GLOBAL RETROSPECTIVE REVIEW OF SEVERE ACUTE RESPIRATORY SYNDROME SARS COV-2 INFECTIONS IN NONDOMESTIC FELIDS: MARCH 2020-FEBRUARY 2021.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in nondomestic felids have been documented in North America, South America, Africa, Europe, and Asia. Between March 2020 and February 2021, at nine institutions across three continents, infection was confirmed in 16 tigers (Panthera tigris), 14 lions (Panthera leo), three snow leopards (Panthera uncia), one cougar (Puma concolor), and one Amur leopard cat (Prionailurus bengalensis euptilurus) ranging from 2 to 21 yr old (average, 10 yr). Infection was suspected in an additional 12 tigers, 4 lions, and 9 cougars. Clinical signs (in order of most to least common) included coughing, ocular and/or nasal discharge, wheezing, sneezing, decreased appetite, lethargy, diarrhea, and vomiting. Most felids recovered uneventfully, but one geriatric tiger with comorbidities developed severe dyspnea and neurologic signs necessitating euthanasia. Clinical signs lasted 1-19 d (average, 8 d); one tiger was asymptomatic. Infection was confirmed by various methods, including antigen tests and/or polymerase chain reaction (PCR) of nasal or oral swabs, tracheal wash, and feces, or virus isolation from feces or tracheal wash. Infection status and resolution were determined by testing nasal swabs from awake animals, fecal PCR, and observation of clinical signs. Shedding of fecal viral RNA was significantly longer than duration of clinical signs. Postinfection seropositivity was confirmed by four institutions including 11 felids (5 lions, 6 tigers). In most instances, asymptomatic or presymptomatic keepers were the presumed or confirmed source of infection, although in some instances the infection source remains uncertain. Almost all infections occurred despite using cloth facemasks and disposable gloves when in proximity to the felids and during food preparation. Although transmission may have occurred during momentary lapses in personal protective equipment compliance, it seems probable that cloth masks are insufficient at preventing transmission of SARS-CoV-2 from humans to nondomestic felids. Surgical or higher grade masks may be warranted when working with nondomestic felids.

Preceding anti-spike IgG levels predicted risk and severity of COVID-19 during the Omicron-dominant wave in Santa Fe city, Argentina

The SARS-CoV-2 Omicron variant has increased infectivity and immune escape compared with previous variants, and caused massive COVID-19 waves globally. Despite a vast majority ([~]90%) of the population of Santa Fe city, Argentina, had been vaccinated and/or had been infected by SARS-CoV-2 by the arrival of Omicron, the epidemic wave that followed was by far the largest one experienced in the city. A serosurvey conducted prior to the arrival of Omicron allowed to assess the acquired humoural defences preceding the wave and to evaluate associations with infection risk and severity during the wave. A very large proportion of the 1455 sampled individuals had immunological memory against COVID-19 at the arrival of Omicron (almost 90%), and about half (48.9%) had high anti-Spike IgG levels (>200 UI/ml). The antibody titres were strongly associated with the number of vaccine shots and the vaccine platform received, and also depended markedly on prior COVID-19 diagnosis and the days elapsed since last antigen exposure (vaccine shot or natural infection). Following-up 514 participants provided real-world data linking antibody levels with protection against COVID-19 during a period of high risk of exposure to an immune-escaping highly transmissible variant. Pre-wave antibody titres were strongly associated with COVID-19 incidence and severity of symptoms during the wave. Also, receiving a vaccine shot during the follow-up period reduced the COVID-19 risk drastically (15-fold). These results highlight the importance of maintaining high defences through vaccination anticipating or during a period of high risk of exposure to immune-escaping variants.

