Efecto de un tratamiento contextual para la regulación de la ira y la inflexibilidad psicológica en adultos jóvenes colombianos

Antecedentes: en la actualidad, son escasas las intervenciones para el manejo de la regulación problemática de la ira y la inflexibilidad psicológica en adultos jóvenes afectados. Objetivo: evaluar la eficacia de una intervención breve, en formato grupal y virtual para la regulación problemática de la ira y la reducción de la inflexibilidad psicológica. Método: un grupo de 40 adultos jóvenes colombianos (40% hombres; 60%mujeres; M = 25.3 años; DE = 3.35) fueron asignados aleatoriamente a una de dos condiciones: intervención basada en la terapia de aceptación y compromiso (ACT) para regulación de la ira y la reducción de la inflexibilidad psicológica y lista de espera. Se evaluaron la evitación experiencial, la fusión cognitiva, la conexión con el momento presente, los valores y la percepción de efectos de la expresión problemática de la ira. Resultados: se encontraron diferencias significativas contamaños de efecto grandes en las variables de evitación experiencial, defusión cognitiva, contacto con el momento presente y obstrucción en valores. Las variables de progreso en valores y percepción de efectos de la ira presentaron cambios en el grupo experimental, pero no en su comparación con el grupo control. Conclusión: los resultados aportaron evidencia sobre la eficacia de esta intervención, aunque se requieren más estudios que así lo confirmen. Palabras clave: terapia de aceptación y compromiso;regulación de la ira; inflexibilidad psicológica; adultos jóvenes;intervención virtual.

Background: At present, interventions for the management of problematic anger regulation and psychological inflexibility inaffected young adults are scarce. Objetive: to evaluate the efficacy of a brief intervention, in a group and virtual format, for anger regulation and psychological inflexibility reduction. Method: A group of 40 Colombian young adults (40% male; 60% female; M = 25.3 years; SD = 3.35) were randomly assigned to one of two conditions: Acceptance and Commitment Therapy-based intervention for anger regulation andpsychological inflexibility reduction and waiting list. Experiential avoidance, cognitive fusion, connection to thepresent moment, values, and perception of negative effects of problematic anger expression were assessed. Results: Significant differences with large effect sizes were found in the experiential avoidance, cognitive defusion, contact with the present moment, and obstruction in values variables. The variables of progressin values and perception of the effects of anger presented changes in the experimental group, but not in their comparison with the control group. Conclusions: the results provide devidence on the efficacy of this intervention, although more studies are required to confirm this. Keywords: Acceptance and Commitment Therapy; Angerregulation; Psychological inflexibility; Young adults; Virtualintervention.

Study of the Predictive Validity of the Burnout Granada Questionnaire in Police Officers.

Professionals with burnout have negative physical and psychological effects, with adverse consequences in their workplace. Burnout mainly affects assisting professions; amongst them, police work is one of the professions at risk of suffering from this syndrome. The aim of this research is to study the adequacy of the Maslach Burnout Inventory and Granada Burnout Questionnaire instruments to measure burnout in police officers through the study of the reliability and validity (concurrent and predictive) of these instruments. A cross-sectional study was carried out. The sample was composed of 1884 police officers, mostly men (85.4%), with an average age of 35.04 (SD = 8.30). The Maslach Burnout Inventory and Granada Burnout Questionnaire were used to measure burnout. The results obtained in this study support the adequacy of both instruments for measuring burnout. The correlation coefficients between the dimensions are significant, with a medium-high magnitude. Participants with burnout had significantly higher scores in emotional exhaustion and depersonalization and lower scores in personal accomplishment in both instruments. The area under the curve estimated for the Granada Burnout Questionnaire provided evidence of the predictive validity of the instrument. The police profession needs validated and sensitive tools to identify police changes in the dimensions of burnout. The Granada Burnout Questionnaire instrument correctly classifies burnout in police professionals.

Corrigendum: Genetic and Phenotypic Characterization of the Etiological Agent of Canine Orchiepididymitis Smooth Brucella sp. BCCN84.3.

[This corrects the article DOI: 10.3389/fvets.2019.00175.].

