Experiencia con el Biofire FilmArray® para meningitis/encefalitis infecciosa en una institución de alta complejidad en Bogotá, Colombia / Experience with the Biofire FilmArray® for infectious meningitis/encephalitis in a high complexity institution in Bogotá, Colombia

Introducción: La meningoencefalitis infecciosa (MEI) es una emergencia neurológica con importante morbimortalidad. El panel Biofire FilmArray? para meningitis/encefalitis (FAME) en el líquido cefalorraquídeo (LCR) ha demostrado ser una valiosa herramienta para el diagnóstico etiológico de la MEI, facilitando una terapia antimicrobiana dirigida. El objetivo es determinar el impacto del panel FAME en las decisiones terapéuticas antimicrobianas en pacientes con sospecha de MEI en las primeras 24 horas de la valoración clínica. Pacientes y métodos: Estudio observacional descriptivo que comenta las manifestaciones cínicas, los resultados de neuroimágenes y paraclínicos, y la antibioticoterapia de pacientes con sospecha de MEI. Se realizó un análisis del impacto que tiene el FAME en la terapia antimicrobiana en las primeras 24 horas de la valoración clínica de los pacientes. Resultados: Se incluyó a 44 pacientes. El tiempo promedio para obtener el resultado del panel FAME en el LCR fue de nueve horas, con un 20,4% (9/44) de pruebas positivas. En las primeras 24 horas de la valoración clínica, su resultado tuvo impacto en las decisiones terapéuticas antimicrobianas en el 75% (33/44) de los casos. En pacientes con alta sospecha clínica de MEI, el resultado del FAME permitió cambiar la terapia empírica inicial a una dirigida en el 15% (3/20) y suspender la terapia empírica inicial en el 35% (7/20) de los sujetos. En pacientes con baja sospecha clínica de MEI, su resultado permitió que al 25% (6/24) se le confirmara la sospecha y se le iniciara antibioticoterapia dirigida; y que al 70,8% (17/24) se le descartara el diagnóstico y no se le iniciara tratamiento. Conclusiones: El resultado del panel FAME en el LCR tiene alto impacto en la toma de decisiones terapéuticas antimicrobianas en las primeras 24 horas de la valoración clínica. Sin embargo, su interpretación debe hacerse con el contexto clínico, la epidemiología local y otros estudios diagnósticos.(AU)

Introduction: Infectious meningoencephalitis (IME) is a neurological emergency with a significant rate of morbidity and mortality. The Biofire FilmArray® meningitis/encephalitis (FAME) panel for testing in cerebrospinal fluid (CSF) has proven to be a valuable tool for the aetiological diagnosis of IME, facilitating targeted antimicrobial therapy. The aim is to determine the impact of the FAME panel on antimicrobial therapeutic decisions in patients with suspected IME in the first 24 hours of clinical assessment. Patients and methods: This is a descriptive observational study that comments on the clinical manifestations, the neuroimaging and paraclinical findings, and the antibiotic therapy of patients with suspected IME. An analysis was performed to determine the impact of FAME on antimicrobial therapy in the first 24 hours of the clinical assessment of patients. Results: Altogether 44 patients were included. The average time required to obtain the result of the FAME panel for testing in CSF was nine hours, with 20.4% (9/44) of tests yielding positive results. Within 24 hours of clinical assessment, their outcome had an impact on antimicrobial treatment decisions in 75% (33/44) of cases. In patients with a high clinical suspicion of IME, the result of FAME made it possible to change the initial empirical therapy to a targeted therapy in 15% (3/20) of cases and to discontinue the initial empirical therapy in 35% (7/20) of the subjects. In patients with low clinical suspicion of IME, their result allowed 25% (6/24) to have their suspicion confirmed and they were started on targeted antibiotic therapy; in contrast, 70.8% (17/24) had their diagnosis ruled out and were not started on treatment. Conclusions: The result of the FAME panel for testing in CSF has a high impact on antimicrobial therapeutic decisions within 24 hours of clinical assessment. However, it must be interpreted with the clinical context, local epidemiology and other diagnostic studies.(AU)

[Experience with the Biofire FilmArray® for infectious meningitis/encephalitis in a high complexity institution in Bogota, Colombia]. / Experiencia con el Biofire FilmArray® para meningitis/encefalitis infecciosa en una institución de alta complejidad en Bogotá, Colombia.

