ABSTRACT
In order to assess risk factors related to bovine tuberculosis (bTB) persistence, a case-control study, comparing persistent versus transient bTB infected beef farms from Central and Southern Spain, was conducted. Farms were matched by herd size and geographical location (county). A questionnaire administered by personal interview was conducted on 150 herds (80 controls and 70 cases) from Andalucia and Castilla La Mancha regions. The questionnaire included questions related to the personnel involved in routine diagnostics, structure of the farm and of the herd, management, presence of other domestic species and of wildlife reservoirs. According to the results of our study, farms with large pasture areas and bTB infected neighbors had more difficulties in eradicating the disease, and therefore, were more likely to suffer a persistent bTB infection. The odds of bTB persistence were between 1.2 and 5.1 (i.e., 95% confidence interval of the OR) times higher in those herds that had a neighbor infected herd. Farms with large pasture areas had odds between 1.2 and 12.7 (i.e., 95% confidence interval of the OR) times higher of having a persistent bTB episode than farms with small pasture areas.
Subject(s)
Tuberculosis, Bovine/epidemiology , Animals , Case-Control Studies , Cattle , Mycobacterium bovis/physiology , Risk Factors , Spain/epidemiology , Tuberculosis, Bovine/microbiology , Tuberculosis, Bovine/transmissionABSTRACT
En el proceso de diagnóstico de los pacientes los errores y retrasos pueden comprometer la seguridad del paciente. Se expresa el diseño e implantación de un sistema de mejora del proceso diagnóstico desde el laboratorio clínico. Se desarrolló un sistema basado en intervenciones para completar estudios analíticos con un algoritmo de exploración secuencial y aportar información útil para la interpretación de resultados en la práctica clínica.Se registraron 23.973 intervenciones, que suponían el 8% de los pacientes estudiados. La exploración de la función Hepato-Biliar y metabolismo lipídico fueron las intervenciones más frecuentes realizadas. En conclusión los laboratorios clínicos pueden adoptar una actitud proactiva en el diagnóstico de los pacientes, que supone un valor añadido útil, con previsible impacto favorable en la efectividad y eficiencia clínica en la atención del paciente (AU)
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Subject(s)
Humans , Quality Improvement/organization & administration , Laboratories, Hospital/standards , Clinical Laboratory Techniques/standards , Laboratory Proficiency TestingABSTRACT
A case of chronic lymphocytic leukemia is described in which peripheral blood films showed lymphocyte agglutination. A serum factor responsible for the agglutination was demonstrated. The factor was dependent upon the presence of anticoagulant solutions and was more active at room temperature than at 37 degrees C. It could be identified as a monoclonal immunoglobulin M. This mechanism has not been previously described in lymphocyte agglutination.
