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1.
Sci Total Environ ; 651(Pt 1): 298-308, 2019 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-30240914

RESUMEN

In this study, total coliforms (TC), Escherichia coli, enterovirus (EV), rotavirus (RV), and human mastadenovirus species C and F (HAdV-C and HAdV-F) were evaluated in water samples from Belo Stream. For HAdV-C and F, the infectivity was assessed by integrated cell culture quantitative real-time polymerase chain reaction (ICC-qPCR). Samples were collected monthly (May/2015 to April/2016) at four sites. Viral analyses were performed for both ultracentrifuge-concentrated and unconcentrated samples. For site P4 (used for recreational purposes), QMRA was applied to estimate health risks associated with exposure to E. coli and HAdV-C and F. TC and E. coli were present throughout the collection period. EV and RV were not detected. HAdV-C were present in 8.51% (1.89E + 06 to 2.28E + 07 GC (Genomic Copies)/L) and 21.27% (2.36E + 05 to 1.29E + 07 GC/L) for unconcentrated and concentrated samples, respectively. For HAdV-F were 12.76% (2.77E + 07 to 3.31E + 08 GC/L) and 48.93% (1.10E + 05 to 4.50E + 08 GC/L) for unconcentrated and concentrated samples, respectively. For unconcentrated samples, infectivity for HAdV-C was detected in 37.20% (1st ICC-qPCR) and 25.58% (2nd ICC-qPCR). For HAdV-F, infectivity was detected in 6.97% (1st ICC-qPCR) and 6.97% (2nd ICC-qPCR). For concentrated samples, HAdV-C infectious was observed in 17.02% (1st ICC-qPCR) and in 8.51% (2nd ICC-qPCR). For HAdV-F, were present in 8.51% for both 1st and 2nd ICC-qPCR. Statistical analyzes showed significant difference between the collection sites when analyzed the molecular data of HAdV-F, data of TC and E. coli. Correlation tests showed direct correlation between HAdV-F with E. coli and TC. E. coli concentrations translated to the lowest estimates of infection risks (8.58E-05 to 2.17E-03). HAdV-F concentrations were associated with the highest infection risks at 9.99E-01 and for group C, 1.29E-01 to 9.99E-01. These results show that commonly used bacterial indicators for water quality may not infer health risks associated with viruses in recreational freshwaters.


Asunto(s)
Medición de Riesgo , Ríos/microbiología , Calidad del Agua , Adenovirus Humanos/aislamiento & purificación , Brasil , Enterobacteriaceae/aislamiento & purificación , Enterovirus/aislamiento & purificación , Escherichia coli/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa , Recreación , Ríos/virología , Rotavirus/aislamiento & purificación
2.
J Nucl Cardiol ; 21(3): 544-52, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24627346

RESUMEN

BACKGROUND: The American College of Cardiology/American Society of Nuclear Cardiology published revised appropriate use criteria (AUC) for SPECT MPI in 2009. We assessed adherence to these guidelines and factors associated with inappropriate utilization at the University Medical Center. METHODS: The AUC was applied retrospectively to 420 SPECT MPI studies. Two-sample t test, Fisher's exact test, and multivariable logistic regression models were used for analysis. RESULTS: There were 322 appropriate (86%) and 54 (14%) inappropriate studies. The odds of having an inappropriate test increased with younger age (P < .001) and female gender (P < .001). Subjects with diabetes (P = .007) and chest pain (P < .001) were less likely to have an inappropriate test. Academic outpatients were three times more likely to have an inappropriate study (P = .123), while community PCPs were 5.6 times (P = .011) and community cardiologists eight times more likely to order inappropriate tests (P = .031). CONCLUSIONS: Inappropriate SPECT MPI in low risk younger women is an important issue on the USA-Mexico border. Initiatives to reduce inappropriate SPECT MPI should focus on a few indications and evaluation of cardiovascular symptoms in younger age women in outpatient/community practices.


Asunto(s)
Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Adhesión a Directriz/estadística & datos numéricos , Imagen de Perfusión Miocárdica/estadística & datos numéricos , Imagen de Perfusión Miocárdica/normas , Tomografía Computarizada de Emisión de Fotón Único/estadística & datos numéricos , Tomografía Computarizada de Emisión de Fotón Único/normas , Procedimientos Innecesarios/estadística & datos numéricos , Distribución por Edad , Cardiología/normas , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/etnología , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Área sin Atención Médica , México/epidemiología , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/normas , Pautas de la Práctica en Medicina/estadística & datos numéricos , Prevalencia , Distribución por Sexo , Estados Unidos/epidemiología , Procedimientos Innecesarios/normas , Revisión de Utilización de Recursos
3.
J Food Prot ; 72(10): 2184-8, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19833043

RESUMEN

A rise in foodborne outbreaks in the United States associated with fresh produce has resulted in increased concerns with the importation of fruits and vegetables. Mexico is a major exporter of produce to the United States, particularly tomatoes and bell peppers. A quantitative microbial risk assessment (QMRA) was conducted to evaluate the public health impact of protozoan-laden water irrigating produce in Culiacan, Sinaloa, Mexico. Specifically, a QMRA was conducted to address the human health impact associated with consumption of tomatoes, bell peppers, cucumbers, and lettuce irrigated with water contaminated with Cryptosporidium and Giardia. Yearly infection risks were estimated and assumed a 120-day exposure in a given year. Annual risks range from 9 x 10(-6) for Cryptosporidium at the lowest concentration associated with bell peppers to almost 2 x 10(-1) for exposure to Giardia on lettuce at the highest detected concentration. With the relatively high number of illnesses resulting from produce-related outbreaks, addressing pre- and postharvest points of contamination for fruits and vegetables consumed raw should be a food industry priority. This research shows how QMRA can be used to interpret microbial contamination data for public health significance and subsequently provide the foundation for guideline development.


Asunto(s)
Cryptosporidium/aislamiento & purificación , Contaminación de Alimentos/análisis , Parasitología de Alimentos , Giardia/aislamiento & purificación , Verduras/parasitología , Agua/parasitología , Animales , Seguridad de Productos para el Consumidor , Humanos , México , Oocistos , Salud Pública , Medición de Riesgo
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