Validation of the bag-mediated filtration system for environmental surveillance of poliovirus in Nairobi, Kenya.

AIMS: This study compared the bag-mediated filtration system (BMFS) and standard WHO two-phase separation methods for poliovirus (PV) environmental surveillance, examined factors impacting PV detection and monitored Sabin-like (SL) PV type 2 presence with withdrawal of oral polio vaccine type 2 (OPV2) in April 2016. METHODS AND RESULTS: Environmental samples were collected in Nairobi, Kenya (Sept 2015-Feb 2017), concentrated via BMFS and two-phase separation methods, then assayed using the WHO PV isolation algorithm and intratypic differentiation diagnostic screening kit. SL1, SL2 and SL3 were detected at higher rates in BMFS than two-phase samples (P < 0·05). In BMFS samples, SL PV detection did not significantly differ with volume filtered, filtration time or filter shipment time (P > 0·05), while SL3 was detected less frequently with higher shipment temperatures (P = 0·027). SL2 was detected more frequently before OPV2 withdrawal in BMFS and two-phase samples (P < 1 × 10-5 ). CONCLUSIONS: Poliovirus was detected at higher rates with the BMFS, a method that includes a secondary concentration step, than using the standard WHO two-phase method. SL2 disappearance from the environment was commensurate with OPV2 withdrawal. SIGNIFICANCE AND IMPACT OF THE STUDY: The BMFS offers comparable or improved PV detection under the conditions in this study, relative to the two-phase method.

Terapia ocupacional: profesión idónea dentro de las estrategias de orientación vocacional en la educación media: revisión de literatura / Occupational therapy: ideal profession inside the strategies of vocational guidance in the secondary education: literature review

La orientación vocacional es reconocida como un proceso dinámico, dirigido al conocimiento de aspectos personales para elegir una profesión, guiado por un profesional. Objetivo: Identificar las estrategias implementadas en los programas de orientación vocacional y los aportes que puede realizar el terapeuta ocupacional. Metodología: Se exponen publicaciones dadas en el período 2000 al 2015, presentes en bases de datos electrónicas como ScienceDirect, EBSCOhost, Proquest y Scopus. Resultados: Se hallaron 1059 artículos durante la búsqueda inicial, nueve de ellos cumplieron con los criterios de inclusión y exclusión establecidos. Conclusión: Se identifica el componente teórico y normativo de la terapia ocupacional y su importancia en la participación de los programas de orientación vocacional en la educación media.

Vocational guidance are recognized as a dynamic process, directed to knowledge of personal aspects to choose a profession, guided by a professional. Objective: To identify the strategies implemented in the programs of vocational guidance and the contributions that can make the Occupational Therapist. Methodology: Publications given in the period 2000 to 2015 are presented in electronic databases such as ScienceDirect, EBSCOhost, Proquest and Scopus. Results: They were found 1059 articles during the initial search, 9 of them met the inclusion and exclusion criteria established. Conclusion: Identifies the theoretical component and normative of the Occupational Therapy and its importance in the participation of vocational guidance programs in secondary education.

Deterioro cognitivo: a propósito de un caso / Cognitive impairment: a case presentation

El deterioro cognitivo es una afección cada vez más frecuente en las consultas de atención primaria y no en todos se debe a enfermedad de Alzheimer o demencia vascular. Entre otras posibilidades diagnósticas, la hidrocefalia normotensiva o hidrocefalia crónica del adulto puede manifestarse de esta forma. Se presenta a continuación un caso clínico de hidrocefalia normotensiva, entidad que se caracteriza por una tríada típica: trastornos de la marcha, demencia e incontinencia urinaria. Con este caso queremos llamar la atención sobre un tipo de deterioro cognitivo que puede ser mejorable si la derivación ventricular es efectiva (AU)

Cognitive impairment is becoming increasingly more common in primary care, and not all is due to Alzheimer's disease or Vascular Dementia. Other diagnostic possibilities, such as normotensive hydrocephalus or chronic adult hydrocephalus also have very similar signs. A clinical case of normotensive hydrocephalus is presented, a condition that is characterised by a typical triad: Gait disturbance, dementia and urinary incontinence (AU)

An automated genotyping tool for enteroviruses and noroviruses.

BACKGROUND: Molecular techniques are established as routine in virological laboratories and virus typing through (partial) sequence analysis is increasingly common. Quality assurance for the use of typing data requires harmonization of genotype nomenclature, and agreement on target genes, depending on the level of resolution required, and robustness of methods. OBJECTIVE: To develop and validate web-based open-access typing-tools for enteroviruses and noroviruses. STUDY DESIGN: An automated web-based typing algorithm was developed, starting with BLAST analysis of the query sequence against a reference set of sequences from viruses in the family Picornaviridae or Caliciviridae. The second step is phylogenetic analysis of the query sequence and a sub-set of the reference sequences, to assign the enterovirus type or norovirus genotype and/or variant, with profile alignment, construction of phylogenetic trees and bootstrap validation. Typing is performed on VP1 sequences of Human enterovirus A to D, and ORF1 and ORF2 sequences of genogroup I and II noroviruses. For validation, we used the tools to automatically type sequences in the RIVM and CDC enterovirus databases and the FBVE norovirus database. RESULTS: Using the typing-tools, 785(99%) of 795 Enterovirus VP1 sequences, and 8154(98.5%) of 8342 norovirus sequences were typed in accordance with previously used methods. Subtyping into variants was achieved for 4439(78.4%) of 5838 NoV GII.4 sequences. DISCUSSION AND CONCLUSIONS: The online typing-tools reliably assign genotypes for enteroviruses and noroviruses. The use of phylogenetic methods makes these tools robust to ongoing evolution. This should facilitate standardized genotyping and nomenclature in clinical and public health laboratories, thus supporting inter-laboratory comparisons.

