Evidencia de daño hepático producido por la infección experimental de corderos con Taenia hydatigena

Los adultos de Taenia hydatigena se desarrollan en el intestino de perros y sus fases larvarias (metacestodos) se localizan en serosas de cavidad abdominal de rumiantes, equinos y cerdos. La presencia de estos metacestodos es comúnmente considerada de poca relevancia y son escasos los trabajos recientes sobre parámetros parasitológicos o efectos patológicos de estos en los ovinos. El objetivo de este estudio fue evaluar la tasa de infección y el daño hepático en corderos infectados experimentalmente con T. hydatigena. Se inocularon seis corderos Columbia con 250 huevos de T. hydatigena, semanalmente se midieron el número de eosinófilos sanguíneos (ES), niveles séricos de transaminasa glutámico-oxaloacética (TGO) y fosfatasa alcalina (FA). Los corderos fueron eutanizados a los 30 días pos-inoculación para contar el número de metacestodos en cavidad abdominal y torácica, así como buscar lesiones hepáticas. Los corderos mostraron un incremento sostenido de los niveles de ES y FA, que fueron significativos (p<0.05) a partir de la segunda semana pos-infección. La TGO no mostró aumento (p>0.05) durante el experimento. En todos los corderos se observaron metacestodos con distribución variable en omentos e hígado. La tasa de infección promedio fue baja (1.1%). Se observaron en todos los corderos, macroscópicamente lesiones hepáticas multifocales fibrosas de 2-7 mm. Histológicamente se observaron lesiones con fibrosis, edema e infiltrado de eosinófilos, neutrófilos y monocitos. Estos resultados mostraron, que aún con una tasa de infección baja y ausencia de manifestaciones clínicas evidentes, se produjeron lesiones y alteraciones hepáticas. Lo anterior, sugiere daño metabólico que probablemente afecta de forma subclínica la productividad de los corderos

Shapes of love in the miracle testimonies of the Virgin of Chiquinquirá, New Kingdom of Granada, 1587 to 1694

A trilogy of texts composed between 1587 and 1694 memorialize the origin of and early devotion to the Virgin of Chiquinquirá in the New Kingdom of Granada: an información jurídica (original ecclesiastical investigation of reported miracles ordered by the archbishop of Bogotá); a manuscript collection of 234 miracle testimonies, long-lost and never studied until now; and the first published history of the cult. The devotees whose experiences comprise these texts had turned to Mary of Chiquinquirá with deeply personal needs and received miraculous interventions. Later, they recounted their experiences under oath before witnesses. This essay examines those accounts, finding vestiges of local society and culture and, more importantly, illumination of the testators\u27 enacted feelings about themselves and others. The essay argues that within the intimate space of a spiritual emotional community, miracle testimonies which purport to focus on love for the Virgin of Chiquinquirá actually reveal a great deal about human love

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort studyResearch in context

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017