INTRODUCTION: Infectious meningoencephalitis (IME) is a neurological emergency with a significant rate of morbidity and mortality. The Biofire FilmArray® meningitis/encephalitis (FAME) panel for testing in cerebrospinal fluid (CSF) has proven to be a valuable tool for the aetiological diagnosis of IME, facilitating targeted antimicrobial therapy. The aim is to determine the impact of the FAME panel on antimicrobial therapeutic decisions in patients with suspected IME in the first 24 hours of clinical assessment. PATIENTS AND METHODS: This is a descriptive observational study that comments on the clinical manifestations, the neuroimaging and paraclinical findings, and the antibiotic therapy of patients with suspected IME. An analysis was performed to determine the impact of FAME on antimicrobial therapy in the first 24 hours of the clinical assessment of patients. RESULTS: Altogether 44 patients were included. The average time required to obtain the result of the FAME panel for testing in CSF was nine hours, with 20.4% (9/44) of tests yielding positive results. Within 24 hours of clinical assessment, their outcome had an impact on antimicrobial treatment decisions in 75% (33/44) of cases. In patients with a high clinical suspicion of IME, the result of FAME made it possible to change the initial empirical therapy to a targeted therapy in 15% (3/20) of cases and to discontinue the initial empirical therapy in 35% (7/20) of the subjects. In patients with low clinical suspicion of IME, their result allowed 25% (6/24) to have their suspicion confirmed and they were started on targeted antibiotic therapy; in contrast, 70.8% (17/24) had their diagnosis ruled out and were not started on treatment. CONCLUSIONS: The result of the FAME panel for testing in CSF has a high impact on antimicrobial therapeutic decisions within 24 hours of clinical assessment. However, it must be interpreted with the clinical context, local epidemiology and other diagnostic studies.

TITLE: Experiencia con el Biofire FilmArray® para meningitis/encefalitis infecciosa en una institución de alta complejidad en Bogotá, Colombia.Introducción. La meningoencefalitis infecciosa (MEI) es una emergencia neurológica con importante morbimortalidad. El panel Biofire FilmArray? para meningitis/encefalitis (FAME) en el líquido cefalorraquídeo (LCR) ha demostrado ser una valiosa herramienta para el diagnóstico etiológico de la MEI, facilitando una terapia antimicrobiana dirigida. El objetivo es determinar el impacto del panel FAME en las decisiones terapéuticas antimicrobianas en pacientes con sospecha de MEI en las primeras 24 horas de la valoración clínica. Pacientes y métodos. Estudio observacional descriptivo que comenta las manifestaciones cínicas, los resultados de neuroimágenes y paraclínicos, y la antibioticoterapia de pacientes con sospecha de MEI. Se realizó un análisis del impacto que tiene el FAME en la terapia antimicrobiana en las primeras 24 horas de la valoración clínica de los pacientes. Resultados. Se incluyó a 44 pacientes. El tiempo promedio para obtener el resultado del panel FAME en el LCR fue de nueve horas, con un 20,4% (9/44) de pruebas positivas. En las primeras 24 horas de la valoración clínica, su resultado tuvo impacto en las decisiones terapéuticas antimicrobianas en el 75% (33/44) de los casos. En pacientes con alta sospecha clínica de MEI, el resultado del FAME permitió cambiar la terapia empírica inicial a una dirigida en el 15% (3/20) y suspender la terapia empírica inicial en el 35% (7/20) de los sujetos. En pacientes con baja sospecha clínica de MEI, su resultado permitió que al 25% (6/24) se le confirmara la sospecha y se le iniciara antibioticoterapia dirigida; y que al 70,8% (17/24) se le descartara el diagnóstico y no se le iniciara tratamiento. Conclusiones. El resultado del panel FAME en el LCR tiene alto impacto en la toma de decisiones terapéuticas antimicrobianas en las primeras 24 horas de la valoración clínica. Sin embargo, su interpretación debe hacerse con el contexto clínico, la epidemiología local y otros estudios diagnósticos.

Aerodynamic characteristics and genesis of aggregates at Sakurajima Volcano, Japan.

