Unmanageable norovirus outbreak in a single resort located in the Dominican Republic.

Noroviruses constitute an important cause of acute gastroenteritis, mainly in semi-closed populations such as hospitals, hotels and cruise ships. This study records the most important norovirus outbreak in the Dominican Republic in a single resort, with more than 800 people being affected in a 15-day period. Analysis of clinical and environmental samples demonstrated that norovirus was the aetiological agent responsible for the outbreak. Although enhanced hygiene and disinfection measures were achieved, the outbreak was only controlled after suspension of entry into the resort.

Social capital and self-rated health in urban low income neighbourhoods in Chile.

OBJECTIVE: To examine the potential association between social capital and self-rated health within a low income community of Santiago, Chile. METHOD: Cross-sectional survey, based on in-home interviews in the municipality of Puente Alto in Santiago, Chile. The participants were 781 residents of four neighbourhoods within Puente Alto (mean age 45.5 years). RESULTS: Principal components analysis with varimax rotation identified five domains of social capital: perceived trust in neighbours, perceived trust in organisations, reciprocity within the neighbourhood, neighbourhood integration, and social participation (Cronbach alphas: 0.58 to 0.77). Trust and reciprocity were significantly associated with better self-rated health. For example, a one standard deviation increase in trust in neighbours was associated with an adjusted odds ratio of 1.10 (95% confidence interval, CI: 1.05 to 1.15) for reporting good self-rated health. By contrast, social participation was associated with a lower odds (0.89, 95% CI: 0.89 to 1.06) of reporting good health. CONCLUSION: Neighbourhood social cohesion, measured by trust and reciprocity, is associated with higher self-rated health. However, social participation did not appear to be associated with better health in this predominantly low income neighbourhood. These findings provide preliminary support to the relevance for social capital as a determinant of health in Chile.

Evolucion de la consanguinidad en el caballo de pura raza española de la yeguada militar respecto al resto de la raza / No disponible

La consanguinidad como método de cría se utiliza desde tiempos remotos, su principal inconveniente es la disminución de la capacidad de adaptación y supervivencia de los individuos con alta tasa de consanguinidad. Se realiza un estudio de la evolución de la consanguinidad de la cabaña equina de Pura Raza Española (PRE) con origen en la Yeguada Militar en comparación con la de la cabaña nacional desde el año 1970. Se detecta una sintonía entre ambas poblaciones (AU)

No disponible

The Mood Spectrum Self-Report: validation and adaptation into Spanish.

This study explores the psychometric properties of the Spanish adaptation of the Mood Spectrum Self-Report (MOODS-SR), an instrument designed to assess a broad range of manifestations of mood psychopathology. A total of 71 Spanish subjects participated: 49 outpatients who met criteria for a mood disorder or generalized anxiety disorder, and 22 normal controls. The instrument proved to have good internal consistency and test-retest reliability. Significant positive correlations were found between the depressive subdomains of the questionnaire and the Beck Depression Inventory, as well as between the manic-hypomanic subdomains and the Clinician-Administered Rating Scale for Mania. Clinical subjects displayed higher mean scores than normal subjects in all domains, and patients with bipolar disorder displayed higher scores than patients with unipolar disorder in the Manic component, particularly in the Energy and the Cognition subdomains. Differences between patients with generalized anxiety and mood disorders were small. The former, however, did not differ from normal controls in several subdomains, whereas patients with mood disorders did.

Variación Anatómica de la Valva Atrioventricular Derecha / Anatomic Variation of the Right Atrioventricular Valve

Si bien la tradición ha consagrado el término "tricúspide" para caracterizar a la valva atrioventricular derecha, numerosos estudios han demostrado la gran variabilidad de presentación de ésta, describiéndose casos con dos y, situaciones extremas, con seis velos valvulares. Parece existir una relación directa entre el incremento del número de válvulas y la morbimortalidad de los portadores de esta variación anatómica. En este trabajo presentamos una valva atrioventricular derecha con dos velos valvulares, estructura donde es posible identificar claramente el componente septal con una sola válvula y el componente mural que se descompone en una extensa válvula anterior y una pequeña válvula comisural anteroseptal.

