Vigilancia epidemiológica de la yersiniosis en España 2005-2014

[ES] La yersiniosis es una enfermedad zoonótica causada por dos especies enteropatógenas de Yersinia. La transmisión al ser humano es por mecanismo fecal-oral o por el consumo de alimentos o agua contaminados. Se han analizado los casos y brotes notificados a la Red Nacional de Vigilancia Epidemiológica (RENAVE) para 2005-2014 y el Conjunto Mínimo de Datos Básicos al Alta Hospitalaria (CMBD-RAE) hasta el año 2013. Se ha realizado un análisis descriptivo de la distribución temporal, geográfica y por sexo y edad, así como de la tasa de hospitalización. Se usó modelo de regresión lineal de joinpoint para valorar la tendencia temporal. En 2005-2014 se notificaron 3.170 casos a la RENAVE de 73 laboratorios de microbiología clínica de 13 comunidades autónomas (CCAA). Se notificaron 5 brotes producidos por Y. enterocolitica, con un total de 65 casos y 3 hospitalizaciones. En el periodo 2005-2013 se registraron en el CMBD-RAE 727 ingresos hospitalarios con diagnóstico principal (76%) o secundario (24%) de yersiniosis. Yersinia enterocolitica causó prácticamente todos los casos. La tendencia temporal es estable con un ligero aumento en los últimos años. No existe un patrón estacional claro. La mayoría de los casos e ingresos se concentraron en la población infantil menor de 5 años de edad. La tasa de hospitalización fue máxima en el grupo de menores de un año y la mediana de la estancia hospitalaria fue de 5 días. La yersiniosis afectó de forma similar a ambos sexos, con un ligero predominio de los casos en varones. [EN] Yersiniosis is a zoonotic disease caused by two different enteropathogenic species of Yersinia. The transmission to the human being is by fecal-oral mechanism or by the consumption of contaminated food or water. The cases and outbreaks notified to the National Epidemiological Surveillance Network (RENAVE) for 2005-2014 and the Minimum Basic Data Set at Hospital Discharge (CMBD-RAE) until 2013 were analyzed. A descriptive analysis of the temporal, geographical and sex and age distribution, as well as the hospitalization rate was carried out. Joinpoint linear regression model was used to assess the temporal trend. In 2005-2014, 3,170 cases were reported to the RENAVE by 73 clinical microbiology laboratories of 13 Regions. Five outbreaks caused by Y. enterocolitica were reported, with a total of 65 cases and 3 hospitalizations. In the 2005-2013 period, 727 hospital admissions with primary (76%) or secondary (24%) diagnosis of yersiniosis were recorded in the CMBD-RAE. Yersinia enterocolitica caused almost all the cases. The temporary trend is stable with a slight increase in recent years. There is no clear seasonal pattern. The majority of cases and hospitalizations occurred in the child population under 5 years of age. The hospitalization rate was maximum in the group of children under one year of age and the median hospital stay was 5 days. Yersiniosis affected similarly to both sexes, with a slight predominance of cases in men

A 2018 Overview of Diuretic Resistance in Heart Failure

Heart failure is a disease with high direct and indirect costs. Current treatment includes drugs that alter disease progression and drugs that to improve symptoms. Loop diuretics are the cornerstone of congestion relief for acute management, as well as for chronic stabilization. In heart failure patients, maximal diuretic response is reduced by many individual factors. Diuretic resistance is defined as failure to achieve effective congestion relief despite appropriate or escalating diuretic doses. Its causes include impaired delivery of the diuretic to its luminal site of action, neurohormonal activation, tubular compensatory adaptation and drug interactions. Several strategies can be employed to aid decongestion of patients with impaired diuretic response. These include salt restriction, a higher effective single dose or higher dose frequency of loop diuretics, continuous infusion of diuretics and/or sequential nephron blockade through a synergistic combination of two or more diuretics from different classes. Ultrafiltration has also been found to be another effective and safe therapeutic option and should be considered in patients with refractory diuretic resistance. Overall, there is a lack of high-quality clinical data to guide the choice of treatment strategy and therapy should be tailored on a case-by-case basis.info:eu-repo/semantics/publishedVersio

A comparative analysis of the intestinal metagenomes present in guinea pigs (Cavia porcellus) and humans (Homo sapiens)

