Bibliometric analysis of scientific literature on intestinal parasites in Argentina during the period 1985-2014

The study of scientific production is a good indicator of the progress in research and knowledge generation. Bibliometrics is a scientific discipline that uses a set of indicators to quantitatively express the bibliographic characteristics of scientific publications. The scientific literature on the epidemiology of intestinal parasites in Argentina is scattered in numerous sources, hindering access and visibility to the scientific community. Our purpose was to perform a quantitative, bibliometric study of the scientific literature on intestinal parasites in humans in Argentina published in the period 1985---2014. This bibliometric analysis showed an increase in the number of articles on intestinal parasites in humans in Argentina published over the past 30 years. Those articles showed a collaboration index similar to that of the literature, with a high index of institutionality for national institutions and a very low one for international collaboration. The original articles were published in scientific journals in the American Continent, Europe and Asia. The use of bibliometric indicators can provide a solid tool for the diagnosis and survey of the research on epidemiology of intestinal parasites and contributes to the dissemination and visibility of information on the scientific production developed in Argentina.El estudio de las publicaciones científicas constituye un buen indicador del progreso de la investigación y de la generación de conocimiento. La bibliometría es una disciplina que CientíficasArgentinasutiliza un conjunto de indicadores para expresar cuantitativamente las características bibli-ográficas de las publicaciones. La literatura científica sobre la epidemiología de los parásitosintestinales en la Argentina se encuentra muy dispersa en numerosas fuentes impresas y online,con escasa visibilidad para la comunidad científica. Nuestro objetivo fue realizar un estudio bib-liométrico cuantitativo de la literatura científica publicada sobre los parásitos intestinales dehumanos en Argentina durante el período 1985---2014. Este análisis mostró un incremento enel número de documentos publicados en los últimos 30 a˜nos. Dicha publicaciones mostraronun índice de colaboración similar a la literatura, con un alto índice de institucionalidad paralas instituciones nacionales y un índice bajo para la colaboración internacional. Los artículosfueron publicados en revistas científicas del continente americano, Europa y Asia. El uso deindicadores bibliométricos proporciona una herramienta sólida para el diagnóstico y estudio dela investigación sobre la epidemiología de los parásitos intestinales y contribuye a la difusión yvisibilidad de la información sobre la producción científica desarrollada en Argentina

Análisis bibliométrico de la literatura científica sobre epidemiología de Giardia en Argentina (1995-2014)

Las publicaciones sobre la epidemiología de Giardia en humanos de Argentina se hallan dispersas en numerosas fuentes de información, lo que dificulta su acceso y visibilidad para la comunidad científica. El objetivo de este trabajo fue realizar un análisis bibliométrico cuantitativo de la producción científica sobre Giardia en humanos de Argentina durante el período 1995-2014. El volumen de publicaciones científicas hallado fue igual a 112 (36 artículos, 73 comunicaciones y 3 tesis). La distribución idiomática mostró un predominio del español. Los artículos fueron publicados en 25 revistas de América, Europa y Asia. Este estudio bibliométrico demostró un incremento del volumen de publicaciones sobre Giardia en Argentina durante los últimos 20 años. Los artículos mostraron un índice de colaboración entre investigadores similar a la bibliografía. El índice de institucionalidad fue elevado para instituciones nacionales, e inexistente para la colaboración internacional. La utilización de indicadores bibliométricos permite contar con una herramienta sólida para el diagnóstico y prospección de las actividades de investigación sobre epidemiología de Giardia y contribuye a la difusión y visibilidad de la información relativa a la producción científica desarrollada en Argentina.The scientific literature on Giardia epidemiology in humans from Argentina is scattered in numerous sources, making it difficult to access them and provide visibility to the scientific community. The aim of this study was to perform a quantitative bibliometric analysis of the scientific production on Giardia in humans from Argentina during the 1995-2014 period. The volume of scientific literature was 112 (36 articles, 73 communications, and 3 theses). The language distribution showed a predominance of Spanish. The articles were published in 25 journals from America, Europe and Asia. This bibliometric study showed an increased volume of publications on Giardia in Argentina during the last 20 years. The articles showed a Collaboration Index between researchers similar to the literature. The institutional Index was elevated for national institutions and non-existent for international collaboration. The use of bibliometric indicators can provide a solid tool for the diagnosis and survey of the research on epidemiology of Giardia, and it contributes to the dissemination and visibility of information on the scientific production developed in Argentina

