Predictive score and probability of CTX-like toxicity in fish samples from the official control of ciguatera in the Canary Islands

This research identifies factors associated with the contamination by ciguatoxins (CTXs) in a population of fish and proposes a predictive score of the presence of CTX-like toxicity in amberjack samples from the official control program of ciguatera in the Canary Islands of the Directorate-General (DG) Fisheries (Canary Government). Out of the 970 samples of fish studied, 177 (18.2%) samples showed CTX-like toxicity. The fish were classified according to the species, amberjack (Seriola dumerili and S. rivoliana) (n = 793), dusky grouper (Epinephelus marginatus) (n = 145) and wahoo (Acanthocybium solandri) (n = 32). The data were separated by species category and statistically examined, resulting in 137 (17.3%) amberjack and 39 (26.9%) grouper samples showing CTX-like toxicity; regarding wahoo species, only 1 toxic sample (3.1%) was found. According to fishing location the contamination rates suggested grouping the islands in four clusters; namely: {El Hierro: HI; La Gomera: LG; La Palma: LP}, {Gran Canaria: GC; Tenerife: TF}, {Fuerteventura: FU} and {Lanzarote: LZ}. For the amberjack species, the multivariate logistic regression showed the factors that maintained independent association with the outcome, which were the warm season (OR = 3.617; 95% CI = 1.249–10.474), the weight (per kg, 1.102; 95% CI = 1.069–1.136) and the island of fish catching. A prediction score was obtained for the probability of contamination by CTX in amberjack fish samples. The area under de curve (AUC) obtained using the validation data was 0.747 (95% CI = 0.662–0.833). Regarding grouper species, the island of fishing was the only factor that showed significant differences associated with the presence of CTX-like toxicity. We provide herein data for a better management and prediction of ciguatera in the Canary Islands, suggesting a review of the minimum limits of fish weight established by the Canary Government for the control program.info:eu-repo/semantics/acceptedVersio

One Health Approach: Invasive California Kingsnake (Lampropeltis californiae) as an Important Source of Antimicrobial Drug-Resistant Salmonella Clones on Gran Canaria Island

The increase in the reptile population has led to a rise in the number of zoonotic infections due to close contact with reptiles, with reptile-associated salmonellosis being particularly relevant. California kingsnake invasion not only threatens the endemic reptile population of the island of Gran Canaria (Spain) but also poses serious public health problems by spreading zoonotic pathogens and their antimicrobial resistance (AMR) to the environment. Thus, the aim of this study was to assess the occurrence, genetic diversity, and AMR among Salmonella spp. strains isolated from California kingsnakes in Gran Canaria Island (Spain). Of 73 invasive individuals captured, 20.5% carried Salmonella spp., belonging to different subspecies and serovars, with subsp. salamae as the most abundant. Pulsed-field electrophoresis showed high genetic diversity among subsp. salamae isolates, and among these, 73.3% showed resistance to at least one of the antimicrobials tested. In conclusion, the present study revealed the importance of wild invasive California kingsnakes as reservoirs of drug-resistant Salmonella spp. that could pose a direct threat to livestock and humans. Identification of drug-resistant Salmonella strains in wildlife provides valuable information on potential routes of transmission that involve risks to public and animal health.This study was supported by the project “POSTLIFE+ Lampropeltis para el control de la culebra real de California en Gran Canaria (LIFE10/NAT/ES/656)” financed by the Government of Canary Islands, Cabildo of Gran Canaria and Universidad Cardenal Herrera-CEU (IDOC 19/15, and INDI 20-21, INDI 22-34).info:eu-repo/semantics/publishedVersio

One Health Approach : Invasive California Kingsnake (Lampropeltis californiae) as an Important Source of Antimicrobial Drug-Resistant Salmonella Clones on Gran Canaria Island

