Survey of coccidia on commercial broiler farms in Colombia: frequency of Eimeria species, anticoccidial sensitivity, and histopathology.

Avian coccidiosis continues to be one of the costliest diseases of commercial poultry. Understanding the epidemiology of Eimeria species in poultry flocks and the resistance profile to common anticoccidials is important to design effective disease prevention and control strategies. This study examined litter samples to estimate the prevalence and distribution of Eimeria species among broiler farms in 4 geographic regions of Colombia. A total of 245 litter samples were collected from 194 broiler farms across representative regions of poultry production between March and August 2019. The litter samples were processed for oocysts enumeration and speciation after sporulation. End-point polymerase chain reaction (PCR) analysis was conducted to confirm the presence of Eimeria species. Anticoccidial sensitivity was determined with 160 Ross AP males in 5 treatment groups: noninfected, nonmedicated control (NNC), infected, nonmedicated control (INC), infected salinomycin treated (SAL, dose: 66 ppm), infected diclazuril treated (DIC, dose: 1 ppm), and infected methylbenzocuate-Clopidol treated (MET.CLO, dose: 100 ppm), All birds were orally inoculated with 1 × 106 sporulated oocysts using a 1 mL syringe, except for the NNC- group who received 1ml of water.Eimeria spp. were found in 236 (96.3%) out of 245 individual houses, representing 180 (92.8%) out of 194 farms. Eimeria acervulina was the most prevalent species (35.0%) followed by Eimeria tenella (30.9%), Eimeria maxima (20.4%), and other Eimeria spp. (13.6%). However, mixed species infections were common, with the most prevalent combination being mixtures of E. acervulina, E. maxima, E. tenella, and other species in 31.4% of the Eimeria-positive samples. PCR analysis identified E. acervulina, E. maxima, E. tenella, Eimeria necatrix, Eimeria mitis, and Eimeria praecox with variable prevalence across farms and regions. Anticoccidial sensitivity testing of strains of Eimeria isolated from 1 region, no treatment difference (P > 0.05) was observed in final weight (BW), weight gain (BWG) or feed conversion (FCR). For the global resistance index (GI) classified SAL and MET.CLO as good efficacy (85.79 and 85.49, respectively) and DIC as limited efficacy (74.52%). These results demonstrate the ubiquitous nature of Eimeria spp. and identifies the current state of sensitivity to commonly used anticoccidials in a region of poultry importance for Colombia.

An overview of the situation of hand surgery in Spain during the peak of COVID-19 pandemic.

Since the first cases were detected in China in December 2019, the COVID-19 pandemic has spread rapidly, collapsing many healthcare systems, and forcing them to adapt. Hand surgery has been indirectly affected by this scenario. This article aims to provide an overview on how Spanish hand surgeons have modified their daily practice. Based on a survey conducted nationwide, we observed a decrease in the number of emergency cases and cancellation of elective cases, shift to a more conservative treatment approach, use of personal protective equipment, and decrease in the number of outpatient visits and tests. Without definitive evidence at this point, knowing how we have dealt with the situation so far will help us adopt the needed measures to ensure both the patient's and surgeon's safety and manage available resources in future pandemics.

Resistance profile and molecular characterization of pyrethroid resistance in a Rhipicephalus microplus strain from Colombia.

Intensive use of chemical acaricides for the control of cattle ticks (Rhipicephalus microplus) has led to the development of multiple acaricide resistance in Colombia. The present study aimed to characterize, using toxicological bioassays and molecular biology techniques, the resistance profile of a tick strain isolated from the Arauca state, Northeast Colombia. Commercial acaricides were used in adult immersion tests to determine its in vitro efficacies. Deltamethrin showed very low activity (4-7.3%), a mixture of cypermethrin and chlorpyrifos had intermediate efficacy (64-75.2%), and ethion presented the highest activity (88.5-100%). A colony (Arauquita strain) was established and larval immersion tests confirmed high resistance level to deltamethrin (241-fold) and susceptibility to ivermectin. A quantitative polymerase chain reaction-high resolution melt technique was used to identify single nucleotide polymorphisms (SNPs) in the para-sodium channel gene. All of the genotyped individuals were mutant, presenting one (n = 7), two (n = 7) or three (n = 9) SNPs previously associated with pyrethroid resistance. Sequencing revealed a novel mutation (F712L), that was found for the first time in R. microplus ticks from South America. This is the first description of mutations associated with pyrethroid resistance in R. microplus from Colombia. The acaricide resistance pattern found in the Arauquita strain is similar to other parts of Colombia.