Blastocystis spp.: avances, controversias y desafíos futuros

Blastocystis spp. es el protista intracelular que se detecta con mayor frecuencia en muestras de materia fecal humana; las tasas de infección pueden superar el 20% en países en vías de desarrollo. El hallazgo de este parásito en heces de diversas especies animales sugiere su potencial zoonótico. La relevancia clínica y el papel patógeno de Blastocystis spp. en el tracto intestinal son inciertos. Varias son las publicaciones que lo reconocen como agente etiológico de desórdenes intestinales como diarrea, enfermedad inflamatoria intestinal y colitis ulcerosa, aunque la patogenicidad de este parásito no ha sido probada. Este amplio rango de respuestas a la infección podría estar relacionado con la diversidad genética de los aislamientos provenientes de hospedadores infectados.In developing countries, infection rates are higher than 20%. The presence of this parasite in the feces of several host species suggests its zoonotic potential. The clinical relevance and the pathogenic role of Blastocystis spp. in the intestinal tract remain unclear. There are several clinical reports that recognize it as the etiologic agent of several intestinal disorders such as diarrhea, inflammatory bowel disease and ulcerative colitis, although the pathogenicity of this parasite has not been proved yet. This wide range of clinical manifestations could be related to the genetic diversity exhibited by this parasite

Agua y salud humana

La protección de la salud pública requiere agua de bebida segura. La realización de frecuentes exámenes para determinar si el agua contiene organismos indicadores sigue siendo el modo más sensible y especifico de estimar la calidad del agua desde el punto de vista de la higiene. En los países donde existe un sistema de vigilancia integrado, la mayoría de los brotes de origen hídrico han sido vinculados a fallas en el tratamiento, inclusión de agua contaminada en la red o a problemas de recrecimiento bacteriano en el sistema de distribución. Es importante por esto optimizar los métodos empleados para la detección de contaminación fecal, mediante la utilización de métodos más sensibles, con el fin de poner al alcance de la población agua segura desde el punto de vista microbiológico y parasitológico.Public health protection requires safe drinking water. The most sensitive and specific way to analize the water quality is to determinate the presence of indicator bacteria. In most countries with an integrated surveillance water system, the great majority of water outbreaks were associated to treatment failures, inclusion of contaminated water or bacterial regrowth at the water network. Is necessary to improve the sensibility of those methods used to detect faecal contamination, to provide safe drinking water from a microbiological and parasitological point of view

Related factors to human toxocariasis in a rural community of Argentina

The objective of this study was to evaluate the relationship between toxocariasis frequency and demographic, environmental, sanitary variables, eosinophylia, and other intestinal parasites in a rural population of Argentina. Serological examination of 100 individuals was carried out by using ELISA technique for the detection of antitoxocara antibodies. Eosinophiles in peripheral blood, presence of intestinal parasites, and demographic, environmental, and socio-cultural data were evaluated. Eighty-one feces samples of dogs belonging to the studied people were analyzed to detect eggs of Toxocara canis. Thirty of them were from 30 dogs and 51 were pools from dog feces. Samples of dirt from around the homes (n: 47) and from public park (n: 4) were taken. To determine the associations, the X2 and Fisher tests were used. The seroprevalence was 23%. Eosinophilia in peripheral blood was detected in 86.95% seropositive individuals and in 37.66% seronegative individuals (p < 0.001, OR = 11.03). Of the 23 people with positive serology, 69.56% had at least one intestinal parasite. All individuals with positive serology had dogs in their homes. Among the dog owners there was a significant association between the presence of anti-toxocara antibodies and home flooding. Eggs of T. canis were detected in the feces of 5/81 dogs and three of these dogs belonged to individuals with positive serology. Eggs of Toxocara spp. were found in 41.17% of the dirt samples, eight of which came from the area surrounding the homes of individuals with positive serology (p = 0.032; OR = 4.36). Taking into account all the variables influencing the frequency of toxocariasis in this population, the implementation of Public Health programs specifically focused on anti-parasitic treatment of dogs is recommended

Comparación de tres técnicas de concentración de heces para recuperar ooquistes de Cryptosporidium

