Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Información Investigador: Rojas Estaba, Agustina del Valle

Resumen Curricular Agustina Rojas Estaba, Licenciada en Biología, experiencia de 6 años como asistente de Investigación, contratada, en el Laboratorio JF Torrealba - Facultad de Ciencias, 30 asistencia a congresos y 20 publicaciones en revistas arbitradas e indexadas Nacionales e Internacionales. Actualmente soy asistente de Laboratorio en la misma dependencia. Aceptada en el Doctorado Biología de Microorganismos (Biomi)-Facultad de Ciencias. PPI Nivel I.Universitario7050I - 2004122 - 2005Bioepidemiología de Leishmaniasis y enfermedad de Chagas.Agosto de 2006Lic. en Biología+58 274 2401285Facultad de Ciencias.Personal de [email protected]

Evaluation of conventional serological tests for the diagnosis of American cutaneous Leishmaniasis

Three serological tests (ELISA, IFAT, DAT) were evaluated using sera from selected individuals with different American cutaneous leishmaniasis (ACL) clinical conditions. Reactivity in at least 2 of the 3 named tests was established as a criterion for declaring a patient as sero-positive. Prior to serological testing, people were diagnosed by clinical (presence of lesion = pl or scar=Sc), parasitological (presence of parasites =pp), immunological (LST) and molecular (PCR) methods. For a statistical comparison of the evaluated tests 4 groups of people were made up: 1) patients with active leishmanial lesion (n=44; pl, pp, +LST, +PCR); 2) patients who had recovered from leishmanial infection (n=43; Sc, +LST, +PCR); 3) asymptomatic individuals from endemic areas showing evidence of having contacted Leishmania-parasites (n=40; +LST, +PCR) and 4) Leishmania-negative people from the above localities where leishmaniasis is endemic and living under the same risk conditions, considered as healthy controls (n=104; -LST, -PCR). Considering the above-established criteria for sero-positives, the analysis of the results obtained with the 3 tests employed revealed very low sensitivity values. Seropositive figures of 50% were recorded for the first group, 9% for the second group, and 12.5% for the third group. Statistical analysis also revealed a low positive predictive value (PPV=0.73), a low negative predictive value (NPV=0.49), and a low kappa coefficient value (k=0.114). The present results raise questions about the use of the 3 conventional serological tests compared here to detect ACL at any clinical [email protected]@[email protected]

Update on Chagas disease in Venezuela - A review

The present article reviews the status of Chagas disease in Venezuela based on the detection of Trypanosoma cruzi infections both in referred patients with clinical presumptive diagnosis (1988-2002) and in individuals sampled from rural localities representative of the different geographical regions of the country (1995-2002). In the former group from 306 individuals examined, 174 (56.8%) were seropositive to T. cruzi; 73 (42%) in the acute phase with 52 (71%) showing blood circulating parasites, and from these 38% were children under 10 years old. The other 101 (58%) showed chronic infection at different degrees of cardiac complication. In addition, serologic examination of 3835 individuals from rural areas revealed 11.7% seroprevalence. From these, 8.5% (38/448) were children aged from 0 to 10 years old. These figures suggest that Chagas disease may be re-emerging in Venezuela judging for the active transmission detected during the last decade. The success of the Venezuelan anti-chagasic campaign during the last 40 years is evaluated in the frame of the present results. The epidemiological situation is discussed and recommendation to consider Chagas disease as a national priority is [email protected]@[email protected]

PCR y PCR-Múltiple: parámetros críticos y protocolo de estandarización

Conceptualmente la reacción en cadena de la polimerasa -PCR- incluye un conjunto de técnicas en apariencia simples, de tal modo que algunas de sus variantes como la detección múltiple lucen atrayentes para el campo de la microbiología asistencial. Sin embargo, su aplicación de manera rutinaria se ve restringida por la necesidad de numerosos y necesarios protocolos de estandarización y optimación para determinaciones particulares. En la presente revisión son abordadas las limitancias que presentan la PCR y en particular la mPCR con miras a una mayor comprensión del proceso y de las restricciones que presentan para este campo asistencial. PCR and PCR-Multiplex: critical parameters and standardization protocol Abstract Conceptually the polymerase chain reaction -PCR- include a set of techniques seemingly simple, so that some of its variants like multiple detection looks attractive to the field of microbiology care. However, its routine application is limited by the need for numerous and necessary protocols of standardization and optimization for individual determinations. In this review are approached the constrict that present the PCR and particularly mPCR with a view to a better understanding of the process and limitations that they represent to the welfare field

Infected dogs as a risk factor in the transmission of human Trypanosoma cruzi infection in western Venezuela