Genetic and Phenotypic Characterization of the Etiological Agent of Canine Orchiepididymitis Smooth Brucella sp. BCCN84.3.

Members of the genus Brucella cluster in two phylogenetic groups: classical and non-classical species. The former group is composed of Brucella species that cause disease in mammals, including humans. A Brucella species, labeled as Brucella sp. BCCN84.3, was isolated from the testes of a Saint Bernard dog suffering orchiepididymitis, in Costa Rica. Following standard microbiological methods, the bacterium was first defined as "Brucella melitensis biovar 2." Further molecular typing, identified the strain as an atypical "Brucella suis." Distinctive Brucella sp. BCCN84.3 markers, absent in other Brucella species and strains, were revealed by fatty acid methyl ester analysis, high resolution melting PCR and omp25 and omp2a/omp2b gene diversity. Analysis of multiple loci variable number of tandem repeats and whole genome sequencing demonstrated that this isolate was different from the currently described Brucella species. The smooth Brucella sp. BCCN84.3 clusters together with the classical Brucella clade and displays all the genes required for virulence. Brucella sp. BCCN84.3 is a species nova taxonomical entity displaying pathogenicity; therefore, relevant for differential diagnoses in the context of brucellosis. Considering the debate on the Brucella species concept, there is a need to describe the extant taxonomical entities of these pathogens in order to understand the dispersion and evolution.

Brucellosis in mammals of Costa Rica: An epidemiological survey.

Brucellosis has been an endemic disease of cattle and humans in Costa Rica since the beginning of XX century. However, brucellosis in sheep, goats, pigs, water buffaloes, horses and cetaceans, has not been reported in the country. We have performed a brucellosis survey in these host mammal species, from 1999-2016. In addition, we have documented the number of human brucellosis reported cases, from 2003-2016. The brucellosis seroprevalence in goat and sheep herds was 0.98% and 0.7% respectively, with no Brucella isolation. Antibodies against Brucella were not detected in feral or domestic pigs. Likewise, brucellosis seroprevalence in horse and water buffalo farms was estimated in 6.5% and 21.7%, respectively, with no Brucella isolation. Six cetacean species showed positive reactions against Brucella antigens, and B. ceti was isolated in 70% (n = 29) of striped dolphins (Stenella coeruleoalba). A steady increase in the diagnosis of human brucellosis cases was observed. Taking into account the prevalence of brucellosis in the various host mammals of Costa Rica, different measures are recommended.

Púrpura de Schonlein-Henoch con afectación peniana: Caso clínico / Henoch-Schonlein purpura involving the penis: A case report

La púrpura de Schonlein-Henoch es responsable de la mayoría de los casos de vasculitis sistémica en niños. La forma de presentación clásica se caracteriza por púrpura palpable, glomerulonefritis, artralgias y dolor abdominal. Aunque manifestaciones genitourinarias, como la afectación testicular y escrotal, han sido ampliamente descritas, otras, como la afectación peniana, son muy raras. Presentamos el caso de un varón de 6 años que consultó por presentar un exantema purpúrico en el glande, el prepucio y el cuerpo del pene, junto con edema doloroso en dicha región. En los tres días previos, había presentado una historia de fiebre, exantema purpúrico palpable en las nalgas y los miembros inferiores, y artralgia de la muñeca derecha. Fue ingresado con el diagnóstico de púrpura de Schonlein-Henoch con afectación peniana y se inició un tratamiento corticoideo oral (prednisona). A los dos días del inicio del tratamiento, se observó una notable mejoría de los síntomas.

Schonlein-Henoch purpura accounts for the majority of cases of systemic vasculitis in children. Classical presentation is characterized by palpable purpura, glomerulonephritis, arthralgias and abdominal pain. Although genitourinary manifestations, in form of testicular and scrotal involvement, have been widely described, penile involvement remains an extremely rare complication. We report a case of a 6-year-old boy who presented with purpuric rash on the glans, prepuce and penile shaft, with painful edema in the penile region. He also had a 3-days history of fever, palpable purpuric rash on the buttocks and lower extremities along with right wrist pain. He was admitted with the diagnosis of Schonlein-Henoch purpura with penile involvement. After 2 days on oral steroids therapy (prednisone) a marked improvement was observed.

