Sporotrichosis is an implantation mycosis with subcutaneo-lymphatic or, more rarely, a viscerally disseminated affection; it can be acquired through traumatic percutaneous inoculation of the fungus present in soil or plant matter, or by feline scratching. Among the causative agents, Sporothrix brasiliensis is considered the most virulent species with a high prevalence in Brazil and recently in Argentina. Objective: Describe a S. brasiliensis outbreak in domestic and feral cats detected in the Magallanes region of southern Chile. Materials and Methods: Between the months of July and September 2022, three cats presented with suppurative subcutaneous lesions located mainly on the head and thoracic limbs. The cytology revealed the presence of yeasts with morphological characteristics suggestive of Sporothrix spp. The histopathology confirmed pyogranulomatous subcutaneous lesions associated with the presence of the same yeasts. The fungal culture followed by the partial gene sequence and analysis of the ITS region confirmed the diagnosis of the S. brasiliensis as the causative agent. The cats were treated with itraconazole associated in one case with potassium iodide. The evolution of the patients was favorable in all cases. Conclusions: An outbreak caused by S. brasiliensis was detected in domestic and feral felines in austral Chile. The correct identification of this fungus and antifungigram is essential for treatment decisions and for designing dissemination control and prevention programs under a one health approach that consider the health of people, animals, and the environment.
Background: Male persons who inject drugs (male PWID) are at heightened risk for HIV, particularly if they also have sex with men. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for this population, but PrEP awareness within different sexual identities among male PWID is not well-understood. We report factors associated with greater awareness among male PWID to identify efficient means of awareness dissemination. Methods: Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chisquared statistics, were conducted to examine correlates of awareness of PrEP with sociodemographic, behavioral, and health care variables. Log-linked Poisson regression with robust standard errors was used to estimate adjusted prevalence ratios and determine differences in awareness of PrEP.
Introduction Operation Bushmaster, a 5-day high-fidelity medical practicum bringing together fourth-year medical students, graduate nursing students, international students, and physicians and other medical professionals in emergency and operational medicine from across the world, is the capstone event of the Uniformed Services University of the Health Sciences’s Military Unique Curriculum. It is designed to simultaneously test students’ medical knowledge, leadership skills, and grace under fire. For many students, this experience represents one of the first times that they concurrently inhabit the dual roles of military officer and (soon-to-be) physician. This is likely the most “tactical” and stressful military simulation that many students have experienced. Methods In this qualitative study, we analyzed a data set of 49 de-identified reflective articles written by fourth-year medical students following the completion of Bushmaster, in order to understand what students gained from the experience. Additionally, we evaluated students’ responses through the lens of the threshold concept, looking for ontological shifts, integration, discursiveness, and troublesomeness during students’ Bushmaster experiences. Results We identified 10 themes throughout the essays that highlighted the lessons learned during the Bushmaster experience, including its importance in guiding professional identity formation and students’ deepened understanding of the unique responsibilities and pressures of the role of military physician. Conclusion One of the resulting themes, “the military physician,” met our criteria for a threshold concept, in that it was transformative, integrative, and troublesome. Before Bushmaster, many of the students saw themselves simply as medical students rather than as almost doctors. Following the field practicum, some identified more strongly with the role of military physician, while others continued to overestimate the amount of time remaining to complete the transformation from student to doctor or to integrate the roles of physician and military officer. Moreover, we identified the entirety of Bushmaster as a threshold experience. This work serves to further describe the liminal space in which military medical students reside on their journey to physician, as well as the moment of realization by many that becoming a military physician encompasses more than simply the sum of the roles of physician and military officer.
The quality of water in swimming pools is essential to avoid risks to the health of users. Medellín has more than 1000 public swimming pools, which are supervised by the Medellín Health Authority to monitor and ensure compliance with relevant regulations. The Health Authority has financed several studies related to the quality of drinking and recreational water in Medellín in order to protect consumers and users. One such study involves the evaluation of the presence of disinfection byproducts (DBP). The best known DBPs resulting from disinfection with chlorine are trihalomethanes (THMs) and halogenated acetic acids (HAAs), as well as other minorities such as chloramines or halophenols (HPs). DBPs pose a greater risk in swimming pool water because there is a greater possibility of ingestion, since exposure occurs through several routes at the same time (direct ingestion of water, inhalation of volatile or aerosol solutes, dermal contact and absorption through skin). In the present work, high concentrations of THMs and HAAs were detected in the public swimming pools selected in the study, but the presence of HPs was not detected in the pools.
Financiación: La presente investigación no recibió ningún tipo de financiación pública o privada. Declaración de conflicto de interes: Los autores declaran no tener ningún conflicto de intereses.
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