Simultaneous detection of infectious bronchitis virus and avian metapneumovirus genotypes A, B, and C by multiplex RT-qPCR assay in chicken tracheal samples in Ecuador.

Respiratory RNA viruses such as Infectious bronchitis virus (IBV) and Avian metapneumovirus (aMPV), which are characterized by generating both respiratory damage and adverse effects on reproductive organs, affect poultry production economically due to high mortality rate and decrease in egg production and quality. Particularly, aMPV has three genotypes that have been reported with greater frequency in chickens: aMPV-A, aMPV-B, and aMPV-C. The present study proposes the design of a multiplex RT-qPCR assay for the simultaneous diagnosis of the 3 genotypes of interest of aMPV and IBV, followed by testing of 200 tracheal samples of vaccinated chickens with respiratory symptoms and finally a phylogenetic analysis of the sequences found. The assay detected up to 1 copy of each viral genome. The standard curves showed an efficiency between 90 and 100% in the multiplex assay and inter- and intra-assay coefficients of variation of 0.363 and 0.459, respectively and inter- and intra-assay coefficients of variation of 0.363 and 0.459, respectively. 69.5% of samples were found positive alone or in coinfection. 114 samples were positive for IBV, 13 for aMPV-A and 25 for aMPV-B. RNA of aMPV-C was no detected. The most commonly found combination was aMPV-B and IBV within 6 samples, and the least common was aMPV-A and aMPV-B in coinfection in 2 samples. The assay was specific for amplification of the genomes of the studied respiratory viruses (IBV, aMPV-A, aMPV-B, aMPV-C) as no amplification was shown from other viral genomes (ChPV, CAstV, ANV, and FAdV) or from the negative controls. Partial genomic Sanger sequencing enabled to identify circulating vaccine-derived and wild-type strains of IBV and vaccine and vaccine-derived strains of aMPV-B. In conclusion, this newly developed multiplex RT-qPCR was shown to be able to detect individual infections as well as co-infections among the respiratory viruses investigated. It was demonstrated to be a reliable and efficient tool for rapidly and safely diagnosing these infections. Furthermore, this study represents the first report of aMPV strains in Ecuadorian poultry and demonstrates the circulation of aMPV-A, aMPV-B, and GI-13 IBV strains in unvaccinated chicken populations in the country. Thus, it highlights the importance of simultaneously identifying these pathogens in greater detail and on a regular basis in Ecuador.

First Report on the Molecular Detection of Canine Astrovirus (CaAstV) in Dogs with Gastrointestinal Disease in Ecuador Using a Fast and Sensitive RT-qPCR Assay Based on SYBR Green®.

Enteric viruses are responsible for a significant number of gastrointestinal illnesses in dogs globally. One of the main enteric viruses is the canine astrovirus (CaAstV), which causes diarrhea in dogs of various ages. It is linked to symptoms such as diarrhea, vomiting, depression and a significant mortality rate due to gastrointestinal disorders. It is a single-stranded positive RNA virus, with three open reading frames, ORF1a, ORF1b and ORF2, where the last one codes for the virus capsid protein and is the most variable and antigenic region of the virus. The aim of this work is to develop and standardize a quick detection method to enable the diagnosis of this etiological agent in dogs with gastroenteritis in Ecuador in order to provide prompt and suitable treatment. The assay was specific for amplification of the genome of CaAstV, as no amplification was shown for other canine enteric viruses (CPV-2, CCoV and CDV), sensitive by being able to detect up to one copy of viral genetic material, and repeatable with inter- and intra-assay coefficients of variation of less than 10% between assays. The standard curve showed an efficiency of 103.9%. For the validation of this method, 221 fecal samples from dogs affected with gastroenteritis of various ages from different provinces of Ecuador were used. From the RT-qPCR protocol, 119 samples were found positive for CaAstV, equivalent to 53.8% of the samples processed. CaAstV was detected in dogs where both the highest virus prevalence in the tested strains and the highest viral loads were seen in the younger canine groups up to 48 weeks; in addition, different strains of the virus were identified based on a sequenced fragment of ORF1b, demonstrating the first report of the presence of CaAstV circulating in the domestic canine population affected by gastroenteritis in Ecuador, which could be associated with the etiology and severity of enteric disease.

Detection and molecular characterization of chicken parvovirus and chicken megrivirus in layer breeders affected by intestinal dilatation syndrome.

RESEARCH HIGHLIGHTS: IDS presented pathognomonic dilatation of the jejunum up to Meckel's diverticulum.IDS caused weight loss, decreased egg production, and increased culling and mortality.Chicken parvovirus (ChPV) was consistently detected through PCR assays.Chicken megrivirus (ChMV) was consistently detected through viral metagenomics.

Molecular Characterization of the Chicken Parvovirus Based on VP1 Gene Circulating in Brazilian Chicken Flocks.

