Social networks as education strategies for indigenous patients with rheumatoid arthritis during COVID-19 pandemic. Are they useful?

INTRODUCTION: The use of online education strategies has been introduced as a tool to support health care in patients with rheumatic disease. However, it is important to consider the patient's sociocultural environment. OBJECTIVE: To design and assessment of bilingual audiovisual material acceptability, by means of two social networks, for patients with rheumatoid arthritis (RA) in the qom community in Argentina. METHODS: A qualitative study was performed in two stages: (1) audiovisual material design, development, and validation implementing a collaborative action research method. (2) Publishing of the material on two social networks at two different times. The selected topic was the coronavirus disease 2019 impact on patients with RA. A qualitative and quantitative data analysis was performed. RESULTS: Forty subjects participated into the initial validation stage with a 70% acceptance rate. First, 28 subjects (70%) participated on Facebook and 25 (62.5%) joined the WhatsApp group. Then, the same number of subjects participated on Facebook, while only 45% of subjects participated on WhatsApp. Most of them participated using short phrases such as "I like it." The 60% of the participants played the videos. However, less than 10% shared them. Videos in Spanish were the once most shared. Participation dramatically fell during the second time, and 40% of the WhatsApp subjects never participated. CONCLUSION: The strategies developed for this indigenous community were of no utility, probably because of socio-cultural, economic, and digital barriers. They should be designed and implemented identifying the target group and its environment. Key Points • Online education strategies should be designed with cultural sensitivity. • Technological barriers make digital inequality visible in vulnerable groups. • Educational interventions should have a collaborative design and they should be created together with the communities. • The COVID-19 pandemic has deepened inequalities in the health care and follow-up of patients with rheumatic diseases, especially between most socially and economically disadvantaged groups.

Effect of 5-Azacitidine Treatment on Redox Status and Inflammatory Condition in MDS Patients.

This study focused on the impact of the treatment with the hypomethylating agent 5-azacitidine on the redox status and inflammation in 24 MDS patients. Clinical and genetic features of MDS patients were recorded, and peripheral blood samples were used to determine the activity of the endogenous antioxidant defense system (superoxide dismutase, SOD; catalase, CAT; glutathion peroxidase, GPx; and reductase, GRd, activities), markers of oxidative damage (lipid peroxidation, LPO, and advanced oxidation protein products, AOPP). Moreover, pro-inflammatory cytokines and plasma nitrite plus nitrate levels as markers of inflammation, as well as CoQ10 plasma levels, were also measured. Globally, MDS patients showed less redox status in terms of a reduction in the GSSG/GSH ratio and in the LPO levels, as well as increased CAT activity compared with healthy subjects, with no changes in SOD, GPx, and GRd activities, or AOPP levels. When analyzing the evolution from early to advanced stages of the disease, we found that the GPx activity, GSSG/GSH ratio, LPO, and AOPP increased, with a reduction in CAT. GPx changes were related to the presence of risk factors such as high-risk IPSS-R or mutational score. Moreover, there was an increase in IL-2, IL-6, IL-8, and TNF-α plasma levels, with a further increase of IL-2 and IL-10 from early to advanced stages of the disease. However, we did not observe any association between inflammation and oxidative stress. Finally, 5-azacitidine treatment generated oxidative stress in MDS patients, without affecting inflammation levels, suggesting that oxidative status and inflammation are two independent processes.

Access to healthcare system of indigenous communities with musculoskeletal disorders and rheumatic disease in Chaco, Argentina: a qualitative study.

