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Concerns about methane (CH4) emissions from rice, a staple sustaining over 3.5 billion people globally, are heightened due to its status as the second-largest contributor to greenhouse gases, driving climate change. Accurate quantification of CH4 emissions from rice fields is crucial for understanding gas concentrations. Leveraging technological advancements, we present a groundbreaking solution that integrates machine learning and remote sensing data, challenging traditional closed chamber methods. To achieve this, our methodology involves extensive data collection using drones equipped with a Micasense Altum camera and ground sensors, effectively reducing reliance on labor-intensive and costly field sampling. In this experimental project, our research delves into the intricate relationship between environmental variables, such as soil conditions and weather patterns, and CH4 emissions. We achieved remarkable results by utilizing unmanned aerial vehicles (UAV) and evaluating over 20 regression models, emphasizing an R2 value of 0.98 and 0.95 for the training and testing data, respectively. This outcome designates the random forest regressor as the most suitable model with superior predictive capabilities. Notably, phosphorus, GRVI median, and cumulative soil and water temperature emerged as the model's fittest variables for predicting these values. Our findings underscore an innovative, cost-effective, and efficient alternative for quantifying CH4 emissions, marking a significant advancement in the technology-driven approach to evaluating rice growth parameters and vegetation indices, providing valuable insights for advancing gas emissions studies in rice paddies.
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Agricultura , Contaminantes Atmosféricos , Monitoreo del Ambiente , Metano , Oryza , Tecnología de Sensores Remotos , Metano/análisis , Monitoreo del Ambiente/métodos , Contaminantes Atmosféricos/análisis , Agricultura/métodos , Dispositivos Aéreos No Tripulados , Gases de Efecto Invernadero/análisis , Suelo/química , Contaminación del Aire/estadística & datos numéricosRESUMEN
There are no studies reporting the effects of Salmonella enterica subsp. enterica serovar Infantis (S. Infantis) on intestinal architecture and immunoglobulin serum levels in chickens. Here, we measured these parameters and hypothesized whether probiotic administration could modulate the observed outcomes. Two-hundred 1-day-old COBB 500 male chicks were allocated into four groups: (I) the control, (II) the group treated with L. fermentum, (III) the group exposed to S. Infantis, and (IV) the group inoculated with both bacteria. At 11 days post infection, blood was gathered from animals which were then euthanized, and samples from the small intestine were collected. Intestinal conditions, as well as IgA and IgM serum levels, were assessed. S. Infantis reduced villus-height-to-crypt-depth (VH:CD) ratios in duodenal, jejunal, and ileal sections compared to control conditions, although no differences were found regarding the number of goblet cells, muc-2 expression, and immunoglobulin concentration. L. fermentum improved intestinal measurements compared to the control; this effect was also evidenced in birds infected with S. Infantis. IgM serum levels augmented in response to the probiotic in infected animals. Certainly, the application of L. fermentum elicited positive outcomes in S. Infantis-challenged chickens and thus must be considered for developing novel treatments designed to reduce unwanted infections.
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In this study, we report the carbapenemase-encoding genes and colistin resistance in Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa in the second year of the COVID-19 pandemic. Clinical isolates included carbapenem-resistant K. pneumoniae, carbapenem-resistant E. coli, carbapenem-resistant A. baumannii, and carbapenem-resistant P. aeruginosa. Carbapenemase-encoding genes were detected by PCR. Carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli isolates were analyzed using the Rapid Polymyxin NP assay. mcr genes were screened by PCR. Pulsed-field gel electrophoresis and whole-genome sequencing were performed on representative isolates. A total of 80 carbapenem-resistant E. coli, 103 carbapenem-resistant K. pneumoniae, 284 carbapenem-resistant A. baumannii, and 129 carbapenem-resistant P. aeruginosa isolates were recovered. All carbapenem-resistant E. coli and carbapenem-resistant K. pneumoniae isolates were included for further analysis. A selection of carbapenem-resistant A. baumannii and carbapenem-resistant P. aeruginosa strains was further analyzed (86 carbapenem-resistant A. baumannii and 82 carbapenem-resistant P. aeruginosa). Among carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli isolates, the most frequent gene was blaNDM (86/103 [83.5%] and 72/80 [90%], respectively). For carbapenem-resistant A. baumannii, the most frequently detected gene was blaOXA-40 (52/86, 60.5%), and for carbapenem-resistant P. aeruginosa, was blaVIM (19/82, 23.2%). For carbapenem-resistant A. baumannii, five indistinguishable pulsotypes were detected. Circulation of K. pneumoniae New Delhi metallo-ß-lactamase (NDM) and E. coli NDM was detected in Mexico. High virulence sequence types (STs), such as K. pneumoniae ST307, E. coli ST167, P. aeruginosa ST111, and A. baumannii ST2, were detected. Among K. pneumoniae isolates, 18/101 (17.8%) were positive for the Polymyxin NP test (two, 11.0% positive for the mcr-1 gene, and one, 5.6% with disruption of the mgrB gene). All E. coli isolates were negative for the Polymyxin NP test. In conclusion, K. pneumoniae NDM and E. coli NDM were detected in Mexico, with the circulation of highly virulent STs. These results are relevant in clinical practice to guide antibiotic therapies considering the molecular mechanisms of resistance to carbapenems.