Cryptosporidium es un parásito causante de cryptosporidiosis. Su estadío infectivo, el ooquiste, se elimina con las heces del hospedador, representando los terneros la principal fuente de infección humana. El objetivo de este trabajo fue comparar tres métodos de concentración de heces para recuperar ooquistes de Cryptosporidium. Fueron estudiados un total de 166 terneros. Una única muestra de materia fecal fresca fue analizada por los métodos de Telemann modificado, agua éter, y Tris Tween 80. La identificación de ooquistes fue realizada mediante coloración de Kinyoun modificada. El número de ooquistes concentrados por cada técnica fue cuantificado en 20 campos a 1000X. Del total de muestras analizadas, 22/166 fueron positivas para Cryptosporidium. El número medio de ooquistes recuperados por cada técnica fue: Telemann modificada (124,2±159,5), agua éter (153,0±156,3), tris Tween 80 (92,2±98,3). ANOVA mostró que no existen diferencias significativas entre métodos. De acuerdo con los resultados obtenidos, las tres técnicas pueden ser empleadas para concentrar ooquistes de Cryptosporidium. Si bien los tres métodos presentaron igual sensibilidad y espcificidad, la técnica de agua éter demostró ser sencilla, de bajo costo, y efectiva para recuperar ooquistes, particularmente si se requiere conservar la viabilidad de los mismos.Cryptosporidium is a parasite which causes cryptosporidiosis. Its infectious stage, the oocyst, is eliminated with the host feces, calves being the main source of human infection. The aim of the present work was to compare three methods of feces concentration to recover Cryptosporidium oocysts. A total of 166 calves were studied. An only sample of fresh feces was analyzed using the following methods: modified Telemann, water ether, and Tris Tween 80. The identification of oocysts was carried out by modified staining Kinyoun technique. The number of concentrated oocysts per technique was quantified in 20 fields at 1000X. From a total of 166 analyzed samples, 22 were Cryptosporidium positive. The average number of recovered oocysts per technique was: modified Telemann (124.2 ± 159.5), water ether (153.0±156.3), Tris Tween 80 (92.2 ± 98.3). ANOVA demonstrated that there are no significant differences between these methods. According to the results obtained, the three techniques may be used to concentrate Cryptosporidium oocysts. Even if there are no differences in sensibility and specificity between these methods, the water ether technique proved to be simple, low-cost, and effective to recover oocysts, particularly if the oocysts condition is to be kept

Isolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry

Isolated distal deep vein thrombosis (IDDVT) represents up to half of all lower limb DVT. This study investigated treatment patterns and outcomes in 2,145 patients with IDDVT in comparison with those with proximal DVT (PDVT; n = 3,846) and pulmonary embolism (PE; n = 4,097) enrolled in the GARFIELD-VTE registry. IDDVT patients were more likely to have recently undergone surgery (14.6%) or experienced leg trauma (13.2%) than PDVT patients (11.0 and 8.7%, respectively) and PE patients (12.7 and 4.5%, respectively). Compared with IDDVT, patients with PDVT or PE were more likely to have active cancer (7.2% vs. 9.9% and 10.3%). However, influence of provoking factors on risk of recurrence in IDDVT remains controversial. Nearly all patients (IDDVT, PDVT, and PE) were given anticoagulant therapy. In IDDVT, PDVT, and PE groups the proportion of patients receiving anticoagulant therapy was 61.4, 73.9, and 81.1% at 6 months and 45.8, 54.7, and 61.9% at 12 months. Over 12 months, the incidence of all-cause mortality, cancer, and recurrence was significantly lower in IDDVT patients than PDVT patients (hazard ratio [HR], 0.61 [95% confidence interval [CI], 0.48-0.77]; sub-HR [sHR], 0.60 [95% CI, 0.39-0.93]; and sHR, 0.76 [95% CI, 0.60-0.97]). Likewise, risk of death and incident cancer was significantly (both p < 0.05) lower in patients with IDDVT compared with PE. This study reveals a global trend that most IDDVT patients as well as those with PDVT and PE are given anticoagulant therapy, in many cases for at least 12 months

Assessment of Outcomes Among Patients With Venous Thromboembolism With and Without Chronic Kidney Disease

