Recovery time after oral and maxillofacial ambulatory surgery with dexmedetomidine: an observational study.

OBJECTIVES: To evaluate the relationship between pharmacokinetic descriptors of dexmedetomidine (predicted area under the curve during the procedure, predicted plasma level at the end of the procedure, and duration of procedure) and sedation depth (proportion of time with bispectral index < 85 during the procedure) with recovery time after ambulatory procedures. MATERIALS AND METHODS: Clinical observational study of patients undergoing oral and maxillofacial ambulatory surgery with dexmedetomidine as sole sedative agent. Patients received a loading dose of dexmedetomidine (0.25-1 µg kg-1) followed by a maintenance infusion (0.2-1.4 µg kg-1 h-1) to keep a bispectral index < 85 until 5 min before the end of the procedure, and were transferred to a post-anesthesia care unit until criteria for discharge were met. RESULTS: Data from 75 patients was analyzed. Sedation depth was directly associated with recovery time (Pearson correlation coefficient [r] = 0.26; p = 0.024). Around 7% of the variation in recovery time was explained by the proportion of time with bispectral index < 85. No association with procedure duration (r = 0.01; p = 0.9), predicted area under the curve (r = 0.1; p = 0.4), or predicted plasma level of dexmedetomidine at the end of the procedure (r = 0.12; p = 0.3) with recovery time was observed. CONCLUSIONS: Sedation depth with dexmedetomidine could play a role in increasing recovery time after oral and maxillofacial ambulatory surgery. In our study, the pharmacokinetic descriptors of dexmedetomidine did not seem to influence recovery time. CLINICAL RELEVANCE: Sedation depth with dexmedetomidine could play a role in increasing recovery time after ambulatory procedures.

High serological and molecular prevalence of Ehrlichia canis and other vector-borne pathogens in dogs from Boa Vista Island, Cape Verde.

Despite the high global impacts of canine vector-borne diseases (CVBD) due to their wide distribution and zoonotic potential, the current epidemiological situation of CVBD in many tropical and subtropical regions remains unknown. This study examines the seroprevalence and molecular prevalence of Ehrlichia canis and other pathogens causing CVBDs (Leishmania infantum, Dirofilaria immitis, Babesia spp., Anaplasma spp. and Hepatozoon canis) in dogs living on the island of Boa Vista (Cape Verde Republic). Blood samples and infesting ticks were taken from 150 dogs across the island (stray, shelter, and pet dogs). Serum samples were tested using a rapid immunochromatographic test (Uranotest® Quattro) that detects antibodies against E. canis, L. infantum, Anaplasma spp. and D. immitis antigen. Levels of serum antibodies against E. canis were measured using the immunofluorescence antibody test (IFAT). In addition, tick-borne pathogens in blood samples (Anaplasma spp., Babesia spp., Hepatozoon spp., and Ehrlichia canis) were detected by microscopy observation and/or PCR plus sequencing. The seroprevalence of E. canis was extremely high at 82% (123/150), as revealed by both immunochromatography and IFAT. Most dogs returning a seropositive test result (82.92%; 102/123) had antibody titres > 1:1280 but showed no clinical signs or notable laboratory abnormalities. Of the 123 animals testing seropositive for E. canis, 67 (54.47%) also presented antibodies against Anaplasma spp., and 13 (10.56%) showed the presence of Hepatozoon spp. gamonts in the blood smear. Ehrlichia canis infection was detected in 17.1% (25/146) of dogs tested by direct sequencing of polymerase chain reaction (PCR) products. Co-infections were detected in seven of these dogs: four dogs tested PCR-positive for both E. canis and A. platys, two dogs tested positive for E. canis and Hepatozoon spp., and one dog tested positive for E. canis, A. platys and Hepatozoon spp. Rhipicephalus sanguineus sensu lato was the only tick species found infesting the canine study population. The high prevalence of tick-borne pathogens detected in dogs from Boa Vista Island highlights a need for improved control measures designed to prevent the transmission of these pathogens.

The role of veterinarians in zoonosis prevention: Advising families of immunocompromised children with pets.

