Reporte de resultados negativos a Trichinella spp. por digestión artificial en cerdos domésticos del valle inferior del río Negro, Patagonia Argentina / Report of negative results to Trichinella spp. by artificial digestion in domestic pigs of the lower valley of the Negro River, Argentine Patagonia

Resumen Actualmente, el género Trichinella está constituido por 10 especies y 3 genotipos. La transmisión ocurre únicamente por ingestión de tejido muscular infectado. Entre los potenciales hospedadores se conforma un ciclo doméstico y un ciclo silvestre con posible retroalimentación constante entre ambos. Desde el año 2017 el funcionamiento del Matadero Social de San Javier, en el valle inferior del río Negro, permite a productores acceder a una faena segura que además brinde garantías al consumidor. El objetivo del presente trabajo fue evaluar la presencia de larvas L1 de Trichinella spp. en porcinos domésticos procedentes de criaderos de pequeña y mediana escala. Se analizaron por el método de digestión artificial 10 gramos de diafragma de cada porcino doméstico, conformando pooles de hasta 10 animales. En total 942 porcinos domésticos resultaron negativos a la presencia de larvas L1 de Trichinella spp. No obstante debe tenerse presente que sistemas de producción con las características de los que provienen los animales analizados, estarían potencialmente expuestos a la retroalimentación de Trichinella spp. desde la fauna silvestre. En este marco, resulta necesario garantizar el control veterinario en la faena de porcinos y presas de caza y sostener acciones de vigilancia, actualización y promoción en relación a la prevención de la triquinelosis.

Abstract Currently the Trichinella genus consists of 10 species and 3 genotypes. Transmission occurs only through ingestion of infected muscle tissue. Between the potential hosts there is a domestic cycle and a wild cycle with possible constant feedback between both. Since 2017, the operation of the San Javier Social Slaughterhouse, in the lower valley of the Río Negro, allows producers to access a safe operation that also provides guarantees to the consumer. The aim of the present study was to evaluate the presence of L1 larvae larvae of Trichinella spp. in domestic pigs from small and medium-scale farms. 10 grams of diaphragm from each domestic pig were analyzed by the artificial digestion method, forming pools of up to 10 animals. In total 942 domestic pigs were negative for the presence of L1 larvae of Trichinella spp. However, it should be borne in mind that production systems with the characteristics from which the analyzed animals come, would potentially be exposed to the feedback of Trichinella spp. from wildlife. Then, it is necessary to guarantee veterinary control in the slaughter of pigs and game prey and to support surveillance, updating and promotion actions in relation to the prevention of trichinellosis.

Terapia con presión positiva para enfermedad de Ménière / Positive pressure therapy for Ménière's disease

INTRODUCCIÓN La enfermedad de Ménière es una anomalía del oído interno caracterizada por episodios de vértigo espontáneo, hipoacusia fluctuante y tinnitus. La terapia con presión positiva ha sido utilizada para reducir la intensidad y la frecuencia de las crisis, pero existe controversia respecto a su eficacia. MÉTODOS Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos cinco revisiones sistemáticas que en conjunto incluyeron 22 estudios primarios, de los cuales cinco corresponden a ensayos aleatorizados. Concluimos que la terapia de presión positiva probablemente empeora levemente la audición y no reduce la intensidad del vértigo. Además, no es posible establecer con claridad si la terapia de presión positiva mejora la funcionalidad o si disminuye la frecuencia de los ataques de vértigo, porque la certeza de la evidencia existente ha sido evaluada como muy baja.

INTRODUCTION Ménière's disease is a disorder of the inner ear characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Positive pressure therapy has been used to reduce the intensity and frequency of episodes, but it is not clear whether it is actually effective. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified five systematic reviews including 22 studies overall, of which five were randomized trials. We concluded positive pressure therapy probably leads to slightly worse hearing and makes little or no difference in the intensity of vertigo. In addition, we are uncertain whether positive pressure therapy improves functionality or decreases vertigo attacks as the certainty of the evidence has been assessed as very low.

Trichinella spiralis in a South American sea lion (Otaria flavescens) from Patagonia, Argentina.