<p>Abstract</p> <p>Background</p> <p>Guinea pig (<it>Cavia porcellus</it>) is an important model for human intestinal research. We have characterized the faecal microbiota of 60 guinea pigs using Illumina shotgun metagenomics, and used this data to compile a gene catalogue of its prevalent microbiota. Subsequently, we compared the guinea pig microbiome to existing human gut metagenome data from the MetaHIT project.</p> <p>Results</p> <p>We found that the bacterial richness obtained for human samples was lower than for guinea pig samples. The intestinal microbiotas of both species were dominated by the two phyla <it>Bacteroidetes</it> and <it>Firmicutes</it>, but at genus level, the majority of identified genera (320 of 376) were differently abundant in the two hosts. For example, the guinea pig contained considerably more of the mucin-degrading <it>Akkermansia</it>, as well as of the methanogenic archaea <it>Methanobrevibacter</it> than found in humans. Most microbiome functional categories were less abundant in guinea pigs than in humans. Exceptions included functional categories possibly reflecting dehydration/rehydration stress in the guinea pig intestine. Finally, we showed that microbiological databases have serious anthropocentric biases, which impacts model organism research.</p> <p>Conclusions</p> <p>The results lay the foundation for future gastrointestinal research applying guinea pigs as models for humans.</p

Interplay of quantum and classical fluctuations near quantum critical points

For a system near a quantum critical point (QCP), above its lower critical dimension $d_L$, there is in general a critical line of second order phase transitions that separates the broken symmetry phase at finite temperatures from the disordered phase. The phase transitions along this line are governed by thermal critical exponents that are different from those associated with the quantum critical point. We point out that, if the effective dimension of the QCP, $d_{eff}=d+z$ ($d$ is the Euclidean dimension of the system and $z$ the dynamic quantum critical exponent) is above its upper critical dimension $d_C$, there is an intermingle of classical (thermal) and quantum critical fluctuations near the QCP. This is due to the breakdown of the generalized scaling relation $\psi=\nu z$ between the shift exponent $\psi$ of the critical line and the crossover exponent $\nu z$, for $d+z>d_C$ by a \textit{dangerous irrelevant interaction}. This phenomenon has clear experimental consequences, like the suppression of the amplitude of classical critical fluctuations near the line of finite temperature phase transitions as the critical temperature is reduced approaching the QCP.Comment: 10 pages, 6 figures, to be published in Brazilian Journal of Physic

Treatment of reducible unstable fractures of the distal radius in adults: a randomised controlled trial of De Palma percutaneous pinning versus bridging external fixation

Background: At present, there is no conclusive evidence regarding the best treatment method for reducible unstable fractures of the distal radius. This study compared the effectiveness of two methods used in surgical treatment of such fractures: percutaneous pinning and external fixation.Methods: We randomly allocated 100 patients into two groups treated surgically with modified de Palma percutaneous pinning and bridging external fixation. Independent but not blinded evaluators administered the DASH quality-of-life questionnaire at postoperative months 6 and 24, performed functional assessment of pain, range of motion, and palm grip strength, and radiographic examinations (volar and radial angle, and height of the radius) before the operation, immediately afterwards, and at 6 and 24 months postoperative. Modified de Palma percutaneous pinning patients used an above-elbow cast whereas external fixation group had unrestricted elbow motion after surgery. Patients who for any reason demonstrated treatment failure or required additional interventions were followed up and their results were included in the group into which these patients had initially been randomised according to the intention-to-treat principle. A significance level of 5% (alpha = 0.05). was used for all statistical tests, such that tests presenting a p-value less than 0.05 were considered statistically significant.Results: Ninety one (58.8 mean age and 66 participants were female) were included in the final assessment at 24 months. the DASH questionnaire evaluation showed a statistically significant result favouring the de Palma group (mean difference = -7.1 p = 0.044) after six months, but this was not maintained at 24 months. There were no statistically differences between the groups with respect to palm grip strength. Analysis of the range-of-motion limitation index (uninjured side minus affected side motion of) showed a statistical difference (mean difference = 2.4 p = 0.043) favoring the external fixator group with regard to the supination movement 6 months after the operation; however, this was not maintained at 24 months. the final results of the radiographic evaluation were similar for the two groups. Overall, five patients developed complications: two with de Palma pinning and three with external fixation.Conclusion: There was a small statistically significant difference favouring the de Palma method in early functional at 6 months according to the DASH questionnaire, and for supination movement favouring the fixator group. However, both were not clinical relevant. By 24 months the groups were similar for all outcome