Aggregation of volcanic ash is known to significantly impact sedimentation from volcanic plumes. The study of particle aggregates during tephra fallout is crucial to increase our understanding of both ash aggregation and sedimentation. In this work, we describe key features of ash aggregates and ash sedimentation associated with eleven Vulcanian explosions at Sakurajima Volcano (Japan) based on state-of-the-art sampling techniques. We identified five types of aggregates of both Particle Cluster (PC) and Accretionary Pellet (AP) categories. In particular, we found that PCs and the first and third type of APs can coexist within the same eruption in rainy conditions. We also found that the aerodynamic properties of aggregates (e.g., terminal velocity and density) depend on their type. In addition, grainsize analysis revealed that characteristics of the grainsize distributions (GSDs) of tephra samples correlate with the typology of the aggregates identified. In fact, bimodal GSDs correlate with the presence of cored clusters (PC3) and liquid pellets (AP3), while unimodal GSDs correlate either with the occurrence of ash clusters (PC1) or with the large particles (coarse ash) coated by fine ash (PC2).

Biological control of mites by xerophile Eurotium species isolated from the surface of dry cured ham and dry beef cecina.

Some meat dry products, including dry cured ham and dry beef cecina, are cured in cellars at moderately cold temperature allowing the growth of a lawn of fungi on their surface. During the curing process, frequently these products became contaminated with fungivore mites of the Acaridae family that feed on fungal mycelium and spores. AIMS: The aim of this article is to study the possible biological control of mites by fungi that form part of the normal microbiota of these meat products. METHODS AND RESULTS: Some yellow/orange pigmented fungi growing on the ham surface decreased the proliferation of mites; therefore, we isolated from ham and cecina xerophilic yellow/orange coloured fungal strains that were identified as members of the genus Eurotium (recently reclassified as Aspergillus section Aspergillus). Using molecular genetic tools, we have identified 158 strains as Eurotium rubrum (Aspergillus ruber), Eurotium repens (Aspergillus pseudoglaucus) and Eurotium chevalieri (Aspergillus chevalieri). Two strains, E. rubrum C47 and E. rubrum C49, showed strong miticidal activity. The toxic compound(s) are associated with the formation of cleistothecia. In synchronized mite development experiments, we observed that all stages of the mite lifecycle were inhibited by the E. rubrum C47 strain. In addition, we searched for miticidal activity in 13 culture collection Eurotium strains isolated from different habitats, and found that only one, Eurotium cristatum NRRL 4222 (Aspergillus cristatus) has a strong miticidal activity. CONCLUSIONS: These fungal strains have proliferated on the surface of ham and cecina for decades, and possibly have acquired miticidal activity as a resistance mechanism against fungivores. SIGNIFICANCE AND IMPACT OF THE STUDY: Biological control of infecting mites by favouring growth of E. rubrun C47, in place of the normal mixed population of Aspergillus and Penicillium, is an attractive approach to control mite infestations.

Evaluation of laser scanning confocal microscopy as a method for characterizing reef-building coral tissue thickness and Symbiodiniaceae fluorescence.

Predicting the sensitivity of reef-building corals to disturbance, including bleaching, requires an understanding of physiological responses to stressors, which may be limited by destructive sampling and the capacity of common methodologies to characterize early life history stages. We developed a new methodology using laser scanning confocal microscopy (LSCM) to measure and track the physiological condition of corals. In a thermal stress experiment, we used LSCM to track coral condition during bleaching in adults and juveniles of two species, Montipora capitata and Pocillopora acuta Depth of fluorescence in coral tissues provides a proxy measure of tissue thickness, whereas Symbiodiniaceae population fluorescence relates to both population density and chlorophyll a content. In response to thermal stress, there were significant shifts in tissue thickness and Symbiodiniaceae fluorescence with differences between life stages. This method is particularly well suited for detecting shifts in physiological condition of living corals in laboratory studies, especially in small juvenile colonies.

Superparamagnetic nanosorbent for water purification: Assessment of the adsorptive removal of lead and methyl orange from aqueous solutions.