Parvovirus infection affects several animal species, especially young animals. In birds, parvovirus infection has been described in Muscovy ducks, turkeys, and chickens, all of which had enteric diseases characterized by diarrhea. Chicken parvovirus (ChPV) has been detected in poultry around the world in animals affected by enteric problems, showing dwarfism, cloacal pasting, and diarrhea. In Brazil, ChPV was detected in chickens affected by diarrhea fifteen years ago. However, the genetic characteristics of ChPV circulating in chicken flocks were not determined. Therefore, the aim of the present investigation was to determine the genetic characteristics of the VP1 gene from ChPV detected in chickens affected by enteric diseases in Brazil. For this purpose, a molecular approach was used. Specific primers were designed to flank the complete VP1 gene of ChPV and amplify it using PCR. The amplified products from samples of chickens with enteric diseases were sequenced, and 22 complete CDs of the VP1 gene were obtained. These samples, compared to the ABU-P1 sequence, showed 17 sequences with high nucleotide (NT) similarity of 92.7-97.4% and amino acid (AA) similarity of 94.8-99.5% associated with Runting and Stunting syndrome (RSS); there were also five samples associated with hens with diarrhea with unusual jejunal dilatation (JD) that had less similarity than the RSS sequences (NT of 86.5% and AA of 93-93.1%). The phylogenetic analysis determined four groups. Group I had sequences from Korea. The second group included sequences from Korea, China, and Brazil (not included in this work). The third group had studied RSS sequences grouped with the ABU-P1 strain and sequences from China and the United States. Finally, the sequences from JD were clustered in a separate group with a bootstrap of 100%, a group that was denoted as group IV, and included sequences from China. RDP4 and SimPlot analysis showed one point of recombination with the sequences of group III ChPV in the JD sequences. Herein, we show that circulating strains of ChPV exhibit genetic differences in the VP1 gene in Brazilian chicken flocks. Nevertheless, more studies are needed to determine the probability of a new genetic group of ChPV based on the analysis of the complete genome.

Bacteria in the blood of healthy stray dogs infested by ticks in northern Mexico.

Objective: The objectives of this study were to determine the richness, abundance, and diversity of bacteria in stray dogs (Canis lupus familiaris) infested by ticks in Comarca Lagunera, northern Mexico, and to establish their pathogenic and or/zoonotic potential. Materials and Methods: Blood samples from 12 dogs were collected, and their deoxyribonucleic acid was extracted. The V3-V4 region of the 16S ribosomal ribunocleic acid gene was amplified by polymerase chain reaction. Next-generation sequencing (NGS) was performed on a MiSeq Illumina platform, and the data were analyzed using quantitative insights into microbial ecology. Results: The operational taxonomic units resulted in 23 phyla, 54 classes, 89 orders, 189 families, 586 genera, and 620 bacterial species; among them, 64 species and/or bacterial genera with pathogenic or zoonotic potential were identified, some of which have been reported in the literature as relevant to public health (Anaplasma phagocytophilum, Brucella spp., Clostridium spp., Corynebacterium affermentants, Cutibacterium spp., Dietzia spp., Ehrlichia canis, Fusobacterium necrophorum, Leptotrichia spp., Mycobacterium spp., Paracoccus spp., and Roseomonas gilardii). Conclusion: This research offers relevant information on the prevalence of tick-borne diseases as well as other potential zoonotic diseases in the blood of stray dogs parasitized by ticks in northern Mexico. New molecular biology and massive NGS techniques may play an important role in the study and documentation of bacterial profiles from animals in close proximity to humans.

Machine Learning to Predict Enzyme-Substrate Interactions in Elucidation of Synthesis Pathways: A Review.

Enzyme-substrate interactions play a fundamental role in elucidating synthesis pathways and synthetic biology, as they allow for the understanding of important aspects of a reaction. Establishing the interaction experimentally is a slow and costly process, which is why this problem has been addressed using computational methods such as molecular dynamics, molecular docking, and Monte Carlo simulations. Nevertheless, this type of method tends to be computationally slow when dealing with a large search space. Therefore, in recent years, methods based on artificial intelligence, such as support vector machines, neural networks, or decision trees, have been implemented, significantly reducing the computing time and covering vast search spaces. These methods significantly reduce the computation time and cover broad search spaces, rapidly reducing the number of interacting candidates, as they allow repetitive processes to be automated and patterns to be extracted, are adaptable, and have the capacity to handle large amounts of data. This article analyzes these artificial intelligence-based approaches, presenting their common structure, advantages, disadvantages, limitations, challenges, and future perspectives.

Presentation of Wernicke encephalopathy in patient secondary to one anastomosis gastric bypass. Case report and literature review.

Wernicke encephalopathy, which is caused by a thiamine deficiency, occurs in 0.8-2% of the population. Only 16% present the typical triad of this disease: nystagmus, confusion and ataxia. We present the case of a postoperative patient with a one anastomosis gastric bypass with reoperation undergoing a Roux-en-Y gastric bypass that begins with confusion and nystagmus on her third postoperative day. The diagnosis of Wernicke encephalopathy is made by imaging, and vitamin B1 is administered with total improvement of nystagmus and altered state of consciousness (lethargy, bradypsychia, bradylalia).

