Efectividad del levamisole contra nematodos gastroentericos y pulmonares de bovinos

Se determinó la efectividad antihelmíntica del Levamisole contra nematodos gastroentéricos y pulmonares de bovinos, naturalmente infectados. Se utilizaron 20 becerros criollos de 8 a 10 meses de edad, siendo 4 grupos de 5 animales cada uno, con las siguientes dosis: grupo A, 3.75 mg/kg, grupo B, 5.0 mg/kg, grupo C, 7.5 mg/kg y grupo D, sin tratamiento. El Levamisole se administró por vía intramuscular y cinco días después los animales fueron sacrificados para verificar la presencia de parásitos en abomaso, intestino delgado, intestino grueso y tracto respiratorio. El porcentaje de efectividad contra nematodos gastroentéricos adultos fue del 96.5%, 99.6% y 100%; y para formar larvarias del 44.5%, 100% y 56.6% para los grupos A, B, y C respectivamente. Contra vermes pulmonares adultos se obtuvo una efectividad de 96.4%, 89.5% y 98.7%; y para las formas larvarias la efectividad fue de 83.8%, 83.8% y 100% respectivamente para los grupos señalados. Con base en el análisis de varianza se observó que sí existe significancia estadística entre los grupos A, B, C con el D (P < 0.1); según la prueba de Duncan el grupo que mejor se comportó contra nematodos gastroenteropulmonares fue el C

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

Abstract 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

Uso de bioclimatogramas en un modelo de predicción de riesgo a infecciones por Haemonchus contortus

Mediante la elaboración de Bioclimatogramas se determinaron los meses de riesgo a la infección por Haemonchus contortus en rumiantes de nueve municipios ganaderos del Estado de Veracruz: Panuco, Tuxpan, Martínez de la Torre, Poza Rica, Xalapa, Veracruz,

Resistencia antihelmíntica de nematodos gastroentéricos en ovinos a febendazol e ivermectina en la región noroeste del estado de Tlaxcala

This experiment examined the problem of anthelmintic resistance in gastro-intestinal nematodes (GIN) to Ivermectin (IVM) and Febendazole (Fbz) in naturally infected sheep from Tlaxcala, Mexico. Twenty flocks were selected from three districts in Northern Tlaxcala: Calpulalpan (4), Nanacamilpa (10) and Hueytotlipan (6). Groups ranged from 10 to 14 sheep each and they were designed as follows: I), control, II) treated with Fbz at 5 mg per kg of body weight per os, and group (III) treated with IVM at 0.2 mg/kg of bodyweight by subcutaneous injection. Faecal samples were collected and nematode egg counting was estimated at days 0 and 14. Results were based on the faecal egg counts and from a flock management survey applied to farmers. The results showed that one flock was resistant to IVM, three flocks were classified as suspicious and sixteen flocks were susceptible. Moreover, infected sheep treated with Fbz did not show anthelmintic resistance, however, three flocks were suspicious and seventeen flocks were susceptible to this drug. On the other hand, the survey analysis showed that the frequency of anthelmintic treatments was 75 % to IVM, 65 % to Fbz and 45 % to Salicilanide. Besides, 55 % of experimental sheep were Merino-Dorset acquired from Australia, 75 % Suffolk, 10 % Hampshire, 10 % Cross-breed and 5 % Columbia, these last four breeds were acquired from local regions. Moreover, resistance to IVM appeared to be related to the frequent use of IVM and by infected sheep with GIN acquired from other regions.En el presente trabajo se analizó la problemática de resistencia a febendazol (Fz) e ivermectina (IM) en ovinos infestados naturalmente con nematodos gastroentéricos (NGE) en tres municipios del estado de Tlaxcala, México. Se realizó un cuestionariopara la selección de animales. Veinte rebaños fueron escogidos de los municipios de Calpulalpan (4), Nanacamilpa (10) y Hueyotlipan (6). Se formaron tres grupos de 10 a 14 ovinos por rebaño, I) control sin tratamiento, II) tratado con 5 mg de Fz por kilogramo de peso por vía oral, III) tratado con 0.2 mg de IM por kilogramo de peso por vía subcutánea. Se determinó la cantidad de huevos en heces los días 0 y 14 antes y después del tratamiento. El 55 % de ovinos experimentales fueron cruza Merino-Dorset provenientes de Australia, 75 % Suffolk, 10 % Hampshire, 10 % Criolla y 5 % Columbia, éstas últimas cuatro razas de origen nacional. Asimismo, las encuestas muestran que 75 % de los ovinos fueron tratados con derivados de lactosas macrociclicas, 65 % de bencimidazoles y 45 % de salicilanidas. Los resultados de la prueba de campo, muestran resistencia a IM en un rebaño de Calpulalpan y se sospecha de resistencia en tres rebaños de Hueyotlipan. No se observó resistencia a Fz en ningún municipio, pero dos rebaños en Hueyotlipan resultaron sospechosos. Haemonchus y Teladorsagia fueron los géneros identificados resistentes a ivermectina y sospechosos de resistencia a febendazol