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COVID-19 , Colistina , Humanos , Colistina/farmacología , Antibacterianos/farmacología , Escherichia coli/genética , México/epidemiología , Pandemias , Farmacorresistencia Bacteriana/genética , Pruebas de Sensibilidad Microbiana , COVID-19/epidemiología , beta-Lactamasas/genética , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Bacterias Gramnegativas , Klebsiella pneumoniae , Pseudomonas aeruginosa/genéticaRESUMEN
Salmonella enterica serovars cause infections in humans. S. enterica subsp. enterica serovar Infantis is considered relevant and is commonly reported in poultry products. Evaluating innovative approaches for resisting colonization in animals could contribute to the goal of reducing potential human infections. Microalgae represent a source of molecules associated with performance and health improvement in chickens. Tetraselmis chuii synthesizes fermentable polysaccharides as part of their cell wall content; these sugars are known for influencing caecal bacterial diversity. We hypothesized if its dietary administration could exert a positive effect on caecal microbiota in favor of a reduced S. Infantis load. A total of 72 one-day-old broiler chickens (COBB 500) were randomly allocated into three groups: a control, a group infected with bacteria (day 4), and a group challenged with S. Infantis but fed a microalgae-based diet. Caecal samples (n = 8) were collected two days post-infection. A PMAxxTM-based qPCR approach was developed to assess differences regarding bacterial viable load between groups. The inclusion of the microalga did not modify S. Infantis content, although the assay proved to be efficient, sensitive, and repeatable. The utilized scheme could serve as a foundation for developing novel PCR-based methodologies for estimating Salmonella colonization.
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Ozone (O3) is an oxidating tropospheric pollutant. When O3 interacts with biological substrates, reactive oxygen and nitrogen species (RONS) are formed. Severe oxidative damage exhausts the endogenous antioxidant system, which leads to the decreased activity of antioxidant enzymes such as catalase (CAT), glutathione peroxidase (GPx), and superoxide dismutase (SOD). Curcumin (CUR) is a natural polyphenol with well-documented antioxidant and anti-inflammatory properties. The aim of this work is to evaluate the effects of curcumin on CAT, GPx, and SOD activity and the inhibition of oxidative damage after the acute and chronic exposure to O3. Fifty male Wistar rats were divided into five experimental groups: the intact control, CUR-fed control, exposed-to-O3 control, CUR-fed (preventive), and CUR-fed (therapeutic) groups. These two last groups received a CUR-supplemented diet while exposed to O3. These experiments were performed during acute- and chronic-exposure phases. In the preventive and therapeutic groups, the activity of plasma CAT, GPx, and SOD was increased during both exposure phases, with slight differences; concomitantly, lipid peroxidation and protein carbonylation were inhibited. For this reason, we propose that CUR could be used to enhance the activity of the antioxidant system and to diminish the oxidative damage caused by exposure to O3.