La encefalopatía de Wernicke se produce por una deficiencia de tiamina se presenta en un 0.8-2% de la población. Solo el 16% de los casos presentan la tríada típica de esta enfermedad: nistagmo, confusión y ataxia. Presentamos el caso de una paciente operada de bypass gástrico de una anastomosis con reintervención convirtiendo a bypass gástrico en Y de Roux que en su tercer día de posoperatorio comienza con confusión y nistagmo. Se realiza por imagen el diagnóstico de encefalopatía de Wernicke se administra vitamina B1 con mejoría total del nistagmo y alteración del estado de consciencia (letargia, bradipsiquia, bradilalia).

Development of a fast and sensitive RT-qPCR assay based on SYBR® green for diagnostic and quantification of Avian Nephritis Virus (ANV) in chickens affected with enteric disease.

BACKGROUND: Enteric viruses are among the most prominent etiological agents of Runting-Stunting Syndrome (RSS). The Avian Nephritis Virus (ANV) is an astrovirus associated with enteric diseases in poultry, whose early diagnosis is essential for maintaining a good poultry breeding environment. ANV is an RNA virus that rapidly mutates, except for some conserved regions such as ORF1b. Therefore, the approach of a diagnostic method based on fast-RT-qPCR using SYBR® Green that focuses on the amplification of a fragment of ORF1b is presented as a feasible alternative for the diagnosis of this viral agent. In this study, the proposed assay showed a standard curve with an efficiency of 103.8% and a LoD and LoQ of 1 gene viral copies. The assay was specific to amplify the ORF 1b gene, and no amplification was shown from other viral genomes or in the negative controls. 200 enteric (feces) samples from chickens (broilers) and laying hens with signs of RSS from Ecuadorian poultry flocks were examined to validate the proposed method. RESULTS: Using our method, 164 positive results were obtained out of the total number of samples run, while the presence of viral RNA was detected in samples collected from one day to 44 weeks old in both avian lines. CONCLUSIONS: Our study presents a novel, rapid, robust, and sensitive molecular assay capable of detecting and quantifying even low copy numbers of the ANV in commercial birds, therefore introducing a handy tool in the early diagnosis of ANV in enteric disease outbreaks in poultry.

Enteroatmospheric fistulas in open abdomen in trauma associated with abdominal reintervention and VAC therapy.

BACKGROUND: Open abdomen is an alternative for the management of trauma patient, and negative pressure therapy of the wound using VAC® device is a genuine sort of treatment. Although the device poses technical advantages, risks are present and a critical complication is the enteroatmospheric fistula formation (EAF). OBJECTIVE: To analize the role of negative pressure therapy length and VAC® device number of changes on the EAF formation in trauma patients udergoing open abdomen. METHOD: Cut-off points were calculated using receiver operational characteristics curve. Values were compared with Student's t or Mann-Withney U tests, considering statistically significant p < 0.05. RESULTS: EAF were present in 39 cases (5.9%). A significant difference in the presence of EAF was present in patients with negative pressure therapy of the wound length ≥ 11.2 days (46.9 vs. 1.3%; relative risk [RR]: 3.67; 95% confidence interval [95% IC]: 2.4-6.68; p = 0.017) and when ≥ 2.6 VAC® device changes were performed (34.6 vs. 0.5%; RR: 6.92; 95% IC: 1.1-4.3; p < 0.001). CONCLUSIONS: At our institution, the practice of >3 VAC® device changes and length of therapy > 11 days should be carefully considered leading to reduce the risk of EAF formation.

INTRODUCCIÓN: El abdomen abierto es una alternativa para manejar al paciente traumatizado, y una variante para instituirlo es la terapia de presión negativa de la herida con el dispositivo VAC®. Aunque tiene ventajas técnicas, no está exento de riesgos y una complicación crítica es la formación de fístulas enteroatmosféricas (FEA). OBJETIVO: Analizar el papel de la duración de la terapia de presión negativa y del número de cambios del dispositivo VAC® sobre la aparición de FEA en pacientes traumatizados manejados con abdomen abierto. MÉTODO: Se establecieron puntos de corte con curva de características operacionales del receptor. Los valores se compararon con la prueba t de Student o U de Mann-Whitney, considerando p < 0.05 como valor estadísticamente significativo. RESULTADOS: La FEA se presentó en 39 casos (5.9%). Hubo una diferencia significativa en la aparición de FEA en pacientes con duración de la terapia de presión negativa de la herida ≥ 11.2 días (46.9 vs 1.3%; riesgo relativo [RR]: 3.67; intervalo de confianza del 95% [IC95%]: 2.4-6.68; p = 0.017) y cuando se practicaron ≥ 2.6 cambios del dispositivo VAC® (34.6 vs. 0.5%; RR: 6.92; IC95%: 1.1-4.3; p < 0.001). CONCLUSIONES: En nuestra institución, la práctica de más de tres cambios del dispositivo VAC® y el mantenimiento de la terapia por más de 11 días debe ser cuidadosamente considerado para reducir el riesgo de formación de FEA.

Antioxidant and Antibacterial Activity of Mexican Oregano Essential Oil, Extracted from Plants Occurring Naturally in Semiarid Areas and Cultivated in the Field and Greenhouse in Northern Mexico.