High degree of genetic diversity of non-polio enteroviruses identified in Georgia by environmental and clinical surveillance, 2002-2005.

Enterovirus surveillance data are useful for establishing temporal and geographical patterns of circulation and for virus characterization to determine phylogenetic relationships between strains. Almost no information is available on circulating enteroviruses in Georgia and the surrounding region. To describe enterovirus circulation in Georgia, determine relationships with previously characterized strains and assess the role of environmental and clinical enterovirus surveillance, this study analysed a total of 112 non-polio enterovirus isolates identified during 2002-2005 from sewage and human stool samples. Viruses were isolated in cell culture using standard methods and typed by partial sequencing of the VP1 gene. A total of 20 different non-polio enterovirus serotypes were identified over the 4-year period. The most commonly detected enteroviruses included echovirus (E) 6 (21 isolates; 18.8 %), E20, E3 and E7 (11 isolates each; 9.8 %), E11, coxsackievirus (CV) B4 and CVB5 (seven isolates each; 6.3 %), and E13, E19 and E30 (six isolates each; 5.4 %). Phylogenetic analysis showed that many serotypes were represented by more than one genetic lineage. The present study showed a very high degree of enterovirus diversity in Georgia and demonstrated the added value of environmental enterovirus surveillance, particularly in settings with limited clinical surveillance. Several serotypes would not have been detected without having both clinical and environmental surveillance in place. Several serotypes detected in Georgia were among those rarely reported in the USA and Europe (e.g. E3, E20 and E19). As the emergence of new genetic lineages of enterovirus in a particular area is often associated with large-scale outbreaks, continued monitoring of enterovirus strains by both environmental and clinical surveillance and genetic characterization should be encouraged.

Otitis media con efusión / Otitis media with effusion

La Otitis Media con Efusión, (OME) es un proceso inflamatorio crónico del espacio del oído medio caracterizado por la acumulación de líquido seroso o mucoide, en ausencia de signos o síntomas de enfermedad aguda como fiebre o dolor. El objetivo del capítulo es presentar una revisión de la evidencia disponible relacionada con la epidemiología, etiología, diagnóstico clínico y tratamientos médicos y quirúrgicos para ayudar en la toma de decisiones frente al paciente.

The Otitis Media with Effusion, (OME) is a chronic inflammatory process of the space of the middle ear, characterized by the accumulation of serous liquid or mucoide secretion, in the absence of signs or symptoms of acute disease like fever or pain. The objective of the chapter is to present a revision of the evidence available related to epidemiology, aetiology, clinical diagnosis and medical and surgical treatments to help in the decision making in front of the patient.

Otitis media aguda / Acute otitis media

La Otitis Media Aguda, (OMA), es una inflamación aguda del espacio del oído medio. Se caracteriza por la acumulación de líquido o secreción purulenta. Es la enfermedad más frecuente en niños, para la cual se usan antibióticos. Se presenta la revisión de la mejor evidencia disponible relacionada con la epidemiología, etiología, diagnóstico clínico y el tratamiento médico y quirúrgico.

The Acute Otitis Media, (AOM), is an acute inflammation of the space of the middle ear. It is characterized by the accumulation of serous or purulent secretion. It is the most frequent disease in children for which antibiotics are used. This is a revision of the best evidence available related to epidemiology, aetiology, clinical diagnosis and the medical and surgical treatment.

Depresión y enfermedades somáticas / Depression and somatic diseases

No disponible

No disponible

Xeroderma pigmentoso.Dos casos más en España / Xeroderma pigmentosum

No disponible

Serotype-specific identification of polioviruses by PCR using primers containing mixed-base or deoxyinosine residues at positions of codon degeneracy.

We have developed a method for determining the serotypes of poliovirus isolates by PCR. Three sets of serotype-specific antisense PCR-initiating primers (primers seroPV1A, seroPV2A, and seroPV3A) were designed to pair with codons of VP1 amino acid sequences that are conserved within but that differ across serotypes. The sense polarity primers (primers seroPV1S, seroPV2S, and seroPV3S) matched codons of more conserved capsid sequences. The primers contain mixed-base and deoxyinosine residues to compensate for the high rate of degeneracy of the targeted codons. The serotypes of all polioviruses tested (48 vaccine-related isolates and 110 diverse wild isolates) were correctly identified by PCR with the serotype-specific primers. None of the genomic sequences of 49 nonpolio enterovirus reference strains were amplified under equivalent reaction conditions with any of the three primer sets. These primers are useful for the rapid screening of poliovirus isolates and for determining the compositions of cultures containing mixtures of poliovirus serotypes.

Comparison of a monoclonal antibody-based IgM capture ELISA with a neutralization assay for assessing response to trivalent oral poliovirus vaccine.

Monoclone-based IgM capture ELISAs were developed for each of the three poliovirus serotypes and compared with a neutralization assay for detecting response to trivalent oral poliovirus vaccine among 224 infants. The IgM-based response rates were significantly higher than the neutralizing antibody-based rates: 95% versus 83% to poliovirus type 1, 99% versus 94% to poliovirus type 2, and 89% versus 59% to poliovirus type 3. IgM responses to the first vaccine dose were significantly associated between serotypes, suggesting that some of the discordance may reflect a heterotypic IgM response. When the response rates in 4 vaccine formulation groups were compared, group differences using the two assays were similar for poliovirus types 1 and 2 but not for type 3. Therefore, IgM results using these assays may not be adequate substitutes for neutralizing antibody results when determining vaccine response.