Epidemiological survey and risk factor analysis on Eimeria infections in calves and young cattle up to 1 year old in Colombia.

A large-scale cross-sectional epidemiological study was conducted to evaluate prevalence, species diversity, and associated risk factors of Eimeria infections in 55 cattle farms across seven states of Colombia, including subtropical and tropical regions. In total, 1333 fecal samples from young animals (< 1 year of age) were examined at a single sampling date from August 2016 to December 2016. Flotation and McMaster techniques were conducted for parasitological investigation. Excreted Eimeria oocysts were allowed to sporulate in vitro and thereafter identified to species level based on morphological and morphometric characteristics. The overall Eimeria prevalence was 75.5% (1006/1333), with no difference observed between age categories. In total, 13 different Eimeria species were identified. The most prevalent species was E. bovis (33.5%), followed by E. auburnensis (12.5%) and E. zuernii (11.9%). Analysis of extrinsic associated risk factors revealed the floor type, feeding system, watering system, and herd size as significant (p < 0.05) risk factors for Eimeria spp. infections. Based on these data, it can be assumed that bovine coccidiosis infections occur ubiquitously in the country and might play an important role especially in its subclinical form by affecting production parameters in conventional cattle management systems.

Occurrence of endoparasites in wild Antillean manatees (Trichechus manatus manatus) in Colombia.

The recognized impact of parasites in wildlife populations demands surveillance of endangered species like the Antillean manatees (Trichechus manatus manatus) in Colombia. We conducted a parasitological survey in four rescued sea cows in order to document the parasite diversity of this sirenian in the Caribbean wetland of Colombia and contribute to the molecular characterization of its trematodes. The flukes Chiorchis fabaceus, Nudacotyle undicola and the protozoans Eimeria manatus and E. nodulosa were identified in analysed faecal samples. For C. fabaceus and N. undicola, partial regions of ribosomal RNA genes were amplified and sequenced in order to infer their phylogenetic relations. The current study constitutes a new sirenian host (T. manatus manatus) record for the genus Eimeria and the trematode N. undicola.

Performance of cardiopulmonary resuscitation feedback systems in a long-distance train with distributed traction.

BACKGROUND: Out-of-hospital cardiac arrest is common in public locations, including public transportation sites. Feedback devices are increasingly being used to improve chest-compression quality. However, their performance during public transportation has not been studied yet. OBJECTIVE: To test two CPR feedback devices representative of the current technologies (accelerometer and electromag- netic-field) in a long-distance train. METHODS: Volunteers applied compressions on a manikin during the train route using both feedback devices. Depth and rate measurements computed by the devices were compared to the gold-standard values. RESULTS: Sixty-four 4-min records were acquired. The accelerometer-based device provided visual help in all experiments. Median absolute errors in depth and rate were 2.4 mm and 1.3 compressions per minute (cpm) during conventional speed, and 2.5 mm and 1.2 cpm during high speed. The electromagnetic-field-based device never provided CPR feedback; alert messages were shown instead. However, measurements were stored in its internal memory. Absolute errors for depth and rate were 2.6 mm and 0.7 cpm during conventional speed, and 2.6 mm and 0.7 cpm during high speed. CONCLUSIONS: Both devices were accurate despite the accelerations and the electromagnetic interferences induced by the train. However, the electromagnetic-field-based device would require modifications to avoid excessive alerts impeding feedback.

Síndrome de burnout en personal de enfermería: asociación con estresores del entorno hospitalario, Andalucía, España / Burnout syndrome among nursing staff: hospital-environment stress associations, Andalucia, Spain / Síndrome de burnout no pessoal de enfermagem: associação com estressores do entorno hospitalar, Andaluzia, Espanha

