Intra-amniotic Candida albicans Infection Treated With Liposomal Amphotericin B With a Successful Neonatal Outcome.

Intra-amniotic infection with Candida species is an uncommon but severe condition with high fetal morbimortality and no established clinical guidelines for its management. We report a Candida albicans intra-amniotic infection diagnosed in a 25-week pregnant woman, successfully treated with high-dose liposomal amphotericin B. Pregnancy was prolonged until 30 weeks, and despite persistently positive Candida cultures in amniotic fluid, a healthy newborn was delivered without evidence of systemic infection. Amphotericin concentration was determined at birth, revealing levels over 30 times higher in mother's and cord blood than in the amniotic fluid, probably explaining the clinical protection despite failure in obtaining fungal clearance.

Panorama del estrés en personal de enfermería durante la pandemia por SARS-CoV-2 / Overview of stress in nursing personnel during the SARS-CoV-2 pandemic

Introducción: la irrupción en el mundo del SARS-CoV-2 ha generado cambios drásticos en el estilo de vida poblacional, particularmente en las instituciones de salud, en donde los profesionales de enfermería han sido sometidos a estrés laboral, desgaste emocional, ansiedad y miedo por la in- certidumbre asociada a esta entidad patológica. Objetivo: identificar el nivel de estrés percibido por el personal de enfermería durante la pandemia por SARS-CoV-2. Metodología: se realizó un estudio transversal descriptivo en una muestra de 280 enfermeras de Quintana Roo. Se les aplicó por medio de un formulario Google la Escala de Estrés Percibido de Cohen, Kamarck y Mermelstein (1983), validada para México en 2007 por González y Landeros. Resultados: 81.4% desarrolló una función asistencial, 8.9% función administrativa, 2.9% una función docente y 6.8% ejerció una doble función. El 7.14% de la muestra percibió un alto nivel de estrés, el 85.71% medio y el 7.14% una percepción baja del estrés; 5.53% de las mujeres presentó un alto nivel de estrés en comparación con el 12.7% de los hombres. Conclusiones: es imperativo que las organizaciones de salud identifiquen y atiendan las situaciones ligadas al estrés, a fin de contribuir al desarrollo de herramientas cognitivas y psicológicas que permitan a los profesionales de enfermería afrontar el impacto emocional de la atención a personas con COVID-19, preservando así su higiene y salud mental.

Introduction: The impact of SARS-CoV-2 in the world has generated drastic changes in the population's lifestyle, particularly in health institutions, where nursing professionals have been subjected to work-related stress, emotional exhaustion, anxiety and fear due to the uncertainty associated with this disease entity. Objective: To identify the level of stress perceived by the nursing staff during the SARS-CoV-2 pandemic. Methods: A descriptive cross-sectional study was carried out on a sample of 280 nurses from Quintana Roo, by applying through a Google form the Perceived Stress Scale of Cohen, Kamarck and Mermelstein (1983), validated for Mexico by González and Landeros (2007). Results: 81.4% developed a care function, 8.9% an administrative function, 2.9% a teaching function, and 6.8% a doble function. 7.14% of the sample perceived a high level of stress, 85.71% medium and 7.14% a low perception of stress; 5.53% of women presented a high level of stress, compared to 12.7% of men. Conclusions: It is imperative that health organizations identify and attend situations related to stress, in order to contribute to the development of cognitive and psychological tools that allow nursing professionals to face the emotional impact of caring for people with COVID-19, thus preserving their hygiene and mental health.

Resistencia antimicrobiana de bacterias aisladas de clínicas veterinarias de la ciudad de Ibagué, Colombia / Antimicrobial resistance of bacteria isolated from veterinary clinics in the city of Ibague, Colombia

