Coxiella burnetii seroprevalence in sheep herd from Paraguay: First evidence of bacterial circulation in the country

Coxiella burnetii is the agent of Q fever, a disease that poses risks to public health and damages livestock. We discovered the circulation of C. burnetii for the first time in Paraguay, based on the seropositivity of a flock of >300 sheep. The animals were tested by IFA for anti-C. burnetii antibodies and by SAM for anti-Leptospira spp. antibodies, an important differential diagnosis for reproductive disorders in sheep in Paraguay. C. burnetii seropositivity was determined in 45%, in contrast to Leptospira spp. which had no reactive samples. Cases of miscarriage and fetal resorption were associated with high seropositivity titers. This study suggests the circulation of a unique genotype in the country and an imminent risk to public health, since in addition to being highly transmissible and infectious to humans, Q fever is still not a cause for concern on the part of government and health agencies in the country.

Threatened Neotropical seasonally dry tropical forest: evidence of biodiversity loss in sap-sucking herbivores over 75 years

Tropical forests cover 7% of the earth's surface and hold 50% of known terrestrial arthropod species. Alarming insect declines resulting from human activities have recently been documented in temperate and tropical ecosystems worldwide, but reliable data from tropical forests remain sparse. The sap-sucking tribe Athysanini is one herbivore group sensitive to anthropogenic perturbation and the largest within the diverse insect family Cicadellidae distributed in America's tropical forests. To measure the possible effects of deforestation and related activities on leafhopper biodiversity, a survey of 143 historic collecting localities was conducted to determine whether species documented in the Mexican dry tropical forests during the 1920s to 1940s were still present. Biostatistical diversity analysis was performed to compare historical to recent data on species occurrences. A data matrix of 577 geographical records was analysed. In total, 374 Athysanini data records were included representing 115 species of 41 genera. Historically, species richness and diversity were higher than found in the recent survey, despite greater collecting effort in the latter. A strong trend in species decline was observed (-53%) over 75 years in this endangered seasonally dry ecosystem. Species completeness was dissimilar between historic and present data. Endemic taxa were significantly less important and represented in the 1920s-1940s species records. All localities surveyed in the dry tropical forest are disturbed and reduced by modern anthropogenic processes. Mexico harbours highly endemic leafhopper taxa with a large proportion of these inhabiting the dry forest. These findings provide important data for conservation decision making and modelling of distribution patterns of this threatened seasonally dry tropical ecosystem.

Effect of intravenous iron on functional outcomes in hip fracture: a randomised controlled trial

OBJECTIVES

to determine the safety and effect of intravenous iron sucrose on functional outcomes, delirium, nosocomial infections and transfusion requirements in older patients with hip fracture.

DESIGN

single-centre randomised, double-blind, placebo-controlled clinical trial.

SETTING AND PARTICIPANTS

orthogeriatric share care service at an academic tertiary care hospital. A total of 253 patients were recruited: 126 patients were assigned to intravenous iron and 127 to placebo.

METHODS

on days 1, 3 and 5 after admission, the iron group received 200 mg Venofer® (iron sucrose) in 100 ml saline and the placebo group 100 ml saline. The primary outcome was absolute functional gain, considered as Barthel index (BI) at discharge minus BI on admission. Secondary outcomes included incidence of postoperative delirium according to the confusion assessment method, proportion of patients recovering prior functional status at 3 months, postoperative transfusion requirements, haemoglobin at 3 months, incidence of nosocomial infections and safety.

RESULTS

the median participant age was 87 (interquartile range, 82.5-91.5) years. Most patients were female (72.7%), and the median previous BI was 81(59-95). No significant effect of intravenous iron was observed for the primary outcome: the median AFG score was 17.1 points (4.8-23.3) in the intravenous iron group and 16 points (6-26) in the placebo group (P = 0.369). No significant treatment effects were observed for other functional outcomes or secondary end points.

CONCLUSION

while we found no impact of intravenous iron sucrose on functional recovery, incidence of postoperative delirium, transfusion requirements, haemoglobin at 3 months, mortality and nosocomial infections rates in older patients with hip fracture, we did find that the intervention was safe.

Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid

Objectives

To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020.

Design

This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people living in NHs from the hospital.

Setting and Participants

A total of 630 patients aged 70 and older with Coronavirus Disease 2019 COVID-19 living in 55 NHs.

Methods

A logistic regression was performed to analyze the factors associated with mortality. In addition, Kaplan-Meier curves were applied according to mortality and its associated factors using the log-rank Mantel-Cox test.

Results

The diagnosis of COVID-19 was mainly made by clinical compatibility (N = 430). Median age was 87 years, 64.6% were women and 45.9% were transferred to be cared for at the hospital. A total of 282 patients died (44.7%) within the 30 days of first attention by the team. A severe form of COVID-19 occurred in 473 patients, and the most frequent symptoms were dyspnea (n = 332) and altered level of consciousness (n = 301). According to multiple logistic regression, male sex (P = .019), the Clinical Frailty Score (CFS) ≥6 (P = .004), dementia (P = .012), dyspnea (P < .001), and having a severe form of COVID-19 (P = .001), were associated with mortality, whereas age and care setting were not.

Conclusions and Implications

Mortality of the residents living in NHs with COVID-19 was almost 45%. The altered level of consciousness as an atypical presentation of COVID-19 should be considered in this population. A severe form of the disease, present in more than three-quarters of patients, was associated with mortality, apart from the male sex, CFS ≥6, dementia, and dyspnea, whereas age and care setting were not. These findings may also help to recognize patients in which the Advance Care Planning process is especially urgent to assist in the decisions about their care.

