Diagnóstico de warfarina en muestras remitidas al CIESA durante el período 2015-2018. Una problemática recurrente

The objective of this work was to determine the number of diagnosed cases of warfarin, used to control or combat "pests" (rodents), in order to highlight the importance of the proper use and application of this substance at the agricultural and even domestic level. There was a total of 21 samples, which corresponded to: Liver, gastric content and prepared baits, sent to the Toxicology area of the Center for Research and Advanced Studies in Animal Health (CEISA), in the period 2015-2018, the determination of warfarin was carried out through thin layer chromatog-raphy, and the descriptive method was used to report the results. The percentage of positivity to warfarin in the study period was 71.41 %. The largest number of samples were livers (14 samples), of which 10 (47.61 %) were positive; followed by gastric content with 3 positives (14.28 %), and prepared baits (pieces of chicken meat, sau-sages and ham) with 2 (9.52 %). In the applications per year, in 2017 and 2018 they increased, with 6 and 9 cases, of which 5 and 7 were positive for warfarin (23.81 and 33.33 %), respectively, 3 samples (livers) were collected and sent from the autopsy area of CIESA, where evidence of lesions suggestive of warfarin intoxication was shown. Under the conditions of occurrence and presentation of cases of warfarin poisoning, regulate the commercialization not only of rodenticides, but of all agricultural products that are currently commer-cialized, in order to minimize the risk of poisoning in the different animal species and even to avoid the harmful effect on public health and the environment. it is necessary toEl objetivo del presente trabajo fue determinar el número de casos diagnosticados de warfarina, empleada para el control o combate de “plagas” (roedores), con la finalidad de remarcar la importancia del adecuado uso y aplica-ción de esta sustancia a nivel agropecuario e incluso doméstico. Un total de 21 muestras, las cuales correspondieron a: hígado, contenido gástrico y cebos preparados, enviados al área de Toxicología del Centro de Investigación y Estudios Avanzados en Salud Animal (CIESA), en el periodo 2015-2018, la determinación de warfarina se realizó a través de cromatografía en capa fina, y para el reporte de resultados se usó el método descriptivo. El porcentaje de positividad a warfarina en el periodo de estudio fue del 71.41 %. El mayor número de muestras fueron hígados (14 muestras), de las cuales 10 (47.61 %) resultaron positivas; seguidos del contenido gástrico con 3 positivas (14.28 %), y los cebos preparados (piezas de carne de pollo, salchichas y jamón) con 2 (9.52 %). En las solicitudes por año, en el 2017 y 2018 se incrementaron, con 6 y 9 casos, de los cuales 5 y 7 fueron positivos a warfarina (23.81 y 33.33 %), respectivamente, 3 muestras (hígados), fueron colectados y enviados del área de necropsias del CIESA, en donde se mostró la evidencia de lesiones sugestivas de intoxicación por warfarina. Bajo las condiciones de ocurrencia y presentación de los casos de intoxicación por warfarina es necesario regular la comercialización no solo de rodenticidas, sino de todos los productos agropecuarios que se comercializan actualmente, con el objeto de minimizar el riesgo de intoxicación en las diferentes especies animales e incluso para evitar el efecto nocivo en salud pública y al ambiente

Riesgos a la salud por el uso de clorhidrato de clembuterol: una revisión

En este trabajo se analiza y valora la información sobre las características y riesgos del uso de clorhidrato de clembuterol (CCL) por su potencial efecto tóxico, debido a su inclusión en la alimentación animal (bovinos, cerdos, ovinos y aves) con la finalidad de mejorar parámetros productivos-reproductivos, pero que descuidan la inocuidad alimenticia. Por eso es necesario revalorar los peligros potenciales que puede ocasionar al emplearse tanto en medicina humana como en veterinaria. El CCL es un β-adrenérgico sintético, polvo blanco, anhidro, muy soluble en agua y altamente estable a temperatura ambiente. Es utilizado en forma clandestina en animales de engorde destinados al consumo humano. Terapéuticamente, se utiliza como un medicamento broncodilatador (pacientes con asma) en competencias deportivas se ha detectado su uso ilegal (dopaje), y en fisicoculturismo es utilizado por su efecto anabólico. Su administración en el ganado para abasto modifica e incrementa el crecimiento de masas musculares, y disminuye la acumulación de grasa se acumula en diferentes órganos. En personas con antecedente del consumo de hígado de bovino contaminado con CCL se ha registrado temblor, dolor muscular, mareos, cefalea y taquicardia. En México, de manera ilegal y clandestina, hay distribución, comercialización y uso de CCL sin embargo, el trabajo de las organizaciones ganaderas para el registro de unidades de producción libres de esta sustancia garantizará el consumo de los productos cárnicos. Proponer el uso de otras sustancias de las cuales hasta el momento no se tiene indicios de toxicidad propiciará una productividad sustentable, segura e inocua en las unidades de producción pecuaria

Reproducibility of Anterior Scalene Stiffness Measurement with Shear Wave Elastography: An Inter-Examiner Reliability Study.