Introducción: El síndrome de burnout, es un padecimiento de contrastada prevalencia en un entorno como el sanitario, donde se convive con altas dosis de responsabilidad, contacto directo con las personas, situaciones cercanas a la muerte. Este problema es causa directa del absentismo y es necesaria su prevención. Objetivo: Identificar con base en el Inventario de Maslach la presencia de síndrome de burnout en personal de enfermería y su asociación con estresores comprendidos en la Escala de Estrés en enfermería (NSS por sus siglas en inglés). Método: Estudio observacional, descriptivo, transversal, de corte prospectivo. La población la componen 140 profesionales de enfermería que trabajan en el Hospital de Montilla (España). Mediante muestreo probabilístico de tipo aleatorio simple se obtiene una muestra representativa de 43 participantes. Se determina la asociación entre cansancio emocional, despersonalización y realización personal (Maslach Burnout Inventory), con cada uno de los nueve factores que miden la presencia de estresores en la escala NSS. Se utilizó el coeficiente de correlación de Pearson y la T de Student. Resultados: Existe asociación entre los niveles de cansancio emocional y los siguientes estresores: muerte y sufrimiento, carga de trabajo, incertidumbre respecto el tratamiento, problemas con la jerarquía, preparación insuficiente, problemas entre el personal enfermero y pasar temporalmente a otros servicios por falta de personal. Con respecto a la despersonalización, sus niveles están asociados con: incertidumbre respecto el tratamiento, preparación insuficiente y problemas entre el personal de enfermería. Conclusiones: Actuar directamente sobre los factores asociados con el desgaste, permitirá a los gestores sanitarios prevenir el avance del burnout entre sus trabajadores.

Introduction: The burnout syndrome is highly prevalent in the health care environments which normally include high levels of responsibility, direct contact with many persons, and near death experiences, among other stressful situations. This syndrome is a direct cause of absenteeism and thus its prevention becomes important. Objective: Based on the Maslach Inventory, to identify the prevalence of burnout among nursing personnel and its associations with the stressors contemplated by the Nursing Stressor Scale (NSS). Method: This is an observational, descriptive, transversal and prospective study. The population is constituted by 140 nursing professors working at the Montilla Hospital in Spain. The representative sample of 43 was obtained by probabilistic sampling. Associations were found between emotional wasting, depersonalization, and individual achievement (Maslach Burnout Inventory) with each of the 9 factors measuring the presence of stressors contemplated by the NSS. The Pearson coefficient and the Student's t were calculated. Results: There are associations between diverse levels of emotional wasting and the following stressors: death and suffering, workload, uncertainty regarding the treatment, hierarchy problems, insufficient preparation, problems among nursing staff, and moving to other services lacking enough personnel. Regarding depersonalization, the different levels are associated with: uncertainty about the treatment, insufficient preparation, and problems among the nursing personnel. Conclusions: Directly addressing the factors associated with emotional wasting will allow healthcare managers to prevent the incidence of burnout syndrome among the staff.

Introdução: A síndrome de burnout, é um padecimento de prevalência contrastada em um entorno como de cuidados de saúde, onde se convive com altas doses de responsabilidade, contato direto com as pessoas, situações próximas à morte. Este problema é causa direta do absentismo e é necessária sua prevenção. Objetivo: Identificar com base no Inventario de Maslach a presença de síndrome de burnout no pessoal de enfermagem e sua associação com estressores compreendidos na Escala de Estresse em enfermagem (NSS por suas siglas em inglês). Método: Estudo observacional, descritivo, transversal, de corte prospectivo. A população a compõem 140 profissionais de enfermagem que trabalham no Hospital de Montilla (Espanha). Mediante amostragem probabilística de tipo aleatório simples obtém-se una amostra representativa de 43 participantes. Determina-se a associação entre cansaço emocional, despersonalização e realização pessoal ("Maslach Burnout Inventory"), com cada um dos nove fatores que medem a presença de estressores na escala "Nursing Stress Scale". Utilizou-se o "coeficiente de correlação de Pearson" e a "T de Student". Resultados: Existe associação entre os níveis de "cansaço emocional" e os seguintes estressores: morte e sofrimento, carga de trabalho, incerteza respeito ao tratamento, problemas com a jerarquia, preparação insuficiente, problemas entre o pessoal enfermeiro e passar temporalmente a outros serviços por falta de pessoal. Com respeito à "despersonalização", seus níveis estão associados com: incerteza respeito ao tratamento, preparação insuficiente e problemas entre o pessoal de enfermagem. Conclusões: Atuar diretamente sobre os fatores associados com o desgaste identificados através desta ferramenta, permitirá aos gestores de saúde prevenir o avance do "burnout" entre sus trabalhadores.

Regional report on Angiostrongylus vasorum in Colombia: Genetic similarity to European lineage.

