RESUMO
Trypanosomosis is a tropical disease caused by various protozoan haemoparasites, which affects wild and domestic animals, the latter ones related to worldwide livestock production systems. Species such as Trypanosoma vivax and Trypanosoma evansi have been described using serological and molecular tools in several countries from South and Central America. However, Ecuador presents a relevant knowledge gap in the associated general epidemiology and risk factors of the disease. Therefore, the objective of this study was to determine the seroprevalence of trypanosomosis in cattle from different regions of Ecuador. 745 serum samples from 7 Coastal and 3 Amazon provinces were screened for IgG anti-Trypanosoma spp. antibodies, using an in-house indirect ELISA. The seropositivity was explored and associated with several variables such as sex, age, breed, region, management, and province, using statistical tools. The general seroprevalence of trypanosomosis was 19.1% (95% CI: 16.30-22.1%). The Amazonian provinces of Sucumbíos and Napo and the Coastal province of Esmeraldas presented the highest seroprevalence values of 36.7% (95% CI: 27.67-46.47%), 23.64% (95% CI: 16.06-32.68%) and 25% (95% CI: 15.99-35.94%), respectively. Statistical significance was found for the region, province, and management variables, indicating as relevant risk factors the extensive management and Amazon location of the cattle analyzed. Specific actions should be taken to identify the exact species on reservoirs and susceptible hosts, evaluate the implication of farm management and cattle movement as risk factors, and implement surveillance and treatment plans for affected herds.
Assuntos
Trypanosoma , Animais , Bovinos , Estudos Soroepidemiológicos , Equador/epidemiologia , Fatores de Risco , Feminino , Masculino , Trypanosoma/isolamento & purificação , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/parasitologia , Doenças dos Bovinos/sangue , Tripanossomíase Bovina/epidemiologia , Tripanossomíase Bovina/sangue , Tripanossomíase/veterinária , Tripanossomíase/epidemiologia , Tripanossomíase/parasitologia , Anticorpos Antiprotozoários/sangue , Ensaio de Imunoadsorção Enzimática/veterináriaRESUMO
Fasciola spp., infections are distributed worldwide including the Andes region of Ecuador, affecting cattle, sheep, porcine, humans, and other herbivores. Triclabendazole (TCBZ) is commonly used to treat animal infections. However, prospective studies on TCBZ efficacy and fascioliosis prevalence have not been studied in the highlands of Ecuador. This study was performed in a rural community at central of the Ecuadorian Andes in freely roaming bovine and ovine aimed to 1) evaluate the efficacy of TCBZ by administering a single oral dose of 12 mg/kg body weight, 2) assess the prevalence of F. hepatica infection and 3) to monitor re-infections for a follow-up period of five months. In total, 122, 86, 111, 110, 89, and 90 and 49, 34, 47, 28, 27, and 31 stool samples were collected each month from bovines and ovine, respectively. Besides, 32 stool samples from porcine were also collected at the beginning of the study. Stools were microscopically analyzed by formalin-ether concentration method to detect F. hepatica ova. The prevalence of F. hepatica infections before treatment was 55,7% and 63,3% for bovine and ovine, respectively. The infection prevalence was of 22% in porcine. The efficacity of triclabendazole was 83% and 97% in bovines and ovine, respectively, at 30 days post-treatment. The re-infection reaches to 54,4% in bovines and 61,3% in ovine after five months. TCBZ had a high efficacy and could be used for bovines and ovine Fasciola infections in the study region; however, re-infections reach the initial prevalence after five months. Therefore, we recommend integrated control strategies, including chemotherapy with a single oral dose of TCBZ, vector control, and future drug resistance studies.