In recent years, the determination of the antioxidant and antibacterial activity of essential oils in wild plants, such as Mexican oregano (Lippia graveolens Kunth), has become increasingly important. The objective was to compare the antioxidant and antibacterial activity of Mexican oregano essential oil obtained from plants occurring naturally in semiarid areas (Wild1 and Wild2), and those cultivated in the field (CField) and greenhouse (CGreenhouse) in northern Mexico. The Mexican oregano essential oil extraction was performed using the hydrodistillation method, the antioxidant activity was determined using the ABTS method, and the antibacterial activity was assessed through bioassays under the microwell method at nine different concentrations. The aim was to determine the diameter of the inhibition zone and, consequently, understand the sensitivity level for four bacterial species. The results revealed an antioxidant activity ranging from 90% to 94% at the sampling sites, with Wild1 standing out for having the highest average antioxidant activity values. Likewise, six out of the nine concentrations analyzed showed some degree of sensitivity for all the sampling sites. In this regard, the 25 µL mL-1 concentration showed the highest diameter of inhibition zone values, highlighting the Wild2 site, which showed an average diameter greater than 30 mm for the four bacteria tested. Only in the case of S. typhi did the CGreenhouse site surpass the Wild2, with an average diameter of the inhibition zone of 36.7 mm. These findings contribute to the search for new antioxidant and antibacterial options, addressing the challenges that humanity faces in the quest for opportunities to increase life expectancy.

Positivización de la autoestima específica en el docente quirúrgico. Resultados del Curso 2CeQ Docencia Quirúrgica® / Positivization of specific self-esteem in the surgical teacher. Results of the grade 2CeQ Surgical Teaching®

Resumen Objetivo: Evidenciar la mejora en la autoestima específica docente y del conocimiento integral de los dominios cognitivos de Bloom en los participantes en el curso 2CeQ®, estimados a través del incremento y análisis comparativo en la puntuación obtenida en la Escala de Autoestima de Rosenberg (EAR) y ejercicios de evaluación pre y poscurso. Diseño, metodología o aproximación: Estudio analítico comparativo transversal, de datos correspondientes a los valores de las variables (puntuación obtenida) de dos cuestionarios (Escala de Autoestima de Rosenberg [EAR] y ejercicios de evaluación pre y poscurso) contestados por los participantes en el curso. Análisis estadístico: frecuencia relativa de ocurrencia, medidas de dispersión y prueba t (p<0.05 fue estadísticamente significativo). Resultados: Se incluyeron 21 individuos. Se observó una mejora significativa en la puntuación de la autoestima específica como docente quirúrgico según la EAR (16.3±5 [7-25] vs 20.9±5.2 [13-30]; p=0.003). En el ejercicio de evaluación, hubo una diferencia estadísticamente significativa en la puntuación pre y poscurso (38.5±14.3 [10.3-70.6] vs 72.4±17 [29.4-88.2]; p=0.006). Limitaciones del estudio o implicaciones: Serie unicéntrica, con limitado número del tamaño de la muestra, lo que impide validar los resultados. Originalidad o valor: Estudio en epistemología educativa quirúrgica nacional, único en su clase. Hallazgos o conclusión: La participación en el Curso "2CeQ Docencia Quirúrgica®" aumenta la autoestima específica para el ejercicio docente y la capacidad técnica para desarrollar el proceso de enseñanza aprendizaje, por lo cual puede coadyuvar a elevar la calidad de los programas educativos.

Abstract Objetive: To show improvement in teaching-specific self-esteem and comprehensive knowledge on Bloom's cognitive domains, among participants in 2CeQ® Course, estimated through increase and comparative analysis of pre- and post-course scores obtained from Rosenberg's Self-esteem Scale (RSS) and evaluation-tests. Design, methodology and approximation: Transversal, analytic and comparative study of pre- and post-course values from data corresponding to RSS and evaluation tests scores, answered by participants. Statistics: Occurrence relative frequency, dispersion calculations, and t test (p<0.05 statistically significant). Results: 21 individuals were included. A significant improvement in surgical-teaching self-esteem from RSS (16.3±5 [7-25] vs 20.9±5.2 [13-30]; p=0.003) and a statistically significant difference between pre- and postcourse test's scores (38.5±14.3 [10.3-70.6] vs 72.4±17 [29.4-88.2]; p=0.006 were observed). Limitations and implications of study: Unicentric series and a limited sample, avoiding the validation of results. Originality or value: Study on national surgical education epistemology, one of a kind. Findings and conclusion: Participation in "2CeQ" Course increases specific self-esteem for teaching and technical ability to develop teaching and learning process, helping to optimize the quality of educational programs.

Detection, Quantification and Molecular Characterization of Fowl Adenoviruses Circulating in Ecuadorian Chicken Flocks during 2019-2021.

