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Abstract Background: Due to many antineoplastic drugs' toxicity and narrow therapeutic window, medication errors are a health concern in pediatric oncology patients. This study aimed to identify and classify medication errors in a pediatric inpatient chemotherapy facility and evaluate the outcomes of these medication errors. Methods: We conducted an observational retrospective study over 5 months in a chemotherapy facility for pediatric patients. The evaluation consisted of the review of the available medical records. The medication errors detected were manually recorded in a medical logbook. The International Classification for Patient Safety was adjusted to our clinical setting for the analysis, the terminology, and the classification system. A descriptive analysis was performed. Results: A total of 286 medical records were reviewed; one type of medication error was noted in at least 97.6%, and 962 errors were identified totally, with an overall rate of 3.36 errors per visit. Most errors occurred in the documentation stage (643; 66.8%), followed by the administration stage (227; 23.6%). Of all medication errors, 37.2% had the potential to cause injury, but only five reached the patient (0.5%), and only two (0.2%) resulted in a severe harmful incident. Conclusions: Medication errors were common, especially at the documentation stage. Better documentation strategies need to be implemented to reduce the rate of near misses and prevent potential adverse events.

Resumen Introducción: Los errores de medicación son un problema de salud en niños con cáncer debido a la toxicidad y a la estrecha ventana terapéutica de muchos fármacos antineoplásicos. El objetivo de este estudio fue identificar y clasificar los errores de medicación en un centro de quimioterapia para pacientes pediátricos hospitalizados, así como evaluar los resultados de estos errores de medicación. Métodos: Se llevó a cabo un estudio observacional retrospectivo realizado durante un periodo de 5 meses en un centro de quimioterapia para pacientes pediátricos. La evaluación consistió en la revisión de las historias clínicas disponibles. Los errores de medicación detectados fueron registrados manualmente en una bitácora. Para el análisis, la terminología y el sistema de clasificación, la Clasificación Internacional para la Seguridad del Paciente se ajustó a nuestro entorno clínico. Se realizó un análisis descriptivo. Resultados: Se revisaron 286 historias clínicas; se observó un tipo de error de medicación al menos en el 97.6%. En total se identificaron 962 errores de medicación, con una tasa general de 3.36 errores por visita. En la etapa de documentación fue donde más errores ocurrieron (643; 66.8%), seguido de la etapa de administración (227; 23.6%). De todos los errores de medicación, el 37.2% tuvo el potencial de causar lesiones, pero solo cinco llegaron al paciente (0.5%) y solo dos (0.2%) provocaron un incidente dañino severo. Conclusiones: Los errores de medicación fueron comunes, especialmente en la etapa de documentación. Es necesario implementar mejores estrategias de documentación para reducir la tasa de cuasi accidentes y prevenir posibles eventos adversos.

https://doi.org/10.24875/bmhim.21000175 56 downloads

Community-Acquired Uropathogenic Escherichia coli, Antimicrobial Susceptibility, and Extended-Spectrum Beta-Lactamase Detection
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Carmona-Cartaya, Yenisel

; Hidalgo-Benito, Mercedes

; Borges-Mateus, Luisa M.

; Pereda-Novales, Niurka

; González-Molina, María K.

; Quiñones-Pérez, Dianelys

MEDICC Review

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Jun 2022, Volume 24 Nº 2 Páginas 20 - 25

