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1.
Child Abuse Negl ; 140: 106155, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37004459

RESUMEN

OBJECTIVES: This study is meant to put a focus on the prevalence of emotional abuse in low-income states like the Sub-Saharan region. METHODOLOGY: Searching PubMed, Google scholar, and web of science during February and April 2021 a total of 2264 articles were identified, 27 met the inclusion criteria. We added the results of 13 VAC (Violence Against Children and Youth) studies, conducted by UNICEF capturing information about experienced sexual, physical, or emotional violence in 13-24-year-olds, as well as 56 MIC (Multiple Indicator Cluster) studies, conducted by the CDC to research the disciplinary methods used with children aged 1-14 years in the past month by older household members. Finally, in a meta-analytic approach, we aimed to calculate a pooled estimate of the prevalence. RESULTS: The included studies depicted a wide range in prevalence rates across countries. For example, while the VAC study in Lesotho in 2018 showed low incidence rates of emotional violence (6.9 % Females, 3.8 % Males), the average prevalence recorded by the MIC study was as high as 57.8 % for females and 59.2 % for males. On average, the MIC studies displayed a higher incidence and the discrepancy of prevalence of emotional abuse between females and males was small. Calculating a pooled estimate of the prevalence was not possible, due to the heterogeneity of the data. CONCLUSIONS: In general countries displayed a high prevalence. A standardized use of a uniform definition of emotional abuse might help to display a more homogenous data set in the future, giving the opportunity for pooled estimates of prevalence.


Asunto(s)
Abuso Emocional , Violencia , Masculino , Femenino , Adolescente , Humanos , Niño , África del Sur del Sahara/epidemiología , Conducta Sexual , Prevalencia
2.
BMC Public Health ; 22(1): 1507, 2022 08 08.
Artículo en Inglés | MEDLINE | ID: mdl-35941626

RESUMEN

BACKGROUND AND OBJECTIVES: Hypertension is one of the leading cardiovascular risk factors with high numbers of undiagnosed and untreated patients in Sub Saharan Africa (SSA). The health systems and affected people are often overwhelmed by the social and economic burden that comes with the disease. However, the research on the economic burden and consequences of hypertension treatment remains scare in SSA. The objective of our review was to compare different hypertension treatment costs across the continent and identify major cost drivers. MATERIAL AND METHODS: Systematic literature searches were conducted in multiple databases (e.g., PubMed, Web of Science, Google Scholar) for peer reviewed articles written in English language with a publication date from inception to Jan. 2022. We included studies assessing direct and indirect costs of hypertension therapy in SSA from a provider or user perspective. The search and a quality assessment were independently executed by two researchers. All results were converted to 2021 US Dollar. RESULTS: Of 3999 results identified in the initial search, 33 were selected for data extraction. Costs differed between countries, costing perspectives and cost categories. Only 25% of the SSA countries were mentioned in the studies, with Nigeria dominating the research with a share of 27% of the studies. We identified 15 results each from a user or provider perspective. Medication costs were accountable for the most part of the expenditures with a range from 1.70$ to 97.06$ from a patient perspective and 0.09$ to 193.55$ from a provider perspective per patient per month. Major cost drivers were multidrug treatment, inpatient or hospital care and having a comorbidity like diabetes. CONCLUSION: Hypertension poses a significant economic burden for patients and governments in SSA. Interpreting and comparing the results from different countries and studies is difficult as there are different financing methods and cost items are defined in different ways. However, our results identify medication costs as one of the biggest cost contributors. When fighting the economic burden in SSA, reducing medication costs in form of subsidies or special interventions needs to be considered. TRIAL REGISTRATION: Registration: PROSPERO, ID CRD42020220957.


Asunto(s)
Diabetes Mellitus , Hipertensión , África del Sur del Sahara/epidemiología , Estrés Financiero , Gastos en Salud , Humanos , Hipertensión/terapia
3.
Zoonoses Public Health ; 65(1): 134-141, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28766871

