Presence of Salmonella as a risk to public health in the Caribbean zone of Colombia

Salmonella is frequently involved in diarrhoeal disease throughout the world and is disseminated mainly by food, polluted waters or infected food-handlers. In Colombia, the serotypes of Salmonella and their distribution in food have not been characterized. Therefore, the objective was to establish the epidemiology of Salmonella in the Caribbean zone. Six hundred thirty-six samples were obtained in fast food outlets located in city squares or markets of Barranquilla (n=245), Montería (n=222), Sincelejo (n=87) and Cartagena (n=82). Salmonella was isolated by the conventional methods recommended by the United States Food and Drug Administration. Briefly, 25 g of each sample was inoculated in 225 ml of broth. Twenty-four hours later, a 1 ml aliquot was inoculated onto selective media for Salmonella. Suspicious colonies were identified by conventional biochemical tests and confirmed by conventional serology for Salmonella detection. Forty-seven Salmonella serotypes were isolated from meat (40%), sausage (25%), cheese (13%), pig (13%), chicken (4.2%) and egg 'arepas' (4.2%). The serologic characterization indicated the following serotypes: S. Anatum (26%), S. Newport (13%), S. Typhimurium (9%), S. Gaminara (9%) and S. Uganda (9%). No statistically significant Salmonella isolations among 4 socioeconomic categories were observed (p=0.05). However, differences were observed when rates were compared for Salmonella by food type for socioeconomic categories 1, 2 and 3 (p<0.05), categories 2 and 3 did not show differences between them (p>0.05).     

Positive mutation as regards n-alkane oxidation in Pseudomonas denitrificans]

Differences in the overall protein composition were studied in the wild-type and mutant cells of Pseudomonas denitrificans. Pleiotropic mutation was established, which was characterized by quantitative and qualitative changes in at least 6 to 8 protein fractions and corresponded to the appearance of 2 to 3 steps of oxidation of higher n-alkanes, as had been found earlier in biochemical experiments. New enzymatic functions may appear on the basis of genetically determined proteins available, upon reorganization of the intracellular structure caused by propagating changes induced by mutation.     

Dynamic health policies for controlling the spread of emerging infections: influenza as an example

The recent appearance and spread of novel infectious pathogens provide motivation for using models as tools to guide public health decision-making. Here we describe a modeling approach for developing dynamic health policies that allow for adaptive decision-making as new data become available during an epidemic. In contrast to static health policies which have generally been selected by comparing the performance of a limited number of pre-determined sequences of interventions within simulation or mathematical models, dynamic health policies produce "real-time" recommendations for the choice of the best current intervention based on the observable state of the epidemic. Using cumulative real-time data for disease spread coupled with current information about resource availability, these policies provide recommendations for interventions that optimally utilize available resources to preserve the overall health of the population. We illustrate the design and implementation of a dynamic health policy for the control of a novel strain of influenza, where we assume that two types of intervention may be available during the epidemic: (1) vaccines and antiviral drugs, and (2) transmission reducing measures, such as social distancing or mask use, that may be turned "on" or "off" repeatedly during the course of epidemic. In this example, the optimal dynamic health policy maximizes the overall population's health during the epidemic by specifying at any point of time, based on observable conditions, (1) the number of individuals to vaccinate if vaccines are available, and (2) whether the transmission-reducing intervention should be either employed or removed.     

Child health in rural Colombia: determinants and policy interventions

We study the determinants of child anthropometrics on a sample of poor Colombian children living in small municipalities. We focus on the influence of household consumption, and public infrastructure, taking into account the endogeneity of household consumption using two different sets of instruments: household assets and municipality average wage. We find that both household consumption and public infrastructure are important determinants of child health. We have also found that the coverage of the piped water network positively influenced child health if the parents have some education.     

Analysis of morphology of adrenal pheochromocytoma as regards their potential malignancy

BACKGROUND: Adrenal pheochromocytoma are diagnosed the most often in patients with arterial hypertension or with thyroid medullar cancer and suspicion of MEN II syndromes. The aim of the study is to analyse the morphology of pheochromocytomas on the basis of Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) in order to estimate their potential malignancy. MATERIAL AND METHODS: Forty tumours were subjected to analysis. Mean patients age was 45.2+/-13.4 years. The diagnosis of pheochromocytoma was establish before surgery in 87.5%. 12.5% of patients were referred to surgery on the basis of tumour diameter (range 70 to 102 mm). In 20.0% of patients MEN II syndromes were diagnosed. RESULTS: In pathological examination benign pheochromo-cytoma was diagnosed in 39 presented patients. In 1 cases malignant form of pheochromocytoma was diagnosed on the basis of lymph nodes metastases. Number of points in PASS was >or=4 in 9 of 40 tumours (22.5%). Among 35 patients operated on more than 12 months ago 2 patients died: 1 patient with malignant pheochromocytoma (PASS=8 points) and 1 patient with MEN IIA syndrome (due to disseminated thyroid medullar cancer). In remaining 7 observed patients with PASS>or=4 points neither recurrence nor metastases were diagnosed within the period of observation (13-90 months). In 1 out of patients with PASS<4 points a local recurrence was surgically removed 82 months after primary operation. CONCLUSION: Analysis of pheochromocytoma in PASS is only of rough character and does not allow for clear-cut histological diagnosis of benign and malignant tumours. The only unquestionable criterion of pheochromocytoma's malignancy remain metastases.