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION Urinary tract infection is the second-leading reason for consults in primary health care. Bacterial urinary tract infections are the most common, of which Escherichia coli is the main etiologic agent. Antimicrobial resistance and multidrug resistance complicate effective community treatment, especially if resistance is caused by extended-spectrum beta-lactamase production. WHO recommends that antimicrobial susceptibility be evaluated in different regions of the world at different times. Community-acquired E. coli’s susceptibility to colistin has not yet been studied in Cuba, and mcr-1 gene screening is necessary. OBJECTIVE Evaluate community-acquired uropathogenic E. coli isolates’ susceptibility to antibiotics, including colistin, and identify extended-spectrum beta-lactamase–producing bacteria. METHODS We conducted a descriptive cross-sectional study that included 281 community-acquired uropathogenic E. coli isolates (153 from the Isle of Youth Special Municipality’s Hygiene, Epidemiology, and Microbiology Center and 128 from Microbiology Laboratories of 7 institutions in Havana) from June 2016 through July 2018. We used the disk diffusion method to determine susceptibility to ampicillin, ampicillin/sulbactam, cefazolin, trimethoprim/sulfamethoxazole, ciprofloxacin, nitrofurantoin and fosfomycin. The disk elution method was used to determine susceptibility to colistin. The combined disk method was used to identify extended-spectrum beta-lactamases. Estimates were made regarding the frequency and percentages of antimicrobial susceptibility and resistance, as well as multidrug-resistance patterns. RESULTS Of the 281 isolates, 68.3% (192/281) were resistant to ampicillin, 54.8% (154/281) were resistant to ciprofloxacin, and 49.5% (139/281) were resistant to trimethoprim/sulfamethoxazole. Resistance to colistin was not detected. On the other hand, 14.2% (40/281) were susceptible to the 8 antibiotics we evaluated, 22.1% (62/281) showed resistance to only 1 antibiotic, and 63.7% (179/281) were resistant to 2 or more antibiotics. In the extended-spectrum beta-lactamase determination, 34.5% (97/281) had inhibition zones ≤14 mm with cefazolin. Of those with inhibition zones, 64.9% (63/97) were positive in the phenotype test, and 35.1% (34/97) were negative. In extended-spectrum beta-lactamase–producing bacteria, 1.6% (1/63) were resistant to fosfomycin, and 3.2% (2/63) were resistant to nitrofurantoin. The most common multidrug-resistance pattern (22.9%; 30/131) was to ampicillin/sulbactam, ampicillin, cefazolin, ciprofloxacin, and trimethoprim/sulfamethoxazole. CONCLUSIONS Uropathogenic E. coli resistance to the antibiotics most frequently used in community medical practice is quite common, and extended-spectrum beta-lactamase–producing bacteria is the mechanism for beta-lactam antibiotic resistance. Multidrug-resistance patterns include resistance to the antibiotics most used in community-acquired infections. Fosfomycin and nitrofurantoin are the most active in extended-spectrum beta-lactamase producing bacteria. All the isolates were susceptible to colistin.

https://doi.org/10.37757/mr2022.v24.n2.2

Water supply and water runoff quality in the sub deciduous forest of the Coast of Oaxaca, Mexico
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Blancas-Díaz, Estrella E.

; Castañeda-Hidalgo, Ernesto

; Robles, Celerino

; Rodríguez-Ortiz, Gerardo

; Santiago-Martínez, Gisela M.

; Villegas-Aparicio, Yuri

Revista Chapingo serie ciencias forestales y del ambiente

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Abr 2022, Volume 28 Nº 1 Páginas 89 - 103

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Introduction: Land use change and waste discharge from coffee processing may be affecting quantity and quality of water supplying urban areas in the coastal region of Oaxaca. Objective: To determine the level of contamination of aquifers and estimate surface water runoff in micro-watersheds of Pluma Hidalgo and Santa María Huatulco in Oaxaca, Mexico. Materials and methods: Seven water supply points were analyzed during the rainy season of 2019. The following physicochemical parameters were determined: pH, total dissolved solids, electrical conductivity, hardness, total solids, chlorides, and chemical oxygen demand (COD). Surface runoff was estimated using the Raws and Prevert methods. Results and discussion. Water bodies are within the permissible limits for human use. The Chacalapilla spring was classified as moderately hard (85 mg CaCO3∙L-1), while the seven water bodies exceeded the permissible limit for COD (40 to 200 mg∙L-1); therefore, water is in a contaminated classification range and is not suitable for human consumption. Surface runoff values suggest a medium conservation condition of vegetation cover; areas with higher cover recorded lower runoff coefficients. Conclusions. The physicochemical parameters indicated that water from Pluma Hidalgo and Santa María Huatulco is suitable for human use, but not for drinking.

Resumen Introducción: El cambio de uso del suelo y el vertido de residuos provenientes del beneficio del café pueden estar afectando la cantidad y la calidad del agua que abastece las zonas urbanas de la región costa de Oaxaca. Objetivo: Determinar el grado de contaminación de cuerpos acuíferos y estimar la escorrentía superficial del agua en las microcuencas de Pluma Hidalgo y Santa María Huatulco en Oaxaca, México. Materiales y métodos: Siete puntos de abastecimiento de agua se analizaron durante la temporada de lluvias de 2019. Se determinaron los parámetros fisicoquímicos siguientes: pH, sólidos disueltos totales, conductividad eléctrica, dureza, sólidos totales, cloruros y demanda química de oxígeno (DQO). La escorrentía superficial se estimó con los métodos Raws y Prevert. Resultados y discusión. Las aguas se encuentran dentro de los límites permisibles para uso humano. El agua del manantial de Chacalapilla se clasificó como moderadamente dura (85 mg CaCO3∙L-1), mientras que la de los siete cuerpos acuíferos excedió el límite permisible de DQO (40 a 200 mg∙L-1); por tanto, el agua se encuentra en un rango de clasificación contaminada y no es apta para consumo humano. Los valores de escorrentía superficial sugieren un estado medio de conservación de la cobertura vegetal; las áreas con mayor cobertura registraron coeficientes menores de escorrentía. Conclusiones. Los parámetros fisicoquímicos indicaron que el agua proveniente de Pluma Hidalgo y Santa María Huatulco es apta para el uso humano, pero no para el consumo.

https://doi.org/10.5154/r.rchscfa.2020.10.063

Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica
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Pavía-López, Abel A.