Background: Pet ownership is widespread, offering numerous benefits to individuals and families. However, the risk of zoonotic diseases must be carefully considered, especially for immunosuppressed patients. Knowledge gaps in preventive measures for zoonoses have been identified, underscoring the vital role of veterinarians in addressing this issue. Objectives: This study aimed to assess the knowledge and recommendations of veterinarians regarding pet ownership by immunocompromised individuals. Additionally, we compared these insights with responses from European healthcare professionals specializing in pediatric transplant recipients. Methods: We conducted an observational, cross-sectional study involving small animal veterinarians in Spain. An online survey was administered to gather information on veterinarians' knowledge of zoonoses and their recommendations for immunocompromised pet owners. Results: A survey of 514 individuals was collected from experienced veterinarians mainly working in primary care clinics. Surprisingly, 63% of respondents did not routinely inquire about the presence of immunocompromised individuals among pet owners, although 54% offered specific recommendations for this group. Most respondents adhered to deworming guidelines for pets owned by immunocompromised individuals and demonstrated sound practices in Leishmania and Leptospira prevention, as well as the avoidance of raw food. However, gaps were noted concerning Bordetella bronchiseptica vaccination. Notably, veterinarians outperformed medical professionals in their knowledge of zoonotic cases and identification of zoonotic microorganisms. The presence of specific recommendations in veterinary clinics was viewed positively by nearly all respondents. Conclusions: Our findings indicate that veterinarians possess a superior understanding of zoonotic pathogens and exhibit greater proficiency in diagnosing zoonoses compared with physicians. They stay well-informed about recommendations outlined in established guidelines and are more likely to provide written recommendations in their clinics than physicians. Nevertheless, knowledge gaps among veterinarians emphasize the need for enhanced communication between medical and veterinary professionals. Reinforcing the "One Health" concept is imperative, with veterinarians playing a pivotal role in this collaborative effort.

Zoonosis screening in Spanish immunocompromised children and their pets.

Introduction: Although pets provide several social-emotional benefits for children, the risk of zoonosis must be considered among immunocompromised individuals. Methods: A prospective study was conducted in a tertiary hospital including immunocompromised patients younger than 20 years owning dogs and/or cats. Colonization and/or infection was evaluated by stool studies, bacterial swabs, blood polymerase chain reaction and serological studies in both patients and their pets, to evaluate potential zoonotic transmission occurrence. Results: We included 74 patients and their 92 pets (63 dogs, 29 cats). Up to 44.6% of the patients and 31.5% of the pets had at least 1 positive result. Up to 18.4% of pets' fecal samples were positive (bacteria, parasites or hepatitis E virus). No helminths were observed despite the high frequency of incorrect intestinal deworming practices. Among children, gastrointestinal microorganisms were found in 37.3% (primarily Clostridium difficile). Colonization by Staphylococcus pseudintermedius was common among pets (8.0%) but not among children (0.0%). No shared colonization between owners and pets was observed, except in one case (Blastocystis in both patient and pet feces). Among patients, serologies were positive for Strongyloides stercoralis (14.8%), Toxocara canis (3.2%), Bartonella henselae (19.1%) and hepatitis E (5.6%). Serology was positive for Rickettsia spp. (22.6%) and Babesia spp. (6.5%) in dogs and for Leishmania spp. (14.3%) and Toxoplasma spp. (14.3%) in cats. Conclusion: Exposure to zoonotic agents was detected in both patients and pets; however, shared colonization events were almost nonexistent. In our cohort, dogs and cats do not appear to entail high zoonosis transmission risk for immunocompromised patients.

In Vitro Study of the Effect of Ensiling Length and Processing on the Nutritive Value of Maize Silages.

The effect of the ensiling length (3, 6, or 9 months), and the processing by dehydration (D) or dehydration and pelleting (P) with respect to the fresh silages (F) were studied in vitro on three maize cultivars in three incubation runs to study the effect of these factors on the nutritive value of maize silage. Gas production pattern, in vitro true digestibility (IVTD), methane concentration (6 and 12 h), ammonia, and volatile fatty acid concentration (VFA) at 12 h were measured. The moisture and pH of F averaged 676 g/kg and 4.09, respectively, and were not affected by the ensiling length, but moisture was reduced, and the pH increased in D and P with respect to F (p < 0.05). The ensiling length did not affect the chemical composition, but differences among the processing forms were detected in a higher acid detergent insoluble nitrogen (ADIN) proportion in P than D, and D than F (p < 0.001). Silages opened at 9 months showed the lowest gas production (p < 0.05), and those that opened after 3 months showed the highest IVTD. The effects of processing on nutrient utilisation only manifested on 3 month silages, with the volume of gas production and IVTD being lower in D than F. However, processing tended (p = 0.064) to reduce the methane proportion at 12 h, indicating both a more efficient fermentation and a lower potential of greenhouse gas emissions compared to the fresh silages. Extending the length of ensiling to 9 months reduced the fermentation of maize silage. The processing increased the dry matter and buffered the feed as well as contributed to an increase in fermentation in 3 month silages.