RESUMEN

Surveillance is an important component of an overall strategy to address antimicrobial resistant bacteria in food animals and the food chain. The poultry market has many points of entry into the Canadian food chain, and some production practices are underrepresented in terms of surveillance. For example, pathogen carriage and antimicrobial resistance surveillance data are limited in smallholder chicken flocks raised for slaughter at provincially inspected abattoirs. In Canada, antimicrobial resistance in Escherichia coli and Salmonella isolated from commercial broiler chicken flocks, slaughtered at federally inspected abattoirs, is monitored by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The objective of this study was to establish baseline information of antimicrobial resistance presence in E. coli and Salmonella isolated from smallholder flocks in Ontario, utilizing CIPARS collection and isolation methodologies, and to compare findings with CIPARS federally inspected abattoir data from Ontario, Canada. Five chickens per flock were sampled from 205 smallholder flocks. Of 1,025 samples, the E. coli prevalence was 99% (1,022/1,025), and 47% (483/1,022) of positive E. coli isolates were resistant to one or more of the 14 antimicrobials. Furthermore, as compared to results reported for the CIPARS commercial flocks, E. coli isolates from smallholder flocks had significantly lower resistance prevalence to six of 14 individual antimicrobials. Recovery of E. coli did not differ between federally inspected and provincially inspected flocks. Salmonella prevalence at the bird level in smallholder flocks was 0.3% (3/1,025), significantly lower (p â‰ª 0.0001, 95% CI 0.080%-0.86%) than federally inspected commercial flocks. The overall differences found between the commercial and smallholder flocks may be explained by differences in poultry husbandry practices and hatchery sources.


Asunto(s)
Pollos , Farmacorresistencia Bacteriana , Escherichia coli/efectos de los fármacos , Enfermedades de las Aves de Corral/microbiología , Salmonella/efectos de los fármacos , Crianza de Animales Domésticos , Animales , Antibacterianos/farmacología , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/veterinaria , Ontario/epidemiología , Enfermedades de las Aves de Corral/epidemiología , Salmonella/aislamiento & purificación , Salmonelosis Animal/epidemiología , Salmonelosis Animal/microbiología
4.
Adv Exp Med Biol ; 1021: 1-14, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28405893

RESUMEN

Waste collectors are exposed to a heterogeneous mixture of bioaerosols able to induce health effects. The study aim was to evaluate inflammatory processes in blood and in the respiratory tract via analysis of atopy and club cell secretory protein 16 (CC16) in serum, exhaled nitric oxide (FeNO), and cellular and soluble mediators in nasal lavage fluid (NALF) and induced sputum (IS). Sixty nine current waste collectors (48% smokers) and 28 former waste collectors (25% smokers) were included in the cross-sectional study. In both groups, 63 and 64% of workers reported complaints of the eyes, nose and/or upper airways. Thirty two percent of the current and 25% of the former workers were classified as atopics. More atopics suffered from rhinitis and conjunctivitis than non-atopics (64% vs. 40% in current workers; 71% vs. 40% in former workers). CC16 values of present non-smokers were significantly higher compared to smokers. In total, FeNO values of 31 participants were lower than 10 ppb, 94% of them were smokers and 85% had respiratory symptoms of lower airways. Most of the IS biomarkers were significantly higher in smokers than in non-smokers. Non-smoking workers with respiratory symptoms of lower airways had slightly elevated mediator IS concentrations compared to asymptomatic non-smokers. We conclude that inflammatory changes in waste collectors are detectable in the content of IS biomarkers, exhaled NO, and serum CC16, which all are influenced by the smoking habit. No significant differences in biomarkers are detectable between current and former waste collectors.


Asunto(s)
Biomarcadores/sangre , Pruebas Respiratorias , Inflamación/diagnóstico , Óxido Nítrico/sangre , Enfermedades Profesionales/diagnóstico , Estudios Transversales , Humanos , Hipersensibilidad Inmediata , Inflamación/sangre , Líquido del Lavado Nasal , Enfermedades Profesionales/sangre , Fumar , Esputo , Uteroglobina/sangre
5.
Occup Environ Med ; 73(12): 829-837, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27507893

RESUMEN

OBJECTIVES: To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols. METHODS: Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data. RESULTS: In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations. CONCLUSIONS: Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study.


Asunto(s)
Aerosoles/efectos adversos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/etiología , Adulto , Anciano , Contaminantes Ocupacionales del Aire/efectos adversos , Estudios de Seguimiento , Volumen Espiratorio Forzado , Hongos , Alemania/epidemiología , Humanos , Inmunoglobulina E , Inmunoglobulina G , Masculino , Persona de Mediana Edad , Análisis de Regresión , Sistema Respiratorio , Suelo , Espirometría , Encuestas y Cuestionarios
6.
J Appl Microbiol ; 120(3): 770-80, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26681503