Trichinella spp. from a sylvatic cycle has been found in several animal species such as pumas (Puma concolor), armadillos (Chaetophractus villosus), rats (Rattus norvegicus), and wild boars (Sus scrofa) in Argentina. Moreover, Trichinella infection has been detected in a wide range of marine mammals around the world, including polar bears (Ursus maritimus) and walruses (Odobenus rosmarus). Until the present time, Trichinella spp. infection has not been detected in marine mammals of South America. Samples from four South American sea lions (Otaria flavescens) found dead in Rio Negro, Argentina, were analyzed by artificial digestion, and in the case of one animal, Trichinella larvae were identified at the species level by nested multiplex PCR as Trichinella spiralis. This is the first report of a Trichinella species infecting marine mammals from South America.

Trichinellosis surveillance in wildlife in northeastern argentine patagonia.

Trichinellosis is a food-borne parasitic disease produced by different nematodes of the genus Trichinella. In Argentina, it is an endemic zoonosis and an important public health problem. The infection has been detected in domestic and wild animals. Trichinella spp. muscle larvae have anaerobic metabolism, which allows their survival in decaying tissues. The aim of this study was to evaluate the presence of Trichinella spp. in carnivorous and/or scavenger wild vertebrates - birds, mammals and reptiles - in northeastern Argentine Patagonia. Skeletal muscle samples from 141 animals, which were found killed on northeastern Argentine Patagonia roads, were analyzed by the artificial digestion method. None of the 141 samples were positive for larvae of Trichinella. These results suggest that Trichinella does not use these species to complete its cycle in this region of the continent and the absence of a significant alteration in the study area makes it difficult to transmit parasitic diseases. However, due to the limited number of samples assessed for some species, this could not be confirmed. The relevance of this study resides in the fact that it is the first systematic study in South America that considers birds, reptiles and mammals as potential hosts for Trichinella.

¿Son efectivos los diuréticos en la enfermedad de Ménière? / Are diuretics effective for Ménière`s disease?

INTRODUCCIÓN: La enfermedad de Ménière es una anomalía del oído interno caracterizada por episodios de vértigo espontáneo, hipoacusia fluctuante y tinnitus. Los diuréticos han sido ampliamente utilizados para el tratamiento de las crisis de esta enfermedad, pero existe controversia respecto a su eficacia. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos tres revisiones sistemáticas que en conjunto incluyen diecinueve estudios primarios, de los cuales, cuatro son ensayos aleatorizados. Concluimos que no está claro si el uso de diuréticos lleva a una mejoría sintomática del vértigo o a una disminución objetiva de la hipoacusia en pacientes con enfermedad de Ménière, porque la certeza de la evidencia es muy baja.

INTRODUCTION: Ménière`s disease is an inner ear disorder characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Diuretics have been widely used for the treatment of attacks, but there is controversy about their effectiveness. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified three systematic reviews including nineteen studies overall, of which four were randomized trials. We concluded it is not clear whether diuretics lead to a symptomatic improvement of vertigo or an objective decrease in hearing loss in patients with Ménière`s disease, because the certainty of the evidence is very low.

Terapia anti interleukina 5 para la rinosinusitis crónica con pólipos / Anti-interleukin 5 therapy for chronic rhinosinusitis with polyps

Resumen INTRODUCCIÓN: La rinosinusitis crónica es la inflamación de la mucosa nasosinusal de duración superior a 12 semanas. Se distinguen dos formas clínicas: rinosinusitis crónica con pólipos y sin pólipos. Los pacientes con rinosinusitis crónica con pólipos presentan niveles elevados de interleukina 5, la cual promueve la diferenciación y supervivencia de eosinófilos, por lo que se ha propuesto minimizar su circulación como una nueva estrategia de tratamiento. Sin embargo, no hay claridad respecto a su real efectividad. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos tres revisiones sistemáticas que en conjunto incluyeron tres estudios primarios, todos correspondientes a ensayos aleatorizados. Concluimos que los inhibidores de interleukina 5 podrían disminuir el puntaje de pólipos nasales. Si bien podrían asociarse a efectos adversos, estos serían poco frecuentes y de baja severidad. Sin embargo, la certeza de la evidencia es baja.