The present study describes the preparation of 50.3 nm superparamagnetic nanosorbents with high surface area for the adsorptive removal of lead and methyl orange from water. This material is based on the surface modification of iron oxide superparamagnetic nanoparticles with a double-shell coating of mesoporous silica whose porosity was increased up to 570 m2/g by the addition of a porogenic material and its calcination. The adsorptive performance of the nanosorbent was evaluated as a function of several parameters (e.g. solution pH, pollutant initial concentration, and contact time), concluding that pHs around 5 are needed to avoid precipitation of Pb2+ as Pb(OH)2 and the equilibrium adsorption capacity is reached after 2 h in all cases. The experimental data on the adsorption capacity of lead and methyl orange onto the nanosorbent were fit to a pseudo-second order kinetic model and Langmuir isotherm model. The maximum adsorption capacity value increases from 35 up to 50 mg/gNS for lead removal with increasing nanosorbent surface area. Contrary, for methyl orange the maximum adsorption goes up to 240 mg/gNS, indicating a larger nanosorbent surface affinity for the organic matter that is able to diffuse through the silica pores as probed by the intraparticle diffusion model. In addition, we found an good reusability (100% recovering after 4 sorption/desorption cycles for methyl orange removal), which makes of this magnetic nanosorbent suitable for remediation technologies.

The coexistence temperature of hydrogen clathrates: A molecular dynamics study.

Extensive molecular dynamics simulations in the equilibrium isobaric-isothermal (NPT) ensemble were developed to determine the coexistence temperatures of the water hydrogen mixture using the direct coexistence method. The water molecules were modeled using the four-site TIP4P/Ice analytical potential, and the hydrogen molecules were described using a three-site potential. The simulations were performed at different pressures (p = 900, 1500, 3000, and 4000 bars). At each pressure, a series of simulations were developed at different temperatures (from 230 to 270 K). Our results followed a line parallel to the experimental coexistence temperatures and underestimated these temperatures by approximately 25 K in the investigated range. The final configurations could or could not contain a fluid phase depending on the pressure, in accordance with the phase diagram. In addition, we explored the dynamics of the H2 molecules through clathrate hydrate cages and observed different behaviors of the H2 molecules in the small cages and the large cages of the sII structure.

Dolor lumbopélvico asociado a discapacidad durante el tercer trimestre de embarazo y su evolución posterior al parto / Lumbopelvic pain associated with disability during the third trimester of pregnancy and its evolution after delivery

RESUMEN El dolor lumbopélvico es una condición muy frecuente, afectando un 50 a 70% de las mujeres durante el embarazo. En la mayoría de los casos ha habido una recuperación al mes o 3 meses postparto. Sin embargo, estudios reportan que la mejoría es incompleta, pudiendo persistir o aumentar años posterior al parto. Esta condición puede causar limitaciones en la vida diaria, provocando algún grado de discapacidad que muchas veces no es abordado con la importancia que se merece. Objetivo Determinar la prevalencia de dolor lumbopélvico y su relación con el grado de discapacidad durante el tercer trimestre de embarazo y 3 meses postparto. Material y método Estudio observacional y cohorte prospectivo; la muestra son 81 mujeres estudiadas en su tercer trimestre de embarazo y 3 meses postparto atendidas durante 2014-2015 en el Departamento de Obstetricia & Ginecología, Clínica Las Condes. Se aplicó un cuestionario y el Índice de discapacidad Oswestry en ambas etapas y autoadministrada. El análisis de datos se realizó con STATA10.0. Resultados El 81,48% de las embarazadas presentaron dolor lumbopélvico, siendo más prevalente y con una asociación significativa en el tercer trimestre (72,84%, p<0,001). El 25,93% de las mujeres lo mantiene después del parto. Existe una asociación significativa entre dolor lumbopélvico y grado de discapacidad (p<0,001), específicamente con actividades de la vida diaria, actividad sexual y actividades domésticas. Conclusiones Existe una alta prevalencia de dolor lumbopélvico en el embarazo, y un porcentaje no menor lo mantiene postparto, y en ambos casos está asociado a un grado de discapacidad.