[Henoch-Schonlein purpura involving the penis: a case report]. / Púrpura de Schonlein-Henoch con afectación peniana: caso clínico.

Schonlein-Henoch purpura accounts for the majority of cases of systemic vasculitis in children. Classical presentation is characterized by palpable purpura, glomerulonephritis, arthralgias and abdominal pain. Although genitourinary manifestations, in form of testicular and scrotal involvement, have been widely described, penile involvement remains an extremely rare complication. We report a case of a 6-year-old boy who presented with purpuric rash on the glans, prepuce and penile shaft, with painful edema in the penile region. He also had a 3-days history of fever, palpable purpuric rash on the buttocks and lower extremities along with right wrist pain. He was admitted with the diagnosis of Schonlein-Henoch purpura with penile involvement. After 2 days on oral steroids therapy (prednisone) a marked improvement was observed.

La púrpura de Schonlein-Henoch es responsable de la mayoría de los casos de vasculitis sistémica en niños. La forma de presentación clásica se caracteriza por púrpura palpable, glomerulonefritis, artralgias y dolor abdominal. Aunque manifestaciones genitourinarias, como la afectación testicular y escrotal, han sido ampliamente descritas, otras, como la afectación peniana, son muy raras. Presentamos el caso de un varón de 6 años que consultó por presentar un exantema purpúrico en el glande, el prepucio y el cuerpo del pene, junto con edema doloroso en dicha región. En los tres días previos, había presentado una historia de fiebre, exantema purpúrico palpable en las nalgas y los miembros inferiores, y artralgia de la muñeca derecha. Fue ingresado con el diagnóstico de púrpura de Schonlein-Henoch con afectación peniana y se inició un tratamiento corticoideo oral (prednisona). A los dos días del inicio del tratamiento, se observó una notable mejoría de los síntomas.

[Prevalence of serum antibodies for the bacterium Brucella sp. in a tropical human population]. / Prevalencia de anticuerpos séricos contra la bacteria Brucella sp. en una población humana tropical.

Prevalence of serum antibodies for the bacterium Brucella sp. in a tropical human population. Brucellosis is a systemic bacterial disease that can last years if not treated properly. The laboratory diagnosis is made by serological tests or isolation of the agent. We studied the prevalence of antibodies against Brucella sp. in inhabitants of rural communities of Cartago, Costa Rica, who are dedicated mainly to dairy cattle activities. We analyzed 714 representative samples with the Rose Bengal plate agglutination test (RBT) and the standard agglutination test in microplate (SAT). The overall prevalence was 0.87%. No seroconversion was demonstrated for seropositive individuals. Even though 71% of the population mentioned consuming non-pasteurized milk, no statistically significant association was found (1.09 %, IC 0.30-2.77) between milk consumption and the presence of antibodies suggestive of infection by Brucella sp. As a brucellosis high-risk population, the absence of symptoms in the population agrees with the observed titers of antibodies, suggesting a low previous exposure to the agent.

[Performance of Cholera-SMART and Pathogen-Detection-Kit in the quick diagnosis of cholera]. / Desempeño de los sistemas Cholera-SMART y Pathogen-Detection-Kit en el diagnóstico rápido del cólera.