Abstract INTRODUCTION: Chronic rhinosinusitis is the inflammation of sinonasal mucosa lasting longer than 12 weeks. Two clinical forms are distinguished: chronic rhinosinusitis with polyps and without polyps. Patients with chronic rhinosinusitis with polyps exhibit high levels of interleukin 5, which promotes differentiation and survival of eosinophils. So, minimizing their circulation has been proposed as a new treatment strategy. However, there is no clarity regarding its real effectiveness. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified three systematic reviews included three primary studies overall, all corresponding to randomized trials. We concluded inhibitors of interleukin 5 might decrease nasal polyps score. Although they might be associated with adverse effects, these would be infrequent and of low severity. However, the certainty of the evidence is low.

Omalizumab para la rinosinusitis crónica / Omalizumab for chronic rhinosinusitis

Resumen INTRODUCCIÓN: La rinosinusitis crónica es una enfermedad inflamatoria crónica de alta prevalencia que compromete la mucosa de la cavidad nasal y senos paranasales. La inmunoglobulina E es un mediador inflamatorio que juega un rol etiopatogénico en esta condición, por lo que se ha planteado que omalizumab, un anticuerpo monoclonal anti-inmunoglobulina E, podría constituir una alternativa de tratamiento. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos cinco revisiones sistemáticas que en conjunto incluyeron cinco estudios primarios, de los cuales dos corresponden a ensayos controlados aleatorizados. Concluimos que en pacientes con rinosinusitis crónica, no está claro si omalizumab lleva a una mejoría en la escala de pólipos nasales, la calidad de vida, el bienestar general o los síntomas nasales porque la certeza de la evidencia es muy baja. Por otra parte, el uso de omalizumab probablemente se asocia a efectos adversos frecuentes.

Abstract INTRODUCTION: Chronic rhinosinusitis is a high prevalence chronic inflammatory disease that involves nasal mucosa and paranasal sinuses. Immunoglobulin E is an inflammatory mediator that plays an etiopathogenic role in this condition, so omalizumab, an anti-immunoglobulin E monoclonal antibody, might be a therapeutic alternative. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified five systematic reviews that included five primary studies overall, of which two correspond to randomized trials. We concluded it is not clear whether omalizumab leads to an improvement in the nasal polyps scale, quality of life, general well-being or nasal symptoms in patients with chronic rhinosinusitis, because the certainty of the evidence is very low. On the other hand, omalizumab is probably associated with frequent adverse effects.

Ácido tranexámico tópico para la epistaxis espontánea / Topical tranexamic acid for spontaneous epistaxis

INTRODUCCIÓN La epistaxis espontánea es uno de los problemas más frecuentes en consultas de urgencia. Existen nuevas alternativas de tratamiento, entre las que se encuentra el ácido tranexámico tópico. Sin embargo, su rol en el manejo de la epistaxis espontánea sigue siendo poco claro, existiendo controversia en cuanto a su efectividad y seguridad. MÉTODOS Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos cinco revisiones sistemáticas que en conjunto incluyeron un estudio primario, el cual corresponde a un ensayo aleatorizado. Concluimos que no está claro si el uso de ácido tranexámico tópico impacta en hemostasia o resangrado porque la certeza de la evidencia es muy baja, además su uso podría aumentar los efectos adversos.

INTRODUCTION Spontaneous epistaxis is one of the most frequent problems in emergency services. New treatment alternatives have emerged, including topical tranexamic acid. However, there is controversy about the actual efficacy of this alternative. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified five systematic reviews that analyzed only one primary study, corresponding to a randomized trial. We concluded it is not clear whether topical tranexamic acid has any impact on hemostasis or risk of rebleeding because the certainty of the evidence is very low. On the other hand, its use could increase adverse effects.

Therapeutic effectiveness of a Calendula officinalis extract in venous leg ulcer healing.