Importance: Patients with venous thromboembolism (VTE) and concomitant chronic kidney disease (CKD) have been reported to have a higher risk of thrombosis and major bleeding complications compared with patients without concomitant CKD. The use of anticoagulation therapy is challenging, as many anticoagulant medications are excreted by the kidney. Large-scale data are needed to clarify the impact of CKD for anticoagulant treatment strategies and clinical outcomes of patients with VTE. Objective: To compare clinical characteristics, treatment patterns, and 12-month outcomes among patients with VTE and concomitant moderate to severe CKD (stages 3-5) vs patients with VTE and mild to no CKD (stages 1-2) in a contemporary international registry. Design, Setting, and Participants: The Global Anticoagulant Registry in the Field-Venous Thromboembolism (GARFIELD-VTE) study is a prospective noninterventional investigation of real-world treatment practices. A total of 10 684 patients from 415 sites in 28 countries were enrolled in the GARFIELD-VTE between May 2014 and January 2017. This cohort study included 8979 patients (6924 patients with mild to no CKD and 2055 patients with moderate to severe CKD) who had objectively confirmed VTE within 30 days before entry in the registry. Chronic kidney disease stages were defined by estimated glomerular filtration rates. Data were extracted from the study database on December 8, 2018, and analyzed between May 1, 2019, and July 30, 2020. Exposure: Moderate to severe CKD vs mild to no CKD. Main Outcomes and Measures: The primary outcomes were all-cause mortality, recurrent VTE, and major bleeding. Event rates and 95% CIs were calculated and expressed per 100 person-years. Hazard ratios (HRs) were estimated with Cox proportional hazards regression models and adjusted for relevant confounding variables. All-cause mortality was considered a competing risk for other clinical outcomes in the estimation of cumulative incidences. Results: Of the 10 684 patients with objectively confirmed VTE, serum creatinine data were available for 8979 patients (84.0%). Of those, 4432 patients (49.4%) were female and 5912 patients (65.8%) were White; 6924 patients (77.1%; median age, 57 years; interquartile range [IQR], 44-69 years) were classified as having mild to no CKD, and 2055 patients (22.9%; median age, 70 years; IQR, 59-78 years) were classified as having moderate to severe CKD. Calculations using the equation from the Modification of Diet in Renal Disease study indicated that, among the 6924 patients with mild to no CKD, 2991 patients had stage 1 CKD, and 3933 patients had stage 2 CKD; among the 2055 patients with moderate to severe CKD, 1650 patients had stage 3 CKD, 190 patients had stage 4 CKD, and 215 patients had stage 5 CKD. The distribution of VTE presentation was comparable between groups. In total, 1171 patients (57.0%) with moderate to severe CKD and 4079 patients (58.9%) with mild to no CKD presented with deep vein thrombosis alone, 547 patients (26.6%) with moderate to severe CKD and 1723 patients (24.9%) with mild to no CKD presented with pulmonary embolism alone, and 337 patients (16.4%) with moderate to severe CKD and 1122 patients (16.2%) with mild to no CKD presented with both pulmonary embolism and deep vein thrombosis. Compared with patients with mild to no CKD, patients with moderate to severe CKD were more likely to be female (3259 women [47.1%] vs 1173 women [57.1%]) and older than 65 years (2313 patients [33.4%] vs 1278 patients [62.2%]). At baseline, the receipt of parenteral therapy alone was comparable between the 2 groups (355 patients [17.3%] with moderate to severe CKD vs 1253 patients [18.1%] with mild to no CKD). Patients with moderate to severe CKD compared with those with mild to no CKD were less likely to be receiving direct oral anticoagulant therapy, either alone (557 patients [27.1%] vs 2139 patients [30.9%]) or in combination with parenteral therapy (319 patients [15.5%] vs 1239 patients [17.9%]). Patients with moderate to severe CKD had a higher risk of all-cause mortality (adjusted hazard ratio [aHR], 1.44; 95% CI, 1.21-1.73), major bleeding (aHR, 1.40; 95% CI, 1.03-1.90), and recurrent VTE (aHR, 1.40; 95% CI, 1.10-1.77) than patients with mild to no CKD. Conclusions and Relevance: In this study of patients with VTE, the presence of moderate to severe CKD was associated with increases in the risk of death, VTE recurrence, and major bleeding compared with the presence of mild to no CKD

Assessment of Outcomes Among Patients With Venous Thromboembolism With and Without Chronic Kidney Disease