Assuntos
Doenças dos Bovinos , Fasciola hepatica , Mariposas , Doenças dos Ovinos , Doenças dos Suínos , Humanos , Animais , Bovinos , Ovinos , Suínos , Triclabendazol/uso terapêutico , Equador/epidemiologia , Reinfecção/veterinária , Prevalência , Estudos Prospectivos , Doenças dos Bovinos/tratamento farmacológico , Doenças dos Bovinos/epidemiologia , Doenças dos Ovinos/tratamento farmacológico , Doenças dos Ovinos/epidemiologiaRESUMO
La lesión del ligamento cruzado anterior (LCA) tiene un alta prevalencia en jugadores de fútbol. En esta disciplina, las carreras con cambios de dirección son frecuentes y pueden ser un factor de riesgo para el desarrollo de lesiones del LCA sin contacto. Objetivo: Describir en futbolistas jóvenes los rangos cinemáticos fisiológicos de rodilla sometida a tareas funcionales con cambios bruscos de dirección. Método: En una muestra de ocho futbolistas con rodillas clínicamente sanas, se evaluó, mediante un sistema de análisis de movimiento 3D, la cinemática de la rodilla de apoyo durante la ejecución de tres tareas funcionales, dos de estas implicaron cambios de dirección en 90° (CD90°) y 180° (CD180°), la tercera golpear un balón (GB). Los rangos fisiológicos de movimiento (ROM) fueron registrados y comparados en la misma rodilla en tres planos diferentes (T-Transversal; F-Frontal; S-Sagital). Resultados: Los rangos fisiológicos obtenidos fueron para las tareas funcionales CD90°: T 11°(13-8), F 5.6° (11-4) y S 22°(30-17); para CD180°: T 9°(12-8), F 6.3°(8-5) y S 17.6°(21-14); y para GB: T 9°(10-5), F 3.8°(10-2), y S 9.6°(15-6). El ROM fue significativamente mayor en el plano transversal para la tarea CD90°. El el plano sagital el ROM fue mayor para CD90° comparado con GB (p<.05), sin embargo no hubo diferencias respecto a la tarea CD180°. No existen diferencias del ROM en el plano frontal. Conclusión: Se logró describir los rangos cinemáticos fisiológicos de la rodilla durante la ejecución de tres tareas funcionales que implicaron cambios bruscos de dirección en futbolistas amateur. En la muestra evaluada, la prueba que produjo una mayor exigencia de los rangos articulares de rodilla en los planos transversal y sagital fue la prueba con cambio de dirección en 90°...
Anterior cruciate ligament (ACL) lesions are frequent among soccer players. In this sport cutting movements are usually made while running and may be a risk factor in developing non-contact ACL injuries. Purpose: To describe the physiological kinematics of the knee during sudden change of direction movements in amateur soccer players. Methods:Eight amateur soccer players without previous injuries were analysed. The kinematics of the support knee were evaluated using 3D motion analysis while executing 3 common manoeuvres: two of them involved a change of direction at 90° and 180° (CD90° and CD180°), and the third while kicking a ball (GB). Physiological articular ranges of motion (ROM) were recorded and compared for the same knee in three different planes (T-Transversal; F-Frontal; S-Sagittal). Results: The physiological ranges obtained were, for manouvre CD90°: T 11°(13-8), F 5.6° (11-4) and S 22°(30-17); for CD180°: T 9°(12-8), F 6.3°(8-5) and S 17.6°(21-14); and for GB: T 9°(10-5), F 3.8°(10-2), and S 9.6°(15-6). ROM was significantly greater in the transversal plane for the CD90° manoeuvre (P<.05). In the sagittal plane, ROM was greater for the CD90° when compared to the GB (P<.05), but no differences were seen when compared to the CD180° manoeuvre (P>.05). There were no differences in ROM in the frontal plane. Conclusion: A description of the physiological kinematic ranges of the knee during three sudden changes of direction manoeuvres in amateur soccer players was presented. According to our results, change of direction in 90° demands a higher range of motion in both the transversal and sagittal planes...
Assuntos
Humanos , Masculino , Adolescente , Adulto , Adulto Jovem , Fenômenos Biomecânicos , Imageamento Tridimensional , Ligamento Cruzado Anterior/lesões , Joelho/fisiologia , Futebol , Ligamento Cruzado Anterior/fisiopatologia , Estudo Observacional , Amplitude de Movimento Articular/fisiologiaRESUMO
El método de Demirjian (MD) es el más ampliamente difundido para estimar la edad dental (ED). Con este método se han realizado numerosos estudios en diferentes grupos étnicos, analizándose niños europeos, asiáticos y norteamericanos entre otros. Estos resultados sugieren posibles diferencias en los patrones de maduración dental entre las diferentes poblaciones. El objetivo del presente estudio fue determinar la edad dentaria aplicando el MD en una muestra de 363 ortopantomografías de pacientes entre 5 y 15 años, obtenidas de un centro radiológico maxilofacial privado en Curicó, VII región, Chile. Se obtuvo un coeficiente de correlación inter-clase (CCI), como medida de correlación entre edad dental y cronológica, de 0,974 (CCI 95% 0,9680,979). El CCI para niños fue de 0,972 (CCI 95% 0,963- 0,979) y en el caso de las niñas fue de 0,977 (CCI 95% 0,9690,983). En general, el método de Demirjian tendió a sobreestimar la edad en los niños y niñas. La ED observada fue mayor que la edad cronológica (EC) en 130 niños y en 138 niñas, resultó igual a la EC en 13 niños y 8 niñas, y fue menor que la EC en 38 niños y 33 niñas. En conclusión, nuestros resultados coinciden con hallazgos en numerosos lugares del mundo, es decir, la ED en este grupo se fue levemente mayor que la muestra original franco-canadiense. Sin embargo, el rango obtenido de la ED es similar al de la EC y el grado de correlación entre ambas es casi perfecto al aplicar el CCI. El grado de correlación entre ambas edades para cada sexo también es muy bueno. Por lo tanto, consideramos que el MD es aplicable a esta muestra de niños.
