Ensayo clínico aleatorizado. Efecto de dos tipos de ayuno en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local en un servicio de hemodinámica en Medellín, 2019 / Randomized clinical trial. Effect of two types of fasting in patients undergoing percutaneous intervention procedures under local anesthesia in a hemodynamic service in Medellín, 2019 / Ensaio clínico randomizado. Efeito de dois tipos de jejum em pacientes submetidos a procedimentos de intervenção percutânea sob anestesia local em um serviço de hemodinâmica em Medellín, 2019

Objetivo: determinar el efecto de dos tipos de ayuno sobre parámetros de satisfacción, náuseas, vómito, presión arterial y glucometría en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local en un servicio de hemodinámica en Medellín, 2019. Metodología: ensayo clínico aleatorizado abierto de dos brazos en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local durante tres meses. Cada brazo con 153 participantes; se asignó un ayuno de seis horas y al grupo de exposición un ayuno de dos horas para alimentos de fácil digestión; no hubo cega­miento, se realizó cálculo de muestra, y se hizo análisis univariado, bivariado y modelo de regresión logística con la variable satisfacción. Resultados: en el grupo de ayuno de seis horas el 2.6% presentó náuseas y en el grupo de exposición el 1.3%; se observó un caso de vómito. La presión arterial y glucometría mostraron diferencias estadísticas sin relevancia clínica. Se encontró significancia esta­dística para mareo, cefalea, hambre, sed y tipo de ayuno respecto con la satisfacción del paciente. Los pacientes con ayuno tuvieron un puntaje de satisfacción entre 60 y 100 y los de dieta ligera entre 82.5 y 100 puntos. Conclusiones: El ayuno de dos horas en dieta ligera mejora la satisfacción de los pa­cientes, disminuye la sensación de hambre, sed, presencia de cefalea y mareo, compa­rado con un ayuno de seis horas. Este estudio no encontró diferencias en las variables hemodinámicas ni en la frecuencia de náuseas y vómito.

Objective: to determine the effect of two types of fasting on parameters of satisfaction, nausea, vomiting, blood pressure and glucose measurement in patients undergoing percutaneous intervention procedures under local anesthesia in a hemodynamic service in Medellín, 2019. Methodology: Two-arm open-label randomized clinical trial in patients undergoing percutaneous interventional procedures under local anesthesia for three months, each arm with 153 participants, who were assigned a six-hour fast and the exposure group a two-hour fast for easily digestible foods. There was no blinding, sample calculation was performed, and univariate and bivariate analysis and logistic regression model were performed with the satisfaction variable. Results: in the six-hour fasting group, 2.6% presented nausea and in the exposure group, 1.3%; one case of vomiting was observed. Blood pressure and blood glucose showed statistical differences without clinical relevance. Statistical significance was found for dizziness, headache, hunger, thirst, and type of fasting with respect to patient satisfaction. Fasting patients had a satisfaction score between 60 and 100 and those on a light diet between 82.5 and 100 points. Conclusions: Fasting for two hours on a light diet improves patient satisfaction, decreases the sensation of hunger, thirst, headache and dizziness, compared to a six-hour fast. This study found no differences in the hemodynamic variables, nor in the frequency of nausea and vomiting.

Objetivo: determinaro efeito de dois tipos de jejum nos parâmetros de satisfação, náuseas, vômitos, pressão arterial e glicemia em pacientes submetidos a procedimentos de intervenção percutânea sob anestesia local em um serviço de hemodinâmica em Medellín, 2019. Metodologia: Ensaio clínico randomizado aberto de dois braços em pacientes submetidos a procedimentos intervencionistas percutâneos sob anestesia local por três meses. Cada braço com 153 participantes; um jejum de seis horas foi designado e o grupo de desafio um jejum de duas horas para alimentos facilmente digeríveis; não houve cegamento, foi realizado cálculo amostral, análise univariada, bivariada e modelo de regressão logística com a variável satisfação. Resultados: no grupo de jejum de seis horas, 2,6% apresentaram náuseas e no grupo de exposição, 1,3%; foi observado um caso de vômito. A pressão arterial e a glicemia apresentaram diferenças estatísticas sem relevância clínica. Foi encontrada significância estatística para tontura, dor de cabeça, fome, sede e tipo de jejum em relação à satisfação do paciente. Os pacientes em jejum tiveram um escore de satisfação entre 60 e 100 e os em dieta light entre 82,5 e 100 pontos. Conclusões: O jejum de duas horas com dieta leve melhora a satisfação do paciente, diminui a sensação de fome, sede, dor de cabeça e tontura, em comparação com o jejum de seis horas. Este estudo não encontrou diferenças nas variáveis hemodinâmicas ou na frequência de náuseas e vômitos.