Importance: Patients with venous thromboembolism (VTE) and concomitant chronic kidney disease (CKD) have been reported to have a higher risk of thrombosis and major bleeding complications compared with patients without concomitant CKD. The use of anticoagulation therapy is challenging, as many anticoagulant medications are excreted by the kidney. Large-scale data are needed to clarify the impact of CKD for anticoagulant treatment strategies and clinical outcomes of patients with VTE. Objective: To compare clinical characteristics, treatment patterns, and 12-month outcomes among patients with VTE and concomitant moderate to severe CKD (stages 3-5) vs patients with VTE and mild to no CKD (stages 1-2) in a contemporary international registry. Design, Setting, and Participants: The Global Anticoagulant Registry in the Field–Venous Thromboembolism (GARFIELD-VTE) study is a prospective noninterventional investigation of real-world treatment practices. A total of 10 684 patients from 415 sites in 28 countries were enrolled in the GARFIELD-VTE between May 2014 and January 2017. This cohort study included 8979 patients (6924 patients with mild to no CKD and 2055 patients with moderate to severe CKD) who had objectively confirmed VTE within 30 days before entry in the registry. Chronic kidney disease stages were defined by estimated glomerular filtration rates. Data were extracted from the study database on December 8, 2018, and analyzed between May 1, 2019, and July 30, 2020. Exposure: Moderate to severe CKD vs mild to no CKD. Main Outcomes and Measures: The primary outcomes were all-cause mortality, recurrent VTE, and major bleeding. Event rates and 95% CIs were calculated and expressed per 100 person-years. Hazard ratios (HRs) were estimated with Cox proportional hazards regression models and adjusted for relevant confounding variables. All-cause mortality was considered a competing risk for other clinical outcomes in the estimation of cumulative incidences. Results: Of the 10 684 patients with objectively confirmed VTE, serum creatinine data were available for 8979 patients (84.0%). Of those, 4432 patients (49.4%) were female and 5912 patients (65.8%) were White; 6924 patients (77.1%; median age, 57 years; interquartile range [IQR], 44-69 years) were classified as having mild to no CKD, and 2055 patients (22.9%; median age, 70 years; IQR, 59-78 years) were classified as having moderate to severe CKD. Calculations using the equation from the Modification of Diet in Renal Disease study indicated that, among the 6924 patients with mild to no CKD, 2991 patients had stage 1 CKD, and 3933 patients had stage 2 CKD; among the 2055 patients with moderate to severe CKD, 1650 patients had stage 3 CKD, 190 patients had stage 4 CKD, and 215 patients had stage 5 CKD. The distribution of VTE presentation was comparable between groups. In total, 1171 patients (57.0%) with moderate to severe CKD and 4079 patients (58.9%) with mild to no CKD presented with deep vein thrombosis alone, 547 patients (26.6%) with moderate to severe CKD and 1723 patients (24.9%) with mild to no CKD presented with pulmonary embolism alone, and 337 patients (16.4%) with moderate to severe CKD and 1122 patients (16.2%) with mild to no CKD presented with both pulmonary embolism and deep vein thrombosis. Compared with patients with mild to no CKD, patients with moderate to severe CKD were more likely to be female (3259 women [47.1%] vs 1173 women [57.1%]) and older than 65 years (2313 patients [33.4%] vs 1278 patients [62.2%]). At baseline, the receipt of parenteral therapy alone was comparable between the 2 groups (355 patients [17.3%] with moderate to severe CKD vs 1253 patients [18.1%] with mild to no CKD). Patients with moderate to severe CKD compared with those with mild to no CKD were less likely to be receiving direct oral anticoagulant therapy, either alone (557 patients [27.1%] vs 2139 patients [30.9%]) or in combination with parenteral therapy (319 patients [15.5%] vs 1239 patients [17.9%]). Patients with moderate to severe CKD had a higher risk of all-cause mortality (adjusted hazard ratio [aHR], 1.44; 95% CI, 1.21-1.73), major bleeding (aHR, 1.40; 95% CI, 1.03-1.90), and recurrent VTE (aHR, 1.40; 95% CI, 1.10-1.77) than patients with mild to no CKD. Conclusions and Relevance: In this study of patients with VTE, the presence of moderate to severe CKD was associated with increases in the risk of death, VTE recurrence, and major bleeding compared with the presence of mild to no CKD