Endovascular Treatment for Pseudoaneurysms after Surgical Correction of Aortic Coarctation

Late complications after surgical repair of aortic coarctation are not uncommon. Among these complications pseudoaneurysms are the most frequent complications, occurring between 3 and 38%. Reoperation in these patients is associated with high morbidity and mortality. In the last decade, endovascular techniques emerged as an alternative to conventional surgery with excellent results. We report the case of two patients who presented with pseudoaneurysms after surgical correction for aortic coarctation, which were treated by endovascular means

First Isolation of <i>Escherichia coli</i> O157:H7 from hamburgers in Paraguay

En los últimos veinte años las infecciones por Escherichia coli Enterohemorrágico (EHEC) representan una gran preocupación para la Salud Pública mundial. E. coli O157:H7/ NM es el prototipo de un grupo de más de 150 serotipos que comparten el mismo potencial patogénico. El objetivo del trabajo fue aislar E. coli O157:H7 de alimentos obtenidos en mercados habilitados para la venta en la ciudad de Asunción, Paraguay. Se analizaron 50 muestras, para el aislamiento se realizó un enriquecimiento en caldo Escherichia coli adicionado con novobiocina y luego se sembró en medios sólidos PRS-Mug y Fluorocult. Las colonias características fueron confirmadas por pruebas bioquímicas y serológicas. A partir de hamburguesas de carne bovina cruda se obtuvieron dos cepas de E. coli O157:H7, ambas portadoras del gen eae, y negativas para los genes ehxA, stx1 y stx2. Este es el primer reporte sobre el aislamiento de E. coli O157:H7 a partir de alimentos en Paraguay.In the last twenty years the infections caused by enterohemorragic Escherichia coli (EHEC) represented a great concern for the world public health. E. coli O157:H7/NM is the prototype into a group of more than 150 serotypes that share the same pathogenical potential. The purpose of this work was to isolate E. coli O157:H7 from food obtained in markets qualified for sale in Asunción city, Paraguay. Fifty samples were analyzed, for the isolation and enrichment in Escherichia coli broth added with novobiocin was carried out, and then it was streaked into solid media PRS-Mug and Fluorocult. Typical colonies were confirmed by biochemical and serological tests. From hamburgers of raw bovine meat two E. coli O157:H7 strains were obtained, both carriers of eae gene and negatives for ehxA, stx1 y stx2 genes. This is the first report about the isolation of E coli O157:H7 from foods in Paraguay.Facultad de Ciencias Veterinaria

Prioritizing persons deprived of liberty in global guidelines for tuberculosis preventive treatment

In this Policy Forum piece, Aditya Narayan and colleagues discuss the challenges and opportunities for tuberculosis preventive treatment in carceral settings

Prevalencia de bacterias enteropatógenas en niños que asisten a un hospital pediátrico en Resistencia, Chaco, Argentina

La enfermedad diarreica aguda continúa siendo uno de los problemas de salud pública más serios en los países en desarrollo, en los que constituye una de las causas principales de enfermedad y muerte en los niños menores de 5 años. Su epidemiología es totalmente dependiente de la región geográfica, nivel socio económico, costumbres y hábitos de la población. El objetivo del presente trabajo fue determinar la prevalencia de agentes etiológicos bacterianos causantes de diarrea aguda, en niños atendidos en un Hospital Pediátrico de Resistencia, Chaco, en el año 2013. Se investigó la presencia de Shigella spp., Salmonella spp., Campylobacte rspp., Escherichia coli O157:H7 en muestras de materia fecal de niños con enfermedad diarreica aguda. Sobre 823 muestras de materia fecal analizadas en el período mencionado, 93 resultaron positivas para alguno de los enteropatógenos estudiados (Tasa de recuperación del 11,3%). Las frecuencias de aislamiento de los enteropatógenos fueron: Shigella spp (82,8%), Salmonella spp (9,7%), Campylobacter spp (6,5%), y E. coli O157:H7 (1%). Con respecto a las especies, dentro del género Shigella predominó S. flexneri (60/77) seguida de S. sonnei (13/77) y S. boydii (4/77). Con excepción de E. coli O157, en el presente trabajo no se estudiaron los diferentes tipos patogénicos. Como en el resto del país, S. flexneri continúa siendo el agente etiológico más frecuentemente aislado. Este es el primer informe sobre la presencia de Campylobacter en coprocultivos en la provincia del Chaco.

Prioritizing persons deprived of liberty in global guidelines for tuberculosis preventive treatment

Persons deprived of liberty (PDLs) are disproportionately impacted by tuberculosis, with high incidence rates and often limited access to diagnostics, treatment, and preventive measures. The World Health Organization (WHO) expanded its recommendations for tuberculosis preventive treatment (TPT) to many high-risk populations, but their guidance does not include PDL, and most low- and middle-income countries do not routinely provide edforthoseusedthroughoutthetext TPT in prisons. :Pleaseverifythatallentriesarecorrectlyabbreviated: Recent studies demonstrate high acceptability and completion rates of short-course TPT regimens in jails and prisons; costs of these regimens have been markedly reduced through international agreements, making this an opportune for further expanding their use. We argue that PDL should be a priority group for TPT in national guidelines and discuss implementation considerations and resource needs for TPT programs in carceral facilities. Scaling access to TPT for PDL is important for reducing disease and transmission in this population; it is also critical to advancing an equitable response to tuberculosis

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Distance delivery of a spoken language intervention for school-aged and adolescent boys with fragile X syndrome

A small randomized group design (N&nbsp;=&nbsp;20) was used to examine a parent-implemented intervention designed to improve the spoken language skills of school-aged and adolescent boys with FXS, the leading cause of inherited intellectual disability. The intervention was implemented by speech-language pathologists who used distance video-teleconferencing to deliver the intervention. The intervention taught mothers to use a set of language facilitation strategies while interacting with their children in the context of shared story-telling. Treatment group mothers significantly improved their use of the targeted intervention strategies. Children in the treatment group increased the duration of engagement in the shared story-telling activity as well as use of utterances that maintained the topic of the story. Children also showed increases in lexical diversity, but not in grammatical complexity