The aim of this study was to investigate the invasive species Lampropeltis californiae (California kingsnake) as a reservoir of Salmonella and its ability to spread different clones of the bacterium with zoonotic potential into the environment, as well as study its antimicrobial resistance patterns in Gran Canaria (Spain). The main results showed that a high diversity of Salmonella subsp. salamae strains circulate in Gran Canaria with a high prevalence of resistance shown for antimicrobials of public health importance, as summarised in the European Decision 2013/652/EU. The increase in the reptile population has led to a rise in the number of zoonotic infections due to close contact with reptiles, with reptile-associated salmonellosis being particularly relevant. California kingsnake invasion not only threatens the endemic reptile population of the island of Gran Canaria (Spain) but also poses serious public health problems by spreading zoonotic pathogens and their antimicrobial resistance (AMR) to the environment. Thus, the aim of this study was to assess the occurrence, genetic diversity, and AMR among Salmonella spp. strains isolated from California kingsnakes in Gran Canaria Island (Spain). Of 73 invasive individuals captured, 20.5% carried Salmonella spp., belonging to different subspecies and serovars, with subsp. salamae as the most abundant. Pulsed-field electrophoresis showed high genetic diversity among subsp. salamae isolates, and among these, 73.3% showed resistance to at least one of the antimicrobials tested. In conclusion, the present study revealed the importance of wild invasive California kingsnakes as reservoirs of drug-resistant Salmonella spp. that could pose a direct threat to livestock and humans. Identification of drug-resistant Salmonella strains in wildlife provides valuable information on potential routes of transmission that involve risks to public and animal health

Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

Trayectos de investigación en trabajo social: hacia una cultura de investigación.

Los contenidos de Trayectos de investigación en Trabajo Social ponen a consideración del público diversas temáticas que, estructuradas como líneas de investigación, motivan la controversia y la construcción de conocimiento al interior del programa, en algunos casos como resultado de procesos de investigación formativa y del desarrollo de semilleros de investigación, y en otros como resultado de apuestas individuales que logran convencer e involucrar a otros miembros del equipo docente. Esto, en atención a la necesidad de resaltar y fortalecer una relación entre docencia e investigación que evite que el proceso formativo se convierte en rutinario y sin sentido, ante la dinámica de los problemas y contextos frente a los cuales se pretende reflexionar y generar conocimiento. En esa medida, es esencial mencionar que el interés de los investigadores del programa es que, además de apreciar el proceso vivido en cada caso, la comunidad académica pueda relacionar entre si las diferentes temáticas que, tal vez por ser presentadas en forma separa como líneas de investigación, puedan no ser visualizadas como parte integral del proceso complejo de configuración del actuar investigativo en el marco del programa de Trabajo Social

100 años investigando el mar. El IEO en su centenario (1914-2014).

Se trata de un libro que pretende divulgar a la sociedad las principales investigaciones multidisciplinares llevadas a cabo por el Instituto Español de Oceanografía durante su primer siglo de vida, y dar a conocer la historia del organismo, de su Sede Central y de los nueve centros oceanográficos repartidos por los litorales mediterráneo y atlántico, en la península y archipiélagos.Kongsberg 20

The Ecology of Non-<i>Candida</i> Yeasts and Dimorphic Fungi in Cetaceans: From Pathogenicity to Environmental and Global Health Implications

Cetaceans, which are integral to marine ecosystems, face escalating anthropogenic threats, including climate change and pollution, positioning them as critical sentinel species for ocean and human health. This review explores the neglected realm of non-Candida yeasts in cetaceans, addressing the gaps in the understanding of their prevalence, pathogenicity, and environmental impacts. By examining identified species such as Cryptococcus spp., Paracoccidioides spp., and several dimorphic fungi, this review emphasizes global prevalence, epidemiology and ecology, pathogenicity, and potential zoonotic implications. It also discusses the fine line between yeast commensalism and pathogenicity by considering environmental influences such as pollution, climate shifts, and immune suppression. Environmental impact discussions delve into how rising ocean temperatures and pollution can modify yeast mycobiota, potentially affecting marine host health and broader ecosystem dynamics. The cetacean’s unique physiology and ecological niches are considered, highlighting potential impacts on behaviors, reproductive success, and survival rates. Identifying crucial knowledge gaps, the review calls for intensified research efforts, employing advanced molecular techniques to unravel the cetacean mycobiome. Systematic studies on yeast diversity, antifungal susceptibility, and their influence on environmental and ecosystem health are proposed, and the balance between commensal and pathogenic species emphasizes the significance of the One Health approach. In conclusion, as marine mammals face unprecedented challenges, unveiling non-Candida yeasts in cetaceans emerges as a critical endeavor with far-reaching implications for the conservation of marine ecosystems and for both animal and human public health

Referrals and sex of physicians and patients: a gender analysis, Andalussia, Spain

