Comparative study of real-time pcr (Taqman probe and sybr green), serological techniques (elisa, ifa and dat) and clinical signs evaluation, for the diagnosis of canine leishmaniasis in experimentally infected dogs

Canine leishmaniasis (CanL) diagnosis is not fully resolved. Currently, two specific methodologies are in continuous development, the detection of the parasite DNA or RNA in target organs and the detection of specific antibodies against Leishmania sp. For a correct diagnosis, it has been shown that the joint use of this type of test is necessary. In this work, a Sybr Green and a TaqMan Probe based on real time PCRs (qPCR) was performed for the detection of Leishmania sp. in order to correlate the results with clinicopathological and serological evaluations (IFA, ELISA and DAT) to propose an optimal biological sample to be used to detect the parasite in both early and late stages of the infection. A total of four samples were processed: conjunctival swabs, popliteal lymph node aspirates, bone marrow aspirates, and peripheral blood from experimentally infected dogs belonging to a larger study. Our results indicated that a single non-invasive sample (conjunctival swab) and the application of both types of qPCR would be reliable for determining Leishmania infection as well as the disease stage in dogs, thus avoiding bone marrow, lymph node aspirate or blood samples collection. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/)

Neutrophil gelatinase-associated lipocalin (NGAL) is related with the proteinuria degree and the microscopic kidney findings in leishmania-infected dogs

Early diagnosis of renal damage in Leishmania infected dogs may allow appropriate treatments and prevent some deaths. This study investigates neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker of kidney disease in dogs experimentally infected with Leishmania infantum. Serum, urine, and kidney samples were collected from 30 infected beagle dogs and six uninfected control dogs. Based on proteinuria and azotemia values, dogs were initially classified. NGAL was measured in urine and serum samples. Then, the urinary NGAL to creatinine ratio (uNGAL/C) was calculated. Kidney samples were taken for histopathological studies, and the dogs were classified according to the severity of glomerular and tubulointerstitial lesions. In Leishmania-infected dogs, the uNGAL/C was significantly higher in proteinuric non-azotemic dogs compared with non-proteinuric non-azotemic dogs (p = 0.038). Serum NGAL (sNGAL) concentration did not differ between groups. Microscopic studies revealed several degrees of glomerulonephritis and slight focal lymphoplasmacytic interstitial nephritis in 89% and 55% of infected dogs, respectively. Urinary protein to creatinine ratio (UPC) and uNGAL/C were significantly higher in dogs with affected glomeruli compared to infected dogs without renal lesions (p = 0.045 and p = 0.043, respectively). The results show that uNGAL/C correlates with proteinuria and the presence of moderate glomerular lesions in non-azotemic dogs experimentally infected with L. infantum

Utilización de montelukast en población pediátrica: estudio en tres farmacias comunitarias

Objetivo: El objetivo de este trabajo es analizar, desde tres farmacias comunitarias, el uso que se está haciendo de montelukast en la población pediátrica. Método: Estudio observacional de prescripción de montelukast realizado en tres oficinas de farmacia en niños (≤15 años) a los que se dispensó el fármaco; la recopilación de datos de los pacientes (edad, patologías, régimen de dosificación, duración del tratamiento, medicación asociada) se hizo a través de encuesta. Se remitió al médico cuando se detectó un tratamiento inadecuado, para su revisión. Resultados: Se recogieron un total de 75 prescripciones médicas. Sólo el 36% de los niños eran asmáticos; de ellos, al 70% se les pautó montelukast como terapia inicial, y el 45% no seguían las recomendaciones de la Guía Española para el Manejo del Asma. El 64% de los niños no eran asmáticos y estaban recibiendo montelukast fuera de indicación (off-label) (44% rinitis alérgica, 56% bronquiolitis), el 21% de ellos en monoterapia y el resto en combinación con otros fármacos. Conclusiones: Se está haciendo un uso fuera de indicación de montelukast en niños no asmáticos con rinitis alérgica o bronquiolitis, y en este último caso no existe evidencia de efectividad. El uso inadecuado podría acarrear problemas de seguridad para los pacientes. Se evidencia la necesidad de proporcionar información independiente a los profesionales sanitarios sobre el papel de montelukast en la terapéutica

Algoritmo de actuación en la farmacia comunitaria para optimizar la utilización de estatinas

INTRODUCCIÓN: Pacientes en tratamiento con estatinas suelen presentar numerosos problemas relacionados con la medicación, no solo de seguridad sino también de necesidad y de efectividad. OBJETIVO: Proponer un algoritmo de actuación del farmacéutico comunitario en la dispensación de estatinas para optimizar la utilización de este grupo de medicamentos. MATERIAL Y MÉTODOS: Recogida de datos (cuestionario) en farmacia comunitaria (3 meses) en pacientes con prescripción de estatinas. Determinación de presión arterial, IMC, perímetro abdominal y cálculo del riesgo cardiovascular (RCV) (tablas SCORE y REGICOR). RESULTADOS: Se incluyen 48 pacientes. Se evidencia falta de control del colesterol (25%) y de la presión arterial (48%). Se deriva al médico el 21% que tiene la presión arterial >140/90 mm Hg y no están diagnosticados. También se derivan al médico cuando la falta de adherencia no es la causa de la inefectividad (29%) o cuando no tienen RCV alto (38%) que justifique la necesidad de estatina. En los restantes se detecta necesidad de información/educación y se interviene. Se han realizado un total de 145 intervenciones enel 90% de pacientes incluidos. En base a estos resultados se propone un algoritmo simplificado de actuación en la dispensación de estatinas. CONCLUSIONES: El grupo de pacientes tratados con estatinas es susceptible de actuación por parte del farmacéutico comunitario, que, mediante un algoritmo de actuación sencillo, puede detectar durante la dispensación numerosos problemas relacionados con la medicación e intervenir para mejorar el uso y la efectividad de estos fármacos

Algoritmo de actuación en la farmacia comunitaria para optimizar la utilización de estatinas

INTRODUCCIÓN: Pacientes en tratamiento con estatinas suelen presentar numerosos problemas relacionados con la medicación, no solo de seguridad sino también de necesidad y de efectividad. OBJETIVO: Proponer un algoritmo de actuación del farmacéutico comunitario en la dispensación de estatinas para optimizar la utilización de este grupo de medicamentos. MATERIAL Y MÉTODOS: Recogida de datos (cuestionario) en farmacia comunitaria (3 meses) en pacientes con prescripción de estatinas. Determinación de presión arterial, IMC, perímetro abdominal y cálculo del riesgo cardiovascular (RCV) (tablas SCORE y REGICOR). RESULTADOS: Se incluyen 48 pacientes. Se evidencia falta de control del colesterol (25%) y de la presión arterial (48%). Se deriva al médico el 21% que tiene la presión arterial >140/90 mm Hg y no están diagnosticados. También se derivan al médico cuando la falta de adherencia no es la causa de la inefectividad (29%) o cuando no tienen RCV alto (38%) que justifique la necesidad de estatina. En los restantes se detecta necesidad de información/educación y se interviene. Se han realizado un total de 145 intervenciones enel 90% de pacientes incluidos. En base a estos resultados se propone un algoritmo simplificado de actuación en la dispensación de estatinas. CONCLUSIONES: El grupo de pacientes tratados con estatinas es susceptible de actuación por parte del farmacéutico comunitario, que, mediante un algoritmo de actuación sencillo, puede detectar durante la dispensación numerosos problemas relacionados con la medicación e intervenir para mejorar el uso y la efectividad de estos fármacos

Utilización de montelukast en población pediátrica: estudio en tres farmacias comunitarias

Objetivo: El objetivo de este trabajo es analizar, desde tres farmacias comunitarias, el uso que se está haciendo de montelukast en la población pediátrica. Método: Estudio observacional de prescripción de montelukast realizado en tres oficinas de farmacia en niños (≤15 años) a los que se dispensó el fármaco; la recopilación de datos de los pacientes (edad, patologías, régimen de dosificación, duración del tratamiento, medicación asociada) se hizo a través de encuesta. Se remitió al médico cuando se detectó un tratamiento inadecuado, para su revisión. Resultados: Se recogieron un total de 75 prescripciones médicas. Sólo el 36% de los niños eran asmáticos; de ellos, al 70% se les pautó montelukast como terapia inicial, y el 45% no seguían las recomendaciones de la Guía Española para el Manejo del Asma. El 64% de los niños no eran asmáticos y estaban recibiendo montelukast fuera de indicación (off-label) (44% rinitis alérgica, 56% bronquiolitis), el 21% de ellos en monoterapia y el resto en combinación con otros fármacos. Conclusiones: Se está haciendo un uso fuera de indicación de montelukast en niños no asmáticos con rinitis alérgica o bronquiolitis, y en este último caso no existe evidencia de efectividad. El uso inadecuado podría acarrear problemas de seguridad para los pacientes. Se evidencia la necesidad de proporcionar información independiente a los profesionales sanitarios sobre el papel de montelukast en la terapéutica

Quantification of milk yield and composition changes as affected by subclinical mastitis during the current lactation in sheep

