21 research outputs found
Parasites associated with Ophidia of the Colombian Pacific
This study describes the diversity of parasites in ophidian species from four ecoregions of Valle del Cauca and Gorgona Island (Colombian Pacific). For this, samples from necropsies, blood and feces were collected from 37 snakes belonging to the species Bothrops asper (terrestrial), Leptodeira annulata (semiarboreal), Imantodes cenchoa (arboreal), Sibon nebulatus (arboreal), Boa constrictor (semiarboreal), Clelia clelia (terrestrial), Mastigodryas boddaerti (terrestrial) and Micrurus mipartitus (terrestrial). Parasite detection was performed using stereoscopic and optical microscopy, and/or concentration and staining methods depending on the sample type; parasites were identified by morphological keys. Eleven snakes (29.7%) belonging to four species were infected with at least one of seven parasite taxa identified (six nematodes and one hemoparasite).
Among nematodes, the families Rhabditidae and Oxyuridae, and the genus Kalicephalus were found for the first time in L. annulata. Worms of the order Strongylida, and the genera Kalicephalus and Ophidascaris were identified in B. asper. Hepatozoon spp. (hemoparasite) presented the highest prevalence of infection, which was only infecting arboreal and semi-arboreal snakes (L. annulata, I. cenchoa and B. constrictor), showing in addition morphological variability of the gametocytes. Our findings suggest that transmission of this parasite may be associated with snake habits and lifestyle.El presente estudio describe la diversidad de endoparásitos en ocho especies de ofidios de las cuatro ecorregiones del Valle del Cauca e Isla Gorgona en Colombia. Para la detección e identificación de parásitos, se obtuvieron muestras de sangre, materia fecal, órganos y tejidos de 37 serpientes pertenecientes a las especies Bothrops asper (terrestre), Leptodeira annulata (semi-arborícola), Imantodes cenchoa (arborícola), Sibon nebulatus (arborícola), Boa constrictor (semi-arborícola), Clelia clelia (terrestre), Mastigodryas boddaerti (terrestre) y Micrurus mipartitus (terrestre). La búsqueda e identificación de parásitos se realizó mediante el uso de microscopia óptica y esteroscópica, y/o métodos de concentración y coloración dependiendo del tipo de muestra; los parásitos fueron identificados mediante claves morfológicas. Once serpientes (29,7%) pertenecientes a cuatro especies estuvieron infectadas con al menos uno de siete taxones parásitos identificados (seis nematodes y un hemoparásito). Entre los nematodes se reportan por primera vez las familias Rhabditidae y Oxyuridae y el género Kalicephalus en L. annulata; en B. asper se identificaron parásitos del orden Strongylida y de los géneros Kalicephalus y Ophidascaris. Hepatozoon spp. (hemoparásito) presentó la prevalencia de infección más elevada, y sólo se halló en I. cenchoa, L. annulata y B. constrictor, de hábitos arbóreo y semiarbóreo, evidenciándose además variabilidad morfológica de los gametocitos. Los hallazgos indican que la transmisión de esta parasitosis puede estar relacionada con el hábito y modo de vida de estas serpientes.Asociación Parasitológica Argentin
Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885
The authors wish to make the following corrections to this paper [...]
Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study
(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery
Role of age and comorbidities in mortality of patients with infective endocarditis
[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.
[Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk.
[Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality.
[Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative
Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research
Aguas del Iténez o Guaporé
Bolivia y Brasil comparten una de las cuencas más atractivas y preservadas de la te-giuri amazônica: la cuenca del rio llénez o Guaporé, que escurre tanto sobre el lecho rocoso del Escudo Precámbrico Brasilefto como sobre las Hanuras del Beni. Estas influencias hacen que la cuenca del iténez tenga una elevada heterogeneidad de habitats, una fauna acuálica peculiar y un alto valor de conservation. Este patrimonio binacional posée un potencial importante para la conservación de la diversidad regional y cl dcsar rollo sostcniblc participativo de las comunidades locales. El libro contiene un resumen del conotimìento de la cuenca y sus recursos, generado en los últimos 10 anos por un equipo de investigadores bolivianos, brasilefios y de otras nacionalidades. Se presenta una descripeión del medio fisico, así como resultados relevantes sobre la biodiversidad acuática, con énfasis en algas, peces, reptiles y mamíferos. El aporte más notable del libro, adernas de la descripeión ecológica del ecosistema, son las lecciones aprendidas que surgieron de experiências locales sobre la élaboration participativa de herramientas para la gestion de los recursos hidrobiológicos.A Bolívia e o Brasil compartilham uma das bacias hidrográficas mais atrativas e preservadas da região amazônica: a bacia do Rio Iténez ou Guaporé. A combinação das influências do escudo pré-cambriano brasileiro e da planícies do Beni é uma das razões pela qual existem na região elevada heterogeneidade de habitats, fauna aquática peculiar e alto grau valor dc conservação. Eslc patrimônio binacional possui potencial significativo para a conservação da diversidade regional e desenvolvimento sustentável participativo das comunidades locais. O livro contém um resumo do conhecimento da bacia e seus recursos, gerado nos últimos dez anos por uma equipe de pesquisadores bolivianos, brasileiros e de outras nacionalidades. Apresentamos uma descrição do meio físico, bem como resultados relevantes da biodiversidade aquática, com ênfase em algas, peixes, répteis e mamíferos. A contribuição mais notável do livro, além da descrição ecológica do ecossistema, é a descrição das lições aprendidas que surgiram a partir de experiências locais sobre elaboração participativa de ferramentas para a gestão dos recursos aquáticos presentes nesta bacia
Importancia clínica del Streptococcus agalactiae como causante de infección
El Streptococcus agalactiae o estreptococo ß-hemolítico del grupo b (S. b) es causa
importante de sepsis neonatal y de infecciones en gestantes y adultos inmunocomprometidos.