OBJECTIVES: To compare the performance of two rapid systems for the diagnosis of cholera with the culture method, and to propose a strategy for improving the specificity and sensitivity of these systems and reducing the costs involved in making a diagnosis. METHODS: The following institutions participated in the study: the National Bacteriology Referral Center (Centro Nacional de Referencia en Bacteriologia, CNRB) of the Costa Rican Institute for Research and Teaching in Nutrition and Health (Instituto Costarricense de Investigacion y Ensenanza en Nutricion y Salud, INCIENSA) and various hospitals in the provinces of Alajuela, Guanacaste and San Jose, in Costa Rica. A total of 237 feces samples were used to asses the performance of two tests for the rapid detection of Vibrio cholerae 01: the Pathogen Detection Kit (PDK, Intelligent Monitoring Systems, Gainesville, Florida, USA) and Cholera-SMART (New Horizons Diagnostics Corp., Columbia, Maryland, USA), both when applied directly (direct SMART and direct PDK) and when applied to specimens cultured in broth-enriched medium for 6 hours (SMART-6 and CPK-6) and for 18 hours (SMART-18 and PDK-18) at 37 degrees C in alkaline peptone water. Liquid and partially formed stools were cultured and examined by means of the rapid direct test; when the initial result was negative, the tests were repeated after culture for periods of 6 and 18 hours. Rectal and fecal swabs were obtained from feces cultured in enriched-broth medium for 6 and 18 hours. In addition, we studied the sensitivity of the rapid testing systems by using pure cultures of V. cholerae 01 (strain SOS-833, CNRB, Costa Rica) that were incubated for 18 to 24 hours, and we assessed the usefulness of observing motility under the microscope in order to rationalize the use of rapid methods. RESULTS: The sensitivity of the direct SMART test and of the direct PDK test was 100% when samples obtained from liquid and partially formed stools and from the intestinal contents of dead bodies were used. With these samples, the direct SMART procedure showed a specificity of 100%, whereas the direct PDK procedure showed a specificity that ranged from 85.7% to 77.4%, depending on the type of sample. False positives obtained with the direct PDK method turned out to be negative with PDK-6 and PDK-18. Among the rectal and fecal swabs of persons with and without diarrhea or who had received prior treatment with antibiotics, three results that were negative with the SMART-6 procedure and two that were negative with the PDK-6 procedure turned out to be positive with the SMART-18 and PDK-18 procedures, respectively. Both systems showed excellent concordance (kappa index above 0.9) throughout. Both systems were sensitive to 6 x 10(7) colony-forming units per milliliter (cfu/mL), which was concordant with the microscopic observation of 10 microorganisms or more per field with the type of motility that characterizes vibrios (at 1000 x magnification). Samples having fewer than 10 microorganisms with the motility that characterizes vibrios had concentrations between 6 x 10(3) and 6 x 10(6) cfu/mL and became positive only after incubation in enriched-broth medium for 6 to 18 hours. We propose a strategy for diagnosing the presence of V. cholerae 01 infection in less time than it takes with traditional methods, with positive and negative predictive values of 100%. CONCLUSIONS: The SMART and PDK systems make it possible to accurately diagnose cholera quickly, don't require sophisticated equipment or highly qualified technical personnel, and perform satisfactorily in field conditions. Through the proposed strategy, it becomes possible to improve the specificity and sensitivity of these systems and to reduce the cost of making a diagnosis, thus making them suitable for use in cholera surveillance in low-income settings where this disease is a serious public health problem.

Desempeño de los sistemas Cholera-SMART® y Pathogen-Detection-Kit® en el diagnóstico rápido del cólera / Performance of Cholera-SMART® and Pathogen Detection-Kit® in the quick diagnosis of cholera