Preliminary survey of the occurrence of mycotoxins in cereals and estimated exposure in a northwestern region of Mexico.

Mycotoxins have several toxicological implications. In the present study, we evaluate the presence of aflatoxin B1 (AFB1), ochratoxin A (OTA), and fumonisin (FB1) in paddy rice, polished rice, and maize from the fields and markets in Nayarit State (Mexico). The results indicated the presence of AFB1 in 21.21% of paddy rice samples and 11.11% of market maize samples. OTA was present in only 3.03% (one sample) of paddy rice samples. FB1 was detected in 87.50% and 88.88% of maize samples from field and market, respectively. The estimated human exposure was calculated for FB1 using the probable daily intake (PDI), which suggested that FB1 could contribute to the development of diseases through the consumption of contaminated maize. Positive samples indicated that some rice and maize samples were not suitable for human consumption. Further efforts are needed to continue monitoring mycotoxins and update national legislation on mycotoxins accordingly.

Short-Term Effects on Agricultural Soils Irrigated with Reclaimed Water in Baja California, México.

In 2014 reclaimed water (RW) started to be used for agricultural irrigation of 200 ha in Maneadero Valley, Baja California, Mexico. The RW had relatively high electrical conductivity (4-5 dS m-1), and K+, Mg2+, PO43- and Cl- concentrations relative to irrigation guidelines. However, no accumulation of these elements, nor total nitrogen, was observed in the studied soils. The main effect of RW irrigation was the downcore leaching of Cl- and Na+ below 120 cm, causing an increase in electrical conductivity in the lower soil horizons. Al, Fe and Zn showed a twofold to eightfold accumulation in the top soil layer after 2 years. Moderate to severe chemical clogging of dripping systems and potential biological clogging are likely to occur. Mexican national guidelines for the reuse of RW do not take into account specific variables that could change the quality of agricultural soil or lead to clogging of drip irrigation systems.

Phylogenetic analyses of Chlamydia psittaci ompA gene sequences from captive blue-fronted Amazon parrots (Amazona aestiva) with hepatic disease in Brazil.

Chlamydia psittaci was detected in 152 (72%) blue-fronted Amazon parrots (Amazona aestiva, parrot from the Psittacidae family) out of a population of 212 that died during 2009-2011 in a wildlife rescue and rehabilitation centre in Minas Gerais, Brazil, following rescue from illegal wildlife trafficking. The macroscopic changes observed in these animals were hepatomegaly with multifocal white foci visible at the serosal surfaces of the liver, and extending into the parenchyma, and splenomegaly. The microscopic lesions observed in the liver included multifocal to coalescing miliary necrosis of hepatocytes with infiltration by heterophils, lymphocytes and plasma cells. In the spleen, loss of the normal architecture and infiltration by macrophages and plasma cells were observed. Stained tissue sections (Gimenez technique) revealed small round clusters suggestive of C. psittaci (reticulate bodies) in the cytoplasm of macrophages from the liver and spleen. Nine sequences of segments of the ompA gene, obtained from different individuals, were randomly selected for sequencing. The phylogenetic analyses showed that all strains clustered with genotype A, which is the most virulent genotype for birds. This genotype is involved in mortality of psittacines, is easily transmitted in captivity and represents a problem for successful rehabilitation. The results indicate the necessity to improve biosecurity in triage and to provide individual personal protection for professionals and caretakers.

Chlamydia psittaci a été détectée chez 152 (72 %) amazones à front bleu (Amazona aestiva, perroquet de la famille des Psittacidés) sur un total de 212 individus rescapés du trafic illégal et décédés en 2009 et 2011 dans un centre de sauvetage et de réhabilitation de la faune sauvage à Minas Gerais (Brésil). Les modifications macroscopiques observées sur ces oiseaux étaient une hépatomégalie avec des foyers blancs multifocaux visibles sur les surfaces séreuses du foie et s'étendant dans le parenchyme, et une splénomégalie. Les lésions microscopiques observées dans le foie comprenaient une nécrose miliaire multifocale à coalescente des hépatocytes avec infiltration d'hétérophiles, de lymphocytes et de plasmocytes. Dans la rate, une perte de l'architecture normale et l'infiltration de macrophages et de plasmocytes ont été observées. La coloration de coupes de tissus (technique de Gimenez) a révélé de petites grappes rondes évoquant C. psittaci (corps réticulés) dans le cytoplasme des macrophages du foie et de la rate. Neuf produits segmentés d'une partie du gène ompA, obtenus de différents individus, ont été sélectionnés de manière aléatoire pour le séquençage. Les analyses phylogénétiques ont montré que toutes les souches se regroupaient dans le génotype A, qui est le plus virulent pour les oiseaux. Ce génotype est responsable de cas de mortalité chez les psittacidés et se transmet facilement en captivité, ce qui représente un risque pour la réussite des opérations de réhabilitation. Au vu de ces résultats, les auteurs soulignent la nécessité d'améliorer la biosécurité lors du tri des animaux dans les centres de soins et de fournir une protection individuelle aux professionnels et aux gardiens.

