Prevalencia del virus de la diarrea viral bovina y de animales portadores del virus en bovinos en la provincia de Espinar, Cusco.

The prevalence of bovine viral diarrhea virus (BVDV) in 406 cattle was evaluated of both sexes and older than 6 months. Animals belonged to 114 small farmers from three rural communities of the province of Espinar, Cusco, Peru. Blood samples were collected according to three age groups Ɩ-12, 13-23, \u3e24 months old). Serum samples were tested for antibodies against BVDV using the viral neutralization test. The 56.2 ± 4.8% 鴤/406) of samples had antibodies against BVDV. Persistently infected animals were not detected. Antibodies were present in the three age groups, but the highest prevalence ࿡.4%) was detected in animals older than 24 months of age. The 51.3% ྴ/39) of young and adult bulls had antibodies against BVDV. Antibodies titers varied from 2 to \u3e256, and high titers 鳀 to \u3e256) were detected in 42.1% of animals of 13 to \u3e24 months of age. The 86.8% ဃ/114) of the small farmers had at least one animal seropositive to BVDV

Frecuencia de leptospira spp en porcinos de crianza tecnificada y de traspatio beneficiados en dos mataderos de lima

The objective of this study was to determine the frequency of antibodies against Leptospira spp in pigs reared in five well-managed farms (n = 163) and from 11 backyard breeding (n = 133) owners in the valley Lima, Peru. Blood samples (n=296) were collected in two slaughterhouses for antibody detection against eight serovars of Leptospira by microaglutination test. The 85.8 ± 3.9% (254/296) of samples had antibodies against one or more serovars of Leptospira. . The 89.6 ± 4.7% (146/163) and 82.1 ± 6.5% (108/133) of samples from well-managed farms and from backyard breeding pigs showed antibodies against Leptospira spp. The serovars icterohaemorrhagiae, pomona, and georgia were the most frequently detected in both groups of pigs. No antibodies were detected against serovars bratislava and grippothyphosa. Antibody titres ranged from 100 to 400, being the highest titles (800 to 1600) detected more frequently in backyard breeding pigs. Serovars icterohaemorrhagiae and pomona were the most common mixed infections found for both type of breeding systems. There were no association between antibodies against Leptospira and type of pig breeding system

Expression of TCRγδ receptor genes in jejunum mucosa of baby alpacas (Vicugna pacos)

El objetivo de este estudio fue determinar la expresión de genes del receptor TCRγδ (gamma y delta) en el epitelio yeyunal de 16 crías de alpaca aparentemente sanas, de 2 a 47 días de edad, mediante la cuantificación de ARN mensajero (ARNm) utilizando cebadores específicos. Se tomaron porciones de yeyuno (2 cm de longitud). El ARNm total de la mucosa de la porción media del yeyuno actuó como molde para la síntesis de ADN complementario mediante transcripción reversa (RT), seguida de un PCR-tiempo real para la amplificación y cuantificación de los ARNm de los polipéptidos que conforman las cadenas gamma y delta del TCR. Se utilizó el método 2-ΔΔCt para la cuantificación relativa de ARNm, teniendo como calibrador a dos crías neonatas que no habían consumido calostro. Las crías de 1, 2, 3 y ≥4 semanas de edad expresaron el gen gamma en 4.75, 6.78, 16.24 y 103.11 veces lo expresado por los animales calibradores, respectivamente, y el gen delta fue expresado en 9.43, 20.78, 25.08 y 146.46 veces, respectivamente. Los resultados demuestran que los genes gamma y delta se expresan en forma creciente con la edad, y significativamente a partir de la cuarta semana de edad (p<0.05), indicando que los linfocitos Tγδ se incrementan en la mucosa intestinal con la edad.The aim of this study was to determine the expression of TCRγδ receptor genes (gamma and delta) in the jejunal epithelium of 16 apparently healthy baby alpacas (2 to 47 days of age), by quantifying messenger RNA (mRNA) using specific primers. Jejunumsamples (2 cm long) were collected. Total mRNA of the medium portion of the jejunum acted as template for complementary DNA synthesis by reverse transcription (RT), followed by real-time PCR for the amplification and quantification of the mRNAs of the polypeptides that make up the gamma and delta chains of the TCR. The 2-ΔΔCt method was used for the relative mRNA quantification, using as calibrator two neonatal alpacas that had not consumed colostrum. The alpacas of 1, 2, 3 and >4 weeks of age expressed the gamma gene at 4.75, 6.78, 16.24 and 103.11 folds as expressed by the calibrator animals, respectively, and the delta gene was expressed at 9.43, 20.78, 25.08, and 146.46 folds, respectively. The results demonstrate that gamma and delta genes are increasingly expressed with age, and significantly from the fourth week of age (p<0.05), indicating that Tγδ lymphocytes increase in the intestinal mucosa with age

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research