OBJECTIVE: Non-healing venous leg ulcers (VLUs) have a significant effect on patients' quality of life and substantially increase expenditures in health-care systems. The aim of this study was to evaluate the clinical efficacy of the Calendula officinalis extract, Plenusdermax, in the treatment of VLUs. METHOD: Patients treated with Calendula officinalis extract (n=38) and control patients (n=19) were evaluated every two weeks for 30 weeks or until their ulcers healed. Assessments included determination of the wound area by planimetry, infection control, and evaluation of the clinical aspects of the wounds. The percentage of healing velocity per week (%HVw), taking the initial area at baseline into account, was also determined. RESULTS: The proportion of the treatment patients achieving complete epithelialisation was 72 % and 32 % in the treatment and control groups, respectively. The average healing time was approximately 12 weeks in the treatment group and 25 % in control patients. Patients with ulcers treated with Calendula officinalis extract had a significant 4-fold increase in percentage healing velocity per week, 7.4 %, compared with 1.7 % in the control group. No adverse events were observed during the Calendula officinalis extract treatment. CONCLUSION: Our findings indicate that Calendula officinalis extract is an effective treatment for VLUs. DECLARATION OF INTEREST: The authors have no conflict of interest.

[Trauma surgery catastrophe aid following the earthquake in Haiti 2010--a report on experiences: injury patterns, special challenges, prospects]. / Unfallchirurgische Katastrophenhilfe nach dem Erdbeben in Haiti 2010--Ein Erfahrungsbericht: Verletzungsmuster, besondere Herausforderung, Aussichten.

The earthquake in Haiti in January 2010 resulted in more than 220,000 deaths and over 300,000 injured and was one of the greatest mass casualties in recent history. "Doctors Without Borders" started a medical relief response immediately after the earthquake, building up to the biggest disaster relief activity in the organization's history. Roughly 173,000 medical consultations and more than 11,700 surgical interventions were performed in 26 medical facilities during the first 4 months. A particular challenge was the sheer number of patients in a situation with a completely destroyed medical infrastructure. While the initial phase mainly focused on life saving surgery, the second phase concentrated on reconstructive surgery of the extremities. Crucial for effective patient care is an ability to act early and employ surgical techniques which are adapted to the overall situation. The following article is a personal report of the early emergency response from the viewpoint of two orthopedic trauma surgeons, who have surgical careers in Germany and also frequently volunteer for "Doctors Without Borders".

Lifetime of THz acoustic nanocavity modes.

We present an ultrahigh resolution Raman study of the lifetime of 1 THz acoustic phonons confined in nanocavities. We demonstrate that the cavity Q factor can be controlled by design. Anharmonicity contributes only marginally to limit the cavity phonon lifetime, even at room temperature, while thickness fluctuations in the scale of 1/10 of a unit cell are the main limitation for the performance of THz phonon cavities.

HLA diversity, differentiation, and haplotype evolution in Mesoamerican Natives.

Genetic variation of the Human Leukocyte Antigen region (HLA) in three Amerindian populations from the Southern Mexican state of Oaxaca, the Zapotec, Mixtec and the Mixe is examined. Individuals were typed using PCR-SSOP for four class II loci (DRB1, DQA1, DQB1, DPB1) and three class I loci (HLA-A, -B, and -C). Based on known HLA distributions, European admixture ranged from 1% to 10%. Individuals with European alleles were excluded from subsequent analysis. New alleles were revealed at each of the class I loci. In general, genotype frequencies were in Hardy-Weinberg equilibrium, although some deviations were detected. Allele frequency distributions at the DRB1, DQA1, DQB1 and HLA-A loci in all populations were more even than expected under neutrality, supporting a model of balancing selection at these loci. A history of directional selection for DPB1 in all three populations was indicated, as homozygosity values were significantly above expected values. Allele frequency distributions at HLA-B and HLA-C did not differ significantly from neutrality expectations. The data also provide evidence from linkage disequilibrium that strong haplotypic associations are present across the entire HLA region in each of the populations. Significant overall linkage disequilibrium exists between all pairs of loci typed in these populations, except those which include the DPB1 locus. These associations exist despite the fact that the recombination fraction between HLA-A, in the class I region, and DQB1, in the class II region, may exceed 0.02. One explanation is that selective pressures are maintaining the relationships between particular alleles at these loci in these populations. These relationships are maintained in general across the entire HLA region in the Oaxacan Amerindians, with the exception of DPB1.

Longitudinal evaluation of growth, puberty, and bone maturation in children with Williams syndrome.