Se detectó Chlamydia psittaci en 152 (72%) amazonas frentiazules (Amazona aestiva, loro de la familia Psittacidae) de un total de 212 que murieron durante 2009­2011 en un centro de rescate y rehabilitación de fauna silvestre de Minas Gerais, Brasil, tras haber sido rescatadas del tráfico ilegal. Los cambios macroscópicos que se observaron en estos animales fueron hepatomegalia con focos blancos multifocales visibles en las superficies serosas del hígado y que se extendían hacia el parénquima, y esplenomegalia. Las lesiones microscópicas observadas en el hígado consistieron en necrosis miliar multifocal a coalescente de hepatocitos con infiltración de heterófilos, linfocitos y células plasmáticas. En el bazo, se observó pérdida de la arquitectura normal y infiltración de macrófagos y células plasmáticas. Cortes de tejido teñidos (con la técnica de Giménez) revelaron pequeños racimos redondos que sugerían la presencia de C. psittaci (cuerpos reticulados) en el citoplasma de macrófagos del hígado y del bazo. A partir de distintos individuos, se escogieron aleatoriamente nueve segmentos del gen ompA para ser secuenciados. Los análisis filogenéticos mostraron que todas las cepas correspondían al genotipo A, que es el más virulento para las aves. Este genotipo está involucrado en la mortalidad de psitácidas, se transmite fácilmente en cautiverio y supone un riesgo para el éxito de la rehabilitación. Los resultados indican la necesidad de mejorar la bioseguridad en el triaje y de procurar protección personal individual a profesionales y cuidadores.

An Overview on Mareks Disease Virus Evolution and Evidence for Increased Virulence in Brazil

Mareks disease virus (MDV) has been shown to be evolving to higher virulence. One of the genetic sites involved in virulence which enables such characterization is the 339-amino acid Meq protein encoding gene (meq). The reemergence of clinical Mareks disease (MD) in vaccinated flocks can be associated to changes in meq. Our studies have shown the presence of very virulent MDV strains in the Brazilian industrial and free-range poultry. We present an overview of MD increasing severity and indicate the necessity of using phylogenetic tools for best accompanying MDV evolution.

An Overview on Mareks Disease Virus Evolution and Evidence for Increased Virulence in Brazil

Mareks disease virus (MDV) has been shown to be evolving to higher virulence. One of the genetic sites involved in virulence which enables such characterization is the 339-amino acid Meq protein encoding gene (meq). The reemergence of clinical Mareks disease (MD) in vaccinated flocks can be associated to changes in meq. Our studies have shown the presence of very virulent MDV strains in the Brazilian industrial and free-range poultry. We present an overview of MD increasing severity and indicate the necessity of using phylogenetic tools for best accompanying MDV evolution.(AU)

Serological diagnosis of influenza A subtype H1 on family poultry of Belo Horizonte, Minas Gerais and Santa Maria, Rio Grande Do Sul, in Brazil

Serum samples (n=687) from Gallus gallus domesticus were collected for the investigation of antibodies to avian influenza virus (AIV-A) in the family poultry of the surrounding counties of Santa Maria/RS and the metropolitan region of Belo Horizonte/MG, totaling twenty different counties. Additional samples of seventeen (n=17) free-flying ducks (C. moschata pure or hybrid with Anas platyrhynchos) were collected in Belo Horizonte. The chosen tests for the survey were performed as described by the World Organization for Animal Health (OIE), including agar gel immunodiffusion (AGID) for antibodies to AIV-A nucleoprotein (N) and haemagglutination- inhibition (HI) for antibodies to subtype H1. Out of the 704 serum tests performed by AGID, eight (8/704) were revealed positive for antibodies to AIV-A N protein, with six (6/704) retested positive for subtype H1. Two sera tested positive by AGID were shown to be non reactive to the H1 subtype, suggesting specificity to another subtype. A low occurrence of antibodies to influenza A (1.13%) was found, and mostly (75%) specific to subtype H1. This represents an approximately 0,85% overall occurrence for subtype H1 antibodies, with an unknown subtype specific antibodies detected in one free-flying anatid. The low occurrence of antibodies in the family poultry may suggest a low AIV-A activity during the period of study, information which remains to be confirmed by virus detection.