Objetivos. Comparar el desempeño de dos sistemas rápidos de diagnóstico de cólera con el método de cultivo y proponer una estrategia que permita mejorar la especificidad y la sensibilidad de estos sistemas y disminuir los costos del diagnóstico. Métodos. En el estudio participaron el Centro Nacional de Referencia en Bacteriología (CNRB) del Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA) y hospitales de las provincias de Alajuela, Guanacaste y San José, en Costa Rica. Se emplearon 237 muestras de heces para evaluar el desempeño de dos pruebas rápidas para el diagnóstico de Vibrio cholerae O1: Pathogen Detection Kit® (PDK, Intelligent Monitoring Systems, Gainsville, Florida, EUA) y Cholera-SMART® (New Horizons Diagnostics Corp., Columbia, Maryland, EUA), tanto en forma directa (SMART directo y PDK directo) como a partir de cultivos de enriquecimiento de 6 horas (SMART-6 y PDK-6) y de 18 horas (SMART18 y PDK-18) a 37 °C en agua de peptona alcalina. Las muestras diarreicas y semiformadas se cultivaron y se evaluaron con las pruebas rápidas directas; cuando el resultado inicial era negativo se repitieron a las 6 y 18 horas de cultivo. Los hisopados rectales y fecales se evaluaron a partir de cultivos de enriquecimiento de 6 y de 18 horas. Adicionalmente se estudió la sensibilidad analítica de los sistemas rápidos con cultivos puros de 18 a 24 horas de incubación de V. cholerae O1 (cepa SOS-833, CNRB, Costa Rica) y se evaluó la utilidad del análisis microscópico de la motilidad para racionalizar el uso de las técnicas rápidas. Resultados. La sensibilidad, tanto de SMART directo como de PDK directo, fue de 100% en muestras de heces diarreicas y semiformadas y en contenido intestinal de cadáveres. Con estas muestras, el procedimiento SMART directo mostró una especificidad de 100%, mientras que con el PDK directo esta fue de 85,7% a 77,4%, en dependencia del tipo de muestra. Los resultados positivos falsos obtenidos mediante PDK directo resultaron negativos con PDK-6 y PDK-18. Entre los hisopados rectales y fecales de personas con y sin diarrea o que recibieron tratamiento previo con antibióticos se observaron tres resultados negativos falsos con SMART-6 y dos con PDK-6, los cuales resultaron positivos mediante SMART-18 y PDK-18, respectivamente. Ambos sistemas mostraron una concordancia excelente (índice kappa superior a 0,9) en las diferentes modalidades evaluadas. La sensibilidad analítica de ambos sistemas fue de 6 107 ufc/mL de V. cholerae O1, lo que concordó con la observación microscópica de 10 microorganismos o más con motilidad típica de vibriones por campo (aumento de 1000). Las muestras con menos de 10 microorganismos con motilidad típica de vibriones tenían concentraciones entre 6 103 y 6 106 ufc/mL y solo resultaron positivas después de un enriquecimiento de 6­18 horas. Se propone una estrategia para establecer la presencia de Vibrio cholerae O1 en un tiempo inferior al de los métodos convencionales, con valores predictivos positivo y negativo de 100%. Conclusiones. Los sistemas SMART y PDK permiten llegar a un diagnóstico certero de cólera en poco tiempo, no requieren de instrumental complejo ni de personal técnico altamente calificado y funcionan satisfactoriamente en condiciones de campo. Mediante la estrategia propuesta se pueden aumentar la especificidad y la sensibilidad de estos sistemas y se reducen los costos del diagnóstico, lo que permite recomendar su empleo para la vigilancia del cólera en áreas con escasos recursos, donde esta enfermedad constituye un grave problema de salud pública