Anatomic tradition uses the term "tricuspid" for the right atrioventricular valve, even though several studies had demonstrated a great variation in the anatomy of this structure. Some studies describe two valvules (or cusps), others describe six veils. Interestingly, it seems to be a direct relationship between the increment in the number of cusps and the patient morbid-mortality. This study present a right atrioventricular valve bicuspid, whit a clearly septal component with one valvule, and a mural component with a wide anterior valvule and a small anteroseptal commissural cusp.

Las atribuciones de incontrolabilidad en el origen de las expectativas de desesperanza en adolescentes / Uncontrollability in the origin of hopelessness expectancies in adolescents

La percepción de no contingencia se muestra determinante en el surgimiento de las expectativas de incontrolabilidad desde el modelo original de Indefensión Aprendida. En su última versión, las expectativas de desesperanza, que consisten en percibir el futuro como incontrolable, dependen de la atribución de los acontecimientos negativos a causas globales y estables. En este estudio se examina si las atribuciones de incontrolabilidad son a su vez determinantes de las expectativas de desesperanza. En una muestra de 256 estudiantes (15-20 años), se administraron el Cuestionario de Estilos Cognitivos para Adolescentes Españoles, el Listado de Experiencias Vitales y la Escala de Desesperanza. Se encontró que ni la globalidad ni la estabilidad predecían expectativas de desesperanza, si bien atribuir los acontecimientos negativos a causas incontrolables las incrementaba significativamente. Estos hallazgos muestran la utilidad de incorporar una nueva dimensión atribucional, que evalúa la percepción de no contingencia, en la predicción de las expectativas de desesperanza (AU)

In the Learned Helplessness model, perception of non contingency is a key factor in the appearance of uncontrollability expectations. In its last version, this model poses that hopelessness expectancies, which consist in perceiving the future as uncontrollable, depend on attributing negative events to stable and global causes. In this study we tested if attributions of uncontrollability are also needed for the development of hopelessness. We used the Spanish Cognitive Style Questionnaire for Adolescents, the Life Experiences Survey, and the Hopelessness Scale in a sample of 256 students (aged 15-20 yrs). Results showed that neither globality, nor stability, predicted hopelessness expectations; however, attributing negative events to uncontrollable causes did predict hopelessness. These findings show the utility of including a new attributional dimension that evaluates the perception of non contingency in the prediction of hopelessness expectancies (AU)

[Quality of life in patients with chronic obstructive pulmonary disease and the impact of physical training]. / Calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica e impacto del entrenamiento físico.

BACKGROUND: Health related quality of life (QoL) is severely impaired in COPD patients as a consequence of dyspnea and limited exercise tolerance, which lead to physical deconditioning and muscle atrophy resulting in weakness and fatigue. Psychosocial factors such as depression and anxiety also contribute to this impairment. AIM: To evaluate: a) the impact of COPD on quality of life, and b) the effect of 10 weeks of exercise training on exercise performance and on QoL. PATIENTS AND METHODS: The Spanish version of the Chronic Respiratory Questionnaire (CRQ) was applied to 55 COPD patients (FEV1 37 +/- 13% pred) for the assessment of QoL and in 30 of them submitted to exercise training for 10 weeks. Exercise performance was evaluated by measuring: six-minute walking distance, maximal workload (Wmax), maximal O2 consumption (VO2max) as well as endurance time, blood lactic acid, dyspnea and leg fatigue during a submaximal exercise. Trained patients were evaluated before and after training. RESULTS: COPD patients showed a reduction (mean +/- SD) in the four domains of the CRQ: dyspnea (3.1 +/- 0.9); fatigue (4.3 +/- 1.3); mastery (4.65 +/- 1.3), emotional function (4.1 +/- 0.97), and in Wmax and VO2max (52 +/- 16 Watt and 970 +/- 301 ml/min). No significant relationship between the impairment in exercise tolerance and in QoL was observed. Exercise training significantly improved the four domains of QoL (p < 0.0001), Wmax (p < 0.05), VO2max (p < 0.02) and endurance time (p < 0.001). Isotime exercise measurements of dyspnea, leg fatigue and lactic acid decreased after training (p < 0.001, each). No significant relation between changes in QoL and changes in exercise performance were observed. CONCLUSIONS: Our results demonstrate that QoL is seriously impaired in patients with COPD and confirm: (a) the lack of relationship of QoL to the usually measured physiological parameters, and (b) the beneficial effect of exercise training on QoL through the reduction of symptoms. These findings stresses the need of measuring quality of life in our patients if we want to evaluate the impact of therapeutic procedures on well-being from the patients' perspective.

Calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica e impacto del entrenamiento físico / Quality of life in patients with chronic pulmonary obstructive disease and the impact of physical training

Background: Health related quality of life (QoL) is severely impaired in COPD patients as a consequence of dyspnea and limited exercise tolerance, which lead to physical deconditioning and muscle atrophy resulting in weakness and fatigue. Psychosocial factors such as depression and anxiety also contribute to this impairment. Aim: To evaluate: a) the impact of COPD on quality of life, and b) the effect of 10 weeks of exercise training on exercise performance and on QoL. Patients and methods: The Spanish version of the Chronic Respiratory Questionnaire (CRQ) was applied to 55 COPD patients (FEV1 37 ñ 13 percent pred) for the assessment of QoL and in 30 of them submitted to exercise training for 10 weeks. Exercise performance was evaluated by measuring: six-minute walking distance, maximal workload (Wmax), maximal O2 consumption (VO2max) as well as endurance time, blood lactic acid, dyspnea and leg fatigue during a submaximal exercise. Trained patients were evaluated before and after training. Results : COPD patients showed a reduction (mean ñ SD) in the four domains of the CRQ: dyspnea (3.1 ñ 0.9); fatigue (4.3 ñ 1.3); mastery (4.65 ñ 1.3), emotional function (4.1 ñ 0.97), and in Wmax and VO2max (52 ñ 16 Watt and 970 ñ 301 ml/min). No significant relationship between the impairment in exercise tolerance and in QoL was observed. Exercise training significantly improved the four domains of QoL (p < 0.0001), Wmax (p < 0.05), VO2max (p < 0.02) and endurance time (p < 0.001). Isotime exercise measurements of dyspnea, leg fatigue and lactic acid decreased after training (p < 0.001, each). No significant relation between changes in QoL and changes in exercise performance were observed. Conclusions: Our results demonstrate that QoL is seriously impaired in patients with COPD and confirm: (a) the lack of relationship of QoL to the usually measured physiological parameters, and (b) the beneficial effect of exercise training on QoL through the reduction of symptoms. These findings stresses the need of measuring quality of life in our patients if we want to evaluate the impact of therapeutic procedures on well-being from the patients' perspective

A comparison of the in-vitro activity of seventeen antibiotics against Streptococcus faecalis.

The in-vitro activity of seventeen antibiotics against 177 clinical strains of Streptococcus faecalis was evaluated. Ampicillin and mezlocillin were the most active beta-lactams tested (geometric mean MICs, 0.61 and 0.74 mg/l, respectively). Aminoglycosides showed poor activity and 22.6% of the strains were resistant to 2000 mg/l of streptomycin. No correlation was observed between MICs of gentamicin and streptomycin. Moderate activity was observed when testing norfloxacin and ciprofloxacin. Teicoplanin and co-trimoxazole were extremely active, showing geometric mean MICs of 0.59 and 0.08 mg/l respectively. All strains were susceptible to vancomycin and teicoplanin.

Evaluation of a commercial beta-glucuronidase test for the rapid and economical identification of Escherichia coli.

A commercial beta-glucuronidase (beta-GUR) test for the rapid and economical identification of Escherichia coli was evaluated. A total of 762 clinical strains and 228 environmental isolates were studied. More than 95% of the E. coli strains were found to be beta-GUR positive. Thirty-one clinical isolates of Shigella sonnei, 10 of Enterobacter cloacae, eight of Enterobacter aerogenes, nine of Citrobacter freundii and one of Salmonella enteritidis also gave positive results. The enzyme beta-GUR was also detected in two environmental strains of E. cloacae and one C. freundii. A comparative study between the beta-GUR test and the conventional identification system was carried out in 233 consecutive isolates of lactose positive enterobacteria. Agreement was observed in 223 cases and 190 E. coli strains were correctly identified using this test. Discrepancies were found in 10 cases: nine E. coli were beta-GUR negative and one C. freundii was beta-GUR positive. Escherichia coli was the only species positive for both beta-GUR and indole tests. This procedure permits a rapid, easy, precise and inexpensive identification of E. coli. beta-GUR positive Enterobacter strains have not previously been described.