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Curcumina , Ozono , Animales , Antioxidantes/metabolismo , Antioxidantes/farmacología , Catalasa/metabolismo , Curcumina/metabolismo , Curcumina/farmacología , Glutatión Peroxidasa/metabolismo , Hipocampo/metabolismo , Peroxidación de Lípido , Masculino , Estrés Oxidativo , Ozono/metabolismo , Ozono/farmacología , Ratas , Ratas Wistar , Especies Reactivas de Oxígeno/metabolismo , Superóxido Dismutasa/metabolismoRESUMEN
Resumen Introducción: el emprendimiento social realizado por profesionales del trabajo social en Colombia plantea diversos retos en la comunidad académica, evidenciando la emergencia del emprendimiento social como nuevos canales para alcanzar resultados desde el abordaje de las problemáticas. Objetivo: indagar las características de los/las emprendedoras sociales graduadas en el trabajo social en Bogotá. Materiales y métodos: se realiza una investigación cualitativa mediante el análisis de caso de estudio, con la técnica de entrevista semiestructurada, en la cual se tuvieron como categorías principales la relación con la comunidad, relaciones con el Estado, recursos y gestión-organización. Resultados: en cuanto a las relaciones con la comunidad, es fundamental que los emprendedores/as sociales se relacionen directamente con las comunidades y fortalezcan el tejido social. En las relaciones con el Estado, se identifica la importancia de fortalecer la participación y la responsabilidad de este, así como de otros actores. Para la gestión de recursos, las/os trabajadoras/es sociales identifican la importancia del trabajo en equipo u otras habilidades para el desarrollo e implementación del emprendimiento. Por último, en la gestión-organización se rescata la importancia de la debida administración de los recursos económicos y humanos, así como la autosostenibilidad de los emprendimientos sociales. Conclusión: se evidencia la necesidad de formación en procesos de emprendimiento social para el trabajo social en Colombia, ya que, permite un cambio a través de la incidencia social, como ejercicio profesional y alternativa laboral.
Abstract Introduction: the social entrepreneurship developed by social work professionals in Colombia poses several challenges in the academic community, highlighting the emergence of social entrepreneurship as new channels to achieve results from addressing problems. Objective: to ask about the characteristics of social entrepreneurs who graduated in social work in Bogotá. Material and methods: a qualitative research are carried out through a case study analysis, using the semi-structured interview technique, in which the main categories of the relationship with the community, relations with the country, resources and management-organization have been studied classified. Results: in community relations, it is essential that social entrepreneurs interact directly with the communities and strengthen the social fabric. In relations with the country, the importance of strengthening the active participation and responsibility of the country, as well as of other actors, is identified. For resource management, social workers identify the importance of working in teams or other skills for the development and implementation of the company. Finally, in management-organization, the importance of poor management of economic and human resources is highlighted, as well as the self-sustainability of social entrepreneurship. Conclusion: there is a need for training in social entrepreneurship processes for social work in Colombia, which allows a change through social impact, such as professional training and alternative employment.
Resumo Introdução: O empreendedorismo social desenvolvido por profissionais de serviço social na Colômbia apresenta vários desafios na comunidade acadêmica, destacando o surgimento do empreendedorismo como novos canais para obter resultados a partir do tratamento de problemas. Objetivo: conhecer as características dos empreendedores sociais formados em serviço social em Bogotá. Material e métodos: é realizada uma pesquisa qualitativa por meio da análise de um estudo de caso, utilizando a técnica da entrevista semiestruturada, em que foram estudadas as principais categorias da relação com a comunidade, relações com o Estado, recursos e gerenciamento-organização. Resultados: no relacionamento com a comunidade, é fundamental que os empreendedores sociais interajam diretamente com as comunidades e fortaleçam o tecido social. Nas relações com o Estado, identifica-se a importância de fortalecer a participação ativa e a responsabilidade do Estado, bem como de outros atores. Para o gerenciamento de recursos, os assistentes sociais identificam a importância do trabalho em equipe ou outras habilidades para o desenvolvimento e implantação da empresa. Por fim, na gerenciamento-organização, destaca-se a importância da má gestão dos recursos econômicos e humanos, bem como a autossustentabilidade do empreendedorismo social. Conclusão: há necessidade de formação em processos de empreendedorismo social para o serviço social na Colômbia, o que permite uma mudança por meio do impacto social, como a formação profissional e alternativas de emprego.