The Demirjian's method (DM) is the most widely used method for estimating dental age. A number of studies with this method have been performed in different ethnic groups, with European, Asian y North American children being analyzed among others. Possible differences in patterns of dental maturation among different population have been suggested. The aim of this study was to determine dental age with the DM in a sample of 363 panoramic radiographs from children 5-15 years old, obtained from a private radiological maxillofacial center in Curicó, Chile. An inter-class correlation coefficient (ICC) was obtained as a measure of correlation between dental and chronological age of 0.974 (ICC 95% 0.968-0.979). The ICC for boys was 0.972 (ICC 95% 0.963- 0.979) and 0.977 for girls (CCI 95% 0.969-0.983). In general, DM overestimated the age in girls and boys. Dental age (DA) was observed to be higher than chronological age (CA) in 130 boys and 138 girls; DA was equal to CA in 13 boys y 8 girls and lower than CE in 38 boys and 33 girls. In conclusion, our study concurs with several other studies in other places of the world, indeed the DA was found to be higher when compared to the original French-Canadian sample. However, the range obtained for DA is similar to CA and the degree of correlation between both is almost perfect when applying ICC. The degree of correlation between both ages for each sex was found as very good. Furthermore, we consider that DM can be applied to this sample of children.
Assuntos
Humanos , Doenças Periodontais , Doenças Periodontais/induzido quimicamente , Periodontite , Tabagismo/complicações , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Microbiota , Doenças Periodontais/microbiologia , Periodontite/induzido quimicamente , Poluição por Fumaça de Tabaco/efeitos adversos , Abandono do Uso de Tabaco , Microbiota/efeitos dos fármacos , Gengivite/induzido quimicamenteRESUMO
PURPOSE: We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. METHODS: We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. RESULTS: We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. CONCLUSIONS: Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.
Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Infecção Hospitalar/epidemiologia , Controle de Infecções/métodos , Infecções Urinárias/epidemiologia , América/epidemiologia , Ásia/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/prevenção & controle , Países em Desenvolvimento/estatística & dados numéricos , Europa (Continente)/epidemiologia , Feminino , Higiene das Mãos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Cateteres Urinários/estatística & dados numéricos , Infecções Urinárias/prevenção & controleRESUMO
(Neuro)cysticercosis is an important zoonotic disease caused by infection with Taenia solium metacestode larvae. Existing immunodiagnostic techniques detect antibodies and circulating antigens (Ag) in serum and cerebrospinal fluid (CSF). Blood/CSF collection is an invasive procedure associated with blood-borne infections and is often not well accepted by communities. Detection of circulating Ag in urine has been suggested as an alternative, however this has been evaluated in clinical settings only. The aim of the present study was to evaluate the performance of a urine Ag-ELISA under field conditions. Paired serum and urine samples were obtained from participants in endemic areas of Ecuador (n=748) and Zambia (n=690) and were subjected to a monoclonal antibody-based Ag-ELISA. Calculation of positive and negative agreement indices (AI) showed better agreement in the negative direction both for Ecuadorian and Zambian samples (AI of 93.1 and 86.8, respectively). Using a Bayesian approach to determine the test characteristics, similar sensitivities were obtained for serum and urine Ag detection, whereas a decreased specificity was determined for the urine Ag-ELISA with a lower specificity (78.6%) for Zambian samples than for Ecuadorian samples (88.4%). This study indicates a higher specificity for the serum test under field conditions and promotes further research to improve the urine test.