Purpose: Although previous studies highlighted the clinical relevance of the anterior scalene muscle (AS) in patients with neck pain or nerve compressive syndromes, evidence reporting the diagnostic accuracy of shear wave elastography (SWE) for assessing the AS stiffness properties is lacking. This study aimed to analyze the SWE inter-examiner reliability for calculating the Young’s modulus and shear wave speed of the AS muscle in asymptomatic subjects. Material and Methods: Using a linear transducer, ultrasound images of the antero-lateral neck region at C7 level were acquired in 35 healthy volunteers by one experienced examiner and one novel examiner. After codifying the images to blind the participant identity, trial and side, Young’s modulus and shear wave speed were obtained by an independent experienced rater in randomized order. Intra-class correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable changes (MDC) and coefficient of variation (CV%) were calculated. Results: The AS metrics assessed showed no side-to-side differences (p>0.05). Sex differences were found for muscle size (p=0.002), but muscle brightness and stiffness were similar (p>0.05). Inter-examiner reliability was good for determining the AS muscle stiffness (ICC = 0.881 for Young’s modulus and 0.850 for shear wave speed). Conclusion: The obtained results suggest that assessing the AS stiffness properties in asymptomatic subjects is a reliable procedure. Further studies should verify the SWE capacity for discriminating healthy and clinical populations and identify potential factors contributing to the variance of measurement errors.pre-print180 K

Identifying Demographic, Clinical, Muscular and Histological Factors Associated with Ultrasound Cervical Multifidus Measurement Errors in a Chronic Neck Pain Population

Ultrasound imaging (US) is a widely used imaging tool in physiotherapy for assessing muscle morphology and quality, among other purposes, such as ensuring the patients’ safety during invasive procedures or providing visual feedback during motor control exercises. Identifying factors associated with measurement errors is essential to target avoid bias in high-risk of bias populations. Therefore, this study aimed to assess whether demographic, clinical, muscular and histological factors are associated with ultrasound measurement errors in patients with idiopathic chronic neck pain. B-mode images were acquired and analyzed in 126 patients with chronic neck pain by two experienced examiners. Cross-sectional area, muscle perimeter, mean echo intensity and percentage of fatty infiltration were analyzed. The interexaminer agreement was assessed by calculating the absolute error, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable changes (MDC). A Pearson’s correlation matrix including all variables was calculated to conduct a multivariate linear stepwise regression model for estimating the explained variance for each measurement error. Results demonstrated excellent reliability (ICC = 0.965) for assessing the cross-sectional area, and good reliability for assessing the muscle perimeter, mean echo intensity and intramuscular infiltrates estimation (ICC = 0.898, 0.882 and 0.758, respectively). Although clinical variables were not associated with measurement errors (p > 0.05), multiple correlations were found between demographic and cervical multifidus characteristics with measurement errors

Características de replicación y supervivencia del virus de viremia primaveral de la carpa (SVCV) aislado en México

Artículo con descripción de características de replicación de SVCVRESUMEN Objetivo. Realizar el aislamiento del virus de la viremia primaveral de la carpa (SVCV) en ejemplares de carpa común (Cyprinus carpio), evaluar su crecimiento en diferentes tipos de células, así como la supervivencia viral a diferentes temperaturas. Materiales y métodos. Diez carpas de entre 400- 500 gramos de una laguna del centro de México fueron procesadas para el diagnóstico de SVCV mediante aislamiento en cultivo de células y RT-PCR semianidado. El virus obtenido se inoculó en células EPC, BF-2, CHSE-214 y RTG-2 para determinar diferencias de crecimiento de SVCV. Además, se evaluó la supervivencia del virus conservado a temperatura ambiente (TA 20-25°C), refrigeración (REF 4°C) y congelación (CONG -80°C) hasta once meses. Los órganos internos se procesaron para análisis histológico. Resultados. Los peces analizados no presentaron signos externos sugestivos de enfermedad, pero interna e histopatológicamente se observaron lesiones sugestivas de infección sistémica. SVCV fue aislado en células EPC y BF-2 y confirmado por RT-PCR semianidado. SVCV únicamente indujo CPE en células EPC y BF-2 y fue negativo en RTG-2 y CHSE-214. El virus conservado a TA perdió viabilidad después de cuatro meses post infección (mpi), siendo total a seis mpi; mientras REF y CONG fueron estables durante los once meses de estudio. Conclusiones. La infección subclínica por SVCV fue confirmada en carpas que presentaron lesiones histológicas asociadas a esta infección. SVCV únicamente causó CPE en células EPC y BF-2 y el virus conservó su viabilidad a 4ºC y -80°C hasta once meses; mientras que a TA se perdió en seis meses