Serological diagnosis of influenza A subtype H1 on family poultry of Belo Horizonte, Minas Gerais and Santa Maria, Rio Grande Do Sul, in Brazil

Serum samples (n=687) from Gallus gallus domesticus were collected for the investigation of antibodies to avian influenza virus (AIV-A) in the family poultry of the surrounding counties of Santa Maria/RS and the metropolitan region of Belo Horizonte/MG, totaling twenty different counties. Additional samples of seventeen (n=17) free-flying ducks (C. moschata pure or hybrid with Anas platyrhynchos) were collected in Belo Horizonte. The chosen tests for the survey were performed as described by the World Organization for Animal Health (OIE), including agar gel immunodiffusion (AGID) for antibodies to AIV-A nucleoprotein (N) and haemagglutination- inhibition (HI) for antibodies to subtype H1. Out of the 704 serum tests performed by AGID, eight (8/704) were revealed positive for antibodies to AIV-A N protein, with six (6/704) retested positive for subtype H1. Two sera tested positive by AGID were shown to be non reactive to the H1 subtype, suggesting specificity to another subtype. A low occurrence of antibodies to influenza A (1.13%) was found, and mostly (75%) specific to subtype H1. This represents an approximately 0,85% overall occurrence for subtype H1 antibodies, with an unknown subtype specific antibodies detected in one free-flying anatid. The low occurrence of antibodies in the family poultry may suggest a low AIV-A activity during the period of study, information which remains to be confirmed by virus detection.(AU)

Pancreatitis aguda severa por hipertrigliceridemia en el adulto: presentación de caso clínico, diagnóstico y tratamiento / Severe acute pancreatitis due to hypertriglyceridemia in adults: Clinical case presentation, diagnosis and treatment

Resumen La pancreatitis es una de las causas más frecuentes de admisión hospitalaria gastrointestinal; en 2009 representó más de 275 000 ingresos a urgencias en Estados Unidos (1). Por su parte, la hipertrigliceridemia es la tercera causa más frecuente, considerándose como de alto riesgo para el desarrollo de pancreatitis los valores superiores a 1000 mg/dL (2); este grupo de pacientes tiene peor pronóstico que quienes cursan con pancreatitis de otra etiología, aunque aún no se logra definir de forma clara y estandarizada un rango de triglicéridos (TAG) que se relacione con la gravedad de la pancreatitis aguda. Existen varios mecanismos fisiopatológicos que explican la aparición de pancreatitis en el contexto de la hipertrigliceridemia, uno de los mejor estudiados es el papel tóxico directo de los ácidos grasos libres sobre el tejido pancreático (3) y otro mecanismo ampliamente acogido es la obstrucción vascular mediada por los quilomicrones, dada la disminución de la expresión genética de la lipoproteína lipasa (LPL) (4). Por su parte, el éxito del tratamiento de esta enfermedad se basa en disminuir los niveles de TAG a menos de 500 mg/dL, teniendo para esto entre otras herramientas la plasmaféresis, tratamiento que ofrece rapidez y efectividad en la reducción de los niveles de TAG.

Abstract Pancreatitis is one of the most frequent gastrointestinal causes of hospital admission. In 2009, it accounted for more than 275,000 admissions to emergency departments in the United States. (1) Hypertriglyceridemia is the third most frequent cause of pancreatitis, and triglyceride levels over 1,000 mg/dl are considering to indicate high risk for its development. (2) This group of patients has a worse prognosis than those with pancreatitis of other etiologies, but to date, no clear standard definition of how the range of triglyceride levels is related to the severity of acute pancreatitis has been defined. There are several pathophysiological mechanisms that explain the onset of pancreatitis in the context of hypertriglyceridemia. One of the best studied is the toxic role of free fatty acids on pancreatic tissue. (3) Another widely accepted mechanism is vascular obstruction mediated by chylomicrons given the decrease in the genetic expression of lipoprotein lipase (LPL). (4) Successful treatment of this disease is based on lowering triglyceride levels below 500 mg/dl. One fast and effective tool for achieving this is plasmapheresis.

Sensitivity assessment of sea lice to chemotherapeutants: Current bioassays and best practices.

Traditional bioassays are still necessary to test sensitivity of sea lice species to chemotherapeutants, but the methodology applied by the different scientists has varied over time in respect to that proposed in "Sea lice resistance to chemotherapeutants: A handbook in resistance management" (2006). These divergences motivated the organization of a workshop during the Sea Lice 2016 conference "Standardization of traditional bioassay process by sharing best practices." There was an agreement by the attendants to update the handbook. The objective of this article is to provide a baseline analysis of the methodology for traditional bioassays and to identify procedures that need to be addressed to standardize the protocol. The methodology was divided into the following steps: bioassay design; material and equipment; sea lice collection, transportation and laboratory reception; preparation of dilution; parasite exposure; response evaluation; data analysis; and reporting. Information from the presentations of the workshop, and also from other studies, allowed for the identification of procedures inside a given step that need to be standardized as they were reported to be performed differently by the different working groups. Bioassay design and response evaluation were the targeted steps where more procedures need to be analysed and agreed upon.

Response of Caligus rogercresseyi (Boxshall & Bravo, 2000) to treatment with Hydrogen Peroxide: Recovery of parasites, fish infestation and egg viability under experimental conditions.

Hydrogen peroxide (HP) is used to remove C. rogercresseyi from fish but little is known about its effect on this species. This study determined EC50 and concentration immobilizing 100% of specimens, capacity of parasites exposed to HP to recover and infest fish, and effect on survival into the copepodid stage. EC50 and concentration immobilizing 100% of specimens were estimated by exposing parasites for 20 min to 11 concentrations and evaluating effect at 1 and 24 h post-exposure. Capacity to recover and infest fish, and survival into copepodid were evaluated by exposing parasites and eggs to HP for 20 min. Recovery and fish infestation were evaluated at 25 and 24 h post-exposure, respectively. Eggs were grown until control reached the copepodid stage and survival calculated. EC50 was 709.8 ppm.100% immobilization was obtained at 825 ppm. Male and female recover 0.5 and 1 h post-exposure, respectively. Percentage of parasites exposed and not exposed to HP that were recovered on fish was not significantly different. Survival to copepodid was lower in those exposed to HP. HP effect is greater on copepodids, but 100% of the mobile stages are immobilized under 825 ppm causing detachment from fish and potentially driven away, reducing infestation risk.

Allergenome characterization of the mosquito Aedes aegypti.

BACKGROUND: Saliva and muscle-derived mosquito allergens have been purified and characterized. However, the complete set of allergens remains to be elucidated. In this study, we identified and characterized IgE-binding proteins from the mosquito species Aedes aegypti. METHODS: Serum was obtained from 15 allergic individuals with asthma and/or rhinitis and sensitized to mosquito. IgE binding was determined by ELISA. Total proteins from freeze-dried bodies of A. aegypti were extracted and IgE-reactive proteins were identified by 2D gel electrophoresis, followed by Western blot with pooled or individual sera. IgE-reactive spots were further characterized by mass spectrometry. RESULTS: Twenty-five IgE-reactive spots were identified, corresponding to 10 different proteins, some of which appeared as different variants or isoforms. Heat-shock cognate 70 (HSC-70) and tropomyosin showed IgE reactivity with 60% of the sera, lysosomal aspartic protease, and "AAEL006070-PA" (Uniprot: Q177P3) with 40% and the other proteins with <33.3% of the sera. Different variants or isoforms of tropomyosin, arginine or creatine kinase, glyceraldehyde-3-phosphate dehydrogenase (GPDH), calcium-binding protein, and phosphoglycerate mutase were also identified. The mixture of three allergens (Aed a 6, Aed a 8, and Aed a 10) seems to identify more than 80% of A. aegypti-sensitized individuals, indicating that these allergens should be considered when designing of improved mosquito allergy diagnostic tools. CONCLUSIONS: The newly identified allergens may play a role in the pathophysiology of mosquito allergy in the tropics, and some of them might be important arthropod-related proteins involved in cross-reactivity between A. aegypti and other allergenic arthropods.

Modelling the effect of pH and water activity in the growth of Aspergillus fumigatus isolated from corn silage.