Fowl adenoviruses are a group of pathogens that cause large economic losses worldwide in the poultry industry, in addition to producing a wide range of diseases, such as IBH, HHS, and enteric and respiratory diseases. The objective of this study was to quantify, identify, and molecularly characterize the types of FAdV circulating in commercial poultry farms (broilers, breeders, and layers) in Ecuador from 2019 to 2021. Molecular characterization was performed by PCR, quantification by qPCR, and subsequent sequencing for each positive sample. The results indicated that the FAdV genotypes circulating in our country are FAdV-2/D2, FAdV-6/E1, FAdV-8a/E2, and FAdV-11/D3; the samples were grouped into different groups that contain sequences that were obtained from countries in Africa, Asia, and America, and that are found in birds at different ages, since early age where can cause different clinical signs, such as diarrhea, ruffled feathers and dwarfism. Therefore, these results indicate that several genotypes of the virus are circulating in commercial poultry flocks, suggesting that biosecurity measures on farms should be improved, in addition to carrying out new or improved vaccination plans.

Encuesta nacional de atención del paciente neurocrítico / National survey of neurocritical care patients / Pesquisa nacional de cuidados a pacientes neurocriticos

Antecedentes: los pacientes neurocríticos constituyen un subgrupo especial en la medicina intensiva. Estudios internacionales recientes han mostrado variabilidad en su monitorización y manejo terapéutico. Objetivo: conocer las características de la atención y manejo de los pacientes neurocríticos en Uruguay. Métodos: estudio prospectivo y descriptivo. Se realizó una encuesta telefónica basada en un cuestionario de estructuras y procesos en la asistencia del paciente neurocrítico. Fue diseñado por la comisión de neurocríticos de la SUMI. Se entrevistó a jefes o coordinadores de cada unidad de cuidado intensivo (UCI), de forma voluntaria y anónima. Resultados: se encuestaron 52 UCI (98% del país), 67% correspondieron al Interior y 65% al sector privado del país. 96% de las UCI reciben pacientes neurocríticos. Se cuenta con neurocirugía presencial en 46%. El estudio de neuroimagen más disponible es la tomografía computada (81%). Se realiza: monitorización de presión intracraneana en 65%, oximetría yugular en 27% y neuromonitorización no invasiva en 58%, siendo la ultrasonografía la más frecuente. Las estrategias más utilizadas para el tratamiento de la hipertensión intracraneana son: osmoterapia (salino hipertónico en 100%), propofol (85%), bloqueo muscular (78%) y descompresiva (75%). Reperfusión en ataque cerebrovascular: trombolisis (88%) y trombectomía mecánica (44%). Los fármacos antiepilépticos más utilizados son: midazolam (100%), levetiracetam y fenitoína (96%). Tratamiento del aneurisma cerebral: clipado quirúrgico (98%) y endovascular (66%). Protocolización en 96% y realización de ateneos clínicos en 61%. Conclusiones: se presenta el primer trabajo realizado en nuestro país sobre el tema. Se encontró variabilidad en la monitorización así como en la disponibilidad de neuroimagenología y especialidades neurointervencionistas. Este estudio proporciona una oportunidad para la investigación comparativa de efectividad.

Background: neurocritical care patients constitute a special subgroup in intensive care medicine. Recent international studies have shown variability in their monitoring and therapeutic handling. Objective. to learn about the handling and care characteristics of neurocritical patients in Uruguay. Method: prospective, descriptive study. A telephone survey was conducted based on a structure and processes questionnaire on neurocritical patients' care. It was designed by the Neurocritical Patients Comittee of the Uruguayan Society of Intensive Medicine (SUMI). Chiefs or coordinators of each intensive care units were interviewed, their participation being voluntary an anonymous. Results: 52 ICU in the country were interviewed, 67% were located in the provinces and 65% belonged to the private sector. 96% of intensive care units received neurocritical care patients. Routine neurosurgery was available in 46% of cases. Computerized technology was the most widely available imaging study (81%). The following procedures were conducted: intracranial pressure monitoring in 65% of patients, jugular venous oximetry in 27%, non-invasive neuromonitoring in 58%, ultrasound being the most frequently used. The most commonly used strategies to treat intracranial hypertension are: osmotherapy (hypertonic saline in 100%), propofol (85%), muscular blockade (78%) and decompressive craniectomy (75%). Reperfusion in cerebrovascular attack, thrombolisis (88%) and mechanical thrombectomy (44%). The most widely used antiepileptic drugs are: midazolam (100%), levetiracetam y phenytoin (96%). Cerebral aneurysm was treated with surgical clipping (98%) and endovascular treatment (66%). Protocols were followed in 96% and case conferences were organized in 61%. Conclusions: the study presents the first research conducted on this topic in our country and it found variability in terms of monitorization and availability of neuro-imagining and neurointerventionist special strategies. The study represents an opportunity for effectiveness comparative research.

