Los mejores relatos breves juveniles de la provincia de Alicante 2006 (Spanish Edition)

However, it remains paradoxical that when Unamuno was offering his analysis, the period of great Carlist role in letters was just about to begin. It lasted for some quarter of a century, as until the late s Carlism remained a key theme of numerous monumental works of Spanish literature. Afterwards it lost its appeal as a literary motive, still later reduced to instrumental role during Francoism. Today it enjoys some popularity, though no longer as catalyst of paramount cultural or political discourse; its role is mostly to provide exotic, historical, romantic and sometimes mysterious setting.

The literary response to the conflict was immediate and massive; its key feature were propagandistic objectives of both sides and often close follow-up to the events as they were unfolding. Two genres serving as key literary battlefields were poetry and drama, the most adapt ones in terms of responsiveness. On both the Cristinos gained immediate advantage, which in the aftermath of the war became visible also in prose, especially in the nascent novel. On the other hand, the popular oral rural response, which made it to literature once written down in the future, was predominantly pro-Carlist.

No Romantic work touching upon the Carlist subject is considered part of the great Spanish literature. The outbreak of the First Carlist War, usually considered the birth moment of Carlism, [2] has almost immediately triggered a literary response. The literary genre which responded first was drama. There were a number of theatrical pieces written as the war was unfolding and it seems that most of them were actually staged, as they served mostly propagandistic purpose of mobilizing support; only few were rather comments to recent or even ongoing events.

Unlike in case of poetry, there is no anthology available. It seems that the anti-Carlist dramas fall into two categories: He made his name as author of theatrical pieces already in the mids; venomous caricatures of "los serviles", e. La Regencia de la Seo de Urgell o las desgracias del padre Liborio might be considered pre-configuration of his later anti-Carlist dramas and perhaps the first pieces of anti-Carlist literature.

The poets [14] responded to the conflict almost as fast as authors of theatrical pieces did. The conflict and its immediate aftermath produced a spate of rhymed pieces, usually first published in press titles of the era. This vast assortment [16] so far can be analyzed mostly in statistical terms; in terms of genre the poetry remains pretty differentiated, with odes , sonnets , eposes , lyrics , cantos, canciones, anthems , marches , satire and other. In terms of key themes the ones listed are: Statistically pro-Cristinos seem to prevail, and their poetic zeal reached as far as to Andalusia , a region less affected by the First Carlist War.

Prose was the last one to acknowledge the Carlist theme. When Spanish novel of the midth century gradually emerged as important cultural weapon against the Carlists, their own response on the field was meager. Navarro Villoslada, now converted into legitimism, fathered a number of acclaimed and popular historical romantic novels, yet they are set in earlier times and at best might be viewed as offering a general Traditionalist perspective.

A separate genre which might not fully fit into the literature rubric is a flood of rhymes of mostly popular and rural origin, which remained alive at times for generations when passed on in oral tradition; they entered literature only when put into writing by later scholars, be it ethnographers or historians. Two such Carlist-related anthologies are available for rhymes in Castellano and in Euskara ; [44] both demonstrate overwhelming support for the Carlist cause among the rural folk, though principally among the Basques. It remains striking that in the European Romantic literature, always in pursuit of a myth, Carlism has been largely ignored, [47] save for the French legitimist poets like Edouard Turquety or Juliette Lormeau.

Greeks fighting the Turks, Poles fighting the Russians, later North American Indians fighting the Whites — yet the Carlists have never been even considered. The phenomena remains to be examined and clarified; some evidence suggests that they were generally associated with late Romantic icons of monstrosity, the reaction and the politics of Holy Alliance , the oppressive forces pitted against revolutionary and freedom-seeking national movements.

Realism shifted the attention of writers tackling the Carlist theme from poetry and drama to prose; it was the novel which emerged as the key genre where the question was discussed and it stays so until today. Very much like during the Romantic period, literature remained a battleground between the Carlists and the Liberals, the latter clearly gaining advantage.

Like everywhere in Europe, periodization remains a problem in history of Spanish literature. Among many in-between figures of Spanish literature, Fernan Caballero with her Carlism-related works is often counted among the post-Romantic writers. The same is the case of Manuel Tamayo Baus , whose early works are counted into Romanticism and the later ones into Realism.