Prognostic Factors for Postoperative Chronic Pain after Knee or Hip Replacement in Patients with Knee or Hip Osteoarthritis: An Umbrella Review

Knee and hip osteoarthritis are highly prevalent in the older population. Management of osteoarthritis-related pain includes conservative or surgical treatment. Although knee or hip joint replacement is associated with positive outcomes, up to 30% of patients report postoperative pain in the first two years. This study aimed to synthesize current evidence on prognostic factors for predicting postoperative pain after knee or hip replacement. An umbrella review of systematic reviews was conducted to summarize the magnitude and quality of the evidence for prognostic preoperative factors predictive of postoperative chronic pain (&gt;6 months after surgery) in patients who had received knee or hip replacement. Searches were conducted in MEDLINE, CINAHL, PubMed, PEDro, SCOPUS, Cochrane Library, and Web of Science databases from inception up to 5 August 2022 for reviews published in the English language. A narrative synthesis, a risk of bias assessment, and an evaluation of the evidence confidence were performed. Eighteen reviews (nine on knee surgery, four on hip replacement, and seven on both hip/knee replacement) were included. From 44 potential preoperative prognostic factors, just 20 were judged as having high or moderate confidence for robust findings. Race, opioid use, preoperative function, neuropathic pain symptoms, pain catastrophizing, anxiety, other pain sites, fear of movement, social support, preoperative pain, mental health, coping strategies, central sensitization-associated symptoms, and depression had high/moderate confidence for an association with postoperative chronic pain. Some comorbidities such as heart disease, stroke, lung disease, nervous system disorders, and poor circulation had high/moderate confidence for no association with postoperative chronic pain. This review has identified multiple preoperative factors (i.e., sociodemographic, clinical, psychological, cognitive) associated with postoperative chronic pain after knee or hip replacement. These factors may be used for identifying individuals at a risk of developing postoperative chronic pain. Further research can investigate the impact of using such prognostic data on treatment decisions and patient outcomes.</p

Infecção por Toxocara canis e sua relevância para a saúde pública e animal: uma revisão

