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Sistema de aglutinación con látex para el diagnóstico rápido de la leptospirosis en Cuba
Obregón,Ana Margarita; Fernández,Carmen; Rodríguez,Islay; Balbis,Yinia; Martínez,Beatriz; Rodríguez,José;
Revista Panamericana de Salud Pública , 2004, DOI: 10.1590/S1020-49892004001000005
Abstract: objectives: to assess the sensitivity, specificity, reproducibility, and stability of five latex agglutination systems for detecting antibodies against leptospira in human and animal sera, by using the leptospira serotypes that are most widely prevalent in cuba. methods: we performed an analytic and descriptive study with 706 human sera (65 tested positive for antibodies against leptospira with microagglutination (mat) and hemagglutination (ha) techniques; 156 sera that tested negative with mat and ha); 485 sera from 424 patients who had clinical or epidemiologic signs of leptospirosis; and 29 animal sera (16 from equines, 6 from bovines, 5 from porcines, 1 from a canine, and 1 from an ovine). all of the samples were tested with five latex conjugates made from whole cells of leptospira interrogans, specifically the four serogroups that circulated most widely in cuba from 2002 to 2004. the cells obtained from cultured cell lines yielded four specific conjugates (latex-canicola, latex-icterohemorrhagiae, latex-pomona, and latex-sejroe), as well as one latex conjugate made from a combination of all four serogroups in equal quantities (latex-pool). in addition, samples were tested with the commercial latex agglutination lepto tek tri dot (biomeriuex, france) kit. the stability and reproducibility of the latex conjugates were assessed through monthly controls over a period of 6 months with positive and negative sera. results: of the systems that were assessed, the best combination of sensitivity and specificity was obtained with the latex-pool conjugate (93,8% and 90,4%, respectively). the best combination of positive and negative predictive values was seen with the latex-sejroe conjugate (90,9% and 95,8%), respectively), followed by the latex-pool conjugate (94.2% and 96.6%, respectively). the positive and negative predictive values of the lepto tek dri dot commercial system were 78.5% and 88.4%, respectively. among the 137 patient samples that tested positive for one o
Genotoxicidad y determinación de compuestos tóxicos en un residuo líquido hospitalario de Buenos Aires, Argentina
PAZ, Marta;MAGDALENO, Anahí;TORNELLO, Carina;BALBIS, Natalia;MORETTON, Juan;
Revista internacional de contaminación ambiental , 2008,
Abstract: abstract raw wastewaters from health centers transport a great variety of chemical compounds like medical drugs, disinfectants, detergent, laboratory reagents, etc. the complex and fluctuant chemical composition of these effluents opens the possibility of an environmental toxicity scenario. even considering that these wastewaters are diluted after their discharge towards the municipal sewer system, certain substances present in the effluents can generate by cumulative effect a biological imbalance in aquatic ecosystems. in buenos aires city, the urban sewer waters are delivered into the río de la plata with no previous depuration treatment, being the latter the main source of drinking water for the city. the objective of this work is to analyze the toxicity and genotoxicity in wastewater samples of san martin hospital, an important medical center that daily releases 565 m3 of wastewaters to the sewer system. the evaluation of the genotoxic potential of hospital effluents was performed with different biological systems: the ames test, the saccharomyces cereviciae d7 test and the rec (+/-) assay with bacillus subtilis. samples of raw wastewater and the correspondent xad4 extract were submitted to biological test. no mutagenic effect, either with the ames test or the rec (+/-), was detected. only those samples taken on friday induced gene conversion in saccharomyces cereviciae d7. simultaneously, the chemical toxicity profile of the samples was studied. cadmium, chromium, mercury and organic halogenated compounds concentrations were in all cases below the toxicity limits established for effluents release to the sewer system. the results obtained confirm the existence of unidentified hazardous substances in hospital wastewater. the determination of toxicants or toxic substances concentration in the samples, in addition to a test battery for genotoxicity detection studies, provide more meaningful information to decision-makers in the estimation of environmental risk of h
Genotoxicidad y determinación de compuestos tóxicos en un residuo líquido hospitalario de Buenos Aires, Argentina
Marta Paz,Anahí Magdaleno,Carina Tornello,Natalia Balbis