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The inappropriate use of antibiotics leads to antibiotic resistance, which reduces their efficacy. The education of undergraduates is likely to influence their practices. Assessing awareness is critical in the general effort to confront the spread of antibiotic resistance. This cross-sectional investigation was carried out using the questionnaire "Antibiotic resistance: Multi-country public awareness" developed by the World Health Organization. Students from different backgrounds at the Central University participated in the study (n = 733). The survey comprised five sections: demographics, knowledge, usage, sources of information, and attitudes. The rate of correct answers was 64.88%; differences were detected between programs of study (p < 0.001); effect size analysis showed that these differences cannot be considered large. Individuals from applied sciences scored higher than their counterparts from social studies. Mostly, interviewees were knowledgeable about usage, but mistakenly associated antibiotics with conditions such as cold/flu or viral illnesses; also, they associated antibiotic resistance with the patient and not with bacteria. Despite these misconceptions, positive attitudes were registered overall, and students generally adhered to common practices. They cited doctors/nurses and teachers as sources of information. As a consequence, it is recommended to develop courses that address deficient knowledge regarding antibiotic resistance, especially for individuals affiliated to social disciplines.
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This pilot investigation aimed at studying the feasibility of using a low dose (0.2%) of dietary microalgae as a means of improving intestinal morphometry, body weight, and selected meat quality parameters in broilers. A total of 72 one-day-old ROSS 308 male chicks were randomly separated into four groups; three experimental pens in which the birds were fed with biomass from Tysochrysis lutea, Tetraselmis chuii, and Porphyridium cruentum over 30 days and a control group. T. chuii and P. cruentum had a positive effect with regard to body weight. In treated animals, duodenal and ileal sections showed characteristic tall and thin villi, with serrated surfaces and goblet cell differentiation. In both sections, values of the villus-height-to-crypt-depth ratio were increased by microalgae ingestion. The thawing weight loss of fillets was reduced in T. chuii-fed animals. The positive effects exerted by T. chuii and P. cruentum on intestinal architecture were associated with the improved body weight. Arguably, these outcomes exhibit the potential of using these species to enhance growth performance in broiler chickens by promoting gut homeostasis and thus nutrient absorption.
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El loxoscelismo sistémico o cutáneo-visceral, es la presentación clínica más severa del loxoscelismo. Actualmente no se cuenta con algún método diagnóstico laboratorial validado que nos permita confirmar la presencia de esta enfermedad frente a un aracneismo. Sin embargo, existe una regla de predicción clínica (RPC), que nos permite predecir la evolución de una picadura hacia un cuadro sistémico y que sería de utilidad en las salas de emergencia. Presentamos el caso de una mujer que desarrollo el cuadro sistémico del loxoscelismo a la que se le aplicó una nueva RPC para la detección temprana del loxoscelismo sistémico, presentando un rendimiento adecuado para la evaluación temprana en los servicios de emergencia.
Systemic or cutaneous-visceral loxoscelism is the most severe clinical presentation of loxoscelism. Currently there is no validated laboratory diagnostic method that allows us to confirm the presence of this disease in the face of arachneism. However, there is a clinical prediction rule (CPR), which allows us to predict the evolution of a bite towards a systemic condition and which would be useful in emergency rooms. We present the case of a woman who developed the systemic picture of loxoscelism to whom a new CPR was applied for the early detection of systemic loxoscelism, presenting adequate performance for early evaluation in emergency services.
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Adherence to preventive measures is influenced by people's knowledge, attitudes and practices towards a disease; therefore, assessing knowledge of COVID-19 is critical in the overall effort to contain the outbreak. This cross-sectional study was conducted among undergraduates (n = 3621) of different programs and different levels of education associated with universities in north-central Ecuador. The form consisted of 32 questions covering demographics, symptoms, detection, treatment, transmission, prevention and knowledge of the virus. The rate of correct answers was 75.5% (21.1 ± 5 out of 28), with differences observed regarding program of study, educational level and location of institution (α = 0.05), although effect size analyses showed that these differences could not be considered large. Multiple linear regression analyses showed that lower scores were associated with initial stages of education, careers related to social sciences and location of institution. Participants possessed sufficient knowledge about detection, transmission and prevention, although they overestimated fatality rate and were less confident about the characteristics of the virus and the effectiveness of traditional medicine. Consequently, future educational programs must place emphasis on addressing deficient knowledge. Certainly, improving COVID-19 literacy will promote the appropriate application of protective measures aimed at preventing the virus' spread.
