Risk for interspecies transmission of zoonotic pathogens during poultry processing and pork production in Peru: A qualitative study.

Interspecies transmission of pathogens is an unfrequent but naturally occurring event and human activities may favour opportunities not previously reported. Reassortment of zoonotic pathogens like influenza A virus can result from these activities. Recently, swine and birds have played a central role as "mixing vessels" for epidemic and pandemic events related to strains like H1N1 and H5N1. Unsafe practices in poultry markets and swine farms can lead to interspecies transmission, favouring the emergence of novel strains. Thus, understanding practices that lead to interspecies interactions is crucial. This qualitative study aimed to evaluate poultry processing practices in formal and informal markets and the use of leftovers by swine farmers in three Peruvian cities: Lima (capital), Tumbes (coastal) and Tarapoto (jungle). We conducted 80 direct observations at formal and informal markets and interviewed 15 swine farmers. Processors slaughter and pluck chickens and vendors and/or processors eviscerate chickens. Food safety and hygiene practices were suboptimal or absent, although some heterogeneity was observed between cities and chicken vendors versus processors. Both vendors (76%) and processors (100%) sold the chicken viscera leftovers to swine farmers, representing the main source of chicken viscera for swine farms (53%). Swine farmers fed the chicken viscera to their swine. Chicken viscera cooking times varied widely and were insufficient in some cases. Non-abattoired poultry leads to the sale of poultry leftovers to small-scale swine farms, resulting in indirect but frequent interspecies contacts that can lead to interspecies transmission of bacterial pathogens or the reassortment of influenza A viruses. These interactions are exacerbated by suboptimal safety and hygiene conditions. People involved in these activities constitute an at-risk population who could play a central role in preventing the transmission of pathogens between species. Educational interventions on hygiene and food safety practices will be important for reducing the risk of interspecies influenza transmission.

Incidencia de resultados clínicos negativos asociados a la utilización de medicamentos trazadores/señaladores en pacientes hospitalizados, Medellín-Colombia / Incidence of negative clinical results associated with the use of tracing/signaling drugs in hospitalized patients, Medellín-Colombia

Objetivo: Determinar la incidencia de resultados clínicos negativos-RNM en pacientes hospitalizados con prescripción de medicamentos trazadores/señaladores durante su estancia hospitalaria. Método: Diseño: Estudio de cohorte abierta. Ámbito: Institución de Salud de alta complejidad -Medellín. Periodo: noviembre 2013-noviembre 2015. Muestra: Grupos (expuestos y no expuestos) se clasificaron como pacientes con uno o más medicamentos trazadores y sin ellos, en una relación 1 (expuestos): 2 (no expuestos); ambos grupos se parearon por variables socio-demográficas y clínicas; edad con una diferencia no mayor a +/-5 años, sexo, diagnóstico principal y comorbilidades principalmente. Variables: número de medicamentos trazadores; mediante seguimiento farmacoterapéutico - SFT se identificaron problemas de necesidad, efectividad y seguridad asociados a los medicamentos. Resultados: Se incluyeron 324 pacientes, 108 (33,3%) expuestos y 216 (66,7%) no expuestos. La edad media fue 52 años (DE 25,7), 198 (61%) hombres. El 31,2% (101) de los pacientes presentó algún tipo de RNM. En los expuestos, la incidencia de RNM fue 43,5% (47 pacientes) y en los no expuestos la frecuencia de RNM fue 25% (54 pacientes). Se observó mayor incidencia de RNM en pacientes con 2 a 3 medicamentos (49,1%). El riesgo asociado a la exposición al factor de riesgo (RR) fue 1,74 (IC95%:1,27-2,39) (P=0,001). Conclusiones: El riesgo relativo (RR) obtenido fue 1,74 (IC95%:1,27-2,39) (P=0,001), indicando que la utilización de medicamentos trazadores/señaladores se asocia a la presentación de RNM. Por tanto, esta estrategia se podría utilizar para la identificación, priorización y selección de pacientes en los programas de farmacoseguridad