INTRODUCTION/OBJECTIVES: The objective of this study is to describe the local healthcare system from the perspective of the health professionals, community health workers, and local representatives of the qom community living in the province of Chaco, Argentina. METHODS: A qualitative study, with an ethnographic approach, was carried out using two techniques: non-participant observations and semi-structured interviews. A guide for the interviews was designed and developed by a multidisciplinary group of GLADERPO researchers. The main aspects included were the following: reference into the local healthcare system and accessibility to the system. Andersen's base conceptual model of health service utilization was applied for the analysis and for structuring the results. RESULTS: A total of 21 people were interviewed, twelve women and nine men with an age ranging between 25 and 60 years old. The main findings were different barriers (communication and cultural) between the community and the healthcare system; "navigation" within the health system carried out by the qom community; and migration and bureaucratization of the health system. CONCLUSIONS: These findings should be incorporated into educational strategies to improve access to healthcare system and adherence to medical treatment, establishing an interaction between the different levels of the local care system and providing community health workers with an appropriate training with the support of the community representatives. Key Points • The different barriers between the community and the healthcare system were described. • The "navigation" within the health system carried out by the qom community and the migration were relevant points. • The bureaucratization of the health system and the need to design and implement educational strategies in the future were highlighted.

Identificación fenotípica de cepas de Acinetobacter circulantes / Phenotypic identification of Acinetobacter circulating strains

Introducción: en la actualidad, a nivel mundial, las infecciones hospitalarias más graves incluyen a cepas de Acinetobacter resistentes a múltiples antibióticos.Objetivo: identificar desde el punto de vista fenotípico cepas de Acinetobacter spp y caracterizar su resistencia a los antibióticos. Métodos: estudio observacional analítico en una muestra de 60 cepas de Acinetobacter spp, de origen hospitalario, aisladas en el Hospital Militar Central Dr Luis Díaz Soto en el primer trimestre de 2014, las cuales se clasificaron en un primer momento según esquema de Bouvet y Grimont (modificado por Gemer-Smidt y otros). Posteriormente se les realizó prueba de sensibilidad a antimicrobianos con discos: piperacilina, piperacilina/tazobactam, cefoperazona, ceftriaxona, ceftazidima, cefepime, imipenem, meropenem, aztreonam, gentamicina, amikacina y ciprofloxacina; e-test: colimicina y por último, producción de biopelícula in vitro por técnica de slime-test. Resultados: la aplicación del esquema solo permitió identificar fenotípicamente a las cepas pertenecientes a la especie Acinetobacter baumannii (88,3 por ciento); en los casos restantes la identificación no fue conclusiva. El 51,6 por ciento de las cepas de Acinetobacter baumannii fue aislado en la Unidad de Cuidados Intensivos de adultos y el 46,6 por ciento a partir de secreciones bronquiales. La resistencia de las cepas de Acinetobacter baumannii fue mayor de 80 por ciento, lo que contrastó con la baja resistencia de las cepas “no baumannii”. Con la aplicación del E-test para colimicina en cepas de Acinetobacter baumannii se constató que el 90 por ciento de ellas fue inhibida a concentraciones inhibitorias mínimas ≤ 0,5 µg/mL. La totalidad de las cepas de Acinetobacter baumannii fueron productoras de biofilm. Conclusiones: la cepa de Acinetobacter baumannii constituye uno de los microorganismos más aislados en el hospital en pacientes graves, con una resistencia bacteriana importante, excepto para colimicina(AU)

Introduction: currently, worldwide, the most serious hospital infections include Acinetobacter strains resistant to multiple antibiotics. Objective: phenotypically identify Acinetobacter spp and characterize their resistance to antibiotics. Methods: an observational study was conducted in a sample of 60 Acinetobacter spp strains of hospital waste origin, which were isolated in Dr. Luis Díaz Soto central military hospital in 2014 first quarter. These strains were initially classified according to Bouvet and Grimont scheme (modified by Gemer-Smidt and others). Subsequently these strains underwent antimicrobial susceptibility testing with disks: piperacillin, piperacillin/ tazobactam, cefoperazone, ceftriaxone, ceftazidime, cefepime, imipenem, meropenem, aztreonam, gentamicin, amikacin and ciprofloxacin; E-test: colimycin and finally, in vitro biofilm production by slime-test technique. Results: the implementation of this scheme only allowed to phenotypically identify Acinetobacter baumannii strains (88.3 percent); in other cases the identification was not conclusive. 51.6 percent of Acinetobacter baumannii strains was isolated in the adult intensive care unit and 46.6 percent from bronchial secretions. Acinetobacter baumannii resistance was 80 percent higher, which contrasted with the no-baumannii strains low resistance. The e-test implementation for colimycin in Acinetobacter baumannii strains found 90 percent inhibited at minimum inhibitory concentrations ≤ 0.5 Ág/mL. All Acinetobacter baumannii strains were biofilm producing. Conclusions: Acinetobacter baumannii strain is one of the most isolated microorganisms in critical patients in hospital, with significant bacterial resistance, except for colimycin(AU)

