Evaluación cuantitativa del riesgo de entrada del virus de la gripe aviar altamente patógeno en la comunidad valenciana por importación de aves vivas

The Region of Valencia has had many imports of live poultry from different countries that have had several outbreaks of Highly Pathogenic Bird flu during their history. The aim of this paper is to do a quantitative assessment of the risk of entry of HPAI in the Region of Valencia and its provinces due to the importation of live poultry, and identify the countries which entail a higher risk. The results indicate that Alicante is the province with more risk and Italy is the country that represents the greatest proportion of risk due to his imports. The probability to introduce the HPAI virus to the Region of Valencia due to life poultry imports is low.En la Comunidad Valenciana (CV) se importa cantidades altas de aves vivas desde países que han sufrido algún brote de influenza aviar altamente patógena (HPAI) a lo largo de su historia. El objetivo de este trabajo es realizar una evaluación cuantitativa del riesgo que hay de que el virus HPAI entre en la CV y sus provincias por importación de aves vivas, e identificar los países desde los que es más probable introducirlo. Los resultados obtenidos muestran a Alicante como la provincia con más probabilidad de sufrir la entrada del virus y a Italia, el país desde donde hay más probabilidad que entre. La probabilidad de introducir el virus HPAI en la CV mediante importaciones de aves vivas es baja

La vida en un laboratorio de alta seguridad biológica

El trabajo e investigación con ciertos microorganismos puede suponer un gran riesgo tanto para el personal que trabaja con ellos, como para los animales y el medio ambiente. Ello hace necesaria la existencia de laboratorios de alta seguridad biológica que permitan su estudio sin riesgo. En este tipo de laboratorios las medidas de bioseguridad son muy estrictas y ello puede afectar al personal que trabaja a diario en estos centros. Conocer cómo les afectan, en qué medida y por qué ha sido el objetivo principal de nuestro trabajo. Para ello se realizó y diseñó una encuesta que ha permitido recoger la opinión de los trabajadores de tres importantes centros de alta seguridad biológica dedicados a Sanidad Animal y Salud Pública. Tras el análisis de las respuestas se observó que la mayoría de encuestados encuentra factores limitantes para su trabajo en este tipo de centros, si bien estos varían de un centro a otro y no impiden valorar la necesidad de estas medidas.To work and research with some kind of microorganism could suppose a high risk for humans, animals and environment. This fact makes necessary the existence of biosafety laboratories. In this type of centres, high security conditions are very strict and that could affect people who work daily inside it. Knowing how it affects them is the main objective of our study. For that reason we have done a survey to know the impressions of people who work in laboratories of Biosafety level 3 (BSL-3) . After analyzing the results of this survey, we could say that working inside BSL-3 implies certain limitations for people who work inside them, but they respect and value the importance of this security conditions

Relación entre los serotipos de lengua azul y su vector, en Europa y cuenca mediterránea

La Lengua Azul es una enfermedad de distribución mundial que afecta a rumiantes y se transmite a través de la picadura de las hembras del mosquito del Género Culicoides. Tradicionalmente, la enfermedad ha estado ligada a la presencia del mosquito Culicoides imicola, pero estudios recientes apuntan a una posible implicación de otras especies de mosquitos que puedan sobrevivir en regiones más frías. Utilizando un sistema de visualización geográfica ARCGIS 9.2 (ESRI®) se ha podido representar la distribución de las principales especies de Culicoides implicadas en la transmisión de Lengua Azul en Europa y norte de África y compararlo con el mapa de distribución de los serotipos del virus de la Lengua Azul. El análisis de los mapas realizados prueba que Culicoides imicola está relacionado con la transmisión de los serotipos 1, 2, 4, 9 y 16 y que el complejo Obsoletus transmite el serotipo 8 y podría ser capaz de transmitir otros serotipos del virus con los que hasta ahora no ha tenido contacto.Bluetongue (BT) is a worldwide spread disease affecting ruminants, which is transmitted by the biting of female midges from the Genus Culicoides. Traditionally, this disease has been linked with the presence of the midge Culicoides imicola, but, recent studies have suggested the possibility of other midge species being involved in the transmission of Bluetongue in cooler regions. By applying the geographic information system ARCGIS 9.2 (ESRI®), the distribution of the main Culicoides species involved in Blue Tongue transmission in Europe and the North of Africa and the distribution of BT serotypes in the same region has been represented. The analysis of the maps obtained shows that Culicoides imicola is involved in the transmission of Bluetongue serotypes 1, 2, 4, 9 and 16 and the Obsoletus complex could be able to transmit, besides BTV-8, other BT serotypes with which it has never been in contact so far

Very low frequency Syndromes

Dismorfología, Citogenética y Clínica: Resultados de estudios sobre los datos del ECEMCThe aim of this chapter is to summarize updated knowledge about the clinical characteristics, etiology, genetic and molecular aspects, as well as mechanisms involved in syndromes having very low frequency, in order to promote their better recognition. During the last five years, a total of 30 syndromes have been published in this chapter of the Boletín del ECEMC. This issue includes the following selected syndromes: Crouzon, Pfeiffer, Apert, Saethre-Chotzen, Carpenter and Muenke. All share craniosynostosis as the main clinical feature but also present with other birth defects, the most important being limb malformations, specially syndactyly and polydactyly. Over 100 syndromes with craniosynostosis have been described, usually involving multiple sutures, and several of them are associated with limb malformations. The clinical overlapping between those syndromes makes difficult to perform a neonatal diagnosis, based on their clinical findings. However, molecular genetic testing, specifically of the FRGR1-3 and TWIST1 genes, could help to establish the diagnosis of some of them. Early diagnosis is important for establishing the most suitable treatment for each patient, as well as to offer an accurate genetic counselling and the possibility of preimplantational and/or prenatal diagnosis.N

Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies

[Background]: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. [Objective]: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts.[Design]: We assessed 18,566 participants in the “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality.[Results]: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII).[Conclusion]: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.Supported by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to R.E.; RTIC RD 06/0045, to Miguel A. Martínez-González) and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional (Proyecto de Investigación (PI) 04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, PI13/00462, PI13/00615, PI13/01090, PI14/01668, PI14/01798, PI14/01764), Ministerio de Ciencia e Innovación (Recursos y teconologia agroalimentarias(AGL)-2009-13906-C02 and AGL2010-22319-C03 and AGL2013-49083-C3-1- R), Fundación Mapfre 2010, the Consejería de Salud de la Junta de Andalucía (PI0105/2007), the Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (Generalitat Valenciana Ayuda Complementaria (GVACOMP) 06109, GVACOMP2010-181, GVACOMP2011-151), Conselleria de Sanitat y, PI14/01764 AP; Atención Primaria (CS) 2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011).). Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology