Hongos queratinofílicos en suelos de parques de la ciudad de Corrientes,Argentina

BackgroundThe soil is a natural reservoir of keratinophilic fungi, which are a small but important group of filamentous fungi, some of which typically develop on keratinized tissues of living animals. There are numerous species of saprophytic fungi with recognized keratinophilic abilities, and several studies have been undertaken in order to link their presence to possible human disease.AimsTo know the biota of geophilic fungi in general and of keratinophilic fungi particularly in soils from two public parks.MethodsSoil samples from two public parks of Corrientes city, Argentina, were studied during two seasons, using the hook technique and serial dilutions for fungal isolation.ResultsUsing the hook technique, 170 isolates were classified into 17 genera and 21 species, among which it is worth mentioning the presence of Microsporum canis. Shannon index for keratinophilic fungi in autumn was 2.27, and 1.92 in spring. By means of the serial dilutions technique, 278 fungi isolated were identified into 33 genera and 71 species. Shannon index in autumn was 3.9, and 3.5 in spring.ConclusionsThe soils studied have particularly favorable conditions for the survival of pathogens and opportunistic geophilic fungi for humans and animals.     

Influencia de la ocupación en el deterioro cognitivo libre de demencia en una muestra de sujetos mayores de 55 años de Zaragoza

Introduction

The prevalence of cognitive impairment with no dementia (CIND) varies between 5.1% and 35.9%, increasing between 65 and 85 years. The CIND increases the risk of dementia. Factors such as education, occupation, and social activities are associated with the risk of cognitive impairment. The main objective of this study was to analyse the association between the main occupation developed throughout life and CIND in a general population sample of over 55 years.

La radiothérapie interne vectorisée par les analogues de la somatostatine,en pratique,en 2019

Somatostatin receptors are overexpressed in differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NET). Radiolabeled somatostatin analogs have been used for a few decades for imaging and more recently for peptide receptor radionuclide therapy (PRRT) in a theranostic approach. Medical access to PRRT has long been limited to a few European specialized medical centers despite promising results in large cohorts of patients. NETTER-1, a phase 3 randomized trial, has demonstrated a drastic improvement of midgut NET patients progression-free survival in PRRT arm as compared to somatostatin analogs, leading to marketing authorizations in USA and Europe. PRRT clinical availability is growing in France, with around 20 medical centers offering this innovative treatment for GEP-NET patients care in 2019. PPRT success-story should lead to improvements of radionuclide therapy developments, which will reshape our medical specialty to a more “clinically” practice. This review aims to detail PRRT in clinical practice in France in 2019, with emphasize on treatment indications, planning and practical aspects. Radioprotection aspects and future optimization perspectives will also be discussed.     

Valor pronóstico de los instrumentos de evaluación de enfermedad avanzada y de final de vida en ancianos ingresados en un centro sociosanitario

Objective

To apply 3 advanced chronic disease evaluation tools in elderly patients admitted to an intermediate and long-term care centre, and evaluate its relationship with mortality.

Applications de la spectrométrie de masse de type MALDI-TOF en microbiologie

In the last few years, matrix assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF-MS) has been introduced in clinical laboratories for routine identification. Initially used for research, MALDI-TOF-MS allows rapid and accurate identification of the main microorganisms isolated from clinical samples, by intact cell mass spectrometry or directly from positive blood culture or urines. Other applications are being in processed as bacterial typing, research and detection of antibiotic resistance or particularly virulent strains.     

Distribution spatio-temporelle de la faune de phlébotomes en zones urbaine et périurbaine de Bamako,Mali

Au Mali la leishmaniose cutanée (LC) est bien décrite en milieu rural, mais sa transmission n’est pas encore établie en milieu urbain. L’objectif de l’étude était de décrire la faune phlébotomienne à Bamako et dans ses environs. Les pièges CDC et adhésifs servaient à collecter les phlébotomes en 2011 et 2012 à Bamako. Les pièges étaient placés dans le district de Bamako répartis en 30 zones (200 m × 200 m) à l’aide des images de satellite SPOT-5. La délimitation des zones était basée sur les facteurs écologiques (relief, hydrographie, couverture végétale) et anthropologiques (nature des maisons, dépôts d’ordure). Les pièges étaient placés en 2011 à Sotuba, zone périurbaine, puis à Donéguébougou et Banambani, deux villages environnants de Bamako. Au total 122 phlébotomes étaient collectés 27 (22,13 %) à Banambani, 12 (9,83 %) à Donéguébougou, 2 (1,63 %) à Sotuba et 81 (66,39 %) à Bamako. La densité des phlébotomes en novembre était plus élevée, avec 48 spécimens capturés (39,3 %), que celle d’avril, mai et décembre (p ≥ 0,001). A Bamako, les zones 6 et 28 étaient associées aux densités les plus élevées de phlébotomes respectivement 32 (26,22 %) et 23 (18,85 %) (p ≤ 0,005). Les résultats suggèrent que le genre Phlebotomus n’était pas présent à Bamako, et que la densité des vecteurs variait en fonction des zones et des mois.     

Bocio,función tiroidea y excreción de yodo en gestantes de la zona de El Bierzo

Estudios publicados en el año 1993 demuestran alta incidencia de bocio en escolares de la zona de El Bierzo.Hemos valorado mediante encuesta el consumo de sal yodada, la presencia de bocio mediante palpación y ecografía, la función tiroidea midiendo concentraciones hormonales en plasma y la excreción de yodo en orina y leche mediante el método de Benotti, en un grupo de mujeres embarazadas de la zona, en los tres trimestres de la gestación y en el posparto.Nuestros resultados demuestran escaso consumo de sal yodada, endemia bociosa grave, hipotiroxinemia materna, pobre excreción de yodo en orina en las gestantes y escasa presencia de yodo en la leche materna. Todo ello indica la necesidad de campañas institucionales para remediar la situación.     