; Alcocer-Gamba, Marco A.

; Ruiz-Gastelum, Edith D.

; Mayorga-Butrón, José L.

; Mehta, Roopa

; Díaz-Aragón, Filiberto A.

; Aldrete-Velasco, Jorge A.

; López-Juárez, Nitzia

; Cruz-Bautista, Ivette

; Chávez-Mendoza, Adolfo

; Secchi-Nicolás, Nikos C.

; Guerrero-Martínez, Francisco J.

; Cossio-Aranda, Jorge E.

; Mendoza-Zubieta, Victoria

; Fanghänel-Salmon, Guillermo

; Valdivia-Proa, Martha

; Olmos-Domínguez, Luis

; Aguilar-Salinas, Carlos A.

; Dávila-Maldonado, Luis

; Vázquez-Rangel, Armando

; Pavia-Aubry, Vanina

; Nava-Hernández, María de los A.

; Hinojosa-Becerril, Carlos A.

; Anda-Garay, Juan C.

; Ríos-Ibarra, Manuel O. de los

; Berni-Betancourt, Ana C.

; López-Cuellar, Julio

; Araiza-Garaygordobil, Diego

; Rivera-Reyes, Romina

; Borrayo-Sánchez, Gabriela

; Tapia-Hernández, Mónica

; Cano-Nigenda, Claudia V.

; Guerra-López, Arturo

; Elías-López, Josué

; Figueroa-Morales, Marco A.

; Montaño-Velázquez, Bertha B.

; Velasco-Hidalgo, Liliana

; Rodríguez-Lozano, Ana L.

; Pimentel-Hernández, Claudia

; Baquero-Hoyos, María M.

; Romero-Moreno, Felipe

; Rodríguez-Vega, Mario

Archivos de cardiología de México

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2022, Volume 92 Supl. 1 Páginas 1 - 62

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Background: Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions. Objective: This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country. Material and methods: This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG. Results: 23 clinical questions were agreed upon which gave rise to their respective clinical recommendations. Conclusions: We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.

https://doi.org/10.24875/acm.m22000081 1458 downloads

Clinical, radiological, and molecular diagnosis of progressive fibrodysplasia ossificans
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Ordóñez-Labastida, Vianey

; Cárdenas-Conejo, Alan

; Huicochea-Montiel, Juan C.

; Paredez-Rivera, Guadalupe E.

; Hidalgo-Bravo, Alberto

; Monterde-Cruz, Lucero M.J.

; Aráujo-Solís, María A.

Boletín médico del Hospital Infantil de México

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Jun 2021, Volume 78 Nº 3 Páginas 234 - 238

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Background: Progressive fibrodysplasia ossificans is a rare genetic disease with heterozygous mutations (autosomal dominant inheritance) in the ACVR1 gene, which causes progressive heterotopic ossification in muscles, tendons, and ligaments, usually secondary to trauma. The ossification foci generate pain, joint ankyloses, and restricted movement. Congenital shortening and medial deviation first metatarsal of the foot is a distinctive feature. This report aimed to present an educational value case of a patient with clinical, imaging, and molecular diagnosis of progressive fibrodysplasia ossificans, recognized as a rare condition that severely affects the quality of life. Case report: We present the case of a 6-year-old female patient with lumps in the right scapular and dorsal region, progressive joint rigidity, and short first metatarsal medially deviated since birth. By imaging studies, we established the diagnosis of progressive fibrodysplasia ossificans. Sanger sequencing of ACVR1 reported c.617G>A (p.Arg206His). Conclusions: Confirmation of the diagnosis allowed genetic counseling, including a comprehensive explanation of the disease’s natural history and measures to prevent its rapid progression.