ABSTRACT Lumbopelvic pain is a very frequent condition that affects between 50 to 70% of pregnant women. In many cases have been a recovery over the month or three months postpartum. However, some studies showed an incomplete improvement, so it could persist or increase through years after childbirth. This condition can cause daily life limitations, it is provoking some disability grade, that many times it didn't understand with the importance that deserve. Aim To identify the lumbopelvic pain prevalence and the relation with disability grade during the third trimester of pregnancy and three months postpartum. Material and Methods Observational and prospective cohort study; the sample was 81 women studied in her third trimester of pregnancy and three months postpartum during 2014-2015 in the "Departamento de Obstetricia & Ginecologia de Clínica Las Condes". It applied a questionnaire and the Oswestry Disability Index in both stages and self-administered. Data analysis was using STATA 10.0 software. Results 81, 48% of pregnant showed lumbopelvic pain, there were being more prevalent and significantly associated with third trimester (72, 84%, p<0,001). 25, 93% of women maintained this condition postpartum. There is a significant association between lumbopelvic pain and disability grade (p<0,001), specifically with daily life, sexual and domestic activities. Conclusions There is a high prevalence of lumbopelvic pain during pregnancy, and not less percentage maintained this condition postpartum, that associated with a high disability grade.

El Sistema de Salud de la ciudad de Buenos Aires en el siglo xix en relación a las enfermedades de transmisión sexual / THE HEALTH SYSTEM IN THE CITY OF BUENOS AIRES DURING THE XIXth CENTURY, RELATED TO THE DISEASES OF SEXUAL TRANSMISSION

The health system of the City of Buenos Aires during the XIX century, related to the diseases of sexual transmission, is presented. The "General Hospital for Acute Diseases Dr. Juan A. Fernandez" of universitary character with a well gained prestige in his influencial zone, accumulates the highest technology in this programmatic area, and is today related with the great epidemic disease of sexual transmission from the XXth. Century: AIDS. Not always is well known the fact that, more than a century ago, this Institution was created to confront also to an epidemic of sexual transmission: syphilis. Is then purpose of this revision to introduce to the reader in the behavioral situation at the time of its foundation, the sanitary problems that conducted to its creation and the history of his former years, all of that related to the evolution of the sexually transmitted diseases at the endings of the XIX century.

Separating the effects of repulsive and attractive forces on the phase diagram, interfacial, and critical properties of simple fluids.

Molecular simulations in the canonical and isothermal-isobaric ensembles were performed to study the effect of varying the shape of the intermolecular potential on the phase diagram, critical, and interfacial properties of model fluids. The molecular interactions were modeled by the Approximate Non-Conformal (ANC) theory potentials. Unlike the Lennard-Jones or Morse potentials, the ANC interactions incorporate parameters (called softnesses) that modulate the steepness of the potential in their repulsive and attractive parts independently. This feature allowed us to separate unambiguously the role of each region of the potential on setting the thermophysical properties. In particular, we found positive linear correlation between all critical coordinates and the attractive and repulsive softness, except for the critical density and the attractive softness which are negatively correlated. Moreover, we found that the physical properties related to phase coexistence (such as span of the liquid phase between the critical and triple points, variations in the P-T vaporization curve, interface width, and surface tension) are more sensitive to changes in the attractive softness than to the repulsive one. Understanding the different roles of attractive and repulsive forces on phase coexistence may contribute to developing more accurate models of liquids and their mixtures.

Tandem mass spectrometry newborn screening for inborn errors of intermediary metabolism: abnormal profile interpretation.

Expanded newborn screening for inherited metabolic disorders using tandem mass spectrometry was introduced in 1990's and is widely used around the world. In contrast to conventional screening methods, tandem mass spectrometry does not measure single analytes but identifies and quantifies metabolite profiles; one single blood spot analyzed provides information of about 60 metabolites including amino acids, acylcarnitines and related ratios that enable the diagnosis of approximately 50 different diseases. However, the interpretation of these profiles can become quite complex. The aim of this work is to present in an easy and practical manner a comprehensive compilation of information needed for tandem mass neonatal screening profile interpretation, and basic actions for immediate follow up of abnormal results, including the tests that are required for confirmatory purposes. Other conditions not attributable to metabolic disorders which can lead to an abnormal profile of these markers are also described as well as a series of general recommendations which would be useful for health professionals who are beginning newborn screening for inborn errors of intermediary metabolism using tandem mass spectrometry.

Side effects of rodent control on non-target species: Rodenticides increase parasite and pathogen burden in great bustards.