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COVID-19 , Estudios Transversales , Ecuador/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , SARS-CoV-2 , Estudiantes , Encuestas y CuestionariosRESUMEN
Neurodegeneration is the consequence of harmful events affecting the nervous system that lead to neuronal death. Toxic substances, including air pollutants, are capable of inducing neurodegeneration. Ozone (O3) is the most oxidative toxic pollutant. O3 reacts with cellular components and forms reactive oxygen and nitrogen species, triggering nitro-oxidative damage during short-term exposure. Curcumin (CUR) is a natural phenolic molecule bearing well-documented antioxidant and anti-inflammatory biological activities in diverse experimental models. The aim of this work was to evaluate the effect of preventive dietary administration of CUR against hippocampal neurodegeneration and nitro-oxidative damage caused by short-term exposure to O3. Eighty Wistar male rats were distributed into four experimental groups, twenty rats each: intact control; CUR dietary supplementation without O3 exposure; exposure to 0.7 ppm of O3; and exposed to O3 with CUR dietary supplementation. Five rats from each group were sacrificed at 1, 2, 4, and 8 h of exposure. The CUR dose was 5.6 mg/kg and adjusted according to food consumption. CUR significantly decreased oxidative damage to plasma lipids and proteins, as well as neurodegeneration in CA1 and CA3 hippocampal regions. Concluding, CUR proved effective protection in decreasing neurodegeneration in the hippocampus and prevented systemic oxidative damage.
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Proteínas Sanguíneas/metabolismo , Curcumina/farmacología , Hipocampo/efectos de los fármacos , Lípidos/análisis , Enfermedades Neurodegenerativas/tratamiento farmacológico , Estrés Oxidativo , Ozono/toxicidad , Animales , Antiinflamatorios no Esteroideos/farmacología , Antioxidantes/farmacología , Hipocampo/metabolismo , Hipocampo/patología , Masculino , Enfermedades Neurodegenerativas/inducido químicamente , Enfermedades Neurodegenerativas/metabolismo , Enfermedades Neurodegenerativas/patología , Óxido Nítrico/metabolismo , Ratas , Ratas WistarRESUMEN
In Peru, diphtheria infection was eradicated in the last two decades. However, recently, diphtheria pharyngeal infection was confirmed and reported in a 5-year-old boy (index case). We report two more cases of this outbreak (in the index case parents) with confirmed diphtheria infection and tox gene identified by molecular assay, who were in close contact with the index case and never presented any symptoms. Both parents had a congestive pharynx with erythematous plaques at the back of it. In adults, diphtheria infection can be oligosymptomatic or mimic viral pharyngitis, which could lead to misdiagnosis and, furthermore, an increased risk of transmission in regions with lower immunization rates.
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Difteria , Adulto , Preescolar , Difteria/diagnóstico , Brotes de Enfermedades , Humanos , Masculino , Perú , Faringitis , VacunaciónRESUMEN
Several public health measures have been implemented to contain the SARS-CoV-2 outbreak. The adherence to control measures is known to be influenced by people's knowledge, attitudes and practices with regard to the disease. This study aimed at assessing COVID-19 knowledge in individuals who were tested for the virus. An online cross-sectional survey of 32 items, adapted to the national context, was conducted among 1656 Ecuadorians. The mean knowledge score was 22.5 ± 3 out of 28, with significant differences being observed with regard to educational attainment. People with postgraduate training scored higher than those with college, secondary and elementary instruction. Indeed, multiple linear regression revealed that lower scores were associated significantly with the latter three levels of education. Interviewees were knowledgeable about the symptoms, detection, transmission and prevention of the disease. However, they were less assertive regarding the characteristics of the virus as well as the usefulness of traditional and unproven treatments. These outcomes indicated a lack of knowledge in fundamental aspects of virus biology, which may limit the effectiveness of further prevention campaigns. Conclusively, educational and communicational programs must place emphasis on explaining the basic molecular characteristics of SARS-CoV-2; such information will certainly contribute to improve the public's adherence to control measures.