The canine lungworm Angiostrongylus vasorum is considered neglected in South America and was only sporadically reported in dogs and wildlife. Gastropods act as obligatory intermediate hosts for this parasitosis. We here analysed Achatina fulica (African giant snail) populations from 5 regions of Colombia for A. vasorum infections. In total, 609 snails were collected from the departments Antioquia, Valle del Cauca and Putumayo. Angiostrongylus vasorum-infected A. fulica were found in all departments with a total prevalence of 3.9%. Larvae originating from Putumayo were molecularly characterized and identified as the European lineage of A. vasorum. This regional report shows for the first time the presence of A. vasorum in intermediate hosts in Colombia and the European genotype in South America.

A Feasibility Study for Measuring Accurate Chest Compression Depth and Rate on Soft Surfaces Using Two Accelerometers and Spectral Analysis.

Background. Cardiopulmonary resuscitation (CPR) feedback devices are being increasingly used. However, current accelerometer-based devices overestimate chest displacement when CPR is performed on soft surfaces, which may lead to insufficient compression depth. Aim. To assess the performance of a new algorithm for measuring compression depth and rate based on two accelerometers in a simulated resuscitation scenario. Materials and Methods. Compressions were provided to a manikin on two mattresses, foam and sprung, with and without a backboard. One accelerometer was placed on the chest and the second at the manikin's back. Chest displacement and mattress displacement were calculated from the spectral analysis of the corresponding acceleration every 2 seconds and subtracted to compute the actual sternal-spinal displacement. Compression rate was obtained from the chest acceleration. Results. Median unsigned error in depth was 2.1 mm (4.4%). Error was 2.4 mm in the foam and 1.7 mm in the sprung mattress (p < 0.001). Error was 3.1/2.0 mm and 1.8/1.6 mm with/without backboard for foam and sprung, respectively (p < 0.001). Median error in rate was 0.9 cpm (1.0%), with no significant differences between test conditions. Conclusion. The system provided accurate feedback on chest compression depth and rate on soft surfaces. Our solution compensated mattress displacement, avoiding overestimation of compression depth when CPR is performed on soft surfaces.

Impact of the Xpert(®) MTB/RIF molecular test on the late diagnosis of pulmonary tuberculosis.

We analysed the impact of the Xpert(®) MTB/RIF molecular test on health-care diagnostic delay among tuberculosis patients. Diagnostic delay was 17.2 days (standard deviation 23.2, median 10 days). Of 128 patients recruited into the study, 60 (47%) were smear-negative; of these, 40 (67%) were Xpert-positive and were started on treatment without culture. The sensitivity of smear microscopy was 53% compared with 82% for Xpert. In smear-negative patients, delay in Xpert-positive and -negative patients was respectively 15.5 ± 13.2 and 25.5 ± 12.5 days (P = 0.002). We conclude that Xpert results were significantly associated with shorter health-care diagnostic delay, particularly in smear-negative patients.

Fractura deprimida cerrada de la fosa posterior en un anciano / Closed depressed fracture of the posterior fossa in an elderly patient

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Las relaciones personales que se establecen por los residentes de un hogar para ancianos / The personal relationships established by residents of a nursing home

Objetivo: El propósito de este trabajo es estudiar y teorizar sobre las relaciones personales que se establecen en el seno de los hogares para ancianos. Metodología: Estudio cualitativo de tipo interpretativo construido a partir del desarrollo de teoría fundamentada. El lugar de realización han sido los 6 hogares para ancianos de la comarca de la campiña sur de Córdoba, en el sur de España. Los participantes han sido 16 residentes y 4 profesionales de estos centros. La recogida de información se ha realizado a través de entrevistas en profundidad. Resultados: En el contexto de las residencias de personas mayores hay principalmente tres grupos humanos que interaccionan con el mayor: los compañeros residentes, el compañero o compañeros de cuarto (si comparten dormitorio) y las personas que lo cuidan. Se han construido una serie de roles en cada una de estos grupos de convivientes, para la cual nos vamos a basar en la dimensionalización de algunas características de estas personas. La situación en uno u otro de estos roles no es estática ni permanente, las personas pueden ir cambiando de unos a otros en función de las diversas circunstancias (AU)

Objective: The purpose of this paper is to study and develop a theory about the personal relationships established within nursing homes. Methodology: qualitative and interactive investigation built from the development of a grounded theory. The study took place in 6 nursing homes in the region of the southern districts of Cordoba, in southern Spain. The participants were 16 residents and 4 professionals of these centers. The collection of information was done through in depth interviews. Results: In the context of the nursing homes there are mainly three groups of people who interact with the elderly: partners, roommates (when sharing a bedroom) and caregivers. We have built some roles in each of these groups living together, on which we will base the dimensioning of some of the characteristics of these people. The situation in either of these roles is not static or permanent, people may change from one to another depending on various circumstances (AU)

Effectiveness of a colonoscopic screening programme in first-degree relatives of patients with colorectal cancer.