Objectives. To compare the performance of two rapid systems for the diagnosis of cholera with the culture method, and to propose a strategy for improving the specificity and sensitivity of these systems and reducing the costs involved in making a diagnosis. Methods. The following institutions participated in the study: the National Bacteriology Referral Center (Centro Nacional de Referencia en Bacteriología, CNRB) of the Costa Rican Institute for Research and Teaching in Nutrition and Health (Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, INCIENSA) and various hospitals in the provinces of Alajuela, Guanacaste and San José, in Costa Rica. A total of 237 feces samples were used to asses the performance of two tests for the rapid detection of Vibrio cholerae 01: the Pathogen Detection Kit© (PDK, Intelligent Monitoring Systems, Gainesville, Florida, USA) and Cholera-SMART© (New Horizons Diagnostics Corp., Columbia, Maryland, USA), both when applied directly (direct SMART and direct PDK) and when applied to specimens cultured in brothenriched medium for 6 hours (SMART-6 and CPK-6) and for 18 hours (SMART-18 and PDK-18) at 37 °C in alkaline peptone water. Liquid and partially formed stools were cultured and examined by means of the rapid direct test; when the initial result for periods of 6 and 18 hours. Rectal and fecal swabs were obtained from feces cultured in enriched-broth medium for 6 and 18 hours. In addition, we studied the sensitivity of the rapid testing systems by using pure cultures of V. cholerae 01 (strain SOS-833, CNRB, Costa Rica) that were incubated for 18 to 24 hours, and we assessed the usefulness of observing motility under the microscope in order to rationalize the use of rapid methods. Results. The sensitivity of the direct SMART test and of the direct PDK test was 100% when samples obtained from liquid and partially formed stools and from the intestinal contents of dead bodies were used. With these samples, the direct SMART procedure showed a specificity of 100%, whereas the direct PDK procedure showed a specificity that ranged from 85.7% to 77.4%, depending on the type of sample. False positives obtained with the direct PDK method turned out to be negative with PDK-6 and PDK-18. Among the rectal and fecal swabs of persons with and without diarrhea or who had received prior treatment with antibiotics, three results that were negative with the SMART-6 procedure and two that were negative with the PDK-6 procedure turned out to be positive with the SMART-18 and PDK-18 procedures, respectively. Both systems showed excellent concordance (kappa index above 0.9) throughout. Both systems were sensitive to 6 107 colony-forming units per milliliter (cfu/mL), which was concordant with the microscopic observation of 10 microorganisms or more per field with the type of motility that characterizes vibrios (at 1 000 magnification). Samples having fewer than 10 microorganisms with the motility that characterizes vibrios had concentrations between 6 103 and 6 106 cfu/mL and became positive only after incubation in enriched-broth medium for 6 to 18 hours. We propose a strategy for diagnosing the presence of V. cholerae 01 infection in less time than it takes with traditional methods, with positive and negative predictive values of 100%. Conclusions. The SMART and PDK systems make it possible to accurately diagnose cholera quickly, don't require sophisticated equipment or highly qualified technical personnel, and perform satisfactorily in field conditions. Through the proposed strategy, it becomes possible to improve the specificity and sensitivity of these systems and to reduce the cost of making a diagnosis, thus making them suitable for use in cholera surveillance in low-income settings where this disease is a serious public health problem

El papel del mycoplasma pneumonial en las exacerbaciones de asma bronquial y enfermedad pulmonar obstructiva crónica del adulto / The role of mycoplasma pneumonial in bronchial asthma exacerbation and in chronic obstructive pulmonary disease in adults

En el presente trabajo se evalua el papel de mycoplasma pneumoniae en reactivaciones de asma bronquial y enfermedad pulmonar obstructiva cronica. Para esto se determinaron los niveles de anticuerpos contra M. Pneumoniae en el zuero de las fases aguda y convaleciente de 28 individuos con reactivacion del cuadro respiratorio. Como controles se analizaron zueros de bancos de sangre del mismo periodo y de años previos al estudio. No se encontraron diferencias significativas entre los pacientes y los controles del mismo año; sin embargo, la seroposidad en los años previos al estudio fue significativamente inferior, lo que sugiere que en 1987 ocurrio un pico epidemico de infecciones por M. pneumoniae

Susceptibilidad a los antibióticos de los principales grupos de bacterias aisladas de pacientes con sepsis intraabdominal en dos hospitales generales de Costa Rica / Antibiotic susceptibility of the principal groups of bacteria isolated from patients with intra-abdominal sepsis in two Costa Rican general hospitals

Durante 1984 y 1985, se recolectó muestras de 68 pacientes con sepsis intra-abdominal, para estudiar la presencia de bacterias anaerobias, facultativas y determinar la sensibilidad a los antibióticos de los principales organismos encontrados. Bacteroides fragilis y Escherichia coli fueron las bacterias aisladas con mayor frecuencia. Todas las cepas de B. Fragilis analizadas, fueron sensibles a tinidazol, metronidazol y al cloranfenicol; sin embargo se encontro porcentajes de resistencia del 97,2 por ciento a la penicilina G, 8,3 por ciento a la clindamicina y 2,7 por ciento a la doxiciclina. Entre las cepas de E. coli estudiadas, los porcentajes de resistencia fueron de 55,9 por ciento al trimetoprin-sulfametoxazol. Los resultados obtenidos hacen ver la importancia de mantener un programa de vigilancia de la sensibilidad a los agentes bacterianos, tanto para las bacterias facultativas como anaerobias