The Toxocara canis parasite represents a worldwide public health problem. This agent is an ascarid that, in its adult stage, lives in the small intestine of the domestic dog and several wild canids; it presents a complex biological cycle that ensures its transmission and permanence in the hosts it affects; in its intestinal phase, it causes mechanical, irritative and obstructive action, interfering in the transit and digestion of food. Toxocariasis affects young dogs and cats; it produces respiratory signs (cough due to migration of pulmonary larvae), growth retardation (emaciation, weakening of the coat and arthralgia) and intestinal disorders (alternating diarrhea and constipation, abdominal bulging, and vomiting). More intense prenatal infections in puppies can lead to severe disease with alternating diarrhea and constipation, vomiting, typical "pot belly," reduced growth with cachexia, poor coat and, in some cases, death. It has been reported to be present in public park soils, where it contaminates the environment and becomes a source of infection for people. In dog infections, especially strays, nematodes are an important epidemic factor. Regarding human infection, the process tends to become a chronic condition with a broad spectrum of clinical manifestations, from an asymptomatic course to characteristic forms of clinical presentations, such as visceral, ocular, neurological, and covert larva migrans. Regarding control and prevention, health education should be considered to modify the risk practices of pet owners and the community.El parásito Toxocara canis representa un problema de salud pública a nivel mundial. Este agente es un ascárido que en estado adulto vive en el intestino delgado del perro doméstico y de varios cánidos silvestres; presenta un ciclo biológico complejo que asegura su transmisión y permanencia en los hospederos que afecta; en su fase intestinal ocasiona acción mecánica, irritativa y obstructiva, interfiriendo en el tránsito y la digestión de los alimentos. La toxocariasis afecta a perros y gatos jóvenes; produce signos respiratorios (tos, debido a la migración de larvas pulmonares), retraso del crecimiento (emaciación, debilitamiento del pelaje y artralgia) y trastornos intestinales (alternancia de diarrea y estreñimiento, abultamiento de abdomen y vómitos). Las infecciones prenatales más intensas en los cachorros pueden conducir a enfermedades graves con diarrea y estreñimiento alterno, vómitos, típico «vientre de olla», crecimiento reducido con caquexia, capa de pelo pobre y, en algunos casos, la muerte. Se ha reportado su presencia en suelos de parques públicos, en donde contamina el ambiente y se convierte en una fuente de infección para las personas. En las infecciones en perros, especialmente vagabundos, los nematodos son un factor epidémico importante en la naturaleza. Respecto a la infección en el humano, el proceso tiende a convertirse en una afección crónica con un amplio espectro de manifestaciones clínicas, desde un curso asintomático hasta las formas características de presentaciones clínicas, como la larva migrans visceral, ocular, neurológica y encubierta. En cuanto al control y la prevención, se debe considerar la educación para la salud, a fin de modificar las prácticas de riesgo de los propietarios de animales de compañía y la comunidad en general.O parasita Toxocara canis representa um problema de saúde pública mundial. Esse agente é uma Ascaridíase (lombriga adulta) que vive no intestino delgado de cães domésticos e de vários canídeos selvagens; possui um ciclo biológico complexo que garante sua transmissão e permanência nos hospedeiros que afeta; em sua fase intestinal, causa ação mecânica, irritativa e obstrutiva, interferindo no trânsito e na digestão dos alimentos. A toxocaríase afeta cães e gatos jovens; causa sinais respiratórios (tosse, devido à migração de larvas pulmonares), retardo no crescimento (emaciação, enfraquecimento da pelagem e artralgia) e distúrbios intestinais (diarreia e constipação alternadas, abaulamento abdominal e vômitos). Infecções pré-natais mais intensas em filhotes podem levar a uma doença grave com diarreia e constipação alternadas, vômitos, a típica "barriga de pote", crescimento reduzido com caquexia, pelagem fraca e, em alguns casos, morte. Há relatos de sua presença em áreas de parques públicos, onde contamina o ambiente e se torna uma fonte de infecção para as pessoas. Em infecções em cães, especialmente cães de rua, os nematódeos são um importante fator epidêmico na natureza. Com relação à infecção em humanos, o processo tem a tendência de se transformar em uma condição crônica com um amplo espectro de manifestações clínicas, desde um curso assintomático até formas características de apresentações clínicas, como larva migrans visceral, ocular, neurológica e oculta. Em termos de controle e prevenção, a educação em saúde deve ser considerada para modificar as práticas de risco dos proprietários de animais de estimação e da comunidade em geral

Efecto del clorhidrato de clembuterol en la ganancia de peso y lesiones histológicas en ratones

El clorhidrato de clembuterol (CCL) es un b-agonista promotor del crecimiento en animales para abasto, pero su uso ilícito ha generado repercusiones en salud pública. Se realizó un modelo biológico con ratones, con el objeto de evaluar el efecto del CCL sobre la ganancia de peso y las lesiones histológicas que ocasiona. Los ratones fueron alimentados con carne de conejo, que previamente fue suplementada con CCL. Treinta y cinco días posexposición se registró el peso corporal se obtuvo la concentración muscular y sérica de CCL a través de la prueba de ELISA, y se colectaron tejidos (hígado y corazón) para análisis histopatológico. Los valores obtenidos de los animales experimentales (G1 y G2) se analizaron mediante un diseño experimental completamente al azar con dos tratamientos (n = 10), sometidos a un análisis de varianza y comparación de medias con la prueba de Tukey (p \u3c 05). Se registró un incremento de peso corporal de 7 g en el G1, contra 4,0 g del G2. El peso del hígado fue de 2,58 g y 1,79, respectivamente (p \u3c 05). En el G1 la concentración muscular de CCL fue 5324 pg g–1 y en suero sanguíneo de 4378 pg g–1. Solo se observaron cambios histológicos en tejidos de los ratones del G1. El hígado mostró tumefacción celular, mitosis moderada, picnosis y degeneración hidrópica en corazón, engrosamiento de fibras, pleomorfismo e hileración nuclear. El CCL favoreció el incremento de peso en los ratones expuestos, y provocó alteraciones estructurales en hígado y corazón

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Programa de prácticas de acuacultura (2004)

El discente describirá la anatomía básica de las principales familias de especies de peces de cultivo en agua dulce (trucha arcoíris, carpa, tilapia, bagre). 2.- El discente establecerá las diferencias anatómicas entre las principales especies de peces de cultivo en la región central del país. 3.- El discente describirá las diferencias anatómicas con respecto de animales terrestres. 4.- El discente establecerá las principales diferencias funcionales de los peces con respecto de animales terrestres