Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Update of the Aujeszky's disease situation in Argentina

There are approximately 3 million pigs in Argentina. The production system is mainly extensive (40%) and semi-extensive (40%), being intensive in only 20% of the farms. Aujeszky's Disease (AD) has been described in South America since 1912, however Argentina remained apparently free until 1979. Since then, a number of outbreaks have been described and confirmed by virus isolation. In 1996, the National Animal Health Service (SENASA) established an AD control programme based on serological detection of infected animals by using an ELISA. This programme is compulsory in breeding farms, since the animals to be commercialised must be certified free of AD. Seropositive animals are segregated or sent to the slaughterhouse. In addition, a voluntary vaccination programme is carried out using an inactivated deleted vaccine (gE). The Virology laboratory of the Faculty of Veterinary Sciences, National University of La Plata is a reference laboratory to SENASA for this disease. Since 1987, the laboratory has been engaged in diagnosis and research on AD. Epidemiological studies, viral isolation and characterisation of AD virus isolates have been performed. From 1988 to 1990 a national serological screening was performed to detect AD antibodies. A total of 5955 sera belonging to 265 farms were tested by ELISA; 624 of these sera (10.5%) taken from 68 farms (25.7%) were seropositive. Similar percentages were found in recent serological studies (data provided by SENASA from a 1998 survey). Several AD viral strains were isolated and characterised from different outbreaks. All Argentine isolates showed similar biological and physicochemical behaviour. The genome of the isolates was analysed using restriction enzymes. Two genome types of the AD virus were found: types I and II as classified by the BamHI cleavage pattern. Major outbreaks have been caused by type I viruses while only one type II virus outbreak has occurred so far in an imported herd. AD is an enzootic disease in Argentina. Genome type I is the major causative agent of infection. A control programme for the disease was established 3 years ago and voluntary vaccination was started in 1998

Feline immunodeficiency virusinfection: a comparative study of different diagnostic techniques Infecção pelo vírus da imunodeficiência felina: estudo comparativo de diferentes técnicas de diagnóstico

This study evaluated an indirect immunofluorescence assay (IFA) to detect feline immunodeficiency virus infection (FIV) antibody in a comprehensive epidemiological survey of FIV in Argentina. IFA modified in our laboratory, was compared with two other immunoassays, western blot (WB) and a sandwich immunochromatographic commercial kit (SI), and also with a direct polymerase chain reaction (PCR) method that detects proviral DNA. IFA showed to be a test with high sensitivity and specificity, and could be useful as a diagnostic tool in epidemiological studies. The presence of a low percentage of results with non-specific reactivity in the IFA could be resolved with further testing or use of an alternative method.<br>Avaliou-se a técnica de imunofluorescência indireta (IFA) na detecção de anticorpos contra o vírus da imunodeficiência felina (FIV) numa pesquisa epidemiológica do FIV na Argentina. A IFA foi modificada e comparada com duas outras técnicas imunológicas: western blot (WB) e imunocromatografia em camadas (SI) com kit comercial e também com reação em cadeia de polimerase (PCR) para detecção do DNA proviral. A IFA mostrou ser um teste com alta sensibilidade e especificidade e poderá ser empregada como ferramenta útil em estudos epidemiológicos. A baixa porcentagem de reatividade não específica pode ser esclarecida com testes mais avançados ou usando métodos alternativos

Occurrence of feline immunodeficiency virus infection in cats Ocorrência da infecção pelo vírus da imunodeficiência felina em gatos

The occurrence of feline immunodeficiency virus (FIV) in Brazil has been previously described. This study aimed to investigate the frequency of FIV infection in 454 blood samples from healthy and sick domestic cats from 13 cities of São Paulo State, Brazil as well as to evaluate the risk factors associated with the infection. The results showed that 14.7% (67/454) of the cats were infected with FIV. The clinical evaluation showed that 29.2% of the FIV-positive animals were sick, while 7.3% did not show any type of clinical manifestation. In addition, the vast majority (23.1%) of positive cases corresponded to free-roaming owned cats. The incidence of FIV infection was higher in males (20.3%) than in females (9.7%). The results suggest that certain characteristics such as gender, health status and lifestyle may be associated with the risk of being infected with FIV in the population of cats studied.<br>No Brasil, a ocorrência da infecção pelo vírus da imunodeficiência felina (FIV) já foi descrita. Neste estudo, objetivou-se investigar a freqüência da infecção pelo FIV em 454 amostras de sangue de gatos domésticos doentes e sadios, oriundos de 13 cidades do Estado de São Paulo, assim como avaliar os fatores de risco associados à infecção pelo FIV. Os resultados demonstraram que 14,7% (67/454) dos gatos estavam infectados pelo FIV. A avaliação clínica dos animais investigados mostrou que 29,2% dos animais soropositivos para FIV estavam doentes, enquanto 7,3% não apresentavam nenhuma manifestação clínica. Além disso, a vasta maioria dos animais positivos (23,1%) vivia em residências e tinha livre acesso à rua. A incidência da infecção pelo FIV foi maior nos gatos machos (20,3%) do que nas fêmeas (9,7%). Os resultados sugerem que certas características como sexo, estilo de vida e estado de saúde podem estar associadas ao risco de contrair a infecção pelo FIV na população de gatos estudada