El Patriarca is a key work of early realist period; in terms of literary style it advances techniques typical for a new era, yet in terms of key message it conveys the same anti-Carlist narrative, presenting the opponents as hypocrites ran by the Jesuits and as murderers of bestial cruelty. The novel, fairly popular in the s, features an extremely complex plot, covering also events of in France. It is valued by historians, as sections referring to the Madrid setting during the early phases of the war are possibly based on the author's first hand experience.

Outbreak of the Third Carlist War has generally reinforced the tone set by Ayguals de Izco and the literary Carlists petrified in their role of fanatic cruel rednecks ran by the treacherous clergy. This time it was clearly the novel which became the key literary weapon, though it fell into two general genres: Focused on atrocities of the Carlist commander Samaniego, active during the last war — at that time the last was the Third Carlist War — it tended to brutal veracity. The first two series of his monumental string of historical novels named Episodios nacionales are set before and it is the following ones, technically written already during the modernist period, which tackle the issue head on.

However, they still represent typical Realism of their author and differ significantly — be it in terms of style or the role of Carlism — from the later modernist works. His objectives were clearly educative; his declared intention was to teach his compatriots their past. His political militancy made him par excellence the Spanish Liberal Crusader; [73] as such, he intended to demonstrate what damage Carlism had inflicted upon the nation.

In history of literature the prevailing view is that galdosian position on Carlism remains fairly stable and can be viewed as homogeneous. People can roam the streets freely, but howling and groaning of the monster can be still heard; since the brute might re-appear in town any minute, vigilance is the order of the day. Also the Third Carlist War triggered popular cultural response, this time reduced almost entirely to the Basque linguistic realm and evading typical historical categories; this production is acknowledged in Karlisten Bigarren Gerrateko bertsoak , anthology edited by Antonio Zavala A Traditionalist through all his life and a militant Carlist in his youth, he fathered a number of poems intended as a praise of Carlism.

They are written in Catalan, exalted in style and very explicit politically. One of them is dubbed "the Carlist anthem" by later scholars, [79] yet it seems it has never been printed and was re-constructed on basis of Verdaguer's manuscripts. In prose the Carlist voice is down to two authors.

In terms of Carlist motives the key difference between Modernism and earlier literary eras was that the movement ceased to be perceived as a direct threat. The Romantic and Realist literature was defined by political militancy; the Modernist writers can already afford another position. For them Carlism is rather a vague phenomenon from the past, fading away yet still casting its dark shadow. Modernism was also the period when Carlism as a motive enjoyed top popularity among the Spanish literary greats. One was genuine, rooted in the rural population but largely unconscious, communitarian if not socialist, federative and anarchist in spirit.

The two Carlisms are constantly present in Paz en la guerra , confusing both the protagonists and the readers; initially Unamuno was accused of nurturing Carlist sympathies, something he immediately denied. In fact, for him Carlism was an element in a dialectic process of forming national identity and as such could not have been simply ignored or rejected. The vision of Pachico from last pages of the novel, namely that "both sides were right and neither was right", is usually attributed to Unamuno himself.

The title of the novel might be interpreted in two ways: This confrontation was not necessarily symbolic; in numerous works and statements Unamuno openly praised civil war as means of overcoming dialectic differences. It was only once he had learnt the deadly toll of first months of the Spanish Civil War that he changed his view. The controversy is whether the apparent exaltation of Carlism, demonstrated by many of his protagonists and not infrequently also by storytellers of his novels, should be taken at face value or whether it is part of an ironic and perhaps provocative discourse.

Settling the issue on basis of literature only seems close to impossible. For others, [] Carlism represents an ambiguous myth, an illusion, sometimes bordering farce; its role is to catalyze a discourse about Spanish history, which blends glory with absurd. Among the giants of Spanish Modernism Baroja was the one who experienced most personal contact with Carlism, from his infancy days in the besieged Bilbao [] to his senility in Vera de Bidasoa.

From his Nietzschean perspective Carlism was the movement of the weak, animated by the Church and luring those unable to become "men of action". Heavily attracted to rural vitality, at times primitive and brutal yet authentic, he lamented that it got hijacked by ideology powered by the priests, with the result of "double bestiality of being a Catholic and a Carlist". Hardly anyone of numerous Carlists, populating the novels of Baroja, is a man who joined the movement out of conviction: Though Baroja was attracted to what he saw as authentic rural virility in the Carlist ranks, he believed it endured despite, not because of their very Carlist nature.

