Descripción de la presencia de un caso de teniasis en nuestro medio

Introducción del caso clínico: Varón, de origen español, de 35 años, que refiere prurito anal en la consulta médica de la cárcel donde cumple condena y que lo relaciona con episodios previos diagnosticados de “lombrices”. Estos fueron tratados con Lomper (Mebendazol) de modo empírico. Se le solicitan estudios parasitológicos en heces frescas al servicio de Microbiología del Hospital Virgen de las Nieves de Granada, hallándose la presencia de huevos de Taenia spp. Para ello, la muestra fue concentrada y visualizada en fresco de acuerdo con el procedimiento estándar previamente publicado por nosotros (1). También se observó a 1000X mediante la tinción de ácido alcohol resistencia (Figuras 1 y 2). Se le puso tratamiento para teniasis con Praziquantel. El estudio de control a los tres meses fue negativo. En la anamnesis posterior este negó haber salido del país ni haber tenido contacto con personas de áreas endémicas. Los episodios de prurito anal los sufre desde la adolescencia habiendo sido tratados siempre. Refiere que cuando era adolescente tuvo contacto con un familiar que también tenía lombrices, una tía que tenía cerdos y gallinas y que acudía a matanzas de cerdos en la localidad de Cenes de la Vega (Granada). En su historia clínica constan que los estudios serológicos del VIH, VHA, VHB, VHC y lúes, así como la prueba de Mantoux fueron negativas

Pedological formations on old mountain geomorphological surfaces of central Spain

The chemo-morphological properties of soils on ancient landforms (quarzitic pliocene alluvial fans, pleistocene terraces), namely “rañizos”, on middle-high mountains (Eastern-Central System, Iberian Peninsula, Rio Negro, Cogolludo) were investigated. Several properties were analyzed by standard procedures. A detailed soil diagnostics and classification on “rañizos” were done, unlike those widely studied on “rañas” (similar landform), by identifying parallel pedogenetic processes in both formations. The genetic and geographic features of Alfisols, Ultisols and Inceptisols are closely related to the nature of their parent materials, based on quartzite and quartz conglomerates, sometimes with an arkosic matrix, red shale, polygenic gravels and pebbles. Soil features were determined by genuine soil-forming inherent lithological rock properties. Other driving factors were flat topography and enough soil formation time to allow intense pedogenesis. The main soil-forming processes were intense weathering, clay enrichment horizons with illuviation, red color caused by iron oxide dehydration and signs of pseudogleyzation processes. Such pedological formations can be considered endemisms; that is, “rare” soils and, up to a point, “relict”. The soil reaction is acid/slightly acid with low base saturation. Despite lying on mountains, soils are characterized by moderate-low organic matter content. Soil conditions and climate provide good vine production requirements despite acidity levels. A common feature of all Rio Negro soils is the presence of gravel (size up to 3–5 cm), which is evenly distributed on arable layers. The results can be used to assess vineyard soil use in a potential Pago (Protected Denomination of Origin) and to extend the database of vineyard soils from poorly studied Mediterranean continental mountain regions

Integrate and learn. Building a farm-to-table blockchain

DecanatoFac. de VeterinariaFALSEsubmitte

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)