AIMS: The aim of this work was to use mathematical kinetic modelling to assess the combined effects of aW, pH, O2 availability and temperature on the growth rate and time to growth of Aspergillus fumigatus strains isolated from corn silage. METHODS AND RESULTS: A full factorial design was used in which two factors were assayed: pH and aW . The aW levels assayed were 0·80, 0·85, 0·90, 0·92, 0·94, 0·96, 0·98 and 0·99. The levels of pH assayed were 3·5, 4, 4·5, 5, 6, 7, 7·5 and 8. The assay was performed at normal oxygen tension at 25 and 37°C, and at reduced oxygen tension at 25°C. Two strains of A. fumigatus isolated from corn silage were used. Kinetic models were built to predict growth of the strain under the assayed conditions. The cardinal models gave a good quality fit for radial growth rate data. The results indicate that the environmental conditions which take place during silage production, while limiting the growth of most micro-organisms, would not be able to control A. fumigatus. Moreover, pH levels in silage, far from limiting its growth, are also close to its optimum. Carbon dioxide at 5% in the environment did not significantly affect its growth. CONCLUSIONS: A need for a further and controlled acidification of the silage exists, as no growth of A. fumigatus was observed at pH 3·5, as long as the organoleptic characteristics of the silage are not much compromised. SIGNIFICANCE AND IMPACT OF THE STUDY: Aspergillus fumigatus is one of the major opportunistic pathogens able to cause illness such as allergic bronchopulmonary aspergillosis, aspergilloma and invasive aspergillosis to rural workers. Exposure of animals to A. fumigatus spores can result in infections, particularly in those organs exposed to external invasion, such as the airways, mammary gland and uterus at birth.

Complicaciones en fracturas de platillos tibiales de alta energía / Complications in high energy tibial plateau fractures

El enfrentamiento y el manejo de las fracturas de platillos tibiales de alta energía representan un desafío para todo cirujano. El compromiso de partes blandas y la conminución articular secundaria a la energía involucrada determinan una mayor tasa de complicaciones y morbilidad. OBJETIVOS: Evaluar la tasa de complicaciones en fracturas de platillos tibiales de alta energía. MATERIALES Y MÉTODO: Estudio clínico imagenológico retrospectivo de fracturas de platillo tibial Schatzker V y VI con mecanismo de alta energía, tratadas con fijador externo y osteosíntesis diferida, entre 2007-2013. Análisis estadístico usando STATA 12.0. RESULTADOS: Cincuenta y dos fracturas se presentaron durante el periodo de estudio, 39 de ellas fueron seleccionadas considerando los criterios de inclusión. Promedio edad 42,4 años, seguimiento 41,8 meses. Complicaciones: neuropraxia 5%, infección Schatzker V (20%) 16,2%, VI (80%) 12,1% (p=0,759). Sin asociación entre infección y edad (p=0,6056), mecanismo involucrado (p=0,131), tiempo de prefijador externo (p=0,0556), ni tiempo en el uso de fijador externo (p=0,53). DISCUSIÓN: Las fracturas de platillos tibiales secundarias a traumatismos de alta energía se asocian a un importante compromiso de partes blandas. La reducción y osteosíntesis inmediata determina altas tasas de complicaciones; utilizar fijador externo transitorio las disminuiría. El abordaje anterior en línea media ha mostrado elevadas complicaciones, mientras que el uso de doble abordaje regularía esta situación. CONCLUSIÓN: Al afrontar el tratamiento de las fracturas de platillos tibiales de alta energía debemos considerar el uso de fijador externo transitorio para un adecuado control de la fractura y de las partes blandas para la cirugía definitiva.

The approach and management of high energy tibial plateau fractures is a challenge for every surgeon. Soft tissue injuries and joint comminution due to the energy involved are associated with a higher rate of complications and morbidity. OBJECTIVES: To evaluate the rate of complications in high energy tibial plateau fractures. MATERIALS AND METHODS: A retrospective imaging-clinical study of Schatzker type V and IV high-energy tibial plateau fractures, treated with an external fixation and delayed osteosynthesis, was conducted between 2007 and 2013. Statistical analysis was performed using STATA 12.0. RESULTS: A total of 52 fractures were treated during the study period, of which 39 met the criteria for selection. The mean age of the patients was 42.4 years, with a follow-up time of 41.8 months. The complications include, neuropraxia, 5%, Schatzker V infection (20%), 16.2%, and Vl (80%), 12.1% (P=.759). There was no relationship between infection and age (P=.6056), mechanism involved (P=.131), time between accidents and the installation of an external fixator (P=.0556), or the time used for external fixation (P=.53). DISCUSSION: High-energy tibial plateau fractures are associated with significant soft tissue injuries. Immediate reduction and osteosynthesis are determining factors for high rates of complications, while using transient external fixation should decrease them. A midline anterior approach has shown increased complications, while a double approach could improve this situation. CONCLUSION: The approach to high energy tibial plateau fractures must consider the use of a temporary external fixation for an adequate control of the fracture and the soft tissue for a definitive surgical treatment.