Revista internacional de contaminación ambiental , 2008,
Abstract: Los líquidos residuales no tratados provenientes de centros de salud presentan un riesgo potencial para la salud y el ambiente debido a que transportan sustancias químicas con efectos tóxicos y genotóxicos. La composición de estos líquidos residuales fluctúa continuamente debido a la gran diversidad de medicamentos, desinfectantes, solventes, reactivos de laboratorio, detergentes y otros compuestos vertidos a los mismos. En la Ciudad de Buenos Aires, las aguas residuales procedentes de los centros hospitalarios no son tratadas in situ, sino que se transportan a través del sistema cloacal y se vierten con un mínimo tratamiento al Río de La Plata, principal fuente de abastecimiento de agua potable para una población de 10 millones de habitantes. El objetivo de este trabajo es analizar la presencia de compuestos tóxicos y la genotoxicidad en aguas residuales del Hospital de Clínicas San Martín de la Universidad de Buenos Aires, centro médico de alta complejidad que vuelca diariamente 565 m3 de agua residual al colector cloacal. Se tomaron muestras de este líquido de lunes a viernes, que se ensayaron como agua cruda filtrada y como extracto obtenido por pasaje a través de resinas XAD4. La determinación de toxicidad y genotoxicidad del efluente hospitalario se realizó utilizando distintos sistemas biológicos normatizados: los ensayos de Ames, Saccharomyces cereviciae D7 y Rec (+/-) con Bacillus subtilis. En ninguno de estos ensayos se evidenció efecto tóxico sobre las cepas empleadas. Los datos obtenidos con los ensayos de Ames y Rec (+/-) no permitieron demostrar actividad mutagénica ni en las muestras de agua cruda ni en los extractos XAD4. Las determinaciones realizadas con Saccharomyces cereviciae D7 mostraron actividad genotóxica en el agua residual del día viernes. Se determinó, además, el perfil de tóxicos presentes en las muestras al seleccionar los más probables, como cadmio, cromo, mercurio y compuestos orgánicos halogenados; en todos los casos, las concentraciones de estos compuestos en las aguas residuales fueron inferiores a los límites establecidos para los vertidos industriales a colectores cloacales. El efecto genotóxico no pudo ser relacionado con la presencia de estos contaminantes, lo que demuestra la importancia de utilizar ensayos químicos y biológicos para determinar el posible riesgo ambiental de estos vertidos.
Actualización acerca de Borrelia burgdorferi sensu lato y enfermedad de Lyme Update on Borrelia burgdorferi sensu lato and Lyme disease
Islay Rodríguez González
Revista Cubana de Medicina Tropical , 2013,
Abstract: Introducción: Borrelia burgdorferi sensu lato es el agente etiológico de la enfermedad de Lyme, zoonosis emergente de difícil diagnóstico, prevención y control, reportada fundamentalmente en el hemisferio norte. Objetivo: facilitar información actualizada acerca de Borrelia burgdorferi. Métodos: se realizó una revisión de la literatura científica y especializada sobre los principales aspectos relacionados con este agente y su enfermedad; como son las características de las borrelias y el ciclo de vida, epidemiología, manifestaciones clínicas en humanos, diagnóstico de laboratorio, definición actual de caso, tratamiento, profilaxis, prevención y control. Resultados: se expone información actualizada y valiosa sobre los temas seleccionados, útil para el personal interesado en las enfermedades infecciosas transmitidas por vectores. Se muestra además información sobre los estudios realizados en Cuba. Conclusiones: se aporta información de utilidad para el manejo epidemiológico, clínico y microbiológico de casos con sospechas de la infección por Borrelia burgdorferi sensu lato. Introduction: Borrelia burgdorferi sensu lato is the causative agent of Lyme disease, an emerging zoonosis, whose diagnosis, prevention and control are difficult and it is mainly reported in the northern hemisphere. Objective: to provide updated information about Borrelia burgdorferi. Methods: a review of scientific and specialized literature on the key aspects of this agent and the disease such as characteristics and life cycle of borrelias, epidemiology, clinical manifestations in humans, laboratory diagnosis, current case definition, treatment, prophylaxis, prevention and control. Results: current valuable information on selected items was set forth, which is useful for the personnel involved in vector-borne infectious diseases. Additionally, information about studies conducted in Cuba was provided. Conclusions: this paper offers updated information for the epidemiological, clinical and microbiological management of suspected cases of infection with Borrelia burgdorferi sensu lato.