Objetivo: Aislar bacterias que circulan en clínicas veterinarias de la ciudad de Ibagué, conocer su perfil de resistencia a antimicrobianos y en algunas, su capacidad de transferir dicha resistencia a bacterias sensibles. Materiales y métodos: Se tomaron muestras de 10 clínicas a las que se les realizó cultivo bacteriológico, identificación bioquímica, antibiograma y pruebas de conjugación bacteriana para transmitir dicha resistencia. El diseño metodológico fue de tipo cuasi-experimental, el análisis de los resultados se hizo mediante estadística descriptiva. Resultados: En todas las áreas de las 10 clínicas se encontraron bacterias potencialmente patógenas multirresistentes que pertenecían a 8 de 16 especies aisladas. Los microorganismos que aparecieron con mayor frecuencia en los diferentes sitios de las clínicas fueron: Staphylococcus intermedius, Acinetobacter baumannii, Pantoea agglomerans, Klebsiella pneumoniae y Burkhordelia cepacia. Los lugares donde se aislaron microorganismos multirresistentes con más frecuencia fueron el piso de consulta externa y la mesa de examen clínico. La resistencia se presentó principalmente a amoxicilina y cloranfenicol. El estudio muestra la presencia de patógenos potenciales de causar infecciones nosocomiales, que se constituyen en reservorio de genes de resistencia a los antibióticos para las bacterias patógenas no resistentes.

Objective: To isolate bacteria circulating in veterinary clinics in the city of Ibague for knowing its antimicrobial resistance profile and in some cases, its ability to transfer this resistance to susceptible bacteria. Materials and Methods: Samples of 10 clinics that underwent bacterial culture, biochemical identification, antimicrobial susceptibility testing and bacterial conjugation to transfer this resistance were taken. The methodological design was quasi-experimental and the analysis of the results was made using descriptive statistics. Results: In all areas of the 10 clinical multiresistant potentially pathogenic bacteria which belonged to 8 of 16 species isolated were found. The microorganisms that occurred more frequently in different clinical places were: Staphylococcus intermedius, Acinetobacter baumannii, Pantoea agglomerans, Klebsiella pneumoniae and Burkhordelia cepacia. The places where multiresistant microorganisms were most frequently isolated were the outpatients' floor and the clinical examination table. The resistance occurred mainly to amoxicillin and chloramphenicol. The study shows the presence of potential pathogens causing nosocomial infections, which constitute a reservoir of resistance genes to antibiotics for non-resistant pathogenic bacteria.

Individualized tailor-made dietetic intervention program at schools enhances eating behaviors and dietary habits in obese Hispanic children of low socioeconomic status.

UNLABELLED: Hispanic children and those from low-socioeconomic status are predisposed to unhealthy eating habits and obesity. AIM: to implement an individualized, face-to-face, parent supported, and school-partnership dietetic intervention to promote healthy eating habits and decrease body mass index. Prospective school year dietetic intervention of 101 obese, Hispanic, low-socioeconomic school-age children representative of Monterrey, Mexico, consisted of anthropometrics, dietetic assessment, energy-restriction tailor-made daily menus, and parental education every three weeks. Student's t-test was used for means comparison. A significant decrease was found in body mass index percentile (96.43 ± 3.32 to 93.42 ± 8.12/P = 0.00) and energy intake/day of -755.7 kcal/day (P = 0.00). Among other energy dense foods with significant decline in servings/day and servings/week were processed meats (3.13 ± 1.43 to 2.19 ± 1.04/P = 0.00 and 5.60 ± 1.75 to 4.37 ± 2.10/P = 0.00, resp.), saturated fat (1.47 ± 1.08 to 0.78 ± 0.79/P = 0.00 and 2.19 ± 2.18 to 1.1 ± 1.36/P = 0.00), sweetened beverages (2.79 ± 1.99 to 1.42 ± 1.21 and 6.21 ± 1.72 to 3.89 ± 2.80/P = 0.00), and desserts and refined-grain bakery (1.99 ± 1.54 to 1.32 ± 1.59 and 2.85 ± 2.54 to 1.57 ± 2.20/P = 0.00). There was a significant increase in servings/day and servings/week of water (2.98 ± 2.02 to 4.91 ± 2.37 and 6.62 ± 2.03 to 6.87 ± 0.91/P = 0.00, resp.) and nutrient dense foods such as fruits (1.31 ± 0.89 to 1.66 ± 0.96 and 3.34 ± 2.24 to 4.28 ± 2.43/P = 0.00) and fish and poultry (3.76 ± 2.15 to 4.54 ± 2.25/P = 0.00). This intervention created healthy eating habits and decreased body mass index in a high risk population. TRIAL REGISTRATION NUMBER: NCT01925976.

Association of ALT and the metabolic syndrome among Mexican children.

