Epidemiological studies, clinical observations, laboratory analyses and immunoserological specific assays (indirect immunofluorescence, IIF, and ELISA) were performed. Food samples were analyzed by artificial digestion, and Trichinella
larvae isolates were identified to the species level by multiplex PCR. The main source of infection, commercially available food, had a parasite load of 1.1 muscle larvae per gram. Larvae were identified as Trichinella spiralis. Patients presented predominantly with oedema, fever and myalgia; and laboratory findings and/or immunoserological tests were positive for trichinellosis. Individuals received outpatient treatment. selleck screening library No deaths or secondary sequelae were recorded. Results suggest
that the presence of T.-spiralis infection should be suspected in all endemic areas, especially where animal husbandry and official food safety controls are not properly conducted. The lack of the AG-881 in vivo cases reported ought not to be taken as a proof of parasite absence. We highlight the importance of the urgent need to implement interdisciplinary and inter-institutional programs aimed to control infection transmission, to guarantee food safety and to conduct epidemiological surveillance studies. (C) 2014 Elsevier B.V. All rights reserved.”
“ObjectiveThe aim of this study was to assess the feasibility of incorporating the Delphi process within the simplifying conditions method (SCM) described in elaboration theory (ET) to identify conditions impacting the complexity of procedural skills for novice learners. MethodsWe generated an initial list of conditions impacting the complexity of lumbar puncture (LP) from key informant interviews (n=5) and a literature
review. Eighteen clinician-educators from six different medical specialties were subsequently recruited as expert panellists. Over three Delphi rounds, these panellists rated: (i) their selleck products agreement with the inclusion of the simple version of the conditions in a representative (epitome’) training scenario, and (ii) how much the inverse (complex) version increases LP complexity for a novice. Cronbach’s -values were used to assess inter-rater agreement. ResultsAll panellists completed Rounds 1 and 2 of the survey and 17 completed Round 3. In Round 1, Cronbach’s -values were 0.89 and 0.94 for conditions that simplify and increase LP complexity, respectively; both values increased to 0.98 in Rounds 2 and 3. With the exception of high CSF (cerebral spinal fluid) pressure’, panellists agreed with the inclusion of all conditions in the simplest (epitome) training scenario. Panellists rated patient movement, spinal anatomy, patient cooperativeness, body habitus, and the presence or absence of an experienced assistant as having the greatest impact on the complexity of LP.