Análisis de costo efectividad de tres intervenciones para la detección de casos de tuberculosis en la ciudad de Santa Fe Argentina / Cost-effectiveness analysis of three interventions for the detection of tuberculosis cases in Santa Fe city, Argentina

La búsqueda activa de casos de tuberculosis (TB) puede resultar costo-efectiva debido a los potenciales beneficios a largo plazo de prevenir nuevos casos, acortar la duración de la morbilidad y minimizar el riesgo de muerte. El objetivo de este estudio fue evaluar la relación costo-efectividad de tres estrategias de detección de casos de TB pulmonar (TBp) en residentes ≥15 años de la ciudad de Santa Fe durante el período de un año. MÉTODOS: A partir de datos primarios, secundarios y del diseño y aplicación de un modelo analítico de decisión estática para evaluar costo-efectividad incremental (CEI), se comparó la búsqueda activa de casos (BAC) en la comunidad y la investigación de contactos en el hogar (ICH) con la búsqueda pasiva de casos (BPC) utilizada como práctica habitual en el contexto de los programas de control de la TB en el país. RESULTADOS: El número de casos verdaderos de TBp captados por BPC en un año fue de 55 para el total de habitantes de la ciudad (17 por 100 000), a un costo medio de USD 2625,62 por caso. El beneficio adicional de sumar la ICH a la BPC fue de 4 casos, a un costo de USD 9518,62 por caso adicional detectado. La suma de la BAC a la estrategia BPC+ICH no produjo beneficio adicional en términos de casos, si bien tuvo un costo adicional de USD 139,26. DISCUSIÓN: Según el umbral de decisión adoptado, la estrategia BPC+ICH calificó como muy costo-efectiva, además de ser más costo-efectiva que la BPC+ICH+BAC.

Las máscaras filosófica-médicas de Goethe, en Fausto / Goethe's philosophical-medical masks, in Faust

Al empezar el siglo XXI, el sector de la salud se debate en una crisis ética-moral médica y, la sociedad, lastimada por la pandemia de violencia e impunidad jurídica, resiente una crisis del estado de derecho sin encontrar aún una respuesta científica ni humanística viable. El artículo, resultado de una investigación en la tragedia decimonónica de Johann Wolfgang Goethe, Fausto, demuestra la coincidencia de sujetos y objetos de la vida real con sujetos y objetos representados literariamente mediante la interpretación de los paradigmas, problemas, dilemas y casos ético-moral médicos identificados: dáimon, reflexión-soledad, libre albedrío, bien-mal, Eros, docta ignorancia, genes, epistemología, etiqueta médica, paternalismo, anatomía de la personalidad, hipocratismo, voluntad, buen humor, peste bubónica. Fausto puede ser una senda nueva para el cambio –hacia el bien común– del galeno si, trazada por su voluntad y recuperando los objetos reales representados, decide reflexionar libre y solitariamente sobre su ejercicio profesional, el saber médico y la relación médicopaciente.

At the beginning of the XXI century the health profession is engaged in a medical ethical and moral crisis and society, hurt by the pandemic of violence and impunity, feels the effect of a state of legal crisis unable to find a viable scientific or humanistic answer. This manuscript, is the result of an investigation into the Johann Wolfgang Goethe's tragedy of the nineteenth century, Faust. It demonstrates the coincidence of real life subjects and objects with literary subjects and objects represented, by means of the interpretation of the paradigms, problems, dilemmas and identified cases of medical ethical-morals: dáimon, reflection-solitude, free will, good-evil, Eros, learned ignorance, genes, epistemology, medical etiquette, paternalism, anatomy of the personality, Hyppocratism, will, good sense of humor, bubonic plague. Faust can be construed as a new path for change--towards the common good--of the physician if traced by their will and recovering the represented real objects, decides to meditate free and lonely on its professional exercise, medical knowledge and the doctor-patient relationship.

[Goethe's philosophical-medical masks, in Faust]. / Las máscaras filosófica-médicas de Goethe, en Fausto.

At the beginning of the XXI century the health profession is engaged in a medical ethical and moral crisis and society, hurt by the pandemic of violence and impunity, feels the effect of a state of legal crisis unable to find a viable scientific or humanistic answer. This manuscript, is the result of an investigation into the Johann Wolfgang Goethe's tragedy of the nineteenth century, Faust. It demonstrates the coincidence of real life subjects and objects with literary subjects and objects represented, by means of the interpretation of the paradigms, problems, dilemmas and identified cases of medical ethical-morals: dáimon, reflection-solitude, free will, good-evil, Eros, learned ignorance, genes, epistemology, medical etiquette, paternalism, anatomy of the personality, Hyppocratism, will, good sense of humor, bubonic plague. Faust can be construed as a new path for change--towards the common good--of the physician if traced by their will and recovering the represented real objects, decides to meditate free and lonely on its professional exercise, medical knowledge and the doctor-patient relationship.