Nonalcoholic fatty liver disease (NAFLD) is emerging as a component of the metabolic syndrome (MetS); Hispanics being particularly predisposed. Alanine aminotransferase (ALT) is considered a marker of NAFLD. The aim of this study was to determine the prevalence and associations between ALT elevations and MetS in normal-weight, overweight and obese Mexican children and adolescents, since data in Mexico is scarce. Body mass index (BMI), waist circumference (WC), percentage body fat, blood pressure, glucose, lipid profiles, ALT and aspartate aminotransferase (AST) were measured in 236, 6-12yo normal-weight, overweight and obese Mexicans from eight public schools. The results showed that elevated ALT (>40 IU/L) was found in 17.7% of the obese and overweight population, with no gender difference. The prevalence of elevated ALT increased linearly across BMI categories (p = 0.001), from 0.0% for the normal-weight group (95%CI 0.0-€“8.0) to 22.4% for the obese one (95%CI 16.2-€“30.2). AST/ALT ratio <1 also increased linearly, as did the prevalence of MetS (p = 0.001), from 0.0% for the normal-weight group to 40.3% for the obese one. The prevalence of MetS was strongly associated with elevated ALT (p = 0.002), 50% in the elevated ALT group (95%CI 34.1-€“65.9) and 24.1% in the normal ALT one (95%CI 18.1-€“31.3). There was also a strong association between MetS and an AST/ALT ratio <1. WC was the best predictor of elevated ALT (AOR = 7.13). Pearson correlation showed that MetS components were significantly correlated with elevated ALT. Therefore elevated ALT levels were highly prevalent and strongly associated with MetS in Mexican children, it should be screened in overweight and obese children.

Clinical and epidemiological features of 2009 pandemic H1N1 influenza differ slightly according to seroprevalence status during the second wave in the general population in México.

BACKGROUND: Clinical features of pandemic H1N1 have been derived from lab-confirmed, hospitalized, or critically ill subjects. This report describes the clinical features of H1N1 and their prevalence from non-confirmed subjects according to seroprevalence status in México. The objective was to determine the prevalence of these clinical features from non-confirmed cases of pandemic H1N1 and to compare them according to seroprevalence status in northern Monterrey, México, during 2009, and to identify the predictive signs and symptoms; there have been no prior serologic studies in México. METHODS: During November-December 2009, 2,222 volunteers, ages 6-99 years, were categorized into 3 symptomatic groups: influenza-like illness, respiratory illness, and non-respiratory illness. Antibodies against influenza A/H1N1/2009 were determined by a virus-free enzyme-linked immunosorbent assay (ELISA) method. Demographics and clinical presentation were assessed through face-to-face questionnaire, and the association with seroprevalence status was determined and compared. RESULTS: Overall seroprevalence was 39%. Of the seropositive subjects, 67% were symptomatic and 33% were asymptomatic. Seventy-one percent of seropositive symptomatic subjects reported respiratory illness, 17% reported non-respiratory symptoms, and 12% reported influenza-like illness. The most common symptoms were rhinorrhea/nasal congestion (93%) and headache (83%). No significant difference was found between the symptom profiles of the seropositive group, compared to the seronegative one, nor of the median duration of symptoms. The seropositive group had a significantly elevated proportion of influenza-like illness (12%), compared to the seronegative group (8%). The proportion of subjects who took days off and who sought medical attention was significantly higher in the seropositive group. No single symptom was associated as a predictor of seropositiveness. CONCLUSIONS: One third of the seropositive subjects were asymptomatic, and few had an influenza-like illness. No difference was found in the symptom profiles of the seropositive and seronegative groups. No single symptom predicted seropositiveness. Large scale population studies are needed, especially in México, to characterize clinical syndromes.

Signos extragenitales de violencia física en la víctima de violación / Estragenital signs of physical violence en rape

Se evalúan la importancia de los signos de violencia física en el área extragenital de la víctima de violación. Se hace una distinción entre la violación sin signos físicos extragenitales y violación con lesiones extragenitales. Estas últimas se clasifican en: 1. Lesiones necesarias causadas por el agresor para lograr su propósito. 2. Lesiones innecesarias realizadas por el autor para satisfacer su lujuria. 3. Lesiones propias de la excitación sexual en coito consentido. Se señalan los casos de intimidación o de incapacidad mental de la víctima en que puede faltar lesiones extragenitales, a pesar de tratarse de una violación.