Seroprevalencia del virus de la leucemia bovina en rodeos lecheros del Departamento Iriondo, Santa Fe, Argentina

El objetivo de este trabajo fue determinar la seroprevalencia del virus de la leucemia bovina (VLB) en rodeos lecheros de la Provincia de Santa Fe. Se procesaron 747 muestras mediante la técnica de inmunodifusión en gel de agar. Se realizó un análisis chi-cuadrado para evaluar la asociación entre la categoría y la general, que fue del 79,1%, siendo la prevalencia por categorías de 82,1% para vacas, 56,2% para vaquillonas y 54,5% para toros. En el análisis estadístico se observó una asociación de seropositividad. Los resultados de prevalencia intra-predial fueron entre el 63% y el 96%. La prevalencia estadísticamente significativa entre adultos y seropositividad, fue teniendo éstos 4 veces más chances de ser seropositivos que las vaquillonas. La elevada seroprevalencia del VLB hallada, demuestra que el virus está ampliamente distribuido en los rodeos lecheros de la región sur de la Provincia de Santa Fe

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection

Las unidades de deshabituación tabáquica como oportunidad para el diagnóstico de EPOC: el proyecto 1000-200

This study received an unconditional grant from GlaxoSmithKline Laboratories Spain

Normalización de las cifras de presión en la arteria pulmonar tras tratamiento efectivo de la enfermedad de Graves

Presentamos el caso de una paciente de 48 años de edad con diagnóstico de hipertensión pulmonar e hipertiroidismo (enfermedad de Graves) en la que se objetivó la normalización de las cifras de presión en la arteria pulmonar tras el tratamiento de su enfermedad tiroidea. Los posibles mecanismos etiopatogénicos involucrados en esta asociación incluirían la presencia de un fallo cardíaco hiperdinámico y/o la existencia de una alteración de la inmunidad subyacente y común a ambos

Prevalence and Outcomes of Infection among Patients in Intensive Care Units in 2017

Importance: Infection is frequent among patients in the intensive care unit (ICU). Contemporary information about the types of infections, causative pathogens, and outcomes can aid the development of policies for prevention, diagnosis, treatment, and resource allocation and may assist in the design of interventional studies. Objective: To provide information about the prevalence and outcomes of infection and the available resources in ICUs worldwide. Design, Setting, and Participants: Observational 24-hour point prevalence study with longitudinal follow-up at 1150 centers in 88 countries. All adult patients (aged 6518 years) treated at a participating ICU during a 24-hour period commencing at 08:00 on September 13, 2017, were included. The final follow-up date was November 13, 2017. Exposures: Infection diagnosis and receipt of antibiotics. Main Outcomes and Measures: Prevalence of infection and antibiotic exposure (cross-sectional design) and all-cause in-hospital mortality (longitudinal design). Results: Among 15202 included patients (mean age, 61.1 years [SD, 17.3 years]; 9181 were men [60.4%]), infection data were available for 15165 (99.8%); 8135 (54%) had suspected or proven infection, including 1760 (22%) with ICU-acquired infection. A total of 10640 patients (70%) received at least 1 antibiotic. The proportion of patients with suspected or proven infection ranged from 43% (141/328) in Australasia to 60% (1892/3150) in Asia and the Middle East. Among the 8135 patients with suspected or proven infection, 5259 (65%) had at least 1 positive microbiological culture; gram-negative microorganisms were identified in 67% of these patients (n = 3540), gram-positive microorganisms in 37% (n = 1946), and fungal microorganisms in 16% (n = 864). The in-hospital mortality rate was 30% (2404/7936) in patients with suspected or proven infection. In a multilevel analysis, ICU-acquired infection was independently associated with higher risk of mortality compared with community-acquired infection (odds ratio [OR], 1.32 [95% CI, 1.10-1.60]; P =.003). Among antibiotic-resistant microorganisms, infection with vancomycin-resistant Enterococcus (OR, 2.41 [95% CI, 1.43-4.06]; P =.001), Klebsiella resistant to \u3b2-lactam antibiotics, including third-generation cephalosporins and carbapenems (OR, 1.29 [95% CI, 1.02-1.63]; P =.03), or carbapenem-resistant Acinetobacter species (OR, 1.40 [95% CI, 1.08-1.81]; P =.01) was independently associated with a higher risk of death vs infection with another microorganism. Conclusions and Relevance: In a worldwide sample of patients admitted to ICUs in September 2017, the prevalence of suspected or proven infection was high, with a substantial risk of in-hospital mortality