Cellular and molecular changes associated with somatic embryogenesis induction in Agave tequilana

In spite of the importance of somatic embryogenesis for basic research in plant embryology as well as for crop improvement and plant propagation, it is still unclear which mechanisms and cell signals are involved in acquiring embryogenic competence by a somatic cell. The aim of this work was to study cellular and molecular changes involved in the induction stage in calli of Agave tequilana Weber cultivar azul in order to gain more information on the initial stages of somatic embryogenesis in this species. Cytochemical and immunocytochemical techniques were used to identify differences between embryogenic and non-embryogenic cells from several genotypes. Presence of granular structures was detected after somatic embryogenesis induction in embryogenic cells; composition of these structures as well as changes in protein and polysaccharide distribution was studied using Coomassie brilliant blue and Periodic Acid-Schiff stains. Distribution of arabinogalactan proteins (AGPs) and pectins was investigated in embryogenic and non-embryogenic cells by immunolabelling using anti-AGP monoclonal antibodies (JIM4, JIM8 and JIM13) as well as an anti-methyl-esterified pectin-antibody (JIM7), in order to evaluate major modifications in cell wall composition in the initial stages of somatic embryogenesis. Our observations pointed out that induction of somatic embryogenesis produced accumulation of proteins and polysaccharides in embryogenic cells. Presence of JIM8, JIM13 and JIM7 epitopes were detected exclusively in embryogenic cells, which supports the idea that specific changes in cell wall are involved in the acquisition of embryogenic competence of A. tequilana.

Use of Dactylopius coccus Costa (Hemiptera: Coccoidea) pigments in the detection of larvae and pupae of Plutella xylostella (L.) (Lepidoptera: Yponomeutidae)

Carmines obtained from the dye of Dactylopius coccus Costa (Hemiptera: Coccoidea) were used for the detection of larvae and pupae of Plutella xylostella (L.) (Lepidoptera: Yponomeutidae) in broccoli inflorescences. Larvae were dyed with carmine II and red cochineal, while the majority of the dyes, with the exception of carmine III and the aqueous extract, were suitable to dye pupae. In the broccoli lumps exposed to the dyes, only the verge of the stems were actually dyed, right in the position where the incision took place, an appropriate characteristic for implementing this technique for commercial use.

Diagnostic and prognostic value of electrophysiologic study in patients with nondocumented palpitations

The 12-lead electrocardiogram helps to define the arrhythmic mechanism in patients with palpitations. However, in the setting of nondocumented palpitations the value of the electrophysiologic study (EPS) needs additional investigation. We investigated the utility of the EPS in patients with nondocumented palpitations. A total of 172 patients with normal electrocardiographic findings and nondocumented palpitations underwent an EPS. The clinical and electrophysiologic characteristics were assessed. The symptoms were long-lasting (>5 minutes) in 56%. Sudden onset was present in 99%, and termination was rapid in 65%. Neck palpitations were reported in 36%. The EPS findings were normal in 86 patients (50%); atrioventricular nodal reentrant tachycardia was induced in 43, orthodromic reentrant tachycardia in 9, and nonsustained atrial tachycardia/fibrillation (AT/AF) in 34. Long-lasting episodes, sudden termination, and neck palpitations predicted positive EPS findings and were associated with reentrant supraventricular tachycardia (p<0.001). The induction of AT/AF was associated with age >50 years and structural heart disease (p<0.001). After 53 ± 36 months of follow-up, 92% of patients with negative EPS findings were symptom free. Only 32% of patients with induced AT/AF remained free of symptoms (p<0.001). The recurrence of palpitations was more prevalent among patients with structural heart disease and aged >50 years (p<0.001). In conclusion, 50% of patients with nondocumented palpitations had positive EPS findings. A long duration, sudden termination, and neck palpitations, together with structural heart disease and age >50 years, predicted tachycardia inducibility and recurrence and could help in selecting patients suitable for EPS and ablation.

[Penile morphometric changes after radical prostatectomy: Evidence-based]

INTRODUCTION

Radical prostatectomy in all its approaches is the treatment of choice for localized prostate cancer and especially in young, sexually active patients with a desire to keep their sex life. In addition to the well-known and defined postoperative erectile dysfunction, erectile silent period causes, in many patients (9-1%), structural changes, in the penile structure, sometimes irreversible. These tissue changes, resulting in a loss of length and girth, that concern patients.

OBJECTIVE

To systematically review to date published data in the literature regarding penile changes after radical prostatectomy.

MATERIAL AND METHODS

We performed a systematic search in: PubMed, EMBASE, Cochrane, SCOPUS, Science Citation Index period January 1990 to September 2009 for the terms prostatectomy, organ size, fibrosis, sexual activity, erectile dysfunction, penile size, radical prostatectomy, prostatic neoplasms, body weights and penis measures. Seven series of patients were selected for analysis.

RESULTS

We described the different measurement methods and their potential biases and differences. Also, we reviewed main physiopathogenic theories to explain this phenomenon. Finally, we detail the results of different series of patients reported.

CONCLUSIONS

It seems to be a proven fact that the penis undergoes major changes in its length and girth after radical prostatectomy. Several authors have communicated the data of their series and the different treatment options (5PDE inhibitors, vacuum devices, penile extenders, etc.). Strategies addressed to preserve and protect cavernous tissue and tunica albuginea after the procedure, as well as to increase oxygenation and allow erection to be recovered in the shortest possible time positive will impact on the quality of life of our patients.