RESUMEN

AIMS: This study investigated the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA), their spa-types, and antimicrobial resistance profiles at various steps during commercial pork production from three plants designated as A, B and C. METHODS AND RESULTS: Over a period of 1 year 2640 samples from three commercial pork plants were obtained on a rotating basis. Sample sources were: nasal swabs after bleeding (NSAB), nasal swab after scalding (NSASs, plant C) or skinning (NSASk, plants A, B), carcass swabs after pasteurization (CSAP, plant C) or washing (CSAW, plants A, B) and retail pork (RP). Overall MRSA prevalence at each sampling point in the pork plants after adjusting for clustering was: 61·93, 28·38 7·58 and 1·21% for NSAB, NSASc/Sk, CSAP/CSAW and RP respectively. The majority of MRSA isolates from the three pork plants belonged to livestock-associated MRSA spa-types t034 and t011 (3·8%; ST398). The mainly human spa-type t002 (15%) was also recovered. All MRSA isolates were resistant to ß-lactam and tetracycline antibiotics. Overall resistance to tigecycline was found in about 10% of MRSA isolates while <3% isolates were resistant to daptomycin, gentamicin, quinupristin/dalfopristin and trimethoprim/sulfamethoxazole. CONCLUSION: A higher prevalence of MRSA in the nasal cavity of incoming pigs was observed at all three plants, but a notable reduction in MRSA along the pork processing steps occurred. SIGNIFICANCE AND IMPACT OF THE STUDY: The highest prevalence of MRSA was found in the nasal cavity of incoming pigs in three commercial pig slaughter and pork processing plants. A reduction in MRSA prevalence occurred along the processing chain, and pork products from these plants showed significantly lower MRSA than the initial steps of slaughter and processing, suggesting a reduction in MRSA during the slaughter process with minimal cross-contamination.


Asunto(s)
Carne/microbiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Animales , Antibacterianos/farmacología , Canadá , Seguridad de Productos para el Consumidor , Contaminación de Alimentos/estadística & datos numéricos , Manipulación de Alimentos/instrumentación , Humanos , Carne/economía , Meticilina/farmacología , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/genética , Prevalencia , Porcinos
7.
Adv Exp Med Biol ; 858: 57-67, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25786401

RESUMEN

Occupational bioaerosol exposures are capable to cause respiratory diseases. We studied the relationship between exposure to bioaerosols and biomarkers' concentration in exhaled breath condensate (EBC) and fractional exhaled nitric oxide (FeNO) in 119 bioaerosol-exposed compost workers taking into account atopy and smoking habits. Atopy was classified according to specific IgE concentrations to common inhalant allergens (sx1). Bioaerosol exposure was estimated according to job title, duration of employment, results of ambient monitoring at the workplaces, and shift time worked under protection of filtered air supply. Concentrations of 8-iso-prostaglandin F2α (8-iso-PGF2α), prostaglandin E2 (PGE2), leukotriene B4 (LTB4), and acid-base balance (pH) in EBC and FeNO were assessed in 59 never-smoking (NS) and 60 smoking (S) compost workers. We found that atopic subjects were equally distributed among NS and S (n=16 each). Levels of 8-iso-PGF2α were significantly higher in workers considered highly exposed to bioaerosols than in low exposed workers (86.6 (66.1; 128.8) pg/mL vs. 74.4 (56.3; 96.7) pg/mL, p=0.047). No associations could be observed between exposures and biomarkers concerning compost workers in total, but there were some in atopic workers (duration of employment and FeNO: r=0.376, p=0.041; filtered air supply and FeNO: r=-0.335, p=0.071). Smokers had significantly lower pH values compared to NS (non-atopic, p=0.041; atopic p=0.050). In conclusion, EBC and FeNO might be useful tools for monitoring of inflammation due to bioaerosol exposures, especially in atopic subjects. Besides smoking also atopy should be considered when investigating airway inflammation.


Asunto(s)
Contaminantes Ocupacionales del Aire/efectos adversos , Hipersensibilidad Inmediata/metabolismo , Óxido Nítrico/metabolismo , Exposición Profesional , Neumonía/metabolismo , Equilibrio Ácido-Base , Adulto , Aerosoles , Biomarcadores/metabolismo , Estudios Transversales , Dinoprost/análogos & derivados , Dinoprost/metabolismo , Dinoprostona/metabolismo , Espiración , Femenino , Humanos , Hipersensibilidad Inmediata/inmunología , Hipersensibilidad Inmediata/fisiopatología , Inmunoglobulina E/metabolismo , Leucotrieno B4/metabolismo , Masculino , Persona de Mediana Edad , Neumonía/inducido químicamente , Neumonía/inmunología , Neumonía/fisiopatología , Fumar/fisiopatología , Suelo/química
8.
Adv Exp Med Biol ; 858: 19-29, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25634128