Baroja is careful to strip the Carlists of their notorious machista appearance, in his vision reduced to cowardly brutality. Not only they can not wage the war like men, pursuing cowardly tactics and harassing women and children, but they are also beaten in one-to-one juvenile fistfights and lose miserably in pelota ; of course, they are neither a match for their opponents when it comes to attracting females. He was identified, personally and as enemy of religion and Carlism, and at a roadside he was held by the Carlists at gunpoint. Ensayos sobre arte mexicano. Instituto Mexicano del Seguro Social, Ilus- trador de cuadernos populares.

Discanto, Xalapa, Uni- versidad Veracruzana, Diccionario de literatura mexicana siglo XX. Tema y Variaciones de Litera- tura, 28, This perspective distinguishes his musical and literary poetic as well as the possibility to revalue this composer in the field of literature and Latin American music.

Y todo por causa de la radio. El reto principal de este ensayo es poder comunicar con palabras el prodigioso mundo musical del compositor mexicano Francisco Gabilondo Soler. Destacan dos trabajos fundamentales: Francisco Gabilondo lo explica con sus propias palabras en una entrevista: Una es grillon, que es la usual, y la otra es cri-cri. Contexto cultural y educativo Si tomamos la fecha de nos encontra- mos ante una marca significativa para la cul- tura mexicana.

Para la Segunda Guerra Mundial, la radio fue vital para poder seguir paso a paso los acontecimientos que afectaban los diversos rincones del mapa europeo. Las noches de verano son luminosas y tibiecitas, cantan las chicharritas: Cuando la luna sale por los copetes de las milpitas, zumban las chicharritas: El texto fue enriquecido entonces con los siguientes versos: En el invierno la nieve crece, en el verano la funde el sol. Se rieron los perritos de tal facilidad y todos juntos deletrearon: Y al verlos rascando tras una lombriz, la dulce Gallina es muy feliz.

El tema tiene varias fuentes: Las otredades La obra de Gabilondo Soler explora ge- nerosamente varios contextos culturales de otras latitudes. De esta manera incluye en su repertorio canciones descriptivas sobre per- sonajes de varias nacionalidades. Presento dos ejemplos orientales: Chong Ki Fu y Jorobita.

Sin embargo, dos canciones completan este rubro del mundo extranjero. What the heck in this house for a manly Cowboy Mouse Hello you! A lo que contesta Cri-Cri: La Patita, quien va al mercado y no encuentra nada que le alcance porque el marido Pato es un vago y perezoso que no aporta sustento a la familia. Varias de sus canciones han trascendido al habla coloquial como sincero reconocimiento al artista que supo condensar parte de la vida en festivas canciones. Instituto Veracru- zano de Cultura, Es autor del libro Buenos Aires entre dos calles: Six works that have to Colon as protagonist or main character are analyzed.

This study also examines the loci and stereotypes about the American landscape and the figure of the Indian who featured in these novels. Y no me refiero a los Pinzones ni a las calaberas, como las llamaba un orador del Ateneo. Podemos citar entre otros: La inevitable distancia temporal y cultural entre el tiempo relatado y el tiempo del lector es aprovechada por la autora para proponer un juego fundamen- tado en el anacronismo. La imagen en cualquier caso es la esperada: La figura del indio representa el otro gran personaje de estas novelas.

El Progreso Editorial, Gran libro de los insultos. La Esfera de los Li- bros, Los cuatro viajes del almirante y su testamento. Aspects of the novel. La disputa del Nuevo Mun- do. Publicaciones Universidad de Alicante, Manzano y Manzano, Juan. Thaler, Danielle, y Jean Bart, Alain. Les Enjeux du roman pour adolescents. El problema del otro. Madrid, Siglo XXI, Antonio Mendoza Fillola coord. La literatura infantil, como la literatura de adultos, permite imaginar posibilidades, ir al encuentro de mundos desconocidos, conocer nuevas formas de pensar y actuar, simular lo que se quiere decir.

Pero sobre todo por los principios morales que todos los seres humanos compartimos en nuestra vida en sociedad: Por ello, la importancia de la literatura. Una obra de literatura no puede construir en el ciudadano unos determinados valores morales simplemente por hablar positivamen- te de estos. Cuando a un personaje se le persigue por sus creencias u opiniones, somos conscientes de que le han privado de libertades que le son propias. Que los milicos se vayan de Chile. Que se vayan los militares del gobierno. Llegaron, comieron, oyeron la radio y se acostaron. Por las noches, escuchan en silen- cio y a escondidas la radio.