English Abstract; Journal Article; Multicenter Study;BACKGROUND It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services. OBJECTIVES To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex. METHODS Observational, cross-sectional, and multicenter study. POPULATION 4 health districts in Andalucía and their physicians. SAMPLE 382 physicians. MEASUREMENTS referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. SOURCES databases of health districts. PERIOD OF STUDY 2010. ANALYSIS Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. RESULTS In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. CONCLUSION There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.YesFundamentos: En atención primaria se han identificado diferencias de práctica según sexo del profesional y, simultáneamente, existen desigualdades de género en la asignación de recursos sanitarios, aspectos ambos que suscitan un interés creciente en la gestión y provisión de servicios de salud. El objetivo del estudio es conocer si existen diferencias de práctica en las derivaciones sanitarias realizadas por médicas y médicos de familia (MF) de centros de salud de Andalucía, si existen desigualdades en las derivaciones recibidas por hombres y mujeres, y si existe interacción sexo de profesional sexo de paciente. Métodos: Estudio transversal y multicéntrico. Población: MF de 4 distritos sanitarios (DDSS). Muestra: 382 MF. Variables: tasa de derivaciones por visita (TDxV), tasa de derivaciones por cupo (TDxC), sexo de paciente; sexo, edad, y formación postgraduada en medicina familiar de MF, tamaño del cupo por sexo, media de visitas/paciente por sexo, edad media del cupo por sexo, y proporción de hombres en el cupo; centro de salud urbano/rural, tamaño del equipo, población adscrita y acreditación docente. Fuentes: bases de datos de los DDSS. Análisis estadístico: descriptivo. Bivariante y multivariante mediante análisis multinivel de la TDxV con modelo mixto de Poisson. Resultados: En 2010 los/as 382 MF realizaron 129.161 derivaciones a especialistas. La TDxC fue 23,47 y la TDxV es 4,92. Las TDxC de las médicas fue 27,23 en mujeres y 19,78 en hombres y las de los médicos 27,37 en mujeres y 19,51 en hombres. La TDxV de las médicas fueron 4,92 en mujeres y 5,48 en hombres y para los médicos 4,54 y 4,93 respectivamente. Conclusiones: No existen diferencias en las derivaciones según sexo de MF, sin embargo, existen indicios de que las mujeres son menos derivadas. No existe interacción sexo profesional-sexo paciente

Derivaciones en los centros de salud de Andalucía según el sexo de profesionales y pacientes: un análisis de género

Background: It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services. Objectives: To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex. Methods: Observational, cross-sectional, and multicenter study. Population: 4 health districts in Andalucía and their physicians. Sample: 382 physicians. Measurements: referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. Sources: databases of health districts. Period of study: 2010. Analysis: Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. Results: In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. Conclusion: There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.Fundamentos: En atención primaria se han identificado diferencias de práctica según sexo del profesional y, simultáneamente, existen desigualdades de género en la asignación de recursos sanitarios, aspectos ambos que suscitan un interés creciente en la gestión y provisión de servicios de salud. El objetivo del estudio es conocer si existen diferencias de práctica en las derivaciones sanitarias realizadas por médicas y médicos de familia (MF) de centros de salud de Andalucía, si existen desigualdades en las derivaciones recibidas por hombres y mujeres, y si existe interacción sexo de profesional sexo de paciente. Métodos: Estudio transversal y multicéntrico. Población: MF de 4 distritos sanitarios (DDSS). Muestra: 382 MF. Variables: tasa de derivaciones por visita (TDxV), tasa de derivaciones por cupo (TDxC), sexo de paciente; sexo, edad, y formación postgraduada en medicina familiar de MF, tamaño del cupo por sexo, media de visitas/paciente por sexo, edad media del cupo por sexo, y proporción de hombres en el cupo; centro de salud urbano/rural, tamaño del equipo, población adscrita y acreditación docente. Fuentes: bases de datos de los DDSS. Análisis estadístico: descriptivo. Bivariante y multivariante mediante análisis multinivel de la TDxV con modelo mixto de Poisson. Resultados: En 2010 los/as 382 MF realizaron 129.161 derivaciones a especialistas. La TDxC fue 23,47 y la TDxV es 4,92. Las TDxC de las médicas fue 27,23 en mujeres y 19,78 en hombres y las de los médicos 27,37 en mujeres y 19,51 en hombres. La TDxV de las médicas fueron 4,92 en mujeres y 5,48 en hombres y para los médicos 4,54 y 4,93 respectivamente. Conclusiones: No existen diferencias en las derivaciones según sexo de MF, sin embargo, existen indicios de que las mujeres son menos derivadas. No existe interacción sexo profesional-sexo paciente