RESUMEN

Inflammatory processes, including respiratory symptoms, can be induced among workers in composting plants exposed to bioaerosols containing microorganisms and their compounds. We evaluated inflammatory processes in the lower respiratory tract via cellular and soluble mediator profiles in induced sputum (IS). IS samples of 140 current (35% smokers) and 49 former compost workers (29% smokers) as well as 29 white-collar workers (17% smokers) were collected and analyzed for the cell count and composition, and for soluble biomarkers. Significant differences between current and former compost workers and white-collar workers were detected for total cell count (p=0.0004), neutrophils (p=0.0045), sCD14 (p=0.008), and 8-isoprostane (p<0.0001). IS of non-smoking former compost workers showed lower concentrations of IL-8, total protein, immunoreactive MMP-9 and sCD14, compared with non-smoking current compost workers. 10.1% of the study population was suffering from chronic bronchitis with significant differences (p=0.018) between former compost workers (24.5%), current workers (5%), and white-collar workers (10.3%). Significantly lower IL-8 (p=0.0002), neutrophils (p=0.001), and MMP-9 (p=0.0023) values were measured in healthy subjects compared with subjects with chronic bronchitis. In conclusion, changes in lower airways were detected by analysis of biomarkers in IS of current exposed and, to a lesser extent, in IS of former compost workers. These effects are especially pronounced in subjects with chronic bronchitis.


Asunto(s)
Contaminantes Ocupacionales del Aire/efectos adversos , Bronquitis/sangre , Exposición Profesional , Neumonía/sangre , Adulto , Biomarcadores/sangre , Proteínas Sanguíneas/metabolismo , Bronquitis/fisiopatología , Recuento de Células , Enfermedad Crónica , Estudios Transversales , Dinoprost/análogos & derivados , Dinoprost/sangre , Femenino , Humanos , Interleucina-8/sangre , Receptores de Lipopolisacáridos/sangre , Masculino , Metaloproteinasa 9 de la Matriz/sangre , Persona de Mediana Edad , Neutrófilos/metabolismo , Neutrófilos/patología , Neumonía/inducido químicamente , Neumonía/fisiopatología , Fumar/fisiopatología , Suelo/química , Esputo/química
9.
Adv Exp Med Biol ; 834: 53-61, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25252907

RESUMEN

Waste collectors may suffer from acute and chronic health effects caused by organic dust (bioaerosols). Pathophysiological symptoms may originate either from allergic or irritative pathomechanisms, but an explicit distinction of the etiology is often complicated although crucial for proper risk assessment and workplace prevention. In this cross-sectional study, a total of 69 male waste collectors from the Ruhr area in Germany underwent a customized testing protocol including a modified questionnaire, basic clinical examination, spirometry, and immunologic parameters. Subjects were classified according to their work tasks into loaders (n=27), floaters (n=29), and drivers (n=13). We found that a high percentage of the workers had complaints (eyes 29.0%, nose 39.1%, and cough 34.8%) which were strongly work-related. Multiple logistic regression analyses indicated that duration of employment in waste collection (per 10 years) was associated with an increased prevalence of cough (OR=1.64, 95% CI 0.81; 3.35) and chronic bronchitis (OR=2.18, 95% CI 0.80; 5.92). An association between rhinitis and cough (OR=2.62, 95% CI 0.94; 7.27) was found, which supports the association between the prevalence of upper and lower airway disease. Furthermore, when adjusting for smoking status, atopic subjects suffered more frequently from irritation of the lower airways as indicated by cough (OR=2.71, 95% CI 0.91; 8.08). In conclusion, the study demonstrates associations between the prevalence of upper and lower airway disease in waste collectors. Notably, an underlying allergic disease in waste collectors could be suspected more commonly than previously reported.


Asunto(s)
Conjuntivitis/epidemiología , Tos/epidemiología , Enfermedades Profesionales/epidemiología , Rinitis/epidemiología , Adulto , Estudios Transversales , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Instalaciones de Eliminación de Residuos
10.
Can Commun Dis Rep ; 40(Suppl 2): 36-41, 2014 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-29769905