A total of 565 mongrel dogs from rural localities of Venezuela were examined by serological (DAT, IFAT and ELISA) and parasitological tests to address the status of Trypanosoma cruzi infection and to evaluate their role in the transmission of the infection to human population. The overall percentage of sero-positive infected dogs shown to be 67.6% (382/565):253 (61.7%) from 47 villages belonging to 8 states located at 4 different geographical regions of western Venezuela and 129 (33.5%) dogs from 48 households located in areas where Chagas disease is endemic. From 101 sampled dogs living in close proximity to 30 acute chagasic patients, 84% expressed specific anti-T. cruzi antibodies (Ab) with 12 of them (14%) showing blood circulating parasites (BCP). In these houses a high proportion of sero-positive people (20%) and frequent indoor infestation by triatomine-bugs (70%) was also recorded. The analysis revealed that from the 47 rural villages sampled during the study, 91.5% had the presence of T. cruzi sero-positive dogs, ranging from 62% positive localities at the states of Falcon and Cojedes to 100% in the other six studied Venezuelan states. This demonstrates that T. cruzi-infected dogs are found throughout all the geographical regions of western Venezuela irrespective of their ecological differences. Molecular typing of T. cruzi isolates from infected dogs using ribosomal and mini-exon gene markers, revealed the presence of both T. cruzi I and T. cruzi II lineages. The coincidence in the circulation of T. cruzi II in dog and human populations at the same locality and at the same time is reported and its significance is discussed. The combined serological, parasitological, epidemiological and molecular data is gathered here to call the attention on the presence of infected dogs as a risk factor in the maintenance of T. cruzi as a source for infection to humans.274 - [email protected]@[email protected]

Trypanosoma rangeli expresses a gene of the group II trans-sialidase superfamily

133–[email protected]@[email protected]@[email protected]

Infección natural por Trypanosoma cruzi en Panstrongylus geniculatus (Latreille, 1811) de la región montana de Mérida, Venezuela

Se reseña el hallazgo de un ejemplar de Panstrongylus geniculatus naturalmente infectado con Trypanosoma cruzi en el interior de una vivienda en la localidad de El Morro, Mérida, Venezuela. Se registra por primera vez la asociación P.geniculatus-T.cruzi en esta localidad ubicada a 1750 msnm. Técnicas moleculares utilizadas corroboraron la identidad de T.cruzi como perteneciente al linaje I. El linaje detectado es similar al que circula en el vecino estado Barinas donde la enfermedad de Chagas es endémica. El hallazgo sugiere la incriminación de P.geniculatus como transmisor intradomiciliar y se discute la importancia epidemiológica potencial para esta regió[email protected]@[email protected]@ula.v

Detection of Anaplasma marginale transplacental transmission in asymptomatic cattle

Se detecta la presencia de Anaplasma marginale en becerros hijos de vacas con infección asintomática. Ensayos de reacción en cadena de la polimerasa (PCR) llevados a cabo en muestras de sangre de 31 vacas lactantes, en aparente buen estado físico y sus respectivas crías, revelaron la presencia de ADN específico de A. marginale en el 70 y 40%, respectivamente. La detección de parte del genoma de A. marginale en becerros recién nacidos, hijos de vacas asintomáticas PCR positivas, sugiere la transmisión de la infección madre-hijo por vía transplacentaria. Se discute las implicaciones epizootiológicas de la infección por A. marginale en animales asintomáticos y se advierte sobre la potencialidad de esta forma de transmisión en el mantenimiento del ciclo de este organismo. Se concluye que la transmisión por vía transplacentaria podría ser un evento de frecuente ocurrencia en el área de estudio y se sugiere la utilización de técnicas producto de la nueva biotecnología como la PCR para incrementar la especificidad en el diagnó[email protected] presence of Anaplasma marginale in calves descendants from cows with asymptomatic infections, was detected. Polymerase chain reaction (PCR) assays carried out in blood samples from 31 healthy cows and their respective calves, revealed the presence of A. marginale-specific DNA in 70 and 40% of them, respectively. The detection of a portion of A. marginale genome in newborn calves, suggests a transplacental motheroffspring transmission. The epizootiological implications of A. marginale-infection in asymptomatic animals and the potential of transplacental transmission in the maintenance of A. marginale were considered. Results lead to conclude that A. marginale transplacental transmission might be of frequent occurrence in the study area, so more specific techniques, such as PCR, are suggested for a more thorough diagnosis

Estudio epidemiológico de Leishmaniasis visceral en El Limón, al norte del estado Lara, Venezuela

El Limón es una comunidad rural ubicada en el Municipio Urdaneta, al Norte del Estado Lara, que limita al Norte con el Municipio Unión,Estado Falcón, Venezuela, una conocida área endémica de leishmaniasis visceral. Debido a su proximidad y tratándose ecológicamente de la misma zona de vida, se realizó el este caserío un estudio epidemiológico, con el objeto de determinar la seroprevalencia a Leishmania sp. humana y canina; e identificar la flebotomofauna de la zona. Se seleccionó una muestra probabilística por azar simple de 71 humanos y 18 caninos, que fueron evaluados por tres métodos serológicos (TAD, IFI, ELISA) para detectar infección por Leishmania sp., encontrándose una seropositividad de 21% y 89% respectivamente. Se realizaron capturas quincenales en refugios naturales y con trampa de Shannon, que revelaron la presencia de Lutzomyia evansi en el área estudiada. La alta seroprevalencia humana y canina observada y la presencia de una especie incriminada en otras áreas como vectora de Leishmania, sugieren que el caserío El Limón es un foco endémico para leishmaniasis [email protected], [email protected]@[email protected]@hotmail.co