More insights about the interfering effect of Mycobacterium avium subsp. paratuberculosis (MAP) infection on Mycobacterium bovis (M. bovis) detection in dairy cattle.

The estimated herd and within herd Mycobacterium bovis (M. bovis) infection prevalence in the southern Chile regions are 0.3 and 0.67%, respectively. However, higher rates of infection still remain in some herds. In parallel, it is well established that a big proportion of cattle herds are infected with Mycobacterium avium subsp. paratuberculosis (MAP), which has been also associated with a clear interference effect on M. bovis diagnosis. The present study aims to provide more insights about the diagnostic interference for Mycobacterium bovis detection due to co-infection with MAP. To better understand the dynamics of this identified interference, the effect of MAP genotype present, as well as MAP faecal shedding values (as proxy of the infection progression), for each of the CFT results was compared. No relationship was observed between MAP genotype with any type of differential response to the diagnostic tests of M. bovis infection. However, MAP shedding values in animals with positive CFT diagnostic results for M. bovis infection was significantly lower than animals with a negative CFT result, observing that as the MAP shedding load raises, the response to the bovine tuberculin test tends to be negative. The findings reported in this study allows to interpret that one of the causes of the prolonged elimination of M. bovis infection from some cattle herds may be due in part to the advanced MAP infection status in co-infected individuals affecting the outcome of screening in-vivo diagnostic techniques such as CFT. These false negative animals that show negative results to M. bovis detection tests, may maintain the infection at herd level and spread the pathogen to healthy individuals.

Programa de Salud para niños y adolescentes con síndrome de Down / Health Program for children and adolescents with Down’s syndrome

Los problemas específicos de salud que presentan los niños con síndrome de Down deben ser objeto de atención por los pediatras. Para integrar estos cuidados con los propios de la edad, diversas organizaciones pediátricas han elaborado programas de salud para personas con síndrome de Down. En ellos se puntualiza sobre las necesidades específicas de los pacientes con trisomía 21, añadiéndolas a las propias de las diversas edades. Los programas de salud suponen una ayuda importante para la atención pediátrica a este grupo poblacional (AU)

Special attention should be given by the pediatricians to the specific health problems that children with Down’s Syndrome have. In order to integrate these cares into those cares characteristic for their age, different pediatric organizations have elaborated health programs for persons with Down’s Syndrome. In these, the specific needs of the patients with trisomy 21 are highlighted, adding these to those characteristic for the different ages. The health programs suppose an important aid for the pediatric care to this population group (AU)

[Open surgery and endovascular treatment on the descending thoracic aorta: 15 years' experience]. / Cirugía abierta y endovascular en la patología de aorta torácica descendente: 15 años de experiencia.

OBJECTIVE: Outcomes of surgical treatment of the descending thoracic aorta have improved markedly, although high associated morbidity and mortality continue to be a concern. Endovascular treatments are therefore attractive alternatives to open surgery. We compared outcomes of endovascular treatment to outcomes of open surgery on both aortic segments. MATERIAL AND METHODS: Retrospective study of patients treated for descending thoracic and thoracoabdominal aorta disease by means of open surgery or endovascular treatment in our hospital between 1995 and 2009. We analyzed preoperative characteristics, intraoperative variables, and postoperative results in both groups. RESULTS: We retrieved the cases of 22 patients, 10 who underwent open surgery and 12 who received endovascular treatment. Surgery was indicated to treat aneurysm (40%), aortic dissection (30%), or both (30%) in the open surgery group. In the endovascular treatment group, 66.7% had aneurysm, 33.3% dissection, and 0% both. Trauma was involved in 20% of the open surgeries and 16.7% of the endovascular procedures. Forty percent of the open surgery cases and 16.2% of the endovascular interventions were emergencies. Patient age was the only statistically significant between-group difference in preoperative characteristics. Postoperative complication rates were similar. Significant differences were observed in duration of surgery, lengths of critical care unit and total hospital stays, and intubation time (P < .05). CONCLUSIONS: The incidence of postoperative complications in the group of patients undergoing open surgery on the descending thoracic aorta was similar to incidences reported by other hospitals with moderate caseloads. A trend toward reduced morbidity and mortality in the endovascular treatment group was observed, and this group had significantly shorter times of intubation and lengths of critical care unit and hospital stays.