La radio se muestra como elemento fronte- rizo entre la postura que favorece la dictadura y, por el contrario, la que la rechaza. Otro elemento importante es la pelota, objeto principal a lo largo de los aconteci- mientos posteriores. Pero, ante todo, es po- sible observarlo en el principio y en el final del texto. El autor chileno consigue con esta obra una aproxima-. La inteligencia de los sentidos. Literatura y cine en Venezuela. El intertexto lec- tor. El espacio de encuentro de las aporta- ciones del texto con las del lector.

Universidad de Castilla-La Mancha, Pliegos de la Insula Barataria: El conocimiento del amor.

El cultivo de la humani- dad. Revista de Estu- dios Sociales, 35 Beatriz Helena Robledo, Hitos de la literatura infantil y juvenil iberoamericana. Arau- caria de Chile, 2, Obteni- do de http: This tradition is very early adapted in the graphic narrative, either through illustrations of classical editions or adaptations of great works in comic books. All of them are setting an iconography that completes the imagine of the gauchos, fundamental in Argentina identity. In this paper we will analyzed cartoons gauchos from traditional magazines, adaptations of literary works, such as the Martin Fierro, to own characters as Lindor Covas or Inodoro Pereyra.

El Gaucho y su literatura Aunque la labor del vaquero en la pampa rioplatense se puede remontar hasta el siglo xvii, se considera que es a lo largo del siglo xix cuando se desarrolla esta figura creando un icono de la cultura argentina. El gaucho es el habitante de los campos argentinos; es sumamente experto en el manejo del caballo y en todos los ejercicios del pastoreo. El gaucho no aprende a cantar. Biblioteca Virtual Miguel de Cervantes.

Entrevistado por Sasturain en , Walter Ciocca explica: Lindor es, guardando las distancias, un Quijote, un hombre bueno como los hay en la realidad Ciocca, en Trillo y Saccomano, Cap. Desde ese momento se siente traicionado y escapa y se muestra rebelde ante cualquier autoridad. Ciocca toma conciencia de la tragedia del gaucho y su protagonista va padeciendo distintos problemas.

Lindor Covas, Ciocca El mismo Casalla en Trillo y Saccomana Cap. Y no es que el mundo de la gauchesca sea pobre, la culpa es nuestra si no lo sabemos dar a conocer. Oscar De Majo, en el especial de Tebeosfera sobre la historieta argentina comenta: Uno de los grandes temas que cues-. Oesterheld en una entrevista para la revista Dibujantes, comenta: Oesterheld, en Trillo y Saccomano Cap. La verdadera, la del alma. La otra es solo su imagen Roume, en Trillo y Saccomano Cap.

En esta se pretende crear una epo- peya nacional con la ima- gen idealizada del gaucho, comparando la Conquista del desierto argentino con la del oeste norteamericano. El Huinca Rapela Luna de sangre , Luna de plata y Luna de agua De los distintos contactos, el primero fue con el uruguayo William Gezzio. Detective Comics , Hay un sitio en Facebook: La historieta gauchesca, [https: Otro destacado dibujante uruguayo: En su blog [http: Santos Cruz, Gezzio Si en el 1 encontramos la portada de Juan Moreira, el 2 hace referencia a la Patria Vieja con el importante reclamo de Oesterheld.

Con trazos fuertes nos muestra el sufrimien- to, la soledad y las miserias del gaucho, el indio y el milico. En este recorrido por las distintas obras, es fundamental mencionar los siguientes momentos o personajes que se repiten en todas las versiones. Sin embargo, cuando el otro gaucho le anima a huir juntos, Inodoro responde: En esta etapa aumenta la aventura con episodios de largo desarrollo y falso suspense, con Pereyra siempre en busca de nuevas aventuras. No le viene a buscar la aventura sino la cotidianeidad o la noticia.

Cuando el tema no viene de afuera, surge de la cotidianeidad del rancho, de avatares diarios; inclusive del calendario: Y son personajes medio intocables. Es un dibujo animado no estrictamente para chicos. No por nada le llaman la Biblia gaucha. Entrevista a Carlos Trillo en Tebeosfera [Web], La prim- era mitad de la historia en Tebeosfera, La historieta en el mundo moderno, Barcelona: La primitiva literatura gauchesca, Buenos Aires: El domicilio de la aventura, Buenos Aires: La tinta en la clepsidra: Trillo, Carlos y Saccomano, Guillermo.

