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Introduction: Latin America accounts for one-quarter of global COVID-19 cases and one-third of deaths. Inequalities in the region lead to barriers to the best use of diagnostic tests during the pandemic. There is a need for simplified guidelines that consider the region’s limited health resources, international guidelines, medical literature, and local expertise. Methods: Using a modified Delphi method, 9 experts from Latin American countries developed a simplified algorithm for COVID-19 diagnosis on the basis of their answers to 24 questions related to diagnostic settings, and discussion of the literature and their experiences. Results: The algorithm considers 3 timeframes (≤7 days, 8–13 days, and ≥14 days) and presents diagnostic options for each. SARS-CoV-2 real- time reverse transcription-polymerase chain reaction is the test of choice from day 1 to 14 after symptom onset or close contact, although antigen testing may be used in specific circumstances, from day 5 to 7. Antibody assays may be used for confirmation, usually after day 14; however, if clinical suspicion is very high, but other tests are negative, these assays may be used as an adjunct to decision-making from day 8 to 13. Conclusion: The proposed algorithm aims to support COVID-19 diagnosis decision-making in Latin America.

The COVID-19 pandemic has caused an unprecedented public health, social, and economic crisis. Improving understanding on available tests for detecting COVID-19 is critical for effective management of the pandemic. We proposed that a multidisciplinary expert panel can establish recommendations on ideal use of diagnostic tools, with a focus on RT-PCR and serological high-affinity antibodies (both IgM and IgG) tests for the Latin America region. Study design: A collaborative multidisciplinary panel of 5 recognized experts in Latin America (an infectious disease specialist, three pathologists, and an immunologist) was convened and supported by Roche Diagnostics to develop standard guidelines and an evidence-based document of best practices on the use of diagnostic tools for COVID-19. Results: The authors reached consensus on the applicability of diagnostic tools to provide testing algorithms for the use of RT-PCR and serological high-affinity antibodies (both IgM and IgG) tests in three settings: 1) For asymptomatic subjects exposed to a SARS-CoV-2 infected person; 2) For epidemiological purposes and; 3) For symptomatic subjects. Conclusion: The serological high-affinity SARS-CoV-2 antibodies (both IgM and IgG) tests play a key role in COVID-19 diagnosis. These tests can be applied for suspected false-negative RT-PCR results and for individual determination of response. The use of these tests can also contribute greatly to public health strategies, such as population screening and supporting vaccination planning. Serological status for high-affinity antibodies (both IgM and IgG) should be performed ideally 21 days after potential infectious contact, given that the majority of exposed individuals will have seroconverted.

The effects of slope aspect and slope declivity on atmospheric potential demands are evaluated in a semiarid inland area of Ebro Basin (NE Spain). Results show spatial and temporal variation e.Ifects of both variables, and calculus expresion are proposed.

To determine clinical and virologic characteristics of pandemic (H1N1) 2009 in Buenos Aires, Argentina, we conducted real-time reverse transcription–PCR on samples from patients with influenza-like illness, June 11–30, 2009. Of 513 patients tested, 54% were positive for influenza virus subtype H1N1. Infection rate was lowest for patients ≥60 years of age.

BackgroundThe apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities.MethodsWe identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group.ResultsOf 332 influenza A H1N1pdm fatalities, 226 (68%) were among persons aged ConclusionPersons with co-morbidities, pregnant and who received antivirals late were over-represented among influenza A H1N1pdm deaths in Argentina, though timeliness of antiviral treatment improved during the pandemic.

We address the problem of estimating pure qubit states with non-ideal (noisy) measurements in the multiple-copy scenario, where the data consist of a number N of identically prepared qubits. We show that the average fidelity of the estimates can increase significantly if the estimation protocol allows for inconclusive answers, or abstentions. We present the optimal protocol and compute its fidelity for a given probability of abstention. The improvement over standard estimation, without abstention, can be viewed as an effective noise reduction. These and other results are illustrated for small values of N . For asymptotically large N , we derive analytical expressions of the fidelity and the probability of abstention and show that for a fixed fidelity gain the latter decreases with N at an exponential rate given by a Kulback–Leibler (relative) entropy. As a byproduct, we give an asymptotic expression in terms of this very entropy of the probability that a system of N qubits, all prepared in the same state, has a given total angular momentum. We also discuss an extreme situation where noise increases with N and where estimation with abstention provides the most significant improvement as compared to the standard approach.