Resumen Introducción: La fibrodisplasia osificante progresiva es una enfermedad genética poco frecuente, causada por variantes patogénicas en estado heterocigoto (herencia autosómica dominante) en el gen ACVR1, que provoca osificación heterotópica progresiva en músculos, tendones y ligamentos, comúnmente secundaria a traumatismos. Los focos de osificación generan dolor, anquilosis articular y restricción del movimiento. Es característico el acortamiento congénito y la desviación medial del primer metatarsiano del pie. El objetivo de este reporte es presentar un caso de alto valor educativo de una paciente con diagnóstico clínico, imagenológico y molecular de fibrodisplasia osificante progresiva, reconocida como una condición infrecuente y que afecta de manera grave la calidad de vida. Caso clínico: Paciente de sexo femenino con tumoraciones induradas en la región dorsal y escapular, detectadas a los 6 años de vida. Cursaba además con rigidez articular progresiva y primer metatarsiano del pie acortado y con desviación en sentido medial desde el nacimiento. Por estudios de imagen se estableció el diagnóstico de fibrodisplasia osificante progresiva. Por secuenciación Sanger se reportó c.617G>A (p.Arg206His) en ACVR1. Conclusiones: La confirmación del diagnóstico permitió ofrecer un asesoramiento genético integral, incluyendo una amplia explicación de la evolución natural del padecimiento y de las medidas preventivas para disminuir su rápida progresión.

https://doi.org/10.24875/bmhim.20000119 174 downloads

Captive wild birds as reservoirs of enteropathogenic E. coli (EPEC) and Shiga-toxin producing E. coli (STEC)
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Sanches, Lilian Aparecida

; Gomes, Marcelo da Silva

; Teixeira, Rodrigo Hidalgo Friciello

; Cunha, Marcos Paulo Vieira

; Oliveira, Maria Gabriela Xavier de

; Vieira, Mônica Aparecida Midolli

; Gomes, Tânia Aparecida Tardelli

; Knobl, Terezinha

Brazilian Journal of Microbiology

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Dez 2017, Volume 48 Nº 4 Páginas 760 - 763

Resumo: En | Texto: En | PDF: En

ABSTRACT Psittacine birds have been identified as reservoirs of diarrheagenic Escherichia coli, a subset of pathogens associated with mortality of children in tropical countries. The role of other orders of birds as source of infection is unclear. The aim of this study was to perform the molecular diagnosis of infection with diarrheagenic E. coli in 10 different orders of captive wild birds in the state of São Paulo, Brazil. Fecal samples were analyzed from 516 birds belonging to 10 orders: Accipitriformes, Anseriformes, Columbiformes, Falconiformes, Galliformes, Passeriformes, Pelecaniformes, Piciformes, Psittaciformes and Strigiformes. After isolation, 401 E. coli strains were subjected to multiplex PCR system with amplification of genes eae and bfp (EPEC), stx1 and stx2 for STEC. The results of these tests revealed 23/401 (5.74%) positive strains for eae gene, 16/401 positive strains for the bfp gene (3.99%) and 3/401 positive for stx2 gene (0.75%) distributed among the orders of Psittaciformes, Strigiformes and Columbiformes. None of strains were positive for stx1 gene. These data reveal the infection by STEC, typical and atypical EPEC in captive birds. The frequency of these pathotypes is low and restricted to few orders, but the data suggest the potential public health risk that these birds represent as reservoirs of diarrheagenic E. coli.

https://doi.org/10.1016/j.bjm.2017.03.003 1111 downloads

Estudio y manejo de nódulos tiroideos por médicos no especialistas. Consenso SOCHED
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Tala, Hernán

; Díaz, René E.

; Domínguez Ruiz-Tagle, José Miguel

; Sapunar Zenteno, Jorge

; Pineda, Pedro

; Arroyo Albala, Patricia

; Barberán, Marcela

; Cabané, Patricio

; Cruz Olivos, Francisco

; Gac, Patricio E.

; Glasinovic Pizarro, Andrea

; González, Hernán E.

; Grob, Francisca

; Hidalgo Valle, Maria Soledad

; Jaimovich, Rodrigo

; Lanas, Alejandra

; Liberman, Claudio

; Lobo Guiñez, Maite

; Madrid, Arturo

; Moreno Seguel, Marcela

; Mosso, Lorena

; Munizaga, Fernando C.

; Ortiz Parada, Eugenia

; Osorio Gonnet, Fernando

; Slater Morales, Jeannie

; Solar, Antonieta

; Stehr, Carlos

; Vásquez Rodríguez, Félix

; Véliz, Jesús

; Villaseca Najarian, Roberto

; Wohllk, Nelson

Revista médica de Chile

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Ago 2017, Volume 145 Nº 8 Páginas 1028 - 1037