His- toria de la Historieta Argentina, Argen- tina: La autora, referente de la literatura argentina, ha escrito novelas, relatos y ensayos y ha obtenido prestigiosos premios como el Hans Christian Andersen en Entre sus libros infantiles y juveniles destacan: Margarita, te voy a contar un cuento.

Una tarde la princesa vio una estrella aparecer; la princesa era traviesa y la quiso ir a coger. Las princesas primorosas se parecen mucho a ti: Y el rey dijo: Y el rey clama: Viste el rey ropas brillantes, y luego hace desfilar cuatrocientos elefantes a la orilla de la mar.

Lilus nunca juega en su cuarto, ese cuarto que el orden ha echado a perder. Todo esto lo mete en una bolsita que le queda sobre el ombligo. Lilus les daba a beber jarabe para la tos y les enyesaba las piernas fracturadas. Es flaca y da pasos gran- des al caminar, porque sus piernas, largas y muy separadas la una de la otra, son saltonas, se engarrotan y luego se le atoran. Ha ob- tenido importantes premios entre ellos el Cervantes en Consen- tida y chiqueada. Es mejor sentir que saber. La amiga de Lilus. Todo era muy raro. En mi maleta llevaba un libro: Estaban derribando la casa de junto y eso provocaba mucho ruido.

Nuestros toquidos apenas se oyeron. Adentro apenas se oye lo que pasa afuera. Tuve ganas de decirle: Un gran actor de reparto. Odiaba que un timbre interrumpiera sus lecturas. Toma —me dio una bol- sita con monedas para pagar las llamadas. Ya descubriste el camino de la ropa sucia. Te aconsejo que te la amarres muy bien. Tengo un libro de nudos y te recomiendo el que se llama Margarita: Todos tenemos nuestros defectillos. Me enojo por cosas que no importan.

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Zumban y zumban y no puedes pensar en otra cosa. Esta casa necesitaba un joven cerebro. Tus sesos son bienvenidos. El escupitajo y la amenaza: Buenos Ai- res, Sudamericana, , pp. Y se lo dijeron en Manchester. De ese modo recorrieron Inglaterra. De modo que la enterraron. Su pregunta no nos molesta. O de un puesto de choripanes, instalado a la entrada del ce- menterio.

An accidental inoculation with a contaminated needle from a research laboratory waste container was identified as the most probable mode of transmission. There should be controls to ensure that waste containers are sealed. Microbiota and Human Health: The human microbiota comprises all the microorganisms of our body, which can also be categorised as commensals, mutualists and pathogens according to their behaviour.

This technological breakthrough has seen a revolution in the knowledge of the microbiota composition and its implications in human health. This article details the different human bacterial ecosystems and the scientific evidence of their involvement in different diseases. The faecal microbiota transplant procedure, particularly used to treat recurrent diarrhoea caused by Clostridium difficile, and the methodological bases of the new molecular techniques used to characterise microbiota are also described.

Urinary tract infection in kidney transplant recipients. Infectious complications remain a major cause of morbidity and mortality among transplant recipients. We sought reviews the incidence and importance of urinary tract infection on graft survival, the microbiology with special emphasis on multidrug resistant microorganisms, the therapeutic management of UTI and the prophylaxis of recurrent UTI among solid organ transplant recipients, highlighting the need for prospective clinical trials to unify the clinical management in this population.

Millions of people in in rural areas and deprived tropical and subtropical regions are infected by soil-transmitted helminths: Ascaris lumbricoides, Trichuris trichiura, hookworms Ancylostoma duodenale and Necator americanus , and Strongyloides stercoralis. Large migratory flows have made their worldwide distribution easier. Besides being debilitating and producing a significant mortality, they cause high morbidity, leading to physical and intellectual impairment in millions of children who live in poverty.

Along with the use of benzimidazoles albendazole and mebendazole , large-scale international campaigns for treatment and prevention have decreased the number of affected individuals. However, re-infestations and benzimidazole-resistance are frequent, so there needs to be awareness about the importance and consequences of these neglected parasites.

Characterization of multidrug-resistant diabetic foot ulcer enterococci. Diabetes mellitus is a highly prevalent chronic progressive disease with complications that include diabetic-foot ulcers. Enterococci isolated from diabetic-foot infections were identified, evaluated by macro-restriction analysis, and screened for virulence traits and antimicrobial resistance. All isolates were considered multidrug-resistant, cytolysin and gelatinase producers, and the majority also demonstrated the ability to produce biofilms.