Experimental coinfection of chicken anemia virus and Mycoplasma gallisepticum vaccine strains in broiler chicks

This study aimed at determining the clinical and pathological effects of the coinfection of young SPF chickens with chicken anemia virus (CAV) and Mycoplasma gallisepticum (MG) vaccine strains. The clinical signs, gross and microscopic lesions were determined after the experimental coinfection broilers with a CAV genotype 1 vaccine strain given intraperitoneally on the first day of age and a MG F-strain vaccine given intranasally on the 8th day of age. The experimental groups included the negative control (group 1), a group infected with the MG F-strain vaccine (group 2), and a group coinfected with CAV and MG vaccines (group 3). Chicks were examined clinically and post mortem at 23 days of age, and gross and microscopic lesions of the trachea, thymus, and air sacs were compared among treatments (Kruskal-Wallis test). Infections were confirmed by PCR for specific genetic fragments of each agent in the target tissues. Mortality was only observed in chicks on group 3, with two deaths and more severe lesions in the trachea, thymus and air sacs compared with groups 1 and 2 (p < 0.01). Dead chicks presented reduced thymus and spleen size, hemorrhagic trachea with catarrhal exudate and partial obstruction, pericarditis, catarrhal airsacculitis, lungs with liquid and ascites. The surviving chicks in group 3 showed more severe respiratory changes than those in group 2, in addition to thymus and spleen size reduction. Results indicate the adverse effects of the coinfection of young chickens with MG F-strain and CAV genotype 1 vaccines.

Experimental coinfection of chicken anemia virus and Mycoplasma gallisepticum vaccine strains in broiler chicks

This study aimed at determining the clinical and pathological effects of the coinfection of young SPF chickens with chicken anemia virus (CAV) and Mycoplasma gallisepticum (MG) vaccine strains. The clinical signs, gross and microscopic lesions were determined after the experimental coinfection broilers with a CAV genotype 1 vaccine strain given intraperitoneally on the first day of age and a MG F-strain vaccine given intranasally on the 8th day of age. The experimental groups included the negative control (group 1), a group infected with the MG F-strain vaccine (group 2), and a group coinfected with CAV and MG vaccines (group 3). Chicks were examined clinically and post mortem at 23 days of age, and gross and microscopic lesions of the trachea, thymus, and air sacs were compared among treatments (Kruskal-Wallis test). Infections were confirmed by PCR for specific genetic fragments of each agent in the target tissues. Mortality was only observed in chicks on group 3, with two deaths and more severe lesions in the trachea, thymus and air sacs compared with groups 1 and 2 (p < 0.01). Dead chicks presented reduced thymus and spleen size, hemorrhagic trachea with catarrhal exudate and partial obstruction, pericarditis, catarrhal airsacculitis, lungs with liquid and ascites. The surviving chicks in group 3 showed more severe respiratory changes than those in group 2, in addition to thymus and spleen size reduction. Results indicate the adverse effects of the coinfection of young chickens with MG F-strain and CAV genotype 1 vaccines.(AU)

Sensitivity of Caligus rogercresseyi (Boxshall and Bravo 2000) to pyrethroids and azamethiphos measured using bioassay tests-A large scale spatial study.

The variety of antiparasitics that can be used against caligid copepods is limited and efforts are needed to maintain their efficacies. The objective of this study was to monitor the sensitivity of Caligus rogercresseyi, populations towards antiparasitics based on deltamethrin, cypermethrin and azamethiphos within and across geographic regions. The bioassay design consisted of exposing parasites collected from 23 farms to the different chemotherapeutants at the concentration and exposure times recommended for field treatment, under laboratory conditions, and evaluating the number of dead and live parasites 48h after exposure. Parasites were collected from 23 farms distributed in four macrozones in the Los Lagos region and three macrozones in the Aysén region. Parasite sensitivity was evaluated using a Generalized Linear Mixed Model of the Binomial family (Logit) fit by the maximum likelihood, using the lme4 package in R. Parasite gender, macrozone, and antiparasitics were used as fixed factors and farm was the random factor. The model including all the factors proved to be a useful tool for predicting parasite sensitivity. This approach identified (i) those macrozones with a greater likelihood of finding parasite populations which are more or less sensitive to the three antiparasitics, (ii) cases in which parasite sensitivity to the different antiparasitics varied within a given macrozone, (iii) differences in sensitivity between females and males and (iv) an important random effect associated with farm. The results indicate a spatial variability of parasite sensitivity to antiparasitics which, added to the continuous treatments applied on farms, suggest it is necessary to regularly update the sensitivity status in the macrozones. This would allow managers to improve their decision making processes regarding the type of antiparasitic to be used in a given situation. The one-concentration type bioassay performed in this study allowed us to perform a large spatial study with replicated tests of the sensitivity of C. rogercresseyi to pyrethroids and azamethiphos. Further studies should focus on the farm effects, the relationship between the sensitivity of parasites and field efficacy, as well as parasite population structure and connectivity with regard to parasite transmission between farms.