For many years anticoagulant rodenticides have been used in vole control campaigns, in spite of the proven risk of secondary poisoning of non-target predators and scavengers. In this paper we analyse for the first time great bustard exposure and intoxication by anticoagulant rodenticides in Spain, based on residues found in the livers of 71 bustard carcasses collected during 1991-2010. Ten individuals contained chlorophacinone and one flocoumafen. Chlorophacinone level was significantly correlated with the pathogen and parasite burden of intoxicated birds. Moreover, through the last 12 years the annual number of great bustards that present chlorophacinone in liver collected in our study areas was correlated with vole peaks at a nearby area, suggesting that the ingestion of rodenticide was proportional to the amounts spread in the fields. We conclude that rodenticide consumption is a regular event among great bustards when baited cereal is spread on fields, and that this may cause chronic weakening of intoxicated individuals, possibly affecting their survival. Future rodent control actions should consider these negative side effects on non target granivorous steppe and farmland species, particularly when they are globally threatened.

Raptor nest decorations are a reliable threat against conspecifics.

Individual quality is often signaled by phenotypic flags, such as bright plumage patches in birds. Extended phenotype signals can similarly show quality, but in these cases the signals are external to the individual, often taking the form of objects scavenged from the environment. Through multiple manipulative experiments, we showed that objects used for nest decoration by a territorial raptor, the black kite (Milvus migrans), act as reliable threats to conspecifics, revealing the viability, territory quality, and conflict dominance of the signaler. Our results suggest that animal-built structures may serve as signaling devices much more frequently than currently recognized.

Principales causas de anormalidades en citologías de cérvix en pacientes no gestantes en edad reproductiva con diagnóstico de VIH/SIDA que asisten a la clínica de Enfermedades Infecciosas del Hospital Roosevelt / Main causes of abnormalities in cervical smears in nonpregnant patients of reproductive age diagnosed with HIV / AIDS attending the clinic Roosevelt Hospital Infectious Diseases

Se realizó una investigación para determinar las principales causas de anormalidades en las citologías de cérvix de pacientes femeninas en edad reproductiva con diagnóstico de virus de inmunodeficiencia humana y síndrome de inmunodeficiencia adquirida que asistieron a la Clínica de Enfermedades Infecciosas del departamento de Medicina Interna del Hospital Roosevelt, durante el período de enero 2005 a diciembre 2009. Entre los objetivos de la investigación se encontraba: determinar las principales causas de anormalidades en las citologías de cérvix en las pacientes, así como establecer cual fue el estado civil de las pacientes que más se vió afectado y en qué estaddío clínico de la CDC predominaron las anormalidades...

Análisis epidemiológico y gestión sanitaria de la epidemia de gripe A H1N1: experiencia en la ciudad de Buenos Aires (invierno de 2009) / Epidemiological analysis and sanitary management of the influenza a H1N1: experience in the city of Buenos Aires (outbreak in winter 2009)

Las pandemias de influenza son eventos impredecibles pero recurrentes, que suponen consecuencias gravosas para las sociedades en todo el mundo. Desde el siglo XV y XVI, con el famoso sudor anglicus, se han descrito pandemias de influenza con intervalos más o menos regulares, entre 10 y 50 años, cuya gravedad y repercusiones han sido variables destacándose en el siglo XX la "gripe española" de 1918/1919, probablemente una de las mayores y más mortíferas pandemias de la historia humana, la influenza asiática entre 1957/1958 y la de Hong Kong entre 1968/1969. En 2003 surgió preocupación mundial ante una posible pandemia de influenza aviar (H5N1) que era sindicada como la gran favorita para un próximo evento de este tipo; no obstante nunca llegó a sortear la imposibilidd de propagarse de humano a humano. En abril de 2009, la OMS (WHO) comenzó a recibir reportes de personas con un nuevo tipo de virus de influenza A (H1N1) en México y EE.UU. La rápida diseminación internacional ulterior llevó a la propia OMS a declarar el 11 de junio de 2009 la primera pandemia de influenza en 41 años. En Argentina y luego del llamado inicial de alerta de Ministerio de Salud de la Nación, el Gobierno de la Ciudad de Buenos Aires inició procesos destinados al reporte, detección y vigilancia epidemiológica de los casos locales. A principios del mes de mayo se difundieron las noticias de los primeros casos de Gripe A confirmados en el país y el 30 de junio se decretó la emergencia sanitaria en la ciudad profundizándose un proceso de análisis sobre las medidas a tomar. Las acciones específicas tomadas por el GCBA y su MSAL pueden agruparse en acciones sobre el sistema de salud y sus efectores y acciones de estrategia comunicacional. Se concluye de este episodio pandémico que la Gripe A desplazó a la gripe estacional siendo la circulación viral en adultos mayormente virus A H1N1...