Cirugía abierta y endovascular en la patología de aorta torácica descendente: 15 años de experiencia / Open surgery and endovascular treatment on the descending thoracic aorta: 15 years’ experience

OBJETIVO: Los resultados quirúrgicos en las enfermedadesde la aorta torácica descendente y toracoabdominalhan mejorado significativamente, aunque la morbimortalidadsigue siendo elevada. Como consecuencia deello las técnicas terapéuticas endovasculares se presentancomo alternativas atractivas. En este trabajo comparamoslos resultados de la cirugía abierta sobre ambossegmentos aórticos con el tratamiento endovascular.MATERIAL Y MÉTODOS: Estudio retrospectivo de lospacientes intervenidos de patología sobre la aorta torácicadescendente y toracoabdominal mediante cirugíaabierta y tratamiento endovascular en nuestro hospitaldesde 1995 a 2009. Analizamos las características preoperatoriase intraoperatorias y los resultados postoperatoriosde ambos grupos.RESULTADOS: Se revisaron 22 pacientes, 10 sometidosa cirugía abierta y 12 a tratamiento endovascular.Las etiologías con indicación quirúrgica fueron aneurismas,disecciones y ambos en el 40%, 30% y 30% enel grupo de cirugía abierta y con el 66,7%, 33,3% y0% en tratamiento endovascular. La patología de origentraumático se correspondió con el 20% y 16,7% yla cirugía de urgencia con el 40% y 16,2% en el grupode cirugía abierta y endovascular respectivamente. Nohubo diferencias estadísticamente significativas en lascaracterísticas preoperatorios (excepto en la edad delos pacientes) entre ambos grupos. Se observaron diferenciasestadísticamente significativas en los tiemposquirúrgicos, estancia en unidad de cuidados críticos yestancia hospitalaria, y en el tiempo de intubación(p<0,05).DISCUSIÓN: La incidencia de complicaciones postoperatoriasen el grupo de cirugía abierta de la aorta torácicadescendente es similar a los centros con un volumenreducido de enfermos...(AU)

OBJECTIVE: Outcomes of surgical treatment of thedescending thoracic aorta have improved markedly,although high associated morbidity and mortalitycontinue to be a concern. Endovascular treatments aretherefore attractive alternatives to open surgery. Wecompared outcomes of endovascular treatment tooutcomes of open surgery on both aortic segments.MATERIAL AND METHODS: Retrospective study ofpatients treated for descending thoracic andthoracoabdominal aorta disease by means of opensurgery or endovascular treatment in our hospitalbetween 1995 and 2009. We analyzed preoperativecharacteristics, intraoperative variables, andpostoperative results in both groups.RESULTS: We retrieved the cases of 22 patients, 10 whounderwent open surgery and 12 who receivedendovascular treatment. Surgery was indicated to treataneurysm (40%), aortic dissection (30%), or both (30%)in the open surgery group. In the endovasculartreatment group, 66.7% had aneurysm, 33.3%dissection, and 0% both. Trauma was involved in 20%of the open surgeries and 16.7% of the endovascularprocedures. Forty percent of the open surgery cases and16.2% of the endovascular interventions wereemergencies. Patient age was the only statisticallysignificant between-group difference in preoperativecharacteristics. Postoperative complication rates weresimilar. Significant differences were observed induration of surgery, lengths of critical care unit andtotal hospital stays, and intubation time (P<.05).CONCLUSIONS: The incidence of postoperativecomplications in the group of patients undergoing opensurgery on the descending thoracic aorta was similar to incidences reported by other hospitals with moderatecaseloads. A trend toward reduced morbidity andmortality in the endovascular treatment group wasobserved, and this group had significantly shorter timesof intubation and lengths of critical care unit andhospital stays(AU)

Síndrome de embolia grasa. Una entidad poco conocida para el dermatólogo / Fat Embolism Syndrome: a Condition Unfamiliar to the Dermatologist

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Molecular epidemiology of caliciviruses causing outbreaks and sporadic cases of acute gastroenteritis in Spain.

The molecular epidemiology of human caliciviruses (HuCVs) causing sporadic cases and outbreaks of acute gastroenteritis around eastern Spain (Catalonia and the Valencian Community) was studied by reverse transcription-PCR (RT-PCR) and by sequencing part of the RNA polymerase gene in open reading frame 1. HuCVs were detected in 44 of 310 stool specimens (14.19%) negative for other enteric pathogens obtained from children with acute gastroenteritis. Norwalk-like viruses (NLVs) were the most common cause of the gastroenteritis outbreaks investigated here. They were detected in 14 out of 25 (56%) outbreaks with an identified pathogen. Genotypes producing both sporadic cases and outbreaks were diverse, with a predominance of GGII strains related to genotypes Melksham and Lordsdale. Five strains clustered with a "new variant" designated GGIIb, which was detected circulating throughout quite a few European countries in the years 2000 and 2001. The emergence mechanism of these strains might be the occurrence of intertypic recombinations between different viruses. The nucleotide sequence of part of the capsid gene (ORF2) from three of these strains demonstrated their relationship with Mexico virus.