Identificación fenotípica de cepas de acinetobacter circulantes / Phenotypic identification of acinetobacter circulating strains

INTRODUCCIÓN: en la actualidad, a nivel mundial, las infecciones hospitalarias más graves incluyen a cepas de Acinetobacter resistentes a múltiples antibióticos. OBJETIVO: identificar desde el punto de vista fenotípico cepas de Acinetobacter spp y caracterizar su resistencia a los antibióticos. MÉTODOS: estudio observacional analítico en una muestra de 60 cepas de Acinetobacter spp, de origen hospitalario, aisladas en el Hospital Militar Central "Dr. Luis Díaz Soto" en el primer trimestre de 2014, las cuales se clasificaron en un primer momento según esquema de Bouvet y Grimont (modificado por Gemer-Smidt y otros). Posteriormente se les realizó prueba de sensibilidad a antimicrobianos con discos: piperacilina, piperacilina/tazobactam, cefoperazona, ceftriaxona, ceftazidima, cefepime, imipenem, meropenem, aztreonam, gentamicina, amikacina y ciprofloxacina; e-test: colimicina y por último, producción de biopelícula in vitro por técnica de slime-test. RESULTADOS: la aplicación del esquema solo permitió identificar fenotípicamente a las cepas pertenecientes a la especie Acinetobacter baumannii (88,3 %); en los casos restantes la identificación no fue conclusiva. El 51,6 % de las cepas de Acinetobacter baumannii fue aislado en la Unidad de Cuidados Intensivos de adultos y el 46,6 % a partir de secreciones bronquiales. La resistencia de las cepas de Acinetobacter baumannii fue mayor de 80 %, lo que contrastó con la baja resistencia de las cepas "no baumannii". Con la aplicación del E-test para colimicina en cepas de Acinetobacter baumannii se constató que el 90 % de ellas fue inhibida a concentraciones inhibitorias mínimas ≤ 0,5 µg/mL. La totalidad de las cepas de Acinetobacter baumannii fueron productoras de biofilm. CONCLUSIONES: la cepa de Acinetobacter baumannii constituye uno de los microorganismos más aislados en el hospital en pacientes graves, con una resistencia bacteriana importante, excepto para colimicina.

INTRODUCTION: currently, worldwide, the most serious hospital infections include Acinetobacter strains resistant to multiple antibiotics. OBJECTIVE: phenotypically identify Acinetobacter spp and characterize their resistance to antibiotics. METHODS: an observational study was conducted in a sample of 60 Acinetobacter spp strains of hospital waste origin, which were isolated in Dr. Luis Díaz Soto central military hospital in 2014 first quarter. These strains were initially classified according to Bouvet and Grimont scheme (modified by Gemer-Smidt and others). Subsequently these strains underwent antimicrobial susceptibility testing with disks: piperacillin, piperacillin/tazobactam, cefoperazone, ceftriaxone, ceftazidime, cefepime, imipenem, meropenem, aztreonam, gentamicin, amikacin and ciprofloxacin; E-test: colimycin and finally, in vitro biofilm production by slime-test technique. RESULTS: the implementation of this scheme only allowed to phenotypically identify Acinetobacter baumanniistrains (88.3 %); in other cases the identification was not conclusive. 51.6 % of Acinetobacter baumannii strains was isolated in the adult intensive care unit and 46.6 % from bronchial secretions. Acinetobacter baumanniiresistance was 80 % higher, which contrasted with the no-baumannii strains low resistance. The e-test implementation for colimycin in Acinetobacter baumannii strains found 90 % inhibited at minimum inhibitory concentrations ≤ 0.5 µg/mL. All Acinetobacter baumannii strains were biofilm producing. CONCLUSIONS: Acinetobacter baumannii strain is one of the most isolated microorganisms in critical patients in hospital, with significant bacterial resistance, except for colimycin.