Global molecular diversity of Hepatitis E virus in wild boar and domestic pig.

Our study aim was to describe and characterize the global Hepatitis E virus (HEV) molecular and genotype geographical distribution in domestic pig and wild boar, which could facilitate the traceability of human cases. We performed a systematic sequence search for HEVs identified in domestic pig and wild boar from the available data in GenBank. Only sequences with lengths greater than 300 nt were included. For all sequences, the sequence length, host (i.e., domestic pig or wild boar), country of origin, and HEV genotype/subtype were recorded. Genotypes were assigned by the HEVnet typing tool. The genotype distributions were described by country and host. In countries with sequences available for both species, the genotype coincidences between both animal populations were analyzed. A total of 1404 viral sequences were included: 32.6% from wild boar and 67.4% from domestic pig. Most sequences were consistent with HEV genotype 3 (n = 1165). Genotype 4 was represented by 193 sequences, while genotypes 5 and 6 were represented by only 6 sequences. Sequences were identified in 39 countries, which included all continents except Antarctica. The genotypes with a wide distribution were 3a and 3f. Twenty-five countries had sequences that were found only in domestic pig, three countries only in wild boar, and 11 countries had sequences in both populations. In all countries with available sequences in both populations, the same viral genotype was identified. Our study shows that the number of swine HEV sequences is small, which limits direct comparisons with the sequences identified in humans. The global distribution of genotype 3, together with the wide distribution of genotype 4 in Asia, strongly limits the interpretation of the molecular analysis in the absence of an epidemiological survey of the cases. Increased HEV sequencing in swine should be a priority.

Efecto del soporte social en la salud mental de trabajadores inmigrantes: una revisión sistemática / Effect of social support on migrant workers' mental health: a systematic review

Introducción: Los trabajadores inmigrantes son una población especialmente vulnerable a desarrollar trastornos de la esfera psicosocial, en probable relación con las diferencias que este grupo de trabajadores presenta: barrera idiomática, dificultad para acceder al sistema, desconocimiento de recursos disponibles, falta y/o ausencia de una red de apoyo social estable y segura. Objetivo: Conocer la incidencia de trastornos psicosociales en trabajadores inmigrantes y la influencia del apoyo sociosanitario en el desarrollo o aparición de los mismos. Material y Métodos: Revisión de Revisiones Sistemáticas con búsqueda en Medline (Pubmed), Embase, Cochrane, Google Académico y Journal of Inmigrant and Minority Health. Se incluyeron revisiones sistemáticas publicadas entre 2003 y diciembre de 2021, en inglés y español. Se empleó AMSTAR2 para evaluar la calidad de los estudios incluidos. Resultados: Se incluyeron tres revisiones sistemáticas, de calidad intermedia. Los estudios mostraban que los trabajadores inmigrantes, presenta más riesgo de desarrollar depresión y hay una prevalencia mayor de ésta, debido a diversos factores como falta de apoyo social y familiar, la incertidumbre o el tipo de trabajo que desarrollan. En cuanto a ansiedad, también se vio un aumento del riesgo y la prevalencia en trabajadores inmigrantes, debido a los mismos factores. Conclusión: Es necesario desarrollar estrategias de prevención para la protección de la salud mental de los trabajadores inmigrantes, ya que por sus característica presentan un mayor riesgo psicosocial con aumento de prevalencia de enfermedades como depresión y ansiedad. Es importante conocer las características de los trabajadores, con el fin de poder emplear los recursos preventivos más acertados. (AU)