These results indicate the importance of enterococci in diabetic-foot infection development and persistence, especially regarding their biofilm-forming ability and resistance to clinically relevant antibiotics. Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: Opportunistic infections continue to be a cause of morbidity and mortality in HIV-infected patients. They often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an opportunistic infection.

The present article is an executive summary of the document that updates the previous recommendations on the prevention and treatment of opportunistic infections in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. The article also addresses immune reconstitution inflammatory syndrome. This document is intended for all professionals who work in clinical practice in the field of HIV infection. Despite the huge advance that antiretroviral therapy represents for the prognosis of infection by the human immunodeficiency virus HIV , opportunistic infections OIs continue to be a cause of morbidity and mortality in HIV-infected patients.

OIs often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an OI. The present article updates our previous guidelines on the prevention and treatment of various OIs in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections.

To compare the leakage rate of esophagojejunal anastomosis performed with stapler or hand sutures. In patients esophagojejunal anastomosis was performed with stapler and in with manual sutures. There were no differences between both groups with regard to age, TNM stage, operating time and hospital stay.

1. Digital Film-making Revised Edition.
2. The Legend of Wara Wa.
3. Carlism in literature.
4. Jumbo Jokes: A Collection of Elephant Jokes;
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6. DanGolfTips.
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There were 8 anastomotic leakage 4. There were no statistical differences in the rate of leakage of the esophagojejunal anastomosis performed with stapler or hand sutures, thus both techniques should be accepted as standard procedures. Galactomannan enzyme immunoassay and quantitative Real Time PCR as tools to evaluate the exposure and response in a rat model of aspergillosis after posaconazole prophylaxis. A steroid-immunosuppressed rat model of invasive pulmonary aspergillosis was use to examine the usefulness of galactomannan enzyme immunoassay GM and quantitative real time PCR RT-PCR in evaluating the association between response and exposure after a high dose of prophylactic posaconazole.

Two different strains of Aspergillus fumigatus with different in vitro posaconazole susceptibility were used. Serum concentrations demonstrated similar posaconazole exposure for all treated animals. However, response to posaconazole relied on the in vitro susceptibility of the infecting strain.

After prophylaxis, galactomannan index and fungal burden only decreased in those animals infected with the most susceptible strain. This study demonstrated that both biomarkers may be useful tools for predicting efficacy of antifungal compounds in prophylaxis. Different approaches to obtain an effective antigen to prevent AHF using complete live or inactivated virus, as well as molecular constructs, have reached diverse development stages. Buenos Aires, Argentina to manufacture the tissue culture derived Candid 1 vaccine is described.

The hospital environment is both a reservoir and source of infection for the hospital patient. Several areas around the patient should be considered: There are pathogens classically associated with each mode of transmission and environmental reservoir, but multi-resistant microorganisms have also been recently been associated with environmental acquisition.

America Sin Nombre 20

Protocols are currently available for the prevention of some classic environmental pathogens, as well as recommendations for the prevention of contamination in some procedures. However, these situations do not cover all forms of transmission, and most investigations of reservoirs or environmental sources are restricted to outbreak situations. Community resilience and Chagas disease in a rural region of Mexico. To explore the pillars of community resilience in a region where Chagas disease is endemic, with the aim of promoting participatory processes to deal with this condition from the resilience of the population.

Qualitative study using ethnographic record and six interviews of focus groups with young people, women and men. The research was carried out in a rural area of the state of Morelos, Mexico, between and We carried out educational sessions with the population in general, so that residents could identify the relationship between the vector Triatoma pallidipennis, the parasite Trypanosoma cruzi , symptoms, and preventive actions for Chagas disease.

The ethnographic record and groups were analyzed based on Taylor and Bogdan's modification, and the focus was to understand the socio-cultural meanings that guide the speeches and activities of residents in relation to the pillars of community resilience. The population felt proud of belonging to that location and three pillars of community resilience were clearly identified: Having these pillars as bases, we promoted the participation of the population concerning Chagas disease, and a Community Action Group was formed with young people, adult men and women, and social leaders.