RESUMEN

This case study outlines the patterns of ciprofloxacin resistance in Campylobacter isolated from retail chicken meat in Canada. Campylobacter is the third most common cause of foodborne enteric illness in Canada; it usually causes a self-limited illness, but in some cases antimicrobials may be indicated. Ciprofloxacin (a fluoroquinolone) is an antimicrobial used to treat a number of infections in humans; other fluoroquinolones are used both therapeutically and prophylactically in livestock animals, including broiler chickens. The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) has been testing retail chicken meat samples across Canada for the presence of Campylobacter and for resistant strains since 2003. At the end of 2010, CIPARS documented that retail chicken meat samples in Canada contaminated with Campylobacter ranged from 36% in the Maritimes to 42% in British Columbia. Furthermore, levels of ciprofloxacin-resistant Campylobacter varied across the country, with higher percentages in British Columbia (17% in 2010) and Saskatchewan (11%), in comparison with lower percentages in Ontario (5%), Québec (2%, and the Maritimes (4%). In 2011 and 2012, resistance declined in British Columbia and Saskatchewan, but began to rise in Québec and Ontario. Recently, the Canadian poultry industry developed a policy to eliminate the preventive use of third generation cephalosporins and fluoroquinolones in broiler chickens (meat chickens) and broiler breeder chickens (chickens that produce the eggs that will become the broilers). CIPARS will continue to monitor trends in antimicrobial use and resistance following this industry intervention. By following good food preparation and hygiene practices, Canadians can reduce the risks of developing a Campylobacter infection (resistant or susceptible) from retail chicken.

11.
Epidemiol Infect ; 141(12): 2536-46, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23472612

RESUMEN

A population-based study investigated the burden of illness, including the duration of illness associated with laboratory-confirmed cases of campylobacteriosis in two health unit areas. Questionnaire data were collected for 250 cases. The median duration of illness was 8 days and 66% of cases reported symptoms of moderate severity or greater. A Cox proportional hazards model identified antimicrobial use factors associated with a significantly increased rate of symptom resolution (shorter duration of illness): macrolides for less than the recommended number of days, ciprofloxacin for at least 3 days, and antimicrobials not recommended for campylobacteriosis. The impact of antimicrobial use was consistent regardless of when, during the course of illness, the antimicrobial use began. The effectiveness of ciprofloxacin in these results may be due to the low prevalence of resistance to ciprofloxacin in isolates from this study. The effect of antimicrobials not recommended for campylobacteriosis should be further investigated.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Campylobacter/tratamiento farmacológico , Infecciones por Campylobacter/epidemiología , Costo de Enfermedad , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
12.
Zoonoses Public Health ; 57 Suppl 1: 71-84, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21083820

RESUMEN

In 2006, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) Farm Program was implemented in sentinel grower-finisher swine herds in Québec, Ontario, Manitoba, Saskatchewan and Alberta. Herds were visited 1-3 times annually. Faecal samples were collected from pens of close-to-market (CTM) weight (>80 kg) pigs and antimicrobial use (AMU) data were collected via questionnaires. Samples were cultured for generic Escherichia coli and Salmonella and tested for antimicrobial susceptibility. This paper describes the findings of this program between 2006 and 2008. Eighty-nine, 115 and 96 herds participated in this program in 2006, 2007 and 2008 respectively. Over the 3 years, antimicrobial resistance (AMR) levels remained consistent. During this period, resistance to one or more antimicrobials was detected in 56-63% of the Salmonella spp. isolates and 84-86% of E. coli isolates. Resistance to five or more antimicrobials was detected in 13-23% of Salmonella and 12-13% of E. coli. Resistance to drugs classified as very important to human health (Category I) by the Veterinary Drug Directorate (VDD), Health Canada, was less than or equal to 1% in both organisms. AMU data were provided by 100 herds in 2007 and 95 herds in 2008. Nine herds in 2007 and five herds in 2008 reported no AMU. The most common route of antimicrobial administration (75-79% of herds) was via feed, predominantly macrolides/lincosamides (66-68% of herds). In both 2007 and 2008, the primary reasons given for macrolide/lincosamide use were disease prevention, growth promotion and treatment of enteric disease. The Category I antimicrobials, ceftiofur and virginiamycin were not used in feed or water in any herds in 2008, but virginiamycin was used in feed in two herds in 2007. Parenteral ceftiofur was used in 29 herds (29%) in 2007 and 20 herds (21%) in 2008. The reasons for ceftiofur use included treatment of lameness, respiratory disease and enteric disease.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/veterinaria , Escherichia coli/efectos de los fármacos , Infecciones por Salmonella/tratamiento farmacológico , Salmonella/efectos de los fármacos , Enfermedades de los Porcinos/tratamiento farmacológico , Animales , Canadá , Farmacorresistencia Bacteriana Múltiple , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/microbiología , Heces/microbiología , Humanos , Pruebas de Sensibilidad Microbiana/veterinaria , Vigilancia de la Población , Salmonella/aislamiento & purificación , Infecciones por Salmonella/microbiología , Porcinos , Enfermedades de los Porcinos/microbiología
13.
Zoonoses Public Health ; 56(9-10): 477-89, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19175572