AIM: The study aimed to assess the diagnostic yield of a colonoscopy screening programme in first-degree relatives of colorectal cancer (CRC) patients and to identify factors associated with advanced neoplasia. METHOD: We conducted a cross-sectional study. Individual characteristics, family trees and colonoscopy findings of asymptomatic first-degree relatives of CRC patients were collected. The findings were classified into cancer (invasive carcinoma and/or non-invasive high-grade neoplasia), high-risk adenomas (≥ 10 mm and/or a villous component) and low-risk adenomas (tubular < 10 mm). The dependent variable was the presence of advanced neoplasia, defined as cancer and/or high-risk adenoma. RESULTS: Two hundred and sixty-three relatives (147 females), 50.0 ± 11.5 (range, 25-75) years of age, agreed to participate out of a total of 618 who were invited (acceptance rate 42.5%). Index cases were diagnosed at 63.8 ± 12.4 (range, 37-88) years of age. The closest familial relationship was parent/offspring in 168 (63.9%) participants and sibling in 95 (36.1%) participants; 14.8% had three or more relatives with CRC/cancer associated with Lynch syndrome, and two or more affected generations were identified in 24.0%. Advanced neoplasia was found in 56 (21.3%) participants. Of these, invasive cancer, non-invasive high-grade neoplasia and high-risk adenomas were detected in five (1.9%), six (2.3%) and 45 (17.1%) participants, respectively. Low-risk adenomas were detected in 20 (7.6%) participants. Male sex (odds ratio, 2.59; P = 0.003) and sibling relationship (odds ratio, 2.74; P = 0.001) were independently associated with advanced neoplasia. CONCLUSION: We detected advanced neoplasia in a considerable number of participants. Our data support colonoscopy screening in first-degree relatives of patients with CRC at an earlier age than in the medium-risk population. Male sex and sibling relationship were predictors of advanced neoplasia.

Reforming dental workforce education and practice in the USA.

The USA dental education programmes are facing challenges similar to those confronting countries around the globe, particularly amongst the industrialised nations. The purpose of this study was to evaluate the educational programmes of 15 USA dental schools to determine their impact on improving workforce diversity and oral health care access. The study investigates the predictors of public service plans of dental school seniors in Pipeline and non-Pipeline Program dental schools. We analysed baseline and post-intervention data collected in the American Dental Education Association (ADEA) Annual Survey of Dental School Seniors and a set of contextual variables. Public service plans (dependent variable) was predicted by four types of independent variables: intervention, contextual, community-based dental education (CBDE), and student characteristics. Findings from the study show that access to a state or federally sponsored loan repayment program was the most significant predictor of public service plans and that increasing educational debt was the most significant barrier. In the short-term we may be able to sustain the USA loan repayment programs to motivate senior dental students to provide public service to address the oral health care access crisis. However, in the long-term, a new workforce development initiative will be required to transform dental education and practice, modelled after the well-respected licensure programmes for Physician Assistants and/or Advanced Practice Registered Nurses, to expand oral health care access, particularly amongst vulnerable population subgroups, such as low-income children and families.

Update on molecular pathology in oral cancer and precancer.

Oral carcinogenesis is a multifactorial process involving numerous genetic events that alter normal functions of oncogenes and tumour suppressor genes. This may increase the production of growth factors or the number of receptors on the cell surface, and/or increase transcription factors or intracellular signal messengers. Together with the loss of tumour suppressor activity, these changes lead to a cell phenotype that can increase cell proliferation, with loss of cell cohesion, and infiltration of adjacent tissue thus causing distant metastasis. Molecular pathology is responsible for defining the molecular mechanisms that underlie the onset of oral precancer and cancer. The aim of this review is to describe recent advances in our understanding of the molecular control of the innumerable pathways related to these processes. These may lead to short- or medium term improvements in the diagnosis and prognosis of oral precancerous and cancerous lesions and to the development of novel therapeutic approaches to this disease.