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

The thyroid nodule is a frequent cause of primary care consultation. The prevalence of a palpable thyroid nodule is approximately 4-7%, increasing up to 67% by the incidental detection of nodules on ultrasound. The vast majority are benign and asymptomatic, staying stable over time. The clinical importance of studying a thyroid nodule is to exclude thyroid cancer, which occurs in 5 to 10% of the nodules. The Board of SOCHED (Chilean Society of Endocrinology and Diabetes) asked the Thyroid Study Group to develop a consensus regarding the diagnostic management of the thyroid nodule in Chile, aimed at non-specialist physicians and adapted to the national reality. To this end, a multidisciplinary group of 31 experts was established among university academics, active researchers with publications on the subject and prominent members of scientific societies of endocrinology, head and neck surgery, pathology and radiology. A total of 14 questions were developed with key aspects for the diagnosis and subsequent referral of patients with thyroid nodules, which were addressed by the participants. In those areas where the evidence was insufficient or the national reality had to be considered, the consensus opinion of the experts was used through the Delphi methodology. The consensus was approved by the SOCHED board for publication.

https://doi.org/10.4067/s0034-98872017000801028 28478 downloads

Resistencia antibiótica de streptococcus pneumoniae en portadores nasofaríngeos sanos de siete regiones del Perú
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Torres, Nancy

; Velásquez, Ricardo

; Mercado, Erik H.

; Egoavil, Martha

; Horna, Gertrudis

; Mejía, Lida

; Castillo, María E.

; Chaparro, Eduardo

; Hernández, Roger

; Silva, Wilda

; Campos, Francisco E.

; Sáenz, Andrés

; Hidalgo, Félix

; Letona, Carolina

; Valencia, Ángel G.

; Cerpa, Rosario

; López-de-Romaña, Bernardo

; Torres, Berenice

; Castillo, Fiorella

; Calle, Andrea

; Rabanal, Synthia

; Pando, Jackeline

; Lacroix, Elizabeth

; Reyes, Isabel

; Guerra, Humberto

; Ochoa, Theresa J.

Revista Peruana de Medicina Experimental y Salud Pública

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Dez 2013, Volume 30 Nº 4 Páginas 575 - 582

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Objectives. To determine the pattern of antibiotic susceptibility of isolated Streptococcus pneumoniae strains of healthy nasopharyngeal carriers younger than 2 years in seven regions of Peru. Materials and methods. Between 2007 and 2009, nasopharyngeal swab samples were collected among 2123 healthy children aged 2-24 months in growth and development medical practices (CRED) and vaccination offices of hospitals and health centers in Lima, Piura, Cusco, Abancay, Arequipa, Huancayo, and Iquitos. The resistance to ten antibiotics through disk diffusion sensitivity testing of isolated pneumococcus strains was determined. Results. 572 strains were isolated. High rates of resistance to co-trimoxazole (58%), penicillin (52.2% non-sensitive); tetracycline (29,1%); azithromycin (28,9%), and erythromycin (26,3%). Resistance to chloramphenicol was low (8.8%). Multiresistance was found at 29.5%. Resistance to azithromycin and penicillin was different in all seven regions (p<0,05), the highest percentage of non-sensitive strains being found in Arequipa (63,6%), whereas the lowest percentage was found in Cusco (23.4%). Conclusions. High levels of resistance found to penicillin, co-trimoxasole and macrolides in isolated pneumococcus strains of healthy carriers in all studied regions, and their association to a previous use of antibiotics, represent a significant public health problem in our country. This emphasizes the need to implement nationwide strategies to reduce the irrational use of antibiotics, especially among children. It is necessary to complement data of resistance to penicillin with the determination of minimal inhibitory concentration to make proper therapeutic recommendations

Objetivos. Determinar el patrón de susceptibilidad antibiótica de cepas de Streptococcus pneumoniae aisladas de portadores nasofaríngeos sanos menores de 2 años de siete regiones del Perú. Materiales y métodos. Entre el 2007 y 2009 se tomaron muestras de hisopado nasofaríngeo a 2123 niños sanos entre 2 y 24 meses de edad en los consultorios de crecimiento y desarrollo (CRED) y vacunación de hospitales y centros de salud de Lima, Piura, Cusco, Abancay, Arequipa, Huancayo, e Iquitos. Se determinó la resistencia a diez antibióticos mediante la prueba de disco-difusión de las cepas de neumococo aisladas. Resultados. Se aislaron 572 cepas. Se encontró altas tasas de resistencia a cotrimoxazol (58%); penicilina (52,2% no-sensibles); tetraciclina (29,1%); azitromicina (28,9%), y eritromicina (26,3%). La resistencia a cloranfenicol fue baja (8,8%). Se encontró 29,5% de multirresistencia. La resistencia a la azitromicina y a la penicilina fue diferente en las siete regiones (p<0,05), hallándose el mayor porcentaje de cepas no-sensibles a penicilina en Arequipa (63,6%), mientras que el menor fue en Cusco (23,4%). Conclusiones. Los elevados niveles de resistencia encontrados para penicilina, cotrimoxazol y macrólidos en cepas de neumococo aisladas de portadores sanos en todas las regiones estudiadas, y su asociación con uso previo de antibióticos, representan un importante problema de salud pública en nuestro país. Esto resalta la necesidad de implementar, a nivel nacional, estrategias para disminuir el uso irracional de antibióticos, sobre todo en la población pediátrica. Es necesario complementar los datos de resistencia a penicilina con la determinación de la concentración mínima inhibitoria para hacer las recomendaciones terapéuticas respectivas

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10.