RESUMEN

Literature reviews are important information sources for multiple stakeholders in zoonotic public health with limited time to keep up with the rapid increase in primary research in this field. However, their validity depends on their methodological soundness. The study purpose was to evaluate the methodological soundness of literature reviews in zoonotic public health. Relevant reviews (n = 132) published between January 2000 and August 2006 were identified on three issues: Mycobacterium avium ssp paratuberculosis as a potential cause of Crohn's disease in humans (30 reviews); antimicrobial use in animals as a risk factor for antimicrobial resistance in human pathogens (36); and the zoonotic potential of transmissible spongiform encephalopathies (66). The zoonotic aspect of the issue was the focus of 59 reviews and a subsection of 73 reviews. Two independent reviewers evaluated reviews using 13 criteria: 10 previously validated in the medical field, and three applicable to aetiology research. No review met more than eight of 13 criteria for methodological soundness; two articles met only one criterion. Two reviews described methods for identifying relevant primary research. In only two and four reviews respectively, authors conducted quantitative syntheses of research evidence or reported summarized measures of effect for the zoonotic risk to humans. Recommendations for future research and economic impact were provided in 64 and 10 reviews respectively. In 14 reviews, conclusions exceeded evidence presented. The various review authors' position on the evidence for the zoonotic association and the zoonotic risk to public health were inconsistent for all three issues. Reviews addressing potential zoonotic public health issues lack structured and transparent methodology preventing the end user from assessing the review's validity. These reviews should adhere to structured scientific principles similar to what is used for primary research articles.


Asunto(s)
Salud Pública , Literatura de Revisión como Asunto , Zoonosis , Animales , Farmacorresistencia Bacteriana , Microbiología de Alimentos , Humanos , Infecciones por Mycobacterium/microbiología , Infecciones por Mycobacterium/transmisión , Enfermedades por Prión/transmisión , Política Pública , Factores de Tiempo
14.
Trials ; 7: 27, 2006 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-16948853

RESUMEN

BACKGROUND: Annually, more than 90000 surgical procedures of the thyroid gland are performed in Germany. Strategies aimed at reducing the duration of the surgical procedure are relevant to patients and the health care system especially in the context of reducing costs. However, new techniques for quick and safe hemostasis have to be tested in clinically relevance randomized controlled trials before a general recommendation can be given. The current standard for occlusion of blood vessels in thyroid surgery is ligatures. Vascular clips may be a safe alternative but have not been investigated in a large RCT. METHODS/DESIGN: CLIVIT (Clips versus Ligatures in Thyroid Surgery) is an investigator initiated, multicenter, patient-blinded, two-group parallel relevance randomized controlled trial designed by the Study Center of the German Surgical Society. Patients scheduled for elective resection of at least two third of the gland for benign thyroid disease are eligible for participation. After surgical exploration patients are randomized intraoperatively into either the conventional ligature group, or into the clip group. The primary objective is to test for a relevant reduction in operating time (at least 15 min) when using the clip technique. Since April 2004, 121 of the totally required 420 patients were randomized in five centers. DISCUSSION: As in all trials the different forms of bias have to be considered, and as in this case, a surgical trial, the role of surgical expertise plays a key role, and will be documented and analyzed separately. This is the first randomized controlled multicenter relevance trial to compare different vessel occlusion techniques in thyroid surgery with adequate power and other detailed information about the design as well as framework. If significant, the results might be generalized and may change the current surgical practice.

15.
BMC Ophthalmol ; 5: 8, 2005 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-15813972

RESUMEN

BACKGROUND: Fundus autofluorescence (AF) imaging using confocal scanning laser ophthalmoscopy (cSLO) provides an accurate delineation of areas of geographic atrophy (GA). Automated computer-assisted methods for detecting and removing interfering vessels are needed to support the GA quantification process in longitudinal studies and in reading centres. METHODS: A test tool was implemented that uses region-growing techniques to segment GA areas. An algorithm for illuminating shadows can be used to process low-quality images. Agreement between observers and between three different methods was evaluated by two independent readers in a pilot study. Agreement and objectivity were assessed using the Bland-Altman approach. RESULTS: The new method (C) identifies vascular structures that interfere with the delineation of GA. Results are comparable to those of two commonly used procedures (A, B), with a mean difference between C and A of -0.67 mm2 (95% CI [-0.99, -0.36]), between B and A of -0.81 mm2, (95% CI [-1.08, -0.53]), and between C and B of 0.15 mm2 (95% CI [-0.12, 0.41]). Objectivity of a method is quantified by the mean difference between observers: A 0.30 mm2 (95% CI [0.02, 0.57]), B -0.11 mm2 (95% CI [-0.28, 0.10]), and C 0.12 mm2 (95% CI [0.02, 0.22]). CONCLUSION: The novel procedure is comparable with regard to objectivity and inter-reader agreement to established methods of quantifying GA. It considerably speeds up the lengthy measurement process in AF with well defined GA zones.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Degeneración Macular/diagnóstico , Oftalmoscopía/métodos , Epitelio Pigmentado Ocular/patología , Algoritmos , Atrofia , Fluorescencia , Fondo de Ojo , Humanos , Rayos Láser , Variaciones Dependientes del Observador , Epitelio Pigmentado Ocular/irrigación sanguínea , Proyectos Piloto , Reproducibilidad de los Resultados
16.
Clin Diagn Lab Immunol ; 8(6): 1213-9, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11687465