Helping to prioritise interventions for depression and schizophrenia: use of Population Impact Measures
Heller Richard F,Gemmell Islay,Patterson Lesley
Clinical Practice and Epidemiology in Mental Health , 2006, DOI: 10.1186/1745-0179-2-3
Abstract: Background To demonstrate the potential of Population Impact Measures in helping to prioritise alternative interventions for psychiatry, this paper estimates the number of relapses and hospital readmissions prevented for depression and schizophrenia by adopting best practice recommendations. The results are designed to relate to particular local populations. Methods Literature-based estimates of disease prevalence, relapse and re-admission rates, current and best practice treatment rates, levels of adherence with interventions and relative risk reduction associated with different interventions were obtained and calculations made of the Number of Events Prevented in your Population (NEPP). Results In a notional population of 100,000 adults, going from current to 'best' practice for different interventions, the number of relapses prevented in the next year for schizophrenia were 6 (increasing adherence to medication), 23 (family intervention), 43 (relapse prevention), and 44 (early intervention); and for depression the number of relapses prevented in the next year were 100 (increasing care management), 227 (continuing treatment with antidepressants), 279 (increasing rate of diagnosis), and 325 (Cognitive Behaviour Therapy). Hospital re-admissions prevented in the next year for schizophrenia were 6 (increasing adherence to medication), 36 (relapse prevention) and 40 (early intervention). Conclusion Population Impact measures provide the possibility for a policy-maker to see the impact of a new intervention on the population as a whole, and to compare alternative interventions to best improve psychiatric disease outcomes. The methods are much simpler than others, and have the advantage of being transparent.
Factors influencing emergency medical readmission risk in a UK district general hospital: A prospective study
Georgios Lyratzopoulos, Daniel Havely, Islay Gemmell, Gary A Cook
BMC Emergency Medicine , 2005, DOI: 10.1186/1471-227x-5-4
Abstract: The printed version of the article describes chronic obstructive pulmonary disease / asthma as composed of ICD-10 codes J44.0-45.9. This should have read: J40.0-J46 (i.e. diagnostic codes relating to Chronic Obstructive Pulmonary Disease, chronic bronchitis, emphysema and asthma), as well as J12.0-J18 (i.e. diagnostic codes relating to pneumonia). We have included asthma and pneumonia in the definition of this group because, based on experience, we felt that in adults over 50 who are admitted to hospital a primary diagnosis of either asthma or pneumonia is very likely to either represent miscoding of COPD for (asthma or pneumonia), and/or an exacerbation episode of underlying Chronic Obstructive Pulmonary Disease. We include the exact composition of this group, by diagnostic code in Table 1.Similarly, in the printed version of the article the group of "acute coronary syndrome" is defined as I20.0 and I21.0-9. This should have read: I20.0-9 (i.e. angina), I21.0-9 (acute MI) and R07.0-9 (i.e. "non-specific pain in throat or chest"). Again we have decided to include non-specific chest pain along with angina and MI, due to potential for miscoding and/or true co-morbidity (of non-specific chest pain with acute ischaemic heart disease presentations). The exact composition of codes used for the "acute coronary syndrome" group is included in Table 2.The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-227X/5/4/prepub
Factors influencing emergency medical readmission risk in a UK district general hospital: A prospective study
Georgios Lyratzopoulos, Daniel Havely, Islay Gemmell, Gary A Cook
BMC Emergency Medicine , 2005, DOI: 10.1186/1471-227x-5-1
Abstract: The study setting was a District General Hospital in Greater Manchester and the study period was 4.5-years. All index emergency medical admission during the study period leading to a live discharge were included in the study (n = 20,209). A multivariable proportional hazards modelling was used, based on Hospital Episodes Statistics data, to examine the influence of various baseline factors on readmission risk. Deprivation status was measured with the Townsend deprivation index score. Hazard ratios (HR) and associated 95% confidence intervals (CI) of unplanned emergency medical admission by sex, age group, admission method, diagnostic group, number of coded co-morbidities, length of stay and patient's deprivation status quartile, were calculated.Significant independent predictors of readmission risk at 12 months were male sex (HR 1.13, CI: 1.07–1.2), age (age >75 (HR 1.57, CI 1.45–1.7), number of coded co-morbidities (HR for >4 coded co-morbidities: 1.49 CI: 1.26–1.76), admission via GP referral (HR 0.93, CI 0.88–0.99) and primary diagnosis of heart failure (HR 1.33, CI: 1.16–1.53) and chronic obstructive pulmonary disease/asthma (HR 1.34, CI: 1.21–1.48). Higher level of deprivation was also significantly and independently associated and with increased emergency medical readmission risk at three (HR for the most deprived quartile 1.21, CI: 1.08–1.35), six (HR 1.21, CI: 1.1–1.33) and twelve months (HR 1.25, CI: 1.16–1.36).There is a potential for improving health and reducing demand for emergency medical admissions with more effective management of patients with heart failure and chronic obstructive airways disease/asthma. There is also a potential for improving health and reducing demand if reasons for increased readmission risk in more deprived patients are understood. The potential influence of deprivation status on readmission risk should be acknowledged, and NHS performance indicators adjustment for deprivation case-mix would be prudent.Over recent years increase
Alcalinización de la orina humana para el aislamiento experimental de leptospiras
Rodríguez,Islay; Rodríguez,José E.; Fernández,Carmen;
Revista Cubana de Medicina Tropical , 2005,
Abstract: the effect of different alkalizing agents of urine on the isolation of leptospiras was studied. better results were obtained on using the basic solution of naoh 1n inoculated in urine one hour after being alkalized.