Molecular detection of enteropathogenic Escherichia coli in asymptomatic captive psittacines
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Saidenberg, André Becker

; Teixeira, Rodrigo Hidalgo F.

; Guedes, Neiva Maria R.

; Allgayer, Mariangela da Costa

; Melville, Priscilla Anne

; Benites, Nilson Roberti

Pesquisa Veterinária Brasileira

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Set 2012, Volume 32 Nº 9 Páginas 922 - 926

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Os psitacídeos são um dos grupos de aves mais ameaçadas no mundo e diversas espécies brasileiras são classificadas desde vulneráveis à criticamente ameaçadas de extinção. Torna-se, portanto, necessário identificar os agentes que causam infecções em animais selvagens em cativeiro e determinar os riscos relacionados de modo a intervir sobre os fatores envolvidos para diminuir a possibilidade de surtos de doenças e promover a conservação de espécies ameaçadas. O objetivo deste estudo foi identificar Escherichia coli Enteropatogência (EPEC) de isolados cloacais de psitacídeos assintomáticos em cativeiro e avaliar a distribuição do patotipo EPEC. Suabes cloacais foram coletados de 46 psitacídeos assintomáticos e os isolados foram testados pela reação em cadeia pela polimerase (PCR) para a presença do gene attaching and effacing (eae) e bundle forming pilus (bfpA) de EPEC. Amostras oriundas de diversas espécies foram testadas e três amostras resultaram positivas para os genes eae e bfp e caracterizadas como EPEC típicas. Esse é o primeiro relato em psitacídeos assintomáticos para esse patotipo. Apesar de que algumas cepas de E.coli serem mais patogênicas do que outras, diversos fatores devem ser considerados para determinar o potencial de isolados de E.coli de causar doença em psitacídeos em cativeiro. Aves positivas para cepas de EPEC (típicas) poderiam ser fontes de infecção zoonóticas e adquirir essas cepas através do contato com humanos e animais domésticos. Esses achados também podem ser valiosos para o manejo a longo prazo de espécies ameaçadas ex situ já que uma amostra de EPEC foi isolada de um Papagaio-de-cara-roxa (Amazona brasiliensis).

Psittaciformes are one of the most endangered groups of birds, and several Brazilian species are classified between vulnerable and critically endangered. It is thus necessary to identify agents that cause infections in captive wild animals and to assess the risks posed thereof and to design interventions to minimize the possibility of disease outbreaks, leading to the conservation of endangered species. The purpose of this study was to identify enteropathogenic Escherichia coli (EPEC) cloacal isolates from asymptomatic psittacines in captivity and evaluate the distribution of the EPEC pathotype. Cloacal swabs were obtained from 46 asymptomatic birds, and resulting isolates were tested by polymerase chain reaction (PCR) for the presence of the attaching and effacing gene (eae) and bundle-forming pilus structural gene (bfpA) of EPEC. Samples from several species were tested, and three samples were found to be positive for the eae and bfpA genes and characterized as typical EPEC. This is the first report of this pathotype in asymptomatic psittacines. Although certain E. coli strains are more pathogenic than others, various factors should be considered when determining the potential of E. coli isolates to cause disease in captive psittacines. Birds that are positive for the EPEC (typical) strain could be zoonotic sources of infection, and may have acquired these strains through contact with humans or domestic animals. These findings may also be valuable for the long-term management of endangered species ex situ as one EPEC sample was isolated from a Red-tailed Amazon (Amazona brasiliensis).

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11.

Serotipos de neumococo en niños portadores antes de la vacunación antineumocócica en el Perú
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Mercado, Erik H.

; Egoavil, Martha

; Horna, Sara G.

; Torres, Nancy

; Velásquez, Ricardo

; Castillo, María E.

; Chaparro, Eduardo

; Hernández, Roger

; Silva, Wilda

; Campos, Francisco E.

; Sáenz, Andrés

; Hidalgo, Félix

; Letona, Carolina

; Valencia, Ángel G.

; Cerpa, Rosario

; López-de-Romaña, Bernardo

; Pando, Jackeline

; Torres, Berenice

; Castillo, Fiorella

; Calle, Andrea

; Rabanal, Synthia

; Ochoa, Theresa J.