RESUMEN

Swine hepatitis E virus is a newly identified potentially zoonotic virus from pigs of particular concern for possible direct transmission to a human xenotransplant recipient by organ transplantation. In the present study, prevalence of serum antibodies to hepatitis E virus was examined in Canadian swine herds. A total of 998 serum samples collected from 6-month-old healthy slaughter hogs were examined by enzyme immunoassay and Western blot analysis for antibodies to the recombinant open reading frame 3 (ORF3) protein of hepatitis E virus expressed in Escherichia coli. These samples represented more than 80 different swine production units from five major swine-producing provinces across Canada. From this study, 594 samples (59.4%) were found to be positive for hepatitis E virus antibody. The seroprevalence was higher in Quebec (88.8%) and Ontario (80.1%) than in Alberta and Saskatchewan (38.3%). By PCR using a pair of oligonucleotide primers deduced from the ORF2 sequence of human hepatitis E virus, a specific hepatitis E virus sequence was recovered from feces of pigs. The nucleotide sequence identity between the U.S. swine hepatitis E virus and the Canadian isolate (SK3) was only 85.8%, suggesting that genotypic variations may exist in swine hepatitis E virus in North America. Among 165 serum samples collected from humans in Saskatchewan, 2.4% were found to be positive for antibodies to the hepatitis E virus ORF3 protein. Our data indicate that hepatitis E virus is highly prevalent in commercial swine populations in Canada and support the suggestion that the swine hepatitis E virus may be an important zoonotic agent for humans.


Asunto(s)
Virus de la Hepatitis E/inmunología , Hepatitis E/epidemiología , Enfermedades de los Porcinos/epidemiología , Animales , Anticuerpos Antivirales/sangre , Secuencia de Bases , Canadá/epidemiología , Reacciones Cruzadas , Regulación Viral de la Expresión Génica , Genotipo , Hepatitis E/inmunología , Virus de la Hepatitis E/clasificación , Virus de la Hepatitis E/genética , Humanos , Datos de Secuencia Molecular , Filogenia , Estudios Seroepidemiológicos , Porcinos , Enfermedades de los Porcinos/inmunología , Enfermedades de los Porcinos/virología , Proteínas Virales/genética , Proteínas Virales/inmunología , Zoonosis
17.
J Physiol ; 453: 69-96, 1992.
Artículo en Inglés | MEDLINE | ID: mdl-1281507

RESUMEN

1. Light-induced currents were measured in Limulus ventral nerve photoreceptors using a two-electrode voltage clamp. Three kinetically distinct components in the light-induced current could be distinguished by varying the light adaptation state of the photoreceptor and the intensity of the stimulus light. 2. The components could be partly separated by choosing appropriate stimulus intensities and dark adaptation time. Thus the properties of the components could be separately studied. The first component is the first to recover after a light adaptation, appears temporally first in the light-induced response, has the lowest activation threshold and is the smallest. The second component needs a longer time to recover after an adapting illumination and its kinetics differ from that of the other components. Applying a bright stimulus to a dark-adapted cell a third component can be observed late in the response. 3. The time to peak of the first and the third components depended on the stimulus intensity, but not on the dark adaptation time. The time to peak of the second component became shorter the longer the dark adaptation time. For a constant adaptation state the time to the maximum of component 2 was independent, but those of components 1 and 3 were dependent on the membrane voltage. 4. To exclude the possibility of the contribution of voltage-gated currents, light-activated currents were measured at clamp potentials more negative than -50 mV after adding 4-aminopyridine into the bath solution or injecting tetraethyl-ammonium chloride into the cell. The properties of the three components remained unchanged under these conditions. 5. The I-V curve of the first component was flat at negative membrane potentials and had a strong outward rectification at positive membrane potentials. The I-V curve of component 3 showed a negative resistance at potentials more negative than about -30 mV. In contrast, the I-V curve for the second component was always nearly linear. 6. No membrane potential was found where the light-induced current was zero. Instead, current traces close to the reversal potential showed a complex waveform indicating different reversal potentials for the three components. 7. The results indicate that the current components are caused by three different populations of light-sensitive channels. The different activations, deactivations and recovery kinetics of the components suggest that the three types of channels are activated by distinct intracellular transmitters.