[Invasive disease due to Streptococcus pyogenes in a patient with A H1N1 influenza infection. Report of one case]. / Enfermedad invasora por Streptococcus pyogenes como coinfección en un paciente con influenza A H1N1.

Bacterial superinfection is a known complication among patients affected by viral respiratory tract infections. Streptococcus pyogenes, a major bacterial agent involved in acute tonsillopharyngitis, skin and soft tissue infections, was reported as a co-infecting microorganism during the 2009 A H1N1 influenza pandemic. We report a 65-year-old male patient who evolved with multifocal pneumonia and multiple organ failure with a fatal outcome. Influenza A H1N1 was detected by a polymerase chain reaction-based technique from a tracheal aspirate sample. S. pyogenes was identified by a rapid test from a nasopharyngeal sample and isolated afterwards from a positive blood culture.

Enfermedad invasora por Streptococcus pyogenes como coinfección en un paciente con influenza A H1N1 / Invasive disease due to Streptococcus pyogenes in a patient with A H1N1 influenza infection. Report of one case

Bacterial superinfection is a known complication among patients affected by viral respiratory tract infections. Streptococcus pyogenes, a major bacterial agent involved in acute tonsillopharyngitis, skin and soft tissue infections, was reported as a co-infecting microorganism during the 2009 A H1N1 influenza pandemic. We report a 65-year-old male patient who evolved with multifocal pneumonia and multiple organ failure with a fatal outcome. Influenza A H1N1 was detected by a polymerase chain reaction-based technique from a tracheal aspirate sample. S. pyogenes was identified by a rapid test from a nasopharyngeal sample and isolated afterwards from a positive blood culture.

Molecular Diagnosis of Beak and Feather Disease in Native Brazilian Psittacines

The incidence of the psittacine beak and feather disease virus (BFDV) was investigated in Brazilian native parrots with normal feathering arriving at rescue and triage centers for wild animals (CETAS, IBAMA) in the state of Minas Gerais, Brazil. BFDV DNA was investigated by previously described PCR technique for the partial amplification of BFDV ORF-1 in DNA extracts from blood, cloacal swab or liver of psittacines. Some birds provided more than one sample. Nine species of psittacines were sampled between January 2009 and October 2010. Blood (n=46) or cloacal swab (n=128) samples were obtained from psittacines immediately upon arrival at the triage centers. Liver samples were collected from necropsied birds dead on arrival (n=167). All swab samples were negative, except for one Ara ararauna individual (n=3) which blood presented the BFDV DNA. On the other hand, 11 liver samples were positive for BFDV DNA, with a prevalence of 7.8% in Amazona aestiva (n=140). No BFDV DNA was detected in the liver of Amazona amazonica (n=11), A. vinacea (n=5), A. rhodochorytha (n=4), Anodorhynchus hyacinthinus (n=3), Ara ararauna, (n=3), Aratinga leucophtalma (n=2), Guarouba guarouba (n=1) and Pionus maximiliani (n=1). In most cases, alopecia was not associated with BFDV detection in liver, and liver histopathology was inconclusive. Although all cloacal swab samples were negative, a few psittacines (n=19) that died at CETAS-Belo Horizonte were retested, and 21% were detected as positive in liver. A group of psittacines (n=16) was clinically evaluated, and despite showing feather dystrophy, all birds were negative in the cloacal swabs, except for one, which blood sample was positive (A. ararauna). The obtained sequences of the BFDV strains BH 215 and BH 732 were deposited in the GenBank (JQ649409 and JQ649410). A 98% similarity with strain sequences described in Australia, Japan, and New Zealand was observed. It is possible that these strains arrived in Brazil through the legal and illegal trade of parrots. However, it was not possible to associate BFDV infection with the geographical origin of birds and no local marker was detected. The rates of detection, although similar to other studies, indicate the tendency of a high incidence of the disease, possibly associated with stress, and high bird density and wide transmission in captivity conditions.