Assuntos
Antígenos de Helmintos/urina , Cisticercose/urina , Taenia solium/isolamento & purificação , Animais , Teorema de Bayes , Cisticercose/diagnóstico , Cisticercose/epidemiologia , Equador/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Zâmbia/epidemiologiaRESUMO
INTRODUCTION: Early graft dysfunction has a negative impact on allograft and patient survivals, evolving to retransplantation or death in the majority of cases. The outcome of a second liver transplant is usually worse than the first procedure. Considering the increasing number of recipients on the waiting list, and the discrepancy between the number of accessible donors and recipients, we sought to analyze the results of retransplantation at our institution and at those within the State of Sao Paulo. METHODS: We reviewed the data of 419 deceased donor transplants on 367 patients from June 2005 to April 2010. Twenty-three patients underwent retransplantation due primary nonfunction (PNF) or early graft dysfunction. The following variables were studied: age, gender, disease that lead to the first transplant, Model for End-Stage Liver Disease (MELD) score on the day before the retransplantation, intensive care unit (ICU) length of stay, and duration of orotracheal intubation (OTI). We compared our patient survival at 30 days and 1 year with that of other patients undergoing retransplantation due to PNF in the Sao Paulo State during the same period. RESULTS: The majority of patients were females (60.87%), with a mean age of 44.6 years. The etiology that led to our first transplantation was cirrhosis due to hepatitis C virus (HCV; n = 6), followed by acute liver failure, (n = 5). The average of ICU stay was 15.08 days (range, 5-45). The mean MELD score was 34.43 (range, 19-50). The survival was 73.92% and 60.78% at 30 days and 1 year postretransplantation, respectively, whereas for São Paulo State, it was 63.04% and 51.63%, respectively.
Assuntos
Falência Hepática/cirurgia , Transplante de Fígado , Reoperação , Adolescente , Adulto , Idoso , Brasil , Feminino , Sobrevivência de Enxerto , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
La literatura tradicional odontológica describe la ubicación radiográfica del foramen lingual en la cara lingual de la mandíbula, de ubicación media entre las espinas mentonianas (apófisis geni) en radiografías periapicales y panorámicas. Tradicionalmente se señala que las espinas mentonianas son las responsables del área radiopaca que rodea al foramen lingual. La ubicación radiográfica en posición mediana del foramen lingual con respecto a las espinas mentonianas es objeto de controversia. El objetivo de la presente investigación fue determinar la relación del foramen lingual con las espinas mentonianas en observación directa de mandíbulas secas, y mediante radiografías periapicales y panorámicas de las mismas, determinar la trayectoria del conducto lingual en tomografías lineales de la zona, y describir su representación radiográfica desde la perspectiva absorso-proyeccional. Esta investigación demostró la no concordancia radiográfica entre las espinas mentonianas y el área radiopaca que rodea al foramen lingual.
Radiological location of lingual foramen is described by traditional dental literature in the median line in the lingual aspect of the mandible, between mental spines, both in periapical and panoramic radiographs. Traditionally the radiopaque area surrounding the lingual foramen is described as produced by mental spines. This interpretation currently is controversial. The aim of this study was to determine the relationship of lingual foramen with mental spines by looking directly at the dry mandibles, and by looking at periapical and panoramic radiographs; to determine trajectory of lingual canal by using linear tomographies of the area of interest, and describe radiographic representation from the absorption projectional point of view. This investigation demonstrated that the radiopaque area surrounding the lingual foramen is not produced by mental spines.
Assuntos
Humanos , Mandíbula/anatomia & histologia , Mandíbula , Radiografia PanorâmicaRESUMO
Neurocysticercosis is recognised as an important but neglected cause of epilepsy in developing countries where the parasite occurs. Data on the transmission dynamics of the parasite in endemic areas are scarce. Individuals living in these areas are likely to be highly exposed to the parasite, but relatively few of them develop active infections. The present study aimed to describe and gain insights into changes in antibody responses and infection patterns related to age and/or gender in a south Ecuadorian rural population by combining antibody and antigen serological data with demographic characteristics. In 25% of the population, antibodies to Taenia solium cysticerci were detected whilst 2.9% had circulating parasite antigens. The proportion of antibody-positive individuals increased significantly until the age of 40years to become stable in older individuals. A rule-based simulation model was developed to explain these variations and to reflect the dynamics of exposure to, and transmission of, the parasite. In contrast, the proportion of people presenting circulating parasite antigens, reflecting an active infection, was significantly higher in people older than 60years. Immunosenescence could explain such an observation since a weaker immune system in the elderly would facilitate the establishment and maintenance of viable cysticerci compared with fully immunocompetent younger individuals. This work points out the role of the immune system in the development of cysticercosis within an exposed population and highlights new essential issues in understanding the transmission dynamics of the parasite, its incidence and the resulting immunological response at a population level.