Introduction: Migrant workers are a special kind of group with notable vulnerability to develop more psychosocial disorders compared to native workers, which may be due to several disadvantages such as language, culture shock, lack of social support or lack of access to health care between others. There are few studies on the health of immigrant groups at present, therefore, it is necessary and vital to explore and identify mental health situation and social support related factors or conditions. Objectives: To have knowledge of the incidence of psychosocial disorders in migrant workers and perceive the influence of social and health support in their development or appearance. Material and Methods: This is a review of Systematic Reviews by searching in Medline (Pubmed), Embase, Cochrane, Google Scholar and Journal of Immigrant and Minority Health. Systematic reviews published between 2003 and December 2022 were included, both in English and Spanish. Results: Three systematic reviews, of intermediate quality according to the AMSTAR2 tool, were included. Regarding depression, they concluded that migrant workers, has a higher risk of developing depression due to some factors such as lack of social and family support, uncertainty, the type of work they develop, etc. Regarding anxiety, an increased risk and prevalence was also seen in migrant workers, also due to the same factors. Conclusion: Prevention strategies are required to protect migrant workers' mental health, as they are a remarkably vulnerable group with a higher psychosocial risk and an increased prevalence of diseases such as depression and anxiety. (AU)

Conocimientos y capacitación autopercibida para la reanimación cardiopulmonar / Cardiopulmonary resusitation knowledge and self-perceived degree of readiness

Objetivo: valorar el nivel de conocimientos de los enfermeros sobre el protocolo de reanimación cardiopulmonar (RCP) e identificar el grado de capacitación subjetiva y necesidad de formación autopercibida de los mismos. Método: estudio descriptivo transversal en tres ámbitos de actuación enfermera: atención primaria (A) (áreas 6 y 7), hospitalización general (B) y Unida desde Cuidados Intensivos (C) (Hospital Universitario 12 de Octubre),durante el mes de marzo de 2012, en la Comunidad de Madrid. Para la recogida de datos se utilizó un cuestionario sobre conocimientos, capacitación subjetiva y necesidad de formación en RCP, elaborado según las recomendaciones de 2010 del European Resuscitation Council (ERC) y la American Heart Association (AHA).Resultados: la muestra estuvo compuesta por 105 enfermeros, 35 de cada uno de los tres ámbitos del estudio. Los enfermeros de AP contestaron correctamente al 51,7% de las preguntas, los de planta al 58.9% y los de UCI al69,1%. El 26% de los profesionales enfermeros con más experiencia (> 25años) y el 11% de los que tenían menos experiencia (≤ 5 años) contestaron menos de 4 preguntas correctamente. Los enfermeros con una experiencia profesional de entre 5 y 15 años fueron los que reflejaron mejores conocimientos, contestando más de 6 preguntas bien el 62% de los mismos. El 62,9%de AP, el 54,3% de planta y el 25,7% de UCI se consideró poco preparado para reanimar. Estimaron muy importante la formación continuada el 71,4%,el 94,3% y el 91,4% de los profesionales de cada ámbito respectivamente. Conclusiones: los enfermeros no tienen los conocimientos suficientes y se sienten poco preparados para reanimar, existiendo diferencias según la unidad de trabajo. Se considera necesario mejorar la formación pre y postgrado de Enfermería en RCP (AU)

Purpose: Evaluate the degree of knowledge nursing professionals possess regarding the CPR protocol and identify the subjective degree of readiness and self-perceived need for training thereof. Method: Descriptive, cross-sectional study in three areas of nursing practice: primary care (A) (Districts 6 & 7), general hospitalization (B) and intensive care units (C) (“12 de Octubre" University Hospital) in March 2012 in the Autonomous Community of Madrid. For data collection, a questionnaire on knowledge , subjective degree of readiness and need for training in CPR was used, having been prepared according to the 2010 recommendations of the European Resuscitation Council (ERC) and the American Heart Association (AHA).Results: The sample was comprised of 105 nursing professionals, 35 from each one of the three fields of the study. The PC nursing personnel answered51.7% of the questions correctly, the hospital nurses, 58.9% and the ICU nurses, 69.1%. A total of 26% of the most experienced nursing professionals(> 25 years) and 11% of those who were less experienced (< 5 years) answered less than 4 questions correctly. The nursing personal possessing 5-15 years of professional experience were those showing the greatest degree of knowledge , 62% thereof having answered more than 6 questions correctly. A total of 62.9% of PC nurses, 54.3% of hospital nurses and 25.7% of ICU nurses considered themselves not very well prepared to perform CPR. A total of 71.4% of the PC nurses, 94.3% of the hospital nurses and 91.4% of the ICU nurses considered continuing training to be highly important. Conclusions: Nurses do not possess sufficient knowledge and do not consider themselves to ill-prepared for performing CPR, differences existing depending on the unit where these nursing professionals work. An improvement in undergraduate and graduate nursing training in CPR is considered necessary (AU)