Revista Peruana de Medicina Experimental y Salud Pública

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Mar 2012, Volume 29 Nº 1 Páginas 53 - 60

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Objectives. To determine the carriage rate and serotype distribution of Streptococcus pneumoniae in the nasopharynx of healthy children younger than 2 years prior to the universal use of the pneumococcal conjugate vaccines in Peru. Materials and methods. Between 2007 and 2009 we collected nasopharyngeal swab samples from 2,123 healthy children aged 2 to 24 months in the vaccination and healthy children consultation offices of pediatric hospitals and health centers in 7 cities in Peru: on the coast (Lima, Piura), highlands (Cusco, Abancay, Arequipa and Huancayo) and amazon basin (Iquitos). The pneumococcal strains were isolated and identified at the central laboratory of the project in Lima, and serotyped by Quellung reaction in the pneumococcal reference laboratory at the Center for Diseases Control and Prevention (CDC). Results. We found 27% (573/2123) of pneumococcal nasopharyngeal healthy carrier children. Among the 526 analyzed strains, we found 42 serotypes; the most common were: 19F (18.1%), 6B (14.3%); 23F (8.9%) and 14 (6.5%). Conclusions. The distribution of vaccine serotypes in the analyzed strains was of 50% for the serotypes present in the seven-valent vaccine, 50.2% for the serotypes present in the ten-valent vaccine and 57.2% for those present in the thirteen-valent vaccine.

Objetivos. Determinar la frecuencia y distribución de serotipos de S. pneumoniae en portadores nasofaríngeos sanos menores de dos años previa al uso universal de la vacuna conjugada antineumocócica en el Perú. Materiales y métodos. Entre los años 2007 y 2009 se tomaron muestras de hisopado nasofaríngeo a 2123 niños sanos entre 2 y 24 meses de edad en los consultorios de crecimiento y desarrollo o vacunación de hospitales y centros de salud de siete ciudades del Perú: costa (Lima, Piura); sierra (Cusco, Abancay, Arequipa y Huancayo) y selva (Iquitos). Las cepas de neumococo fueron aisladas e identificadas en el laboratorio central del proyecto en Lima y serotipificadas por reacción de Quellung en el Laboratorio de Referencia de Neumococo del Centro de Control y Prevención de Enfermedades. Resultados. Se encontró 27,0% (573/2123) de portadores nasofaríngeos sanos de neumococo. En las 526 cepas analizadas se encontraron 42 serotipos; los más frecuentes fueron: 19F (18,1%), 6B (14,3%); 23F (8,9%) y 14 (6,5%). Conclusiones. La distribución de serotipos vacunales en las cepas analizadas fue de 50,0% para los serotipos presentes en la vacuna conjugada heptavalente; 50,2% para los serotipos presentes en la vacuna decavalente y 57,2% para la vacuna 13-valente.

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12.

Antioxidant capacity of eugenol derivatives
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Hidalgo, María E.

; De la Rosa, Carlos

; Carrasco, Héctor

; Cardona, Wilson

; Gallardo, Claudio

; Espinoza, Luis

Química Nova

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2009, Volume 32 Nº 6 Páginas 1467 - 1470

Resumo: En | Texto: En | PDF: En

Toxicity and antioxidant capacity of eugenol derivatives (E2 = 2-Methoxy-4-[1-propenylphenyl]acetate, E3 = 4-Allyl-2-methoxyphenylacetate, E4 = 4-Allyl-2-methoxy-4-nitrophenol, E5 = 5-Allyl-3-nitrobenzene-1,2-diol, E6 = 4-Allyl-2-methoxy-5-nitrophenyl acetate) were evaluated in order to determine the influence of the sustituents. E2-E6 were synthesized from eugenol (E1). E1 was extracted from cloves oil, and E2-E6 were obtained through acetylation and nitration reactions. Antioxidant capacity evaluated by DPPH (1, 1-Diphenyl-2-picrylhydrazil) and ORAC fluorescein demonstrated that E1 and E5 have a higher capacity and the minor toxicity evaluated by red blood cells haemolysis and the Artemia saline test. In accordance with our results, the compound's (E1-E5) use in the pharmaceutical, cosmetic and or food industries could be suggested.

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13.