Tinea capitis. Experiencia de 2 años en un hospital de pediatría de Buenos Aires,Argentina

Tinea capitis is an infection caused by dermatophytes of the genera Microsporum and Trichophyton, and constitutes a major health problem in Argentina. The aim of the present study was to find out the incidence of those etiological agents and the therapeutic response in patients attending a High-Complexity Paediatric Hospital within a two-year period. A total of 98 tinea capitis were diagnosed, 13 of which were Celsus kerion. Microsporum canis was isolated in 61.28%. The range of values for minimum inhibitory concentrations were >32, 0,06–4; <0,015–2; <0,015–0.25; 0.13–8; 0.06–128 μg/mL for fluconazole itraconazole, voriconazole, terbinafine, ketoconazole and griseofulvin, respectively.     

Incidencia de cáncer de tiroides en la provincia de Neuquén,período 2001-2012

During the past decades, an increasing incidence of thyroid cancer (TC) has been reported worldwide. In Argentina there is no national cancer registry, and its incidence has therefore not been established. The aim of our study was to determine the incidence of TC in the province of Neuquén and to compare it to that reported in the literature. The medical records of 229 patients admitted over a period of 12 years (2001 to 2012) were used for data analysis.Tumor size, age, sex, and histological type were evaluated. The study period was divided into four three-year periods, and differences in each of these features were analyzed. We found an incidence of 4.72/100,000 inhabitants/year, and almost all patients had papillary TC. TC was five times more common in females as compared to males (7.78 and 1.55 respectively). Mean tumor size was 22.2 ± 1.1 mm. Tumor size was significantly greater in men (31.8 ± 3.7 mm) than in women (20.4 ± 1.0 mm). When grouped by three-year periods, a higher number of cases was found in the last one (47, 49, 49 and 84 respectively). As regards tumor distribution by size, there was a significant decrease in mean tumor size in the fourth period and an increase in the proportion of tumors <10 mm.We report an increase in TC incidence in the Argentinean province of Neuquén which is similar to the overall increase reported in the international literature.     

Frecuencia de dermatofitos en una muestra de felinos del área urbana del Gran Mendoza,Argentina

BackgroundThe cat, considered the main reservoir of Microsporum canis, lives in urban areas, and also plays an important role in the emergence of dermatomycoses.AimsTo determine and analyse the frequency of zoonotic dermatophytes in a sample of cats in an urban area of the Gran Mendoza region.MethodsThe animals selected were household cats and cats less than one year old that came from shelters and kennels from urban areas in the Gran Mendoza region. A total of 45 samples from cats with and without dermatological lesions were analysed. These samples were collected through skin scraping, hair removal and Mackenzie brush, respectively. Direct observation was made with KOH and glycerol after heat exposure. Samples were cultured on Sabouraud and Lactrimel agar slants with chloramphenicol and cycloheximide for 30 days.ResultsThe frequency of dermatophytes isolated in this preliminary study was 13.3%. There were not statistically significant differences by source, age, sex, race or dermatological condition. Zoonotic dermatophytes were found in 2 household cats out of the 21 that had direct contact with children or the elderly. M. canis was isolated in 83.3% cases.ConclusionsThe frequency of isolation of zoonotic dermatophytes in the sample of cats in an urban area of the Gran Mendoza region was 13.3%, a value higher than expected. M. canis was the most isolated species.     

Uso de sujeciones físicas en relación con el riesgo de caídas en una residencia de ancianos

Backgrounds and objectivesThe use of physical restraints (PR) is common in the care of the elderly. However, their efficacy and safety are not supported by scientific evidence. The aim of this study was to determine the role of PR in preventing falls.Materials and methodsA retrospective cohort study design was used, in which each fall incident (n = 575) was examined in the residents over 65 years of age who resided at the one nursing homes from February 2009 to September 2013. An analysis was made of the association between the use of PR and risk of falls using a multivariate logistic regression, adjusting for the characteristics of residents that were associated with the use of PR according to a bivariate analysis.ResultsRisk factors for falls after accounting for PR use, include: risk of falling (Tinetti test) (OR 4.57; 95% CI 1.76-11.75); ability to walk (OR 6.40; 95% CI 2.78-14.74); hearing impairment (OR 2.12; 95% CI 1.05-4.29); and history of a previous fall (OR 17.81; 95% CI 8.83-35.93). The risk of falls was greater in restrained, ambulatory residents with cognitive impairment (OR 18.95; 95% CI 7.06-50.85). No differences were found in injuries between falls that occurred with and without PR.ConclusionsRestraint use was not significantly associated with fewer falls and injuries. The risk of falls could increase in ambulatory residents with cognitive impairment. The study results suggest the need to consider whether restraints provide adequate protection against the risk of falls.     

El anciano en la unidad de geriatría de agudos

Although the implementation of acute geriatric units (AGUs) in general hospitals has a grade A of evidency, in Spain, only 12% of them have this resource. The estimation of geriatric especializad beds for the care of acute frail elderly people is of 2.6/1000 inhabitants older than 75 years. AGUs have demonstrated to reduce the functional loss associated with the hospitalization and to increase the percentage of older people that can return home, without increases in mortality nor costs. In this review we present the characteristics of patients who benefit from AGUs, the services offered, the structure and functioning of the unit, the role of the professionals that work in it and the quality indicators that must be acomplished.