Aislamiento de Estreptococo grupo B en muestras extragenitales en adultos: una localización emergente / Isolation of Group B Streptococcus in adult extragenital samples: an urgent localization

Se realizó una investigación para identificar la presencia del Estreptococo grupo B (EGB) en pacientes adultos, a partir de muestras de origen extragenital no asociadas con estado de gestación. Para la identificación del microorganismo se utilizó un esquema clásico que incluía las pruebas de factor CAMP y la hidrólisis del hipurato de sodio. Se probó la susceptibilidad in vitro a los antibióticos mediante el método de difusión con discos. Se procesaron 2 085 muestras, de las cuales se aislaron 50 cepas pertenecientes a Estreptococo grupo B, lo que representó 2,3 por ciento de aislamiento. La muestra que más aportó fue la lesión del miembro inferior (12; 24 por ciento). El 58 por ciento de las muestras procedían de pacientes extrahospitalarios, mientras que el resto correspondían a casos ingresados, sobre todo de sala de Angiología (6; 12 por ciento). Se comprobó la emergencia del Estreptococo grupo B como patógeno en localizaciones extragenitales en pacientes adultos.

Authors made a research to identify presence of Group B Streptococcus (EGB) in adult patients from samples of a extragenital origin non-associated with pregnancy. For identification of microorganism we used a classic scheme including tests of CAMP factor and hydrolysis of sodium Hypurate. Sensitivity to antibiotics by means of disc diffusion method was tested in vitro. A total of 2 085 samples were processed, from which it was possible to isolate 50 strains from Group B Streptococcus, representing a 2.3 percent of isolation. Sample with a greater contribution was lower limb lesion (12; 24 percent). Fifty eight percentage (58 percent) of samples came from extra-hospital patients and remainder was of admitted cases, mainly in Angiology service (6; 12 percent). Emergence of Group B Streptococcus as a pathogen in extragenital areas in adult patients was confirmed.

Aislamiento de Estreptococo grupo B en muestras extragenitales en adultos: una localización emergente / Isolation of Group B Streptococcus in adult extragenital samples: an urgent localization

Se realizó una investigación para identificar la presencia del Estreptococo grupo B (EGB) en pacientes adultos, a partir de muestras de origen extragenital no asociadas con estado de gestación. Para la identificación del microorganismo se utilizó un esquema clásico que incluía las pruebas de factor CAMP y la hidrólisis del hipurato de sodio. Se probó la susceptibilidad in vitro a los antibióticos mediante el método de difusión con discos. Se procesaron 2 085 muestras, de las cuales se aislaron 50 cepas pertenecientes a Estreptococo grupo B, lo que representó 2,3 por ciento de aislamiento. La muestra que más aportó fue la lesión del miembro inferior (12; 24 por ciento). El 58 por ciento de las muestras procedían de pacientes extrahospitalarios, mientras que el resto correspondían a casos ingresados, sobre todo de sala de Angiología (6; 12 por ciento). Se comprobó la emergencia del Estreptococo grupo B como patógeno en localizaciones extragenitales en pacientes adultos(AU)

Authors made a research to identify presence of Group B Streptococcus (EGB) in adult patients from samples of a extragenital origin non-associated with pregnancy. For identification of microorganism we used a classic scheme including tests of CAMP factor and hydrolysis of sodium Hypurate. Sensitivity to antibiotics by means of disc diffusion method was tested in vitro. A total of 2 085 samples were processed, from which it was possible to isolate 50 strains from Group B Streptococcus, representing a 2.3 percent of isolation. Sample with a greater contribution was lower limb lesion (12; 24 percent). Fifty eight percentage (58 percent) of samples came from extra-hospital patients and remainder was of admitted cases, mainly in Angiology service (6; 12 percent). Emergence of Group B Streptococcus as a pathogen in extragenital areas in adult patients was confirmed(AU)