Caracterização fenotípica pelo antibiograma de cepas de Escherichia coli isoladas de manipuladores, de leite cru e de queijo "Minas Frescal" em um laticínio de Goiás, Brasil
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Maria Raquel Hidalgo, Campos

; Kipnis, André

; André, Maria Cláudia Dantas Porfírio Borges

; Vieira, Carla Atavila da Silva

; Jayme, Liana Borges

; Santos, Patrícia Pimentel

; Serafini, Álvaro Bisol

Ciência Rural

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Ago 2006, Volume 36 Nº 4 Páginas 1221 - 1227

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Este trabalho objetivou caracterizar fenotipicamente isolados de Escherichia coli a partir de amostras obtidas de mãos e narizes de manipuladores, de leite cru e de queijo Minas Frescal produzidos em um laticínio em Goiás, Brasil, visando a estabelecer uma relação de contaminação entre o manipulador e/ou a matéria-prima e o produto final. Foram coletadas 24 amostras de leite cru e de queijo Minas Frescal, 46 swabs de mãos e 46 de narizes dos manipuladores envolvidos na fabricação do queijo, no período entre março/2004 e fevereiro/2005. As 69 cepas isoladas foram submetidas ao teste de suscetibilidade a seis antimicrobianos (ampicilina, cefalotina, ciprofloxacina, gentamicina, sulfametoxazol trimetoprin e tetraciclina) e, a partir deste teste, foi possível agrupá-las em 17 diferentes perfis fenotípicos (A-Q). Somente um perfil fenotípico (E) foi semelhante entre cepas de E. coli isoladas, tanto de amostra de queijo (14Qb) como de um dos manipuladores (10M1). Tal resultado sugere uma possível contaminação do produto durante a sua manipulação; portanto, apenas neste caso pôde-se estabelecer a origem da E. coli para o queijo. Nas demais situações, não foi possível determinar a fonte da bactéria para o queijo. Conclui-se que o antibiograma não se mostrou um teste eficiente na determinação da fonte de microrganismos para o produto final.

The present work aimed to type E. coli strains obtained from handlers hands and noses, raw milk and Minas Frescal cheese produced by a dairy milk processing plant in Goiás, Brazil in order to establish a contamination relationship between the sources of E. coli and cheese. Twenty-four samples were collected from raw milk and Minas Frescal cheese, 46 from hands and 46 from noses of handlers involved in the cheese manufacturing, between March/2004 and February/2005. All 69 E. coli strains isolated were submitted to the susceptibility test for six antimicrobials (ampicillin, cephalothin, ciprofloxacin, gentamicin, trimethopim-sulphamethoxazole and tetracycline. The strains were grouped in 17 different phenotypic susceptibility profiles (A-Q). The test allowed to establish correlation among a cheese strain (14Qb) and a handler (10M1) strain that presented the same susceptibility profile (E) suggesting a possible product contamination during the handling. In conclusion, the phenotypic susceptibility profiles determinated by the antibiogram method failed to establish a correlation between the strains obtained from the probable sources (handlers and milk) and the final products.

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14.

Respuesta humoral específica en ratones Balb/c inoculados con una librería genómica de expresión de Trypanosoma cruzi
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Alberti Amador, Esteban

; Acosta Domínguez, Armando

; Sarmiento, María E.

; Hidalgo Grass, Carlos

; Fachado Carvajales, Alberto

; Vidal Martínez, Teresita

; Luis Leyva, Jorge

; Fonte Galindo, Luis

Revista Cubana de Medicina Tropical

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Abr 1999, Volume 51 Nº 1 Páginas 20 - 25

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

A genomic expresion library of Trypanosoma cruzi (T. cruzi) was made using plasmid pcDNA3 as a vector, with wich male mice from the Balb/c isogenic line were intramuscullary inoculated. It was used a positive control group that was administered soluble antigens of T. cruzi. Other 2 groups received genomic and plasmid DNA, respectively. One group was not immunized. Weeckly blood samples were obtained from all the animals until the fourth week and 2 weeks after reinmunization to study the response of specific antibodies against the microorganism antigens by an indirect immunoenzimatic assay (ELISA). It was observed a significant increase of specific antibodies in the animals reinmunized with 50 mug of the library, as well as in the group immunized with soluble antigens of T. cruzi.

Se construyó una librería genómica de expresión de Trypanosoma cruzi (T. cruzi) utilizando como vector el plásmido pcDNA3, con la cual se inmunizaron ratones machos de la línea isogénica Balb/c por la vía intramuscular. Se empleó un grupo control positivo al que se le administró antígenos solubles de T. cruzi y otros 2 grupos que recibieron ADN genómico y plásmido, respectivamente; un grupo no recibió inmunización. A todos los animales se les extrajo sangre semanalmente hasta la cuarta semana y 2 semanas después de la reinmunización, para estudiar la respuesta de anticuerpos específicos contra los antígenos del microorganismo mediante un ensayo inmunoenzimático indirecto (ELISA). Se evidenció un aumento significativo de anticuerpos específicos en los animales reinmunizados con 50 myg de la librería y en el grupo inmunizado con los antígenos solubles de T. cruzi.

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