Imported cysticercosis in Spain: A retrospective case series from the +REDIVI Collaborative Network

Neurocysticercosis (NCC) is the most common parasitic neurological disease worldwide and a major cause of epilepsy. Spain is the country reporting the highest number of NCC imported cases in Europe. Retrospective case series of NCC patients registered in the +REDIVI Network from October 1, 2009 to July 2018. A specific questionnaire, including clinical and diagnostic characteristics, was created and sent to the collaborator centers. 46 cases were included in the analysis. 55% were male, mean age of 40 years. 95.6% were migrants. The median duration since migration from an endemic area was 10 years. Predominant nationalities were Ecuadorians (50%) and Bolivians (30.4%). Frequent locations were parenchymal (87%), subarachnoid (26.1%) and intraventricular cysts (10.9%). Serological analysis was performed in 91.3%, being 54.8% positive. Most prevalent clinical manifestations were persistent headache (60.9%), epilepsy (43.5%) and visual changes (13%). Patients were mainly treated with albendazole (76.1%), corticosteroids (67.4%), and anticonvulsionants (52.2%). 82.5% had a favorable clinical outcome. Most NCC cases were long-standing migrants. Few clinical differences were observed depending on the cysticerci location. The treatment was often not according to current recommendations, and no uniform criteria were followed when it came to the therapeutic regimen. NCC case management in Spain (including clinician awareness and laboratory capacity improvements) needs to be strengthened.We would thanks María Jesús Perteguer from the National Center of Microbiology for the information and update on NCC lab techniques currently performed in Spain. The corresponding author’s affiliation centre belongs to the ISCIII-Sub. Gral. Redes- Network Biomedical Research on Tropical Diseases (RICET in Spanish) grant RD16CIII/0003/0001, RD16/0027/0020, RD16CIII/0003/0001 and the European Regional Development Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

Inter-Rater Variability in the Evaluation of Lung Ultrasound in Videos Acquired from COVID-19 Patients

12 páginas, 7 figuras, 1 tablaLung ultrasound (LUS) allows for the detection of a series of manifestations of COVID-19, such as B-lines and consolidations. The objective of this work was to study the inter-rater reliability (IRR) when detecting signs associated with COVID-19 in the LUS, as well as the performance of the test in a longitudinal or transverse orientation. Thirty-three physicians with advanced experience in LUS independently evaluated ultrasound videos previously acquired using the ULTRACOV system on 20 patients with confirmed COVID-19. For each patient, 24 videos of 3 s were acquired (using 12 positions with the probe in longitudinal and transverse orientations). The physicians had no information about the patients or other previous evaluations. The score assigned to each acquisition followed the convention applied in previous studies. A substantial IRR was found in the cases of normal LUS (κ = 0.74), with only a fair IRR for the presence of individual B-lines (κ = 0.36) and for confluent B-lines occupying 50% (κ = 0.50). No statistically significant differences between the longitudinal and transverse scans were found. The IRR for LUS of COVID-19 patients may benefit from more standardized clinical protocols.This research was partially funded by CDTI (Spanish acronym: Centre for Industrial Tech- nological Development), funding number COI-20201153. Partially supported by the Google Cloud Research Credits program with the funding number GCP19980904, by the project RTI2018-099118- A-I00 founded by MCIU/AEI/FEDER UE and by the European Commission–NextGenerationEU, through CSIC’s Global Health Platform (PTI Salud Global)

Revisión sistemática y metaanálisis sobre la comparación entre la ivermectina y los benzimidazoles en el tratamiento de la infección crónica por "strongyloides stercoralis"

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Microbiología, leída el 03/07/2013Depto. de Inmunología, Oftalmología y ORLFac. de MedicinaTRUEunpu

Incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural de la selva peruana.

Objetivo: Determinar la incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural localizada en la selva del departamento de San Martín, Perú. Material y métodos: Una cohorte de 119 personas fue seleccionada al azar entre la población de 446 habitantes y seguida diariamente por un mes entre enero y febrero de 1999, buscando casos de diarrea aguda, definida como tres ó más cámaras de deposiciones al día por no más de 3 días. Un estudio caso control pareado fue diseñado para determinar los factores de riesgo para adquirir diarrea. Resultados: Fueron observados 18 casos de diarrea aguda; la incidencia fue 15.1 casos por 100 personas-mes (IC 95%: 9.45-23.12). La edad media de los casos fue de 10.7 años (rango: 1-34 años) y 66% de los casos fueron niños menores de 10 años de edad. Los factores de riesgo para adquirir diarrea fueron: consumo de alimentos crudos, RR: 2.2 (IC 95%: 1.12-4.33), consumo de alimentos no lavados, RR: 4.47 (IC 95%: 1.56-12.82), falta de lavado de manos antes de alimentarse, RR: 9.61 (95% IC: 1.44-64.16), consumo de agua no hervida, RR: 4.52 (IC 95%: 1.23-16.65) y alimentación fuera de casa, RR: 2.2 (IC 95%: 1.51-3.20). La diferencia en el número promedio (( DE) de personas que vivían por casa entre casos y controles fue de 4.38 (1.03) vs. 3.22 (0.54), p=0.0003, respectivamente. No hubo diferencia en el tiempo de residencia en la comunidad entre casos y controles, media de 5.61 (( 5.04) años vs. 8.83 (( 9.79), p=0.5747. Conclusiones: Diarrea aguda es un problema de salud pública en la selva de San Martín. Hacinamiento, carencia de saneamiento y pobres prácticas higiénicas son los responsables para adquirir diarrea aguda en esta comunidad de bajo nivel socioeconómico. Campañas educativas y mejora en las condiciones sanitarias son claramente necesarias para superar este problema. ( Rev Med Hered 2002; 13: 44-48 )

Incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural de la selva peruana

Objetivo: Determinar la incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural localizada en la selva del departamento de San Martín, Perú. Material y métodos: Una cohorte de 119 personas fue seleccionada al azar entre la población de 446 habitantes y seguida diariamente por un mes entre enero y febrero de 1999, buscando casos de diarrea aguda, definida como tres ó más cámaras de deposiciones al día por no más de 3 días. Un estudio caso control pareado fue diseñado para determinar los factores de riesgo para adquirir diarrea. Resultados: Fueron observados 18 casos de diarrea aguda; la incidencia fue 15.1 casos por 100 personas-mes (IC 95%: 9.45-23.12). La edad media de los casos fue de 10.7 años (rango: 1-34 años) y 66% de los casos fueron niños menores de 10 años de edad. Los factores de riesgo para adquirir diarrea fueron: consumo de alimentos crudos, RR: 2.2 (IC 95%: 1.12-4.33), consumo de alimentos no lavados, RR: 4.47 (IC 95%: 1.56-12.82), falta de lavado de manos antes de alimentarse, RR: 9.61 (95% IC: 1.44-64.16), consumo de agua no hervida, RR: 4.52 (IC 95%: 1.23-16.65) y alimentación fuera de casa, RR: 2.2 (IC 95%: 1.51-3.20). La diferencia en el número promedio (DE) de personas que vivían por casa entre casos y controles fue de 4.38 (1.03) vs. 3.22 (0.54), p=0.0003, respectivamente. No hubo diferencia en el tiempo de residencia en la comunidad entre casos y controles, media de 5.61 ( 5.04) años vs. 8.83 (9.79), p=0.5747. Conclusiones: Diarrea aguda es un problema de salud pública en la selva de San Martín. Hacinamiento, carencia de saneamiento y pobres prácticas higiénicas son los responsables para adquirir diarrea aguda en esta comunidad de bajo nivel socioeconómico. Campañas educativas y mejora en las condiciones sanitarias son claramente necesarias para superar este problema

Imported cysticercosis in Spain: A retrospective case series from the +REDIVI Collaborative Network

Background Neurocysticercosis (NCC) is the most common parasitic neurological disease worldwide and a major cause of epilepsy. Spain is the country reporting the highest number of NCC imported cases in Europe. Methodology Retrospective case series of NCC patients registered in the +REDIVI Network from October 1, 2009 to July 2018. A specific questionnaire, including clinical and diagnostic characteristics, was created and sent to the collaborator centers. Results 46 cases were included in the analysis. 55% were male, mean age of 40 years. 95.6% were migrants. The median duration since migration from an endemic area was 10 years. Predominant nationalities were Ecuadorians (50%) and Bolivians (30.4%). Frequent locations were parenchymal (87%), subarachnoid (26.1%) and intraventricular cysts (10.9%). Serological analysis was performed in 91.3%, being 54.8% positive. Most prevalent clinical manifestations were persistent headache (60.9%), epilepsy (43.5%) and visual changes (13%). Patients were mainly treated with albendazole (76.1%), corticosteroids (67.4%), and anticonvulsionants (52.2%). 82.5% had a favorable clinical outcome. Conclusions Most NCC cases were long-standing migrants. Few clinical differences were observed depending on the cysticerci location. The treatment was often not according to current recommendations, and no uniform criteria were followed when it came to the therapeutic regimen. NCC case management in Spain (including clinician awareness and laboratory capacity improvements) needs to be strengthened

Inter-Rater Variability in the Evaluation of Lung Ultrasound in Videos Acquired from COVID-19 Patients

Lung ultrasound (LUS) allows for the detection of a series of manifestations of COVID-19, such as B-lines and consolidations. The objective of this work was to study the inter-rater reliability (IRR) when detecting signs associated with COVID-19 in the LUS, as well as the performance of the test in a longitudinal or transverse orientation. Thirty-three physicians with advanced experience in LUS independently evaluated ultrasound videos previously acquired using the ULTRACOV system on 20 patients with confirmed COVID-19. For each patient, 24 videos of 3 s were acquired (using 12 positions with the probe in longitudinal and transverse orientations). The physicians had no information about the patients or other previous evaluations. The score assigned to each acquisition followed the convention applied in previous studies. A substantial IRR was found in the cases of normal LUS (κ = 0.74), with only a fair IRR for the presence of individual B-lines (κ = 0.36) and for confluent B-lines occupying < 50% (κ = 0.26) and a moderate IRR in consolidations and B-lines > 50% (κ = 0.50). No statistically significant differences between the longitudinal and transverse scans were found. The IRR for LUS of COVID-19 patients may benefit from more standardized clinical protocols