[EN] The aim of this work was to quantify, on a half-udder basis, the changes in ewe milk yield and composition caused by unilateral subclinical mastitis within the current lactation. Fluctuations due to production level, infection severity, time from the onset of infection, and lactation curves were also studied. Yield and composition of milk from half-udders of unilateral infected ewes were compared between them and with a set of healthy halves using a mixed model. The experiment was completed with a whole-udder approach on the same animals. To test the effect of intramammary infection (IMI) in the 7 wk following the onset of infection, 20 ewes that acquired unilateral subclinical mastitis during lactation and 40 healthy ewes were used. Another group of 20 unilaterally infected ewes from wk 1 of lactation and other 40 healthy ewes were studied to test the effect of IMI on lactational milk yield and composition. The individual milk loss in ewes infected during lactation was 15% for the 7 wk following the onset of infection, and 6.6% more milk was produced by the uninfected half to compensate milk lost by the infected half. Lactational milk yield loss in ewes infected from wk 1 postpartum was 17%. The changes in milk yield were noticed from the week of infection diagnosis. The production level of animals influenced the milk yield changes caused by IMI in such a way that the more productive ewes lost more milk, although these losses were proportional to their production level. On the other hand, infection severity affected milk loss between glands, being more pronounced as somatic cell count increased. A clear decrease of lactose content and casein:protein ratio due to subclinical IMI was observed and it remained throughout the postinfection period. Improving udder health status is necessary to maintain milk production and quality in dairy ewes during lactationThe authors thank the regional government of Valencia ("Generalitat Valenciana") for its support by means of a research fellowship.Martí De Olives, AM.; Díaz, J.; Molina Pons, MP.; Peris Ribera, CJ. (2013). Quantification of milk yield and composition changes as affected by subclinical mastitis during the current lactation in sheep. Journal of Dairy Science. 96(12):7698-7708. doi:10.3168/jds.2013-6998S76987708961

Characterization of Patients with Chronic Diseases and Complex Care Needs: A New High-Risk Emergent Population

Background: To analyze the prevalence and main epidemiological, clinical and outcome features of in-Patients with Complex Chronic conditions (PCC) in internal medicine areas, using a pragmatic working definition. Methods: Prospective study in 17 centers from Spain, with 97 in-hospital, monthly prevalence cuts. A PCC was considered when criteria of polypathological patient (two or more major chronic diseases) were met, or when a patient suffered one major chronic disease plus one or more of nine predefined complexity criteria like socio-familial risk, alcoholism or malnutrition among others (PCC without polypathology). A complete set of baseline features as well as 12-months survival were collected. Then, we compared clinical, outcome variables, and PROFUND index accuracy between polypathological patients and PCC without polypathology. Results: The global prevalence of PCC was 61% (40% of them were polypathological patients, and 21% PCC withouth polypathology) out of the 2178 evaluated patients. Their median age was 82 (59.5% men), suffered 2.3 ± 1.1 major diseases (heart diseases (70.5%), neurologic (41.5%), renal (36%), and lung diseases (26%)), 5.5 ± 2.5 other chronic conditions, met 2.5 ± 1.5 complexity criteria, and presented functional decline (Barthel index 55 (25-90)). Compared to polypathological patients, the subgroup of PCC without polypathology were younger, with a different pattern of major diseases and comorbidities, a better functional status, and lower 12-months mortality rates ((36.2% vs 46.8%; p = .003; OR 0.7(0.48-0.86). The PROFUND index obtained adequate calibration and discrimination power (AUC-ROC 0.67 (0.63-0.69)) in predicting 12-month mortality of PCC. Conclusion: Patients with complex chronic conditions are highly prevalent in internal medicine areas; their clinical pattern has changed in parallel to socio-epidemiological modifications, but their death-risk is still adequately predicted by PROFUND index

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Measurement of the azimuthal anisotropy of Y(1S) and Y(2S) mesons in PbPb collisions at √S^{S}NN = 5.02 TeV

The second-order Fourier coefficients (υ$_{2}$) characterizing the azimuthal distributions of Υ(1S) and Υ(2S) mesons produced in PbPb collisions at $\sqrt{s_{NN}}$ = 5.02 TeV are studied. The Υmesons are reconstructed in their dimuon decay channel, as measured by the CMS detector. The collected data set corresponds to an integrated luminosity of 1.7 nb$^{-1}$. The scalar product method is used to extract the υ$_{2}$ coefficients of the azimuthal distributions. Results are reported for the rapidity range |y| < 2.4, in the transverse momentum interval 0 < p$_{T}$ < 50 GeV/c, and in three centrality ranges of 10–30%, 30–50% and 50–90%. In contrast to the J/ψ mesons, the measured υ$_{2}$ values for the Υ mesons are found to be consistent with zero