This Group initiated actions of epidemiological and entomological surveillance in the community to deal with this problem. It is necessary to create more experiences that deepen the understanding of the pillars of community resilience, and how they contribute to enhance participation in health to deal with Chagas disease. Phlebotominae from the Colombian Andean coffee-growing region]. An updated list of phlebotomine sand flies species in coffee growing areas in the Colombian Andean region is presented.

Fifty three species were reported from 12 departments. In addition, species distribution in the region was derived from specimens obtained during intensive field work in five departments, from previously published studies and from the taxonomic revision of specimens in the entomological collection of the Programa de Estudio y Control de Enfermedades Tropicales PECET.

The list includes the genera Brumptomyia 2 species , Lutzomyia 50 species and Warileya 1 species. The updated list contains eleven new records in the region under study, including Lutzomyia panamensis , a species of medical importance not recorded previously in this zone. Eighteen of the species are considered to be anthropophilic, and many of them have been implicated in the transmission of leishmaniasis.

Malaria is a common parasitic disease diagnosed in the returned traveler. Imported malaria cases usually present with fever, headache and myalgia, but other symptoms may appear. The diagnosis should be performed as soon as possible, using thick smear or rapid diagnostic tests, and a blood smear. Treatment should be initiated urgently. In cases of severe malaria, the use of intravenous artemisinins has proved to be superior to intravenous quinine. Collection, transport and general processing of clinical specimens in Microbiology laboratory.

The interpretation and the accuracy of the microbiological results still depend to a great extent on the quality of the samples and their processing within the Microbiology laboratory. The type of specimen, the appropriate time to obtain the sample, the way of sampling, the storage and transport are critical points in the diagnostic process. The availability of new laboratory techniques for unusual pathogens, makes necessary the review and update of all the steps involved in the processing of the samples.

Nowadays, the laboratory automation and the availability of rapid techniques allow the precision and turn-around time necessary to help the clinicians in the decision making. In order to be efficient, it is very important to obtain clinical information to use the best diagnostic tools. Rapid diagnosis of sexually transmitted infections. Sexually transmitted infections STIs are responsible for an enormous burden of morbidity and mortality. Worldwide, millions of cases of STIs, such as syphilis, chlamydia, or gonorrhoea occur every year, and there is now an increase in antimicrobial resistance in pathogens, such as gonococcus.

Delay in diagnosis is one of the factors that justifies the difficulty in controlling these infections. Rapid diagnostic tests allow the introduction of aetiological treatment at the first visit, and also leads to treating symptomatic and asymptomatic patients more effectively, as well as to interrupt the epidemiological transmission chain without delay. Streptococcus agalactiae SGB es causa de infecciones severas en menores de tres meses.

Sin embargo, actualmente se han detectado cepas con sensibilidad disminuida a penicilina por lo que resulta importante realizar la vigilancia de la sensibilidad al mismo para asegurar su utilidad durante la profilaxis. In the current context of increased life expectancy and progressive aging of the population a very significant increase in the number of people with cognitive impairment and dementia is expected.

Consequently, Spain will face an enormous social and health problem in the next decades. The working group consisted of an Advisory Committee of 5 national experts and a Committee of Experts from each region made up of professionals in the field of Neurology, Geriatrics, Psychiatry, and Primary Care, as well as representatives of Family Associations of People with Alzheimer's and other dementias. The Expert Committee of each region held meetings in which the current situation of care was reviewed.

Plans available in Spain for dementia management are mostly obsolete or have not been implemented. Prevention and early detection activities are generally not carried out. There is great variability of care process that patients must follow for the diagnosis, treatment, and follow-up of the disease, and not all diagnostic test are available in different regions. In general, resources are considered scarce and unknown.

Furthermore, the study has revealed that, in Spain, the necessary conditions are in place in Spain, such as the availability and capacity of professionals involved, as well as there being the potential diagnostic and health care resources to address this room. A Nationwide Cohort Study. To determine the incidence, clinical characteristics, and management of psoriasis induced by anti-TNF therapy in a large nationwide cohort of inflammatory bowel disease patients.

Patients who developed psoriasis by anti-TNF drugs were the cases, whereas patients treated with anti-TNFs without psoriasis were controls. Cox regression analysis was performed to identify predictive factors. The incidence rate of psoriasis is 0. In the multivariate analysis, the female sex HR 1. The age at start of anti-TNF therapy, type of inflammatory bowel disease, Montreal Classification, and first anti-TNF drug used were not associated with the risk of psoriasis.

In most patients, skin lesions were controlled with topical steroids. More than half of