OBJECTIVES: To establish syndrome-specific growth curves and growth rate (GR) curves for Williams syndrome (WS) and define the pattern of bone maturation and pubertal development. METHODS: In a prospective longitudinal study between 1990 and 1997, the growth data of 244 children with WS were collected: 295 values for GR were calculated for 74 girls and 331 values for 89 boys. RESULTS: Mean GR of children with WS was below normal by 1 to 2 cm/y in the first few years of life. One group of girls (n = 20) experienced an early pubertal growth spurt at age 9 years (maximal GR, 7.8 +/- 2.1 cm/y; menarcheal age, 10.4 +/- 1.4 years). A second group (n = 5) showed the growth spurt at age 11 years (7.5 +/- 1.1 cm/y; menarcheal age, 12.6 +/- 1.3 years). In boys, peak height velocity (8.7 +/- 2.3 cm/y) occurred at age 11 to 12 years. Bone age was delayed in both sexes during childhood and accelerated markedly during puberty. Final height was 152.4 +/- 5.7 cm in girls (n = 38) and 165.2 +/- 10. 9 cm in boys (n = 43). CONCLUSIONS: The syndrome-specific GR curves for WS showed a premature and abbreviated pubertal growth spurt in both sexes. This growth spurt was directly related to bone age acceleration during puberty. The data from this longitudinal study provide an overview of both the dynamics of growth and its course in children with WS.

mtDNA and Y-chromosome polymorphisms in four Native American populations from southern Mexico.

mtDNA sequence variation was examined in 60 Native Americans (Mixtecs from the Alta, Mixtecs from the Baja, Valley Zapotecs, and Highland Mixe) from southern Mexico by PCR amplification and high-resolution restriction endonuclease analysis. Four groups of mtDNA haplotypes (haplogroups A, B, C, and D) characterize Amerind populations, but only three (haplogroups A, B, and C) were observed in these Mexican populations. The comparison of their mtDNA variation with that observed in other populations from Mexico and Central America permits a clear distinction among the different Middle American tribes and raises questions about some of their linguistic affiliations. The males of these population samples were also analyzed for Y-chromosome RFLPs with the probes 49a, 49f, and 12f2. This analysis suggests that certain Y-chromosome haplotypes were brought from Asia during the colonization of the Americas, and a differential gene flow was introduced into Native American populations from European males and females.

The health status of women in Oaxaca: determinants and consequences.

Survey data from a sample of 575 women from the city of Oaxaca de Juárez, Mexico, are analyzed to ascertain the effect of the receipt of job-related benefits, including health benefits, on the self-reported health status of women, their rating of the health of the members of their household, and their satisfaction with the health of the members of their household. Health status depends on the woman's age, her socioeconomic status, and the number of children she has borne. Her rating of the health of the members of her household is related to her age, her socioeconomic status, and her rating of her own health. Satisfaction with the physical health of the members of the household is a function her health, her rating of the health of her household, her age, her socioeconomic status and the number of children she has borne. The overall conclusion is that, in this study, it is socioeconomic and demographic factors that are important in determining the woman's health status, rather than the receipt of job-related benefits. That she reports good health is an important factor in her view of her family's health and her satisfaction with her own health and that of her family.

Migrants to and in Oaxaca City.

"This paper examines migration to Oaxaca City, an intermediate city in southern Mexico, and describes the differences between migrants and non-migrants. The data show that migrants to Oaxaca City tend to come from district capitals rather than more rural municipios. Once in Oaxaca, migrants are not as different from non-migrants as is commonly asserted in the literature."

Residential patterns at monte alban, oaxaca, Mexico.

Monte Alban was founded in period I (about 500 B.C.) probably by households from previously existing villages in the Valley of Oaxaca. There is some evidence for status variation in period I households, but more information is needed to determine its role in the early development of the city. During the millennium or more of urban growth at Monte Alban a change occurred in the organization of household space from an open outward-directed focus to a closed inward-directed one. This was accompanied by a formalization of household and interhousehold space and by a standardization in household sizes and burial treatment reflecting emergence of a social class hierarchy. These changes indicate development from a flexible to a highly structured society, which may be a general trend in urbanization.