Objective: To determine the incidence of negative clinical results - MNR in hospitalized patients with prescription of tracer/marker drugs during their hospital stay. Method: Design: open cohort study. Scope: high complexity Health Institution - Medellin. Period: November 2013 - November 2015. Sample: groups (exposed and unexposed) were classified as patients with one or more tracer drugs and without them, in a ratio 1 (exposed): 2 (not exposed); both groups were matched by socio-demographic and clinical variables. The main ones were: age with a difference no greater than +/- 5 years, sex, main diagnosis and comorbidities. Variables: number of tracer drugs; Pharmacotherapeutic follow-up - SFT identified problems of need, effectiveness and safety associated with drugs. Results: We included 324 patients, 108 exposed (33.3%) and 216 unexposed (66.7%). The average age was 52 years (SD: 25.7), 198 (61%) patients were male. 31.2% (101) of patients had some type of Medication Negative Results. In those exposed, the incidence of MNR was 43.5% (47 patients) and in the no exposed the frequency of MNR was 25% (54 patients). A higher incidence of MNR was observe in patients with 2 or 3 medications (49.1%). The risk associated with the risk factor (RR) was 1.74 (CI 95% 1.27 - 2.39) (P = 0.001). Conclusions: The relative risk (RR) obtained was 1.74 (95% CI, 1.27-2.39) (P = 0.001), which indicates that the use of tracer / marker drugs is associated with the presentation of MNR. Therefore, this strategy could be used to identify and prioritize the selection of patients who must enter the pharmacy safety programs

Histone deacetylase inhibitors promote glioma cell death by G2 checkpoint abrogation leading to mitotic catastrophe.

Glioblastoma multiforme is resistant to conventional anti-tumoral treatments due to its infiltrative nature and capability of relapse; therefore, research efforts focus on characterizing gliomagenesis and identifying molecular targets useful on therapy. New therapeutic strategies are being tested in patients, such as Histone deacetylase inhibitors (HDACi) either alone or in combination with other therapies. Here two HDACi included in clinical trials have been tested, suberanilohydroxamic acid (SAHA) and valproic acid (VPA), to characterize their effects on glioma cell growth in vitro and to determine the molecular changes that promote cancer cell death. We found that both HDACi reduce glioma cell viability, proliferation and clonogenicity. They have multiple effects, such as inducing the production of reactive oxygen species (ROS) and activating the mitochondrial apoptotic pathway, nevertheless cell death is not prevented by the pan-caspase inhibitor Q-VD-OPh. Importantly, we found that HDACi alter cell cycle progression by decreasing the expression of G2 checkpoint kinases Wee1 and checkpoint kinase 1 (Chk1). In addition, HDACi reduce the expression of proteins involved in DNA repair (Rad51), mitotic spindle formation (TPX2) and chromosome segregation (Survivin) in glioma cells and in human glioblastoma multiforme primary cultures. Therefore, HDACi treatment causes glioma cell entry into mitosis before DNA damage could be repaired and to the formation of an aberrant mitotic spindle that results in glioma cell death through mitotic catastrophe-induced apoptosis.

Interferon-alpha induced transient thyroid dysfunction in hepatitis C.

We report the case of thyroid dysfunction that developed in a 36-year-old female patient who required combination therapy with interferon and ribavirine for chronic hepatitis C. Firstly, she suffered a hyperthyroidism followed by a hypothyroidism stage requiring thyroxine replacement therapy. Nevertheless, combination treatment was not discontinued, reaching a sustained biochemical and virological response. The pathogenesis of autoimmune diseases in patients with Hepatitis C virus infection and interferon therapy is not clear, but usually these disorders are reversible and only require supervision and treatment if clinical or laboratory abnormalities are present.

Alteración transitoria de la función tiroidea en la hepatitis C inducida por interferón-alfa / Interferon-alpha induced transient thyroid dysfunction in hepatitis C

Describimos un caso de alteración de la función tiroidea que se presentó en una mujer de 36 años que requirió tratamiento combinado con interferón y ribavirina para su hepatitis crónica C. En primer lugar, presentó un hipertiroidismo seguido por un hipotiroidismo que requirió tratamiento con tiroxina. Sin embargo, el tratamiento combinado no fue suspendido, alcanzando una respuesta mantenida bioquímica y virológica. La patogenia de las enfermedades autoinmunes en pacientes con infección por el virus C de la hepatitis tratados con interferón no está clara, pero generalmente estos trastornos son reversibles y sólo requiere supervisión y tratamiento si se presentaran anormalidades clínicas o bioquímicas (AU)

Periodontal aspects of hereditary epidermolysis bullosa.

Hereditary epidermolysis bullosa, a rare dermatologic disease is discussed. Its oral manifestations and association with periodontal alterations, and possible systemic and periodontal treatment are described. An example of a case in which conventional periodontal therapy was effective is presented.