New insights into the pathogenesis and transmission of Brucella pinnipedialis: systemic infection in two bottlenose dolphins (Tursiops truncatus).

IMPORTANCE: Brucella spp. are zoonotic pathogens that can affect both terrestrial and marine mammals. Brucella ceti has been identified in various cetacean species, but only one sequence type (ST27) has been reported in humans. However, it is important to conduct surveillance studies to better understand the impact of marine Brucella species on marine mammals, a typically understudied host group. Here, we describe a systemic infection by two related strains of Brucella pinnipedialis (ST25) in a couple of live-stranded bottlenose dolphins, with more severe lesions in the younger animal. Furthermore, B. pinnipedialis was first detected in milk from a female cetacean that stranded with its offspring. Our study reveals novel insights into the epidemiology and pathological consequences of B. pinnipedialis infections in cetaceans, emphasizing the crucial importance of ongoing surveillance and accurate diagnosis to understand the impact of this pathogen on marine mammal populations.

Mediastinal Ectopic Thyroid Carcinoma and Concurrent Multinodular Pulmonary Fibrosis in a Horse.

A 30-year-old Standardbred gelding was referred for chronic pleural effusion. Thoracic ultrasound revealed marked bilateral pleural effusion and a large heterogeneous mass within the cranial mediastinum, which extended from the right 5th to the 11th intercostal space. Subsequently, on thoracic radiographs, the cranial mediastinal mass was confirmed, and a nodular interstitial pattern was identified in the lungs. Because of progressive clinical deterioration of the patient, the owners elected humane euthanasia and necropsy was performed. The mediastinal mass was consistent with an ectopic thyroid carcinoma, and the pulmonary nodules represented equine multinodular pulmonary fibrosis (EMPF). This case report describes a type of mediastinal tumor not previously described in horses. Moreover, it shows the need of including EMPF as a possible differential diagnosis for a nodular interstitial pulmonary pattern in conjunction with a mediastinal or other masses.

Aprendizaje centrado en las perspectivas del paciente: el caso de las escuelas de medicina en México / Perspectives on patient centred learning: A study in Mexican medical schools

INTRODUCCIÓN: La educación médica ha evolucionado en etapas. La más reciente de educación basada en sistemas implica un análisis desde perspectivas de alta complejidad para alinearlas a las necesidades del paciente. De esta forma surge el aprendizaje centrado en las perspectivas del paciente que incluye 4 dimensiones: humana, biomédica, gestión y emprendimiento. OBJETIVO: Describir el concepto de aprendizaje centrado en las perspectivas del paciente como estrategia didáctica y explorar su aplicación en las escuelas de medicina de México. MATERIAL Y MÉTODOS: El método fue exploratorio, descriptivo y transeccional. Se realizó una encuesta a 85 profesores y directivos pertenecientes a escuelas de medicina afiliadas a la Asociación Mexicana de Facultades de Escuelas de Medicina (AMFEM) para evaluar la implementación de las dimensiones del aprendizaje centrado en las perspectivas del paciente en escala Likert de 1 (Totalmente en desacuerdo) a 5 (Totalmente de acuerdo). RESULTADOS: La media por perspectiva fue: humana (3,76), biomédica (3,72), gestión (3,49) y emprendimiento (3,33). Destaca el mayor énfasis en ¿quién es el paciente? y el menor en ¿cómo puedo mejorar?. DISCUSIÓN: El modelo presentado evoluciona desde la educación basada en competencias implementadas en la educación a partir de contenidos aislados, a un enfoque en base a perspectivas que colocan en el centro al paciente para abordar desde un mismo caso múltiples competencias del médico

INTRODUCTION: Medical education has evolved through severel stages. The most recent one, systems-based learning, involves an analysis of complex perspectives an adapting them to patient needs. From this notion, the concept perspectives for patient centred learning emerges. It includes four dimensions: human, biomedical, managerial, and entrepreneurial. OBJECTIVE: The aim of this study was to define the perspectives for patient centred learning as a teaching strategy and examine its application in medical schools in Mexico. MATERIAL AND METHODS: The method was exploratory, descriptive and cross-sectional. A questionnaire was completed by 85 faculty members and deans from the Mexican Association of Schools and Faculties of Medicine (AMFEM for its initials in Spanish) to assess the implementation of perspectives for patient centred learning, using a Likert scale from 1 (Total disagreement) to 5 (Total agreement). RESULTS: The mean calculated by perspective was: human (3.76), biomedical (3.72), management (3.49), and entrepreneurship (3.33). Higher emphasis was placed on who is the patient?, and a lower focus on how the system should be improved?. DISCUSSION: The presented model evolves from a competency based framework implemented in education as isolated contents, to a perspective based focus that places the patient in the centre, analysing the same case from multiple medical skills