Introdução: os pacientes neurocríticos constituem um subgrupo especial na medicina intensiva. Estudos internacionais recentes têm mostrado variabilidade em seu monitoramento e manejo terapêutico. Objetivo: conhecer as características de atendimento e manejo de pacientes neurocríticos no Uruguai. Métodos: estudo prospectivo e descritivo. Fez-se uma pesquisa telefônica utilizando um questionário sobre estruturas e processos do cuidado de pacientes neurocríticos. Foi projetado pela comissão de neurocríticos de la Sociedad Uruguaya de Medicina Intensiva. Os chefes ou coordenadores de cada unidade de terapia intensiva (UTI) foram entrevistados de forma voluntária e anônima. Resultados: pesquisaram-se 52 UTIs (98% do país), 67% do Interior e 65% do setor privado do país. 96% das UTIs recebem pacientes neurocríticos. A neurocirurgia no local está disponível em 46%. O estudo de neuroimagem mais disponível é a tomografia computadorizada (81%). Realiza-se monitorização da pressão intracraniana em 65%, oximetria jugular em 27% e neuromonitorização não invasiva em 58%, sendo a ultrassonografia a mais frequente. As estratégias mais utilizadas para o tratamento da hipertensão intracraniana são: osmoterapia (soro fisiológico 100% hipertônico), propofol (85%), bloqueio muscular (78%) e descompressão (75%). Faz-se reperfusão no ataque cerebrovascular por trombólise (88%) e trombectomia mecânica (44%). As drogas antiepilépticas mais utilizadas são: midazolam (100%), levetiracetam e fenitoína (96%). Tratamento do aneurisma cerebral: clipagem cirúrgica (98%) e endovascular (66%). Protocolização em 96% e reuniões clínicas em 61%. Conclusões: este é o primeiro trabalho realizado em nosso país sobre o tema. Foi encontrada variabilidade no monitoramento, bem como na disponibilidade de especialidades de neuroimagem e neurointervenção. Este estudo oferece uma oportunidade para a pesquisa comparativa de eficácia.

Thermophilic bacteria from Peruvian hot springs with high potential application in environmental biotechnology.

Hot springs are extreme environments in which well-adapted microorganisms with biotechnological applications can thrive naturally. These thermal environments across Peruvian territory have, until now, remained poorly investigated. In this study, two hot springs, El Tragadero and Quilcate, located in Cajamarca (Peru) were selected in order to investigate the biotechnological potential of indigenous thermophilic bacteria. Enrichment and isolation processes were carried out using microbial mats, sediments, biofilms, and plastic polymers as samples. Screening for biosurfactants and siderophores production, as well as for polyethylene terephthalate (PET) hydrolysis was done using culture-dependent techniques. After molecular identification, Bacillus was found as the most abundant genus in both hot springs. Bacillus velezensis was found producing biosurfactants under high-level temperature. Anoxybacillus species (A. salavatliensis and A. gonensis) are here reported as siderophore-producing bacteria for the first time. Additionally, Brevibacillus and the less-known bacterium Tistrella mobilis were found demonstrating PET hydrolysis activity. Our study provides the first report of thermophilic bacteria isolated from Peruvian hot springs with biotechnological potential for the bioremediation of oil-, metal- and plastic-polluted environments.

Detection and molecular characterization of infectious laryngotracheitis virus (ILTV) in chicken with respiratory signs in Brazil during 2015 and 2016.

Avian infectious laryngotracheitis (ILT) is a respiratory disease that causes severe economic losses in the poultry industry, mainly due to high morbidity and mortality and reduced egg production. Molecular characterization was performed on samples collected from flocks in the Brazilian States of São Paulo, Pernambuco, and Minas Gerais during 2015 and 2016 that presented clinical signs of respiratory disease. End-point PCR was used for viral detection, and DNA sequencing was used for differentiation of vaccine and field strains. Molecular analysis based on the infected cell protein (ICP4) gene separated four of the nine samples together with previous Brazilian isolates (São Paulo and Minas Gerais), one sample was grouped on the same branch as Minas Gerais strains (along with another related sample), one sample was separately branched but still related to the tissue culture origin (TCO) vaccine strain, and two samples were grouped on the same branch as the TCO vaccine strain. Molecular analysis of the thymidine kinase (TK) gene showed the existence of strains of both high and low virulence. The characterization of two fragments of the ICP4 gene and a fragment of the TK gene in this study suggested that the virus circulating in Guatapará, as well as those in Barretos and Itanhandu, that is causing respiratory problems in birds is a highly virulent field strain. The clinical signs point to a TCO vaccine strain that most likely underwent some reversal event and is a latent reactivated infection.

Plants growing in Colombia as sources of active ingredients for sunscreens.

INTRODUCTION: Plants can be sources of photoprotective/antigenotoxic compounds that prevent cellular mutations involved in skin cancer and aging by regulating UV-induced mutability. PURPOSE: The study was aimed at investigating the sunscreen properties of plants growing in Colombia. MATERIALS AND METHODS: Ultraviolet (UV) radiation-absorption capability of different plant extracts was examined. In vitro photoprotection efficacies were evaluated using in vitro indices such as sun protection factor (SPFin vitro) and critical wavelength (λc). Pearson correlation analysis was used to examine the relationship between SPFin vitro and complementary UVB- antigenotoxicity estimates (%GI) based on the SOS Chromotest database. The cytotoxicity in human fibroblasts was studied using the trypan blue exclusion assay. Major compounds of promising plant extracts were determined by gas chromatography coupled to mass spectrometry (GC/MS). RESULTS: We showed that plant extracts have sunscreen properties against UVB, whereas broad-spectrum radiation protection efficacy was poor. SPFin vitro and %GI were correlated (R = 0.71, p < .0001) for the plant extracts under study. Three extracts obtained from Achyrocline satureioides, Chromolaena pellia, and Lippia origanoides species resulted to possess high protection efficacy and relatively low cytotoxicity in human fibroblasts. These plant extracts contained major compounds such as α-pinene, trans-ß-caryophyllene, γ-muurolene, γ-cadinene and caryophyllene oxide in A. Satureioides extract, trans-ß-caryophyllene, caryophyllene oxide, squalene and α-amyrin in C. pellia extract, and p-cymene, carvacrol, trans-ß-caryophyllene and pinocembrin in L. origanoides extract. CONCLUSIONS: Plants growing in Colombia contain compounds that can be useful for potential sunscreens. SPFin vitro and %GI estimates were correlated, but %GI estimates were more sensitive to detecting activity at lower plant extract concentrations. Our results supported the need to use DNA damage detection assays as a complement to photoprotection efficacy measurement.