Asunto(s)
Cangrejos Herradura/fisiología , Canales Iónicos/fisiología , Células Fotorreceptoras/fisiología , 4-Aminopiridina/farmacología , Adaptación Ocular/fisiología , Animales , Electrofisiología , Activación del Canal Iónico/efectos de los fármacos , Luz , Potenciales de la Membrana , Tetraetilamonio , Compuestos de Tetraetilamonio/farmacología
18.
J Physiol ; 433: 467-82, 1991 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-1841953

RESUMEN

1. Limulus ventral photoreceptors were injected with Arsenazo III and the internal change in the calcium concentration, [Ca2+]i, was measured under voltage clamp conditions. It is shown that in response to a light flash the rising phase of the [Ca2+]i is independent of the clamp voltage, Vm. This observation is contrary to other results reported in the literature. Experiments are reported that resolve this contradiction (see paragraph 4). 2. The relaxation of the [Ca2+]i after a bright light flash was observed to have a fast and slow phase. A function consisting of the sum of an exponential and a ramp was fitted to the relaxation. The fast phase, characterized by the time constant of the exponential, was observed not to depend on Vm, while the slow phase, characterized by the slope of the ramp, was strongly dependent on Vm. Furthermore the slope of the slow phase is shown to depend on the external Na+ concentration, but not the time constant of the fast phase. 3. In the dark the [Ca2+]i was observed to increase when the cell was depolarized and to decrease when the cell was hyperpolarized. This observation was more pronounced when the cell was continuously illuminated. 4. When the cell was clamped to a depolarizing voltage before illumination of the cell, the maximum of the calcium indicator signal was observed to depend on how long the cell had been clamped before applying the light stimulus. This experiment resolves the contradiction mentioned in paragraph 1. 5. The results presented here are consistent with the interpretation that a Na(+)-Ca2+ exchanger with a stoichiometry greater than 2:1 is the predominant link between intra- and extracellular calcium. Secondly that the light-induced intracellular calcium increase comes from a release by intracellular stores. Finally a measurable uptake of calcium occurs after a light-induced release, possibly by the internal calcium stores. The two-phase recovery of [Ca2+]i after a light flash is interpreted as being a calcium uptake by the internal stores, the fast phase, and removal by the electrogenic Na(+)-Ca2+ exchanger, the slow phase.


Asunto(s)
Calcio/metabolismo , Proteínas Portadoras/metabolismo , Cangrejos Herradura/metabolismo , Células Fotorreceptoras/metabolismo , Animales , Arsenazo III , Espacio Extracelular/metabolismo , Técnicas In Vitro , Líquido Intracelular/metabolismo , Transporte Iónico , Luz , Potenciales de la Membrana , Células Fotorreceptoras/efectos de la radiación , Sodio/metabolismo , Intercambiador de Sodio-Calcio
19.
Can Vet J ; 31(6): 433-6, 1990 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17423605

RESUMEN

Two trials were performed to evaluate the efficacy of prostaglandins administered via the vulvomucosal route at one-half the recommended dosage in comparison to prostaglandins injected intramuscularly (IM) at the standard dosage. In trial 1, sows on three commercial swine farms were given prostaglandin F2alpha at a dosage of 10 mg IM (n = 110) or 5 mg prostaglandin F2alpha using a vulvomucosal injection (n = 94). The numbers of sows farrowing within 36 h postinjection were 92 (84%) and 83 (88%), respectively. In trial 2, sows on four commercial swine operations were induced to farrow by means of one of three treatments: cloprostenol 175 mug IM (n = 71); cloprostenol 87.5 mug vulvomucosally (n = 57); or prostaglandin F2alpha 5 mg vulvomucosally (n = 96). The numbers of sows farrowing within 36 h postinduction were 69 (97%), 53 (93%), and 91 (94%), respectively.Vulvomucosal injections of prostaglandin F2alpha and cloprostenol at one-half the dosage appeared to be as effective as intramuscular injections of prostaglandin F2alpha and cloprostenol at the recommended level. There were fewer sows demonstrating restless behavior following the injection of lower dosages of prostaglandin F2alpha vulvomucosally, compared to sows given the recommended dosage of prostaglandin F2alpha IM.

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