To date, descriptions of pathologic conditions of the seminal vesicle in rabbits are scarce and limited to the laboratory animals in experimental conditions. The present article describes three cases of strangury, abdominal pain, and anorexia associated with seminal vesiculitis in pet rabbits. Three non-neutered male pet rabbits aged 3.6, 1.5, and 2.1 yrs were presented with strangury, abdominal pain, and anorexia. Seminal vesiculitis was diagnosed based on clinical signs and ultrasonography findings. Vesiculectomy was performed in two cases that presented strangury refractory to medical treatment, and diagnosis was confirmed by histopathology. In the third case, the patient received medical treatment, and a sequela in the form of lithiasis of the seminal vesicle was detected 3 yrs later. Plain radiographs were nearly unremarkable, and results from complete blood analysis and urinalysis were not specific in all three cases. Contrast radiography was performed in one case, showing a dilated seminal vesicle. Ultrasound and surgical biopsy seem to be the most sensitive techniques in the diagnosis of this pathology. Seminal vesiculitis must be included in the differential diagnosis of acute or chronic strangury in male pet rabbits. [ABSTRACT FROM AUTHOR]

Uncomplicated urinary tract infections rank among the most frequent bacterial infections in women in the outpatient setting and represent a major cause of antimicrobial prescription. The aims of this study were to assess frequencies and antimicrobial resistance of current uropathogens causing uncomplicated urinary tract infection. In a prospective multicenter study, patients were recruited in ambulatory settings of four participating hospitals between June 2011 and December 2013. We analyzed 138 patients that met clinical and bacteriological diagnostic criteria. The mean age was 28 years. Cystitis was defined in 70% (n: 97) and pyelonephritis in 30% (n: 41). Frequencies of isolated microorganisms were: Escherichia coli 70% (n: 97), Staphylococcus saprophyticus 17% (n: 24), Proteus spp. 7% (n: 10), Klebsiella spp. 4% (n: 5), Enterococcus spp. and Pseudomonas aeruginosa 1 (0.7%) each. The antimicrobial resistance was: ampicillin-sulbactam 37% (n: 51) cephalexin 28% (n: 39), trimethoprim/sulfamethoxazole 22% (n: 31), nitrofurantoin 12% (n: 17), gentamicin 7% (n: 10) and ciprofloxacin 5% (n: 7). The levels of resistance found for ampicillin-sulbactam, trimethoprim/sulfamethoxazole and cephalexin were higher than those previously reported in Argentina. A better knowledge of the etiology and local antimicrobial susceptibility allows the design of more adequate guidelines for empirical treatment.

Introduction: During the 2009 influenza H1N1virus pandemic, health-care workers were exposed to elevated risk of infection. The aim of this study was to estimate the risk for severe acute respiratory disease (SARD) in this population during the pandemic period in Argentina., Methodology: we conducted a retrospective survey in which all members of the Argentine Society of Infectious Diseases were invited to answer an online survey providing information on health-care staff working at their hospital or health center, who were hospitalized for SARD, between May and August 2009. Results were compared to population-based SARD surveillance data obtained from the Ministry of Public Health., Results: Fifty hospitals completed the survey. Out of a total population of 58,902 health-care workers, 41 were reported to have been hospitalized for SARD (hospitalization rate 69.6/100000), 19 of whom tested positive for H1N1 using real time polymerase chain reaction. Hospitalization rate in the general population during the same time period was 20.3/100000 (p < 0.01), thus indicating increased SARD hospitalization risk in health-care workers (OR 3.1 95% CI: 2.3 - 4.1; p < 0.01)., Conclusions: During the 2009 pandemic, health-care workers in Argentina suffered increased risk of hospitalization due to SARD compared to the general population. We recommend immunization of all personnel, as well as enforcing stricter infection control measures in hospitals to prevent future transmission of influenza H1N1virus.

Background: The apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities., Methods: We identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group., Results: Of 332 influenza A H1N1pdm fatalities, 226 (68%) were among persons aged <50 years. Acute respiratory failure was the leading cause of death. Of all cases, 249 (75%) had at least one comorbidity as defined by Advisory Committee on Immunization Practices. Obesity was reported in 32% with data and chronic pulmonary disease in 28%. Among the 40 deaths in children aged <5 years, chronic pulmonary disease (42%) and neonatal pathologies (35%) were the most common co-morbidities. Twenty (6%) fatalities were among pregnant or postpartum women of which only 47% had diagnosed co-morbidities. Only 13% of patients received antiviral treatment within 48 hours of symptom onset. None of children aged <5 years or the pregnant women received antivirals within 48 h of symptom onset. As the pandemic progressed, the time from symptom-onset to medical care and to antiviral treatment decreased significantly among case-patients who subsequently died (p<0.001)., Conclusion: Persons with co-morbidities, pregnant and who received antivirals late were over-represented among influenza A H1N1pdm deaths in Argentina, though timeliness of antiviral treatment improved during the pandemic.

To determine clinical and virologic characteristics of pandemic (H1N1) 2009 in Buenos Aires, Argentina, we conducted real-time reverse transcription-PCR on samples from patients with influenza-like illness, June 11-30, 2009. Of 513 patients tested, 54% were positive for influenza virus subtype H1N1. Infection rate was lowest for patients >or=60 years of age.

We retrospectively assessed the renal toxicity associated with the use of intravenous colistin. Fifty-four patients with multidrug-resistant Acinetobacter infections were included. At the end of therapy 6/54 patients (11%) suffered renal impairment. Renal impairment associated with the use of colistin is less frequent than initially reported.