Unveiling the Fecal Microbiota in Two Captive Mexican Wolf (Canis lupus baileyi) Populations Receiving Different Type of Diets.

The Mexican wolf (Canis lupus baileyi) was once distributed in southern United States and northern Mexico. It is an endangered subspecies detached from the gray wolf, and likely exemplifies one of the original migration waves of C. lupus into the new world. This is a canine whose individuals survive in specialized facilities, zoos, and museums as part of captive-breeding programs. In order to contribute to the improvement of the management of this species and favor its long-term conservation in Mexico, we aimed to evaluate the diversity and abundance of the fecal bacterial microbiota in two populations exposed to different types of diet: (1) Michilia (23° N, 104° W); kibble daily and raw meat sporadically, and (2) Ocotal (19° N, 99° W); raw meat daily and live animals periodically. Next generation sequencing (V3-V4 16S rRNA gene) by Illumina was implemented. The operational taxonomic units (OTUs) in Michilia resulted in 9 phyla, 19 classes, 34 orders, 61 families, 204 genera, and 316 species, while in Ocotal there were 12 phyla, 24 classes, 37 orders, 69 families, 232 genera, and 379 species. Higher estimated Chao1 richness, Shannon diversity, and core microbiota were observed in Ocotal. Differences (p < 0.05) between populations occurred according to the Bray-Curtis beta diversity index. In the Michilia, dominance of bacteria that degrade carbohydrates (Firmicutes, Lachnospiraceae, Blautia, Clostrodium, Eisenbergiella, Romboutsia, and Ruminococcus) was observed; they are abundant in kibble diets. In contrast, the Ocotal microbiota was dominated by protein-degrading bacteria (Fusobacteria, Fusobacteriaceae, and Fusobacteria), indicating a possible positive relation with a raw meat diet. The information generated in this study is fundamental to support the implementation of better management plans in the two populations considered here, as well as in different facilities of southern United States and Mexico, where this subspecies is kept in captivity for conservation purposes.

Comparison of hemagglutination inhibition tests, immunoperoxidase monolayer assays, and serum neutralizing tests in detecting antibodies against blue eye disease in pigs.

Blue eye disease (BED) of pigs was identified in the early 1980s in La Piedad, Michoacan, Mexico. The causal agent is Porcine orthorubulavirus (PRV), which affects pigs of all ages, producing nervous, respiratory, and reproductive disorders. BED is geographically endemic to the center of Mexico, where 75% of the country's swine industry is concentrated. Due to its adverse effects on the swine industry and the risk of dissemination to other countries, it is essential to have reliable diagnostic methods for BED. The objective of this study was to establish the optimal conditions for three serological tests, hemagglutination inhibition (HI), immunoperoxidase monolayer assay (IPMA), and serum neutralization (SN), and to compare their sensitivity, specificity, kappa coefficient, and predictive values. Twelve different HI protocols (9408 tests), one SN protocol and one IPMA protocol (784 tests, each) were evaluated. Forty-nine sera were analyzed, and thirty-seven sera showed true positive results, while twelve showed true negative results. The kappa coefficient was used to assess the variation in each test. The best HI protocol registered a sensitivity and specificity of 89 and 100%, respectively, the IPMA test showed values of 85 and 100%, and the SN test registered a sensitivity of 91% and a specificity of 96%. One of the disadvantages of the HI test is that when chicken red blood cells (RBCs) are used, elution occurs in a short incubation time, which would decrease the specificity. The use of bovine RBCs increases the specificity of the testy and makes it more stable, but it decreases the sensitivity. The results of HI and SN revealed the importance of eliminating the complement system of the serum and removing other inhibitors to avoid test nonspecificity. The IPMA test does not use an active virus; hence, it is considered safe and does not present any risk of disseminating PRV.