Se trata de una bacteria encapsulada cuya virulencia se atribuye a una toxina
polisacárida y se caracteriza por presentar una alta concentración inhibitoria mínima
(CIM) a la penicilina. Su papel como patógeno potencial se ha reconocido ampliamente en
países industrializados donde en la actualidad se desarrollan estrategias de diagnóstico y
prevención dada su alta morbimortalidad; sin embargo, en países en desarrollo no se
informa con frecuencia la infección por este germen, básicamente debido a la circulación
de serotipos menos virulentos y la falta de una búsqueda y diagnóstico adecuados. La
experiencia de la Fundación Valle del Lili, Cali, Colombia, revela en poco tiempo la
presencia frecuente de esta bacteria como colonizante y como origen de infecciones severas
en neonatos y adultos, con una resistencia moderada a la penicilina y alta a la gentamicina
y tetraciclina. Por las implicaciones de esta infección y por lo imperativo de conocer más
acerca de ella, se revisan las características de la infección y de los casos, con lo que se
pretende alertar sobre la presencia de este germen en Cali a fin de orientar hacia
estrategias adecuadas para mejorar su descubrimiento en el laboratorio y hacer un buen
diagnóstico y un manejo terapéutico eficaz. Streptococcus agalactiae (Lancefield
group B Streptococcus) (GBS)
has been recognized over the last few
years as the main etiological agent of
serious neonatal disease and maternal
peripartum infections in the developed
world. Group B streptococcal
disease may also be an emerging public health problem among non-pregnant
adults, particularly those with serious
underlying disease. The potential virulence
of this bacterium is attributable
to its capsulate and a high inhibitory
concentration to penicillin. In industrialized
countries the report of
invasive disease is more frequent than
in developing countries. A possible
explanation for this, could be other
prevalent serotypes, inappropriate
diagnosis and inadequate screening
techniques to detect GBS. In our hospital
we found frequently GBS vaginal
colonization in mothers and nonpregnant
women, and also we have seen
GBS infection in adults and invasive
infection in neonates. Those isolates
were highly resistant to gentamicin
and tetracycline and moderate to penicillin.
In order to know the impact
of GBS infection in Colombia we
need more studies. In this review it is
proposed, that is imperative to guide
efforts to promote the use of strategies
to prevent it, particularly in neonates.
Besides this, in order to decrease the
morbility and mortality for GBS infection,
it is very important to have a
good detection and identification of
GBS in the microbiology laboratory, a
better clinical diagnosis, and opportune
and effective treatment
Micobacterias no tuberculosas en personas VIH positivas y en personas sin factores de riesgo a la infección
Por la ubicuidad de las micobacterias no tuberculosas (MNTBs) en el ambiente y la alta
prevalencia observada en VIH positivos cuya interpretación era confusa, se realizó un
estudio para determinar la prevalencia de MNTBs en la población general y saber cuál era
la naturaleza del hallazgo de MNTBs en VIH positivos. Se comparó un grupo de 101
individuos VIH positivos del Servicio Integrado de Enfermedades Infecciosas del Instituto
de Seguro Social y 100 individuos controles sin riesgo para infección por VIH. En ambos
grupos se tomaron muestras de jugo gástrico para tinción y cultivo. La prevalencia de
micobacterias en los VIH positivos fue 7% así: TBC, 2%; y MNTBs, 5%. Las MNTBs
aisladas fueron: M. gordonae, 2; M. szulgai, 1; M. fortuitum, 1; y M. avium, 1, todas
tan sólo en el cultivo y en pacientes de estadío IV; sin embargo, apenas un caso se asoció
con enfermedad. En los controles la prevalencia fue 6%: 1 micobacteria se encontró en el
Ziehl Neelsen pero no se aisló en cultivo y las 5 restantes que se aislaron en cultivo, eran
M. szulgai; ninguna se asoció con enfermedad. No se encontró asociación entre pH,
mucosidad, celularidad, leucocitos y otras características del jugo gástrico en las muestras
de pacientes con y sin MNTBs. Por consiguiente, se pudo concluir que la prevalencia de
MNTBs fue igual tanto en VIH positivos como en el grupo de las personas con factores de
riesgo a la infección, población general y bastante menor que la encontrada en un estudio
previo. En los VIH positivos la presencia de MNTBs se asoció con estadíos avanzados de
la infección y con el consumo de antibióticos orales. El hallazgo de MNTBs obedece a una
exposición al ambiente contaminado; por lo general se trata de colonizaciones y su
significado clínico en individuos con infección por el VIH está supeditado a las condiciones
inmunológicas del enfermo. La presencia de MNTBs se considera dentro del contexto
clínico del paciente y amerita una evaluación detallada con estudios repetidos