Detección molecular de patógenos emergentes de importancia médica y veterinaria en garrapatas capturadas sobre caballos domésticos Molecular detection of emerging pathogens of medical and veterinary importance in ticks found in domestic horses
Islay Rodríguez,Lise Gern,Olivier Rais,Omar Fuentes
Revista Cubana de Medicina Tropical , 2009,
Abstract: INTRODUCCIóN: en la actualidad son varias las especies de patógenos emergentes de importancia médica y veterinaria transmitidos por garrapatas. Los estudios sobre estos agentes y sus enfermedades han sido escasos en Cuba. OBJETIVOS: conocer la presencia de algunos de estos patógenos en garrapatas cubanas que afectan el ganado equino. MéTODOS: se procesaron 95 garrapatas colectadas de caballos domésticos, conservadas en alcohol e identificadas taxonómicamente según claves convencionales. A cada una se le realizó extracción de ADN y posteriormente diferentes reacciones en cadena de la polimerasa utilizando cebadores específicos para los grupos microbianos Borrelia burgdorferi sensu lato, Anaplasma-Ehrlichia, y Babesia-Theileria. Cada uno de los productos de las reacciones en cadena de la polimerasa fue sometido a hibridaciones en línea reversa utilizando sondas para cada grupo en cuestión, así como específicas para las principales especies de estos. RESULTADOS: las garrapatas estudiadas pertenecían a las especies Dermacentor (Anocentor) nitens (60 %), Amblyomma cajennense (38 %) y Rhipicephalus (Boophilus) microplus (2 %). Se detectaron 7 garrapatas Dermacentor (Anocentor) nitens infectadas con bacterias del grupo Anaplasma/Ehrlichia, y no se pudo identificar la especie en cuestión con las sondas utilizadas. Una de estas garrapatas estaba además coinfectada con Babesia bovis. CONCLUSIONES: se sugiere la circulación de una nueva especie de Anaplasma o Ehrlichia no reportada antes en Cuba, por lo que se necesita estudiar un número mayor de garrapatas, así como la incorporación de nuevas sondas en la hibridación en línea reversa u otras metodologías que permitan conocer con exactitud las especies que pudiesen afectar hoy día los caballos domésticos. INTRODUCTION: at present, there are several tick-borne emerging pathogen species of medical and veterinary importance. Few studies on these agents and its diseases have been made in Cuba. OBJECTIVES: to determine the presence of some of these pathogens in Cuban ticks existing in the equine cattle. METHODS: ninety five ticks collected from domestic use horses were processed, preserved in alcohol and taxonomically identified according to the set classifications. Their DNA was extracted and subjected to several polymerase chain reactions with specific primers for microbial groups Borrelia burgdorferi sensu lato, Anaplasma-Ehrlichia, y Babesia-Theileria. Each of the products from polymerase chain reactions underwent reverse line blot hybridation using probes for each group as well as specific probes for the main spec
Alcalinización de la orina humana para el aislamiento experimental de leptospiras Alkalinization of human urine for the experimental isolation of leptospiras
Islay Rodríguez,José E. Rodríguez,Carmen Fernández
Revista Cubana de Medicina Tropical , 2005,
Abstract: Se estudió el efecto de diferentes agentes alcalinizantes de la orina sobre el aislamiento de leptospiras. Se obtuvieron mejores resultados al emplear la solución básica de NaOH 1N y en la orina inoculada 1 h después de haber sido alcalinizada. The effect of different alkalizing agents of urine on the isolation of leptospiras was studied. Better results were obtained on using the basic solution of NaOH 1N inoculated in urine one hour after being alkalized.
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