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39116543

RESUMEN

Limited data exist on the factors affecting feline rabies vaccination outcomes during primary immunization. This study aimed to assess if specific factors (signalment, vaccination count, vaccine brand, and time since last vaccination) correlated with meeting global antibody titer standards and absolute titers in young cats given monovalent inactivated rabies vaccines. Analyzing a dataset from cats tested before their first annual booster using the FAVN test, logistic and linear regression models were applied. Among 379 cats, 94.2 % achieved titers meeting or exceeding the standard threshold (≥0.5 IU/ml). Time since last vaccination proved to be the primary predictor of vaccination success. Cats receiving two vaccinations tended toward higher titers. Age, sex, breed, and vaccine type showed no impact on outcomes. The present study indicates that vaccination failure in young cats is uncommon, and that the time interval from the latest vaccination is the single most important predictor of successful rabies vaccination.


Asunto(s)
Anticuerpos Antivirales , Enfermedades de los Gatos , Vacunas Antirrábicas , Rabia , Vacunación , Animales , Gatos , Vacunas Antirrábicas/administración & dosificación , Vacunas Antirrábicas/inmunología , Rabia/prevención & control , Rabia/veterinaria , Enfermedades de los Gatos/prevención & control , Enfermedades de los Gatos/inmunología , Enfermedades de los Gatos/virología , Anticuerpos Antivirales/sangre , Vacunación/veterinaria , Femenino , Masculino , Virus de la Rabia/inmunología , Vacunas de Productos Inactivados/inmunología , Vacunas de Productos Inactivados/administración & dosificación , Eficacia de las Vacunas
20.
Toxins (Basel) ; 16(4)2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38668593

RESUMEN

The aim of this in vivo study was to investigate the effects of a novel mycotoxin detoxifier whose formulation includes clay (bentonite and sepiolite), phytogenic feed additives (curcumin and silymarin) and postbiotics (yeast products) on the health, performance and redox status of weaned piglets under the dietary challenge of fumonisins (FUMs). The study was conducted in duplicate in the course of two independent trials on two different farms. One hundred and fifty (150) weaned piglets per trial farm were allocated into two separate groups: (a) T1 (control group): 75 weaned piglets received FUM-contaminated feed and (b) T2 (experimental group): 75 weaned piglets received FUM-contaminated feed with the mycotoxin-detoxifying agent from the day of weaning (28 days) until 70 days of age. Thiobarbituric acid reactive substances (TBARSs), protein carbonyls (CARBs) and the overall antioxidant capacity (TAC) were assessed in plasma as indicators of redox status at 45 and 70 days of age. Furthermore, mortality and performance parameters were recorded at 28, 45 and 70 days of age, while histopathological examination was performed at the end of the trial period (day 70). The results of the present study reveal the beneficial effects of supplementing a novel mycotoxin detoxifier in the diets of weaners, including improved redox status, potential hepatoprotective properties and enhanced growth performance.


Asunto(s)
Alimentación Animal , Curcumina , Oxidación-Reducción , Destete , Animales , Curcumina/farmacología , Alimentación Animal/análisis , Porcinos , Fumonisinas/toxicidad , Antioxidantes/farmacología , Bentonita/farmacología , Bentonita/química , Silicatos de Aluminio/química , Silicatos de Aluminio/farmacología , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Contaminación de Alimentos/prevención & control , Carbonilación Proteica/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/metabolismo , Masculino , Micotoxinas/toxicidad
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