Recomendaciones de la Sociedad Uruguaya de Medicina Intensiva sobre los aspectos bioéticos en la pandemia Covid-19 / Recommendations by the Uruguayan Society of Intensive Care on the Covid-19 pandemic / Recomendações da Sociedade Uruguaia de Medicina Intensiva sobre aspectos bioéticos na pandemia Covid-19

Resumen: Introducción: la pandemia provocada por el SARS-CoV-2 genera un importante desafío para el sistema sanitario y especialmente para la Medicina Intensiva. Es necesario prepararse en múltiples aspectos. Además, considerar plausible una demanda extraordinaria de camas críticas que puede llevar a un desbalance entre las necesidades clínicas y la disponibilidad efectiva de los recursos sanitarios. Objetivos: realizar un análisis bioético para brindar una orientación en la atención a los pacientes críticos. Objetivos específicos: 1) Analizar los principios bioéticos fundamentales en este contexto. 2) Apoyar a los clínicos en la toma de decisiones difíciles. 3) Hacer explícitos los criterios de asignación de recursos. 4) Definir líneas de acción ante un posible escenario de "desastre sanitario". Método: la SUMI ha generado un ámbito de trabajo colectivo cuyo método de trabajo fue la deliberación. En la documentación se utiliza la revisión bibliográfica y los protocolos ya existentes. Resultados: el trabajo plantea un análisis teórico documentado sobre los principios bioéticos involucrados en el contexto de pandemia, sobre los escenarios de demanda asistencial y sobre la fundamentación para un cambio en los criterios éticos ante un escenario de saturación del sistema. Conclusión: se plantean recomendaciones prácticas para: 1) Toma de decisiones de ingreso y egreso en demanda controlada. 2) Criterios de acción ante el aumento de la demanda estableciendo definiciones de los diferentes escenarios. 3) Recomendaciones para aplicar en un escenario de saturación del sistema.

Summary: Introduction: the pandemic caused by SARS-CoV2 constitutes a significant challenge for the health system, and especially for Critical Care Units, so we need to prepare in many aspects. Likewise, we need to consider there could be an extraordinary demand for beds in critical care units, what would lead to an imbalance between clinical needs and the effective availability of health resources. Objectives: the study aims to perform a bioethical analysis that could provide guidelines for the assistance of patients in critical care. Specific objectives: 1) to analyse the main bioethical principles in this context, 2) to support clinicians in the making of difficult decisions, 3) to make the resource allocation criteria specific, 4) to define action lines upon a potential "health's disastrous" scenario Method: the Uruguayan Society of Intensive Care has generated a space for collective work based on discussion processes. Documents include a bibliographic review and the existing protocols. Results: the study presents a theoretical analysis that is backed up by the bioethical principles involved in the pandemic context on the scenarios of demand for assistance and, by the arguments calling for a change in the ethical criteria upon the saturation of the health system. Conclusion: practical recommendations are made: 1) for the making of decisions about admission and discharge in a controlled demand. 2) to define action criteria upon an increase in demand, clearly defining the different scenarios, 3) to apply upon the saturation of the health system.

Resumo: Introdução: a pandemia causada pelo SARS-CoV2 gera um importante desafio para o sistema de saúde e principalmente para a Medicina Intensiva. É preciso se preparar em vários aspectos. Além disso, considera plausível uma demanda extraordinária por leitos críticos, que pode levar a um desequilíbrio entre as necessidades clínicas e a disponibilidade efetiva de recursos de saúde. Objetivos: realizar uma análise bioética para orientar o cuidado ao paciente crítico. Objetivos específicos: 1) Analisar os princípios bioéticos fundamentais neste contexto, 2) Apoiar os médicos na tomada de decisões difíceis, 3) Tornar explícitos os critérios de alocação de recursos, 4) Definir linhas de ação perante um possível cenário de " desastre de saúde ". Métodos: a SUMI gerou um ambiente de trabalho coletivo cujo método de trabalho era deliberativo. A documentação usa a revisão da literatura e os protocolos existentes. Resultados: o trabalho propõe uma análise teórica documentada sobre os princípios bioéticos envolvidos no contexto da Pandemia, sobre os cenários da demanda de saúde e sobre os fundamentos para uma mudança de critérios éticos em um cenário de saturação do sistema. Conclusão: são propostas recomendações práticas para: 1) tomada de decisão para admissão e alta sob demanda controlada. 2) critérios de atuação frente ao aumento da demanda, estabelecendo definições dos diferentes cenários. 3) recomendações a serem aplicadas em um cenário de saturação do sistema.

Establishing consensus on the perioperative management of cholecystectomy in public hospitals: a Delphi study with an expert panel in Mexico.

BACKGROUND: Several guidelines have put forward recommendations about the perioperative process of cholecystectomy. Despite the recommendations, controversy remains concerning several topics, especially in low- and middle-income countries. The aim of this study was to develop uniform recommendations for perioperative practices in cholecystectomy in Mexico to standardize this process and save public health system resources. METHODS: A modified Delphi method was used. An expert panel of 23 surgeons anonymously completed two rounds of responses to a 29-item questionnaire with 110 possible answers. The consensus was assessed using the percentage of responders agreeing on each question. RESULTS: From the 29 questions, the study generated 27 recommendations based on 20 (69.0%) questions reaching consensus, one that was considered uncertain (3.4%), and six (20.7%) items that remained open questions. In two (6.9%) cases, no consensus was reached, and no recommendation could be made. CONCLUSIONS: This study provides recommendations for the perioperative management of cholecystectomy in public hospitals in Mexico. As a guide for public institutions in low- and middle-income countries, the study identifies recommendations for perioperative tests and evaluations, perioperative decision making, postoperative interventions and institutional investment, that might ensure the safe practice of cholecystectomy and contribute to conserving resources.