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COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Pandemias , Estudios Transversales , Ecuador/epidemiología , Humanos , Encuestas y CuestionariosRESUMEN
This research was conducted to investigate if the administration of the probiotic Lactobacillus fermentum could influence body weight, intestinal morphometry and the cecal cytokine response in Campylobacter jejuni-infected chickens. Seventy-two 1-day old COBB 500 male chicks were allocated randomly into four experimental groups. (I) Control group (C), in which chicks were left untreated. (II) LB group, treated with L. fermentum. (III) Cj group, infected with C. jejuni and (IV) coexposure group in which both bacteria were administered. Body weight was registered and then all birds were slaughtered; samples from the small intestine and caecum were collected at 4- and 7-days post infection. The experiment lasted eleven days. Villi height and crypt depth ratios of the duodenum, jejunum and ileum were evaluated using appropriate software, while reverse transcription quantitative PCR (RT-qPCR) was utilized for assessing transcript levels of key cecal inflammatory cytokines (IL-1ß, IL-18, IL-17, IL-15, IL13 and IL-4). Campylobacter-infected birds showed lower body weight values than those supplemented with the probiotic; these birds, in turn, proved to be heavier than those reared under control conditions. L. fermentum administration improved morphometrical parameters of the duodenum, jejunum and ileum; in general, villi were larger and crypts deeper than those identified in control conditions. Moreover, the negative effects elicited by C. jejuni were not observed in chickens exposed to the probiotic. Significant differences were also determined with regards to transcript abundance of all evaluated cytokines in the caecum. C. jejuni induced a downregulation of the studied interleukins; however, such a response was heightened by administration of L. fermentum, with an increase rate of transcription that promoted a more effective response to a C. jejuni infection. The effects of experimental treatments proved to vary between sampling points. Conclusively, these results demonstrate that L. fermentum lessens the negative effects elicited by C. jejuni on body weight by alleviating the impact on intestinal morphometry and cecal cytokine response, which ultimately improve chicken growth performance.
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Resumen Bajo las nuevas condiciones generadas por la pandemia de COVID-19, los tratamientos para el cáncer de mama requieren algunas reorientaciones y cuidados que se exponen en este artículo. Se consideran aquí las tres fases de gravedad de la pandemia y los respectivos tratamientos que demandan en función de los lineamientos dictados por el Ministerio de Salud y Protección Social de Colombia. Se trata de un conjunto de referencias para orientar las terapias y tratamientos, inspiradas en las políticas de salud regionales, nacionales e institucionales.
Abstract Under the new conditions generated by the COVID-19 pandemic, breast cancer treatments requires some reorientations and cares that are discussed in this article. The three phases of severity of the pandemic and the respective treatments they require -based on the guidelines issued by the Ministry of Health and Social Protection of Colombia- are considered here. It is a set of references to guide therapies and treatments, inspired by regional, national and institutional health policies.
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Humanos , Femenino , Neoplasias de la Mama , COVID-19 , Política Pública , PandemiasRESUMEN
RESUMEN Objetivo: determinar la frecuencia, incidencia y describir las características clínico- epidemiológicas de los pacientes con diarrea nosocomial por Clostridioides difficile en el Hospital Nacional Edgardo Rebagliati Martins en el período abril a julio de 2019. Materiales y métodos: estudio observacional y transversal realizado en los servicios de medicina interna, cuidados intensivos, hematología, gastroenterología y emergencia. Se realizó una vigilancia activa de los pacientes mayores de 18 años con tres o más deposiciones no formadas en 24 horas luego de 48 horas de admisión hospitalaria. Se empleó un algoritmo diagnóstico, que incluyó la glutamato deshidrogenasa y toxina fecal A y B de C. difficile. En caso de resultados discordantes, se realizó la prueba de amplificación de ácidos nucleicos de los genes productores de toxinas. Resultados: de 107 pacientes con diarrea nosocomial, 12 fueron positivos para C. difficile con una frecuencia de 11,2% (IC 95%: 6,44-18,82). Un paciente fue NAP1-BI-027 positivo. La mayor densidad de incidencia fue en hematología (5,54 x 10 000 pacientes-día). Siete (7/12, 58,3%) fueron varones y la edad fue 64,58 ± 21,34 años. El principal antibiótico indicado previo a la diarrea fue meropenem (9/12, 75%). Solo dos pacientes recibieron clindamicina. La mayoría (8/12, 66,7%) tuvo un episodio inicial no grave. La mortalidad general fue 28% (IC 95%: 20,27-37,38) y cuatro fallecidos tuvieron infección por C. difficile. Conclusiones: la frecuencia de diarrea nosocomial por C. difficile en nuestra institución fue menor al reportado previamente en otro hospital público de Lima. El uso racional de antibióticos y las medidas preventivas explicarían estos hallazgos.