Influenza pandemics are unpredictable but recurrent events, involving serious consequences for societies worldwide. From the fifteenth and sixteenth century, with the famous anglicus sweat, there have been described pandemics of influenza within more or less regular intervals, between 10 and 50 years, whose severity and impact has been variale, emphasizing in the twentieth century the "Spanish flu" of 1918/1919, probably one of the largest and most dedly pandemics in human history, between 1957/1958 the Asian flu and the Hong Kong flu from 1968 to 1969. In 2003, concern arose about a possible global pandemic of avian influenza (H5N1), which was syndicated as the most probable cause for an upcoming event of this king, yet it never get around the inability to spread from human to human. In April 2009, WHO began to receive reports of Mexico and the U.S. The rapid internatinal spread further les WHO to declare on June 11 th 2009 the first influenza pandemic in 41 years. In Argentina and after the initial warning call of the Ministry of Health of the Nation, the Government of the City of Buenos Aires initiated processes for the reporting, detection and epidemilogical surveillance of local cases. In early May, the news spread of the first confirmed cases of influenza A in the country and on June 30 was declared a health emergency in the city getting stronger a process of discussion of measures to take. The specific actions taken by the GCBA and The Ministry of Health can be grouped into action on the health system and its effectors, and communications strategies and activities. We conclude from this episode of pandemic Influenza that the A virus H1N1 has replace the seasonal flu virus, because influenza virus circulation among adults was mostly H1N1 virus, that in spite of the fact of being getting trough a pandemic episode, the overall death rate was lower of that of the seasonal flu...

Fatal embryo chondral damage associated with fluoroquinolones in eggs of threatened avian scavengers.

Stabled livestock reared in housed conditions are often subjected to intensive treatments with veterinary drug, which residues may be present in livestock meat ingested by scavengers, but nothing is known about their presence in eggs of wild birds and their potential detrimental effects on breeding success. We searched for residues of veterinary drugs and other toxicants in infertile and embryonated unhatched eggs of griffon vultures (Gyps fulvus) and red kites (Milvus milvus), two threatened avian scavengers. Quinolones (ciprofloxacin and enrofloxacin) were found in most unhatched eggs of both scavenger species clearly associated with severe alterations in the development of embryo cartilage and bones that could preclude embryo movements and subsequently normal development, pre-hatch position and successful hatching. The detrimental effects on developing eggs of veterinary drugs from livestock operations may help to explain reduced breeding success of avian scavengers.

Reforma del modelo de atención de la salud mental en la Ciudad Autónoma de Buenos Aires. Ejes conceptuales e instrumentos operativos / Supports for the reformulation of the model for the mental care at the city of buenos Aires

Se presentan las bases operativas del cambio de modelo de atención en salud mental, incluyendo su base de sustentación en la Ley 448, en los documentos nacionales e internacionales en la materia, los cambios programados en infraestructura, equipamiento, recursos humanos y gestión del ingreso a la red de complejidad ascendente.

The aim of this report was to present the supports for the reformulation of the model for the mental health care at the city of Buenos Aires, with conceptual guidelines and the operative instrumentation.

Evaluación de resultados en programas sanitarios: marco conceptual e instrumental oerativo aplicaados en el ámbito del Ministerio de Salud de la Ciudad de Buenos Aires / Evaluation of reults in sanitary programs

Evaluation of results in sanitary programs: conceptual mark and operative instrumentable, applied in the concern of the Ministery of Health from the city of Buenos Aires.

Epidemiología y medicamentos: esenciales, genéricos y el programa Remediar / Epidemiology and pharmaceutical drugs: essential and generics

This report describes the epidemiology and pharmaceutical drugs: essentials and generics.