Frecuencia de nemátodos gastroentéricos en bovinos de tres áreas de clima subtropical húmedo de México

The genera and species of bovine gastrointestinal (GI) nematodes were recorded from 1995 to 1997 throughout four seasons, in three different humid, wet, subtropical locations, i.e.: Sauta, Medellin, and Tizimin (Mexico's states of Nayarit, Veracruz, and Yucatan, respectively). In each location, five freshly weaned, GI nematode-free calves were placed on grasslands, during four time periods. Placements were performed as follows: a) mid raining season (August), b) late raining season (November), c) early dry season (February), and d) early raining season (June). After a 30-day, free-range period cattle were slaughter and adult GI nematodes were collected and identified. Means and standard deviations of nematode species were as follows: Sauta, Haemonchus contortus 32+-8, 615+-115, 267+-87, and 20+-4, Bunostomum phlebotomum: 5+-1, 2+-2, 2+-2, and 0, Oesophagostomum radiatum: 84+-22, 46+-21, 76+-39, and 22+-14, and Trichuris ovis 8+-1, 104+-21, 92+-35, and 112+-38, Medellin, H. contortus 326+-152, 613+-210, 1167+-387, and 12+-8, H. similis: 30+-21, 56+-22, 35+-16, and 0, Cooperia punctata: 320+-185, 414+-409, 47+-28, and 0+-0, B. phlebotomum: 10+-7, 2+-2, 5+-2, and 0, O. radiatum: 106+-42, 228+-61, 72+-39, and 228+-144, Tizimin, H. contortus: 160+-58, 440+-380, 1514+-718, and 300+-184, C. punctata: 46+-31, 90+-84, 930+-1180, and 55+-34, O. radiatum: 4+-4, 26+-33, 0, and 7+-7, for the animals placed in August, November, February, and June, respectively. Significant differences (PSe registraron los géneros y especies de nemátodos gastroentéricos de bovinos de 1995 a 1997, durante cuatro épocas climáticas, en tres lugares con clima tropical subhúmedo cálido: Sauta, Nayarit, Medellín, Veracruz y Tizimín, Yucatán. En cada uno de estos y durante cuatro ocasiones se introdujeron en un potrero cinco becerros recién destetados, libres de nemátodos gastroentéricos. La primera introducción se realizó durante la temporada de lluvias (agosto), la segunda durante la temporada de nortes (noviembre), la tercera al término de nortes (febrero) y la última, al inicio de las lluvias (junio). Después de 30 días de libre pastoreo, los animales fueron sacrificados para la recuperación e identificación de los nemátodos gastrointestinales adultos. La media y desviación estándar de las especies identificadas fueron: en Sauta, Haemonchus contortus 32±8, 615±115, 267±87 y 20±4, Bunostomum phlebotomum: 5±1, 2±2, 2±2 y negativo, Oesophagostomum radiatum: 84±22, 46±21, 76±39 y 22±14 y Trichuris ovis 8±1, 104±21, 92±35 y 112±38, En Medellín, H. contortus 326±152, 613±210, 1167±387 y 12±8, H. similis: 30±21, 56±22, 35±16 y negativo, Cooperia punctata: 320±185, 414±409, 47±28 y 0±0, B. phlebotomum: 10±7, 2±2, 5±2 y negativo, O. radiatum: 106±42, 228±61, 72±39 y 228±144. En Tizimín, H. contortus: 160±58, 440±380, 1514±718 y 300±184, C. punctata: 46±31, 90±84, 930±1180, 55±34, O. radiatum: 4±4, 26±33, negativo, 7±7, para los animales pastoreados en agosto, noviembre, febrero y junio en cada uno de los lugares respectivamente. Se encontró diferencia en los tres sitios en estudio (

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care