ABSTRACT Objective: to determine frequency, incidence, and to describe clinical and epidemiological characteristics of patients with nosocomial diarrheal disease caused by Clostridioides difficile in Edgardo Rebagliati-Martins National Hospital in Peru, between April to July 2019. Material and methods: this is an observational and cross-sectional study that was performed in Internal Medicine, Intensive Care, Hematology, Gastroenterology, and Emergency services. Active surveillance of patients more than 18-years old who had three or more non-formed stools in a 24-hour period at 48-hours after being admitted to the hospital. A diagnostic algorithm was used, including glutamate dehydrogenase and A and B C. difficile fecal toxins. In case of discordant results, nucleic acid amplification for toxin producing genes tests were performed. Results: out of 107 patients with nosocomial diarrheal disease, 12 were positive for C. difficile, with 11.2% frequency (95% CI: 6.44 - 18.82). One patient was NAP1-BI-027 positive. The maximum incidence was found in the hematology service (5.54 x 10000 patients- day). Seven (7/12, 58.3%) patients were male and average age was 64.58 ± 21.34 years. The most frequently prescribed antibacterial agent prior to the diarrheal disease was meropenem (9/12, 75%). Only two patients had received clindamycin. Most patients (8/12, 66.7%) had an initial non severe episode. Overall mortality was 28% (95% CI: 20.27-37.38) and four deceased patients had C. difficile infection. Conclusions: The frecuency of nosocomial diarrheal disease caused by C. difficile in our institution was lower than that reported in another public hospital in Lima. Rational use of antibacterial agents and preventative measures may explain these findings.
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Background: Surveillance of antimicrobial resistance (AMR) requires an international approach with national and local strategies. Our aim was to summarize a retrospective 10-year report of antibiotic resistance of gram-positive and gram-negative bacteria in Mexico. Methods: A total of 46 centers from 22 states of Mexico participated. Databases of AMR from January 2009 to December 2018 were included for most species. The 10-year period was divided into five 2-year periods. Results: For Staphylococcus aureus, a decrease in resistance in all specimens was observed for erythromycin and oxacillin (p < 0.0001 for each). For Enterobacter spp., resistance to meropenem increased for urine specimens (p = 0.0042). For Klebsiella spp., increased drug resistance in specimens collected from blood was observed for trimethoprim/sulfamethoxazole, gentamicin, tobramycin (p < 0.0001 for each), meropenem (p = 0.0014), and aztreonam (p = 0.0030). For Acinetobacter baumannii complex, high drug resistance was detected for almost all antibiotics, including carbapenems, except for tobramycin, which showed decreased resistance for urine, respiratory, and blood isolates (p < 0.0001 for each), and for amikacin, which showed a decrease in resistance in urine specimens (p = 0.0002). An increase in resistance to cefepime was found for urine, respiratory, and blood specimens (p < 0.0001 for each). For Pseudomonas aeruginosa, aztreonam resistance increased for isolates recovered from blood (p = 0.0001). Conclusion: This laboratory-based surveillance of antibiotic resistance shows that resistance is increasing for some antibiotics in different bacterial species in Mexico and highlights the need for continuous monitoring of antibiotic resistance.
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Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/microbiología , Farmacorresistencia Bacteriana/efectos de los fármacos , Humanos , México , Pruebas de Sensibilidad Microbiana/métodos , Estudios RetrospectivosRESUMEN
Knowledge of genetics is crucial for understanding genetic and genomic tests and for interpreting personal genomic information. Despite this relevance, no data are available about the level of knowledge of genetics in an Ecuadorian population. This investigation sought to survey such knowledge in undergraduate students affiliated with private and public institutions in Quito, the capital city of Ecuador. A total of 350 individuals responded to a validated questionnaire measuring knowledge of genetics. Scores ranged from 45% to 87% (mean: 66.8%), and students achieved slightly better results when asked about genetics and diseases (mean score: 68.3%) than when asked about genetic facts (mean score: 64.9%). Additionally, no significant differences in performance were found among students from private and public institutions. Surprisingly, the lower score obtained (45%) was from a question about how chromosomes are passed to the next generation. The highly educated status of the surveyed population could explain the overall results; nonetheless, the possibility that the correct responses were given by chance cannot be ignored. Therefore, the actual knowledge of genetics among the participants might be different than that revealed by the percentages of correct answers. Consequently, to achieve the goal of ensuring informed decision-making concerning genetic and genomic tests, it seems evident that the national education programs of Ecuador require improvement in the teaching of genetic concepts.
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Toma de Decisiones , Genética , Conocimientos, Actitudes y Práctica en Salud , Estudiantes , Ecuador , Genética/educación , Humanos , Encuestas y CuestionariosRESUMEN
Objetivo: Determinar la percepción del gastroenterólogo sobre las necesidades de educación médica continua (EMC) en el Perú. Material y métodos: Estudio transversal y descriptivo. La muestra fue no probabilística. Se aplicó una encuesta a los gastroenterólogos miembros de la Sociedad de Gastroenterología del Perú. El cuestionario se elaboró en base al "Canadian Association of Gastroenterology Educational Needs Assessment Report" con una escala tipo Likert de 5 puntos (1= no necesario y 5= indispensable). Se determinó el promedio de los puntajes obtenidos en cada uno de los 33 ítems de las áreas clínica, endoscópica y métodos de aprendizaje. Resultados: Hubo 75 participantes y la edad promedio fue 43,40 años (DE ± 10,22 años). El lugar de trabajo principalmente fue Lima (68%) y la mayoría (50,67%) tuvo un tiempo de servicio menor de 5 años. La percepción de necesidades educativas en el área clínica fue mayor para el cáncer gástrico (4,37 ± 0,87) y el cáncer de colon (4,37 ± 0,83); en el área endoscópica fueron la polipectomía (4,15 ± 0,95) y las técnicas de emergencia (4,13 ± 0,99). Los principales métodos de aprendizaje para los gastroenterólogos fueron la asistencia a congresos (4,29 ± 0,83) y los talleres endoscópicos (4,19 ± 1,06). Conclusiones: La percepción del gastroenterólogo encuestado sobre las necesidades de EMC fue principalmente sobre temas de cáncer gástrico y de colon. La mayoría de ellos consideró la asistencia a congresos como el principal método de aprendizaje.
Objective: To determine the perception of the gastroenterologist about the needs of continuing medical education (CME) in Peru. Material and methods: Cross-sectional and descriptive study. The sample was not probabilistic. A survey was applied to the gastroenterologists members of the Society of Gastroenterology of Peru. The questionnaire was developed based on the "Canadian Association of Gastroenterology Educational Needs Assessment Report" with a Likert scale of 5 points (1 = not necessary and 5 = indispensable). The average of the scores obtained in each of the 33 items of the clinical, endoscopic and learning methods areas was determined. Results: There were 75 participants and the average age was 43.40 years (SD ± 10.22 years). The place of work was mainly Lima (68%) and the majority (50.67%) had a service time of less than 5 years. The perception of educational needs in the clinical area was higher for gastric cancer (4.37 ± 0.87) and colon cancer (4.37 ± 0.83); in the endoscopic area were polypectomy (4.15 ± 0.95) and emergency techniques (4.13 ± 0.99). The main learning methods for gastroenterologists were attendance at congresses (4.29 ± 0.83) and endoscopic workshops (4.19 ± 1.06). Conclusions: The perception of the gastroenterologist surveyed on the needs of CME was mainly on gastric and colon cancer issues. Most of them considered congress attendance as the main learning method.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Actitud del Personal de Salud , Educación Médica Continua , Gastroenterología/educación , Perú , Estudios Transversales , Evaluación de Necesidades , AutoinformeRESUMEN
AIM: To determine the prevalence of drug and substance abuse among high school students in Jalisco and its association with the severity of health, behavior and psychosocial problems in order to provide evidence for possible prevention and treatment needs. METHODS: A multi-stage random sample of Jalisco high school students was given a paper-and-pencil survey based upon an adapted version of the drug use screening inventory (DUSI) (n = 24699; n = 2832). The DUSI showed adequate psychometric characteristics in this population. The statistical analyses accommodated the complex survey design with attention to unequal probability of selection and clustering of participants within schools and regions. RESULTS: An estimated 44% of the students had smoked tobacco, one in five students was a current smoker, and one in four students used to smoke but had not smoked for one year or more. By contrast, 6.8% of the students reported having used marijuana, cocaine, or both. Behavioral problems, deviant peer affiliation, and troubled families were independently associated with drug use. One in two students who used tobacco or alcohol had used these drugs in the past year (46% and 54%, respectively), and one in four students who used marijuana or cocaine in their lifetime had used those drugs in the past year (28% in both cases). CONCLUSION: The rates of cocaine use as well as the proportion of current users were higher than expected among high school students and indicate changing patterns of drug use in Mexico. These results corroborate that the general trend of drug use by youth in Mexico is increasing. Results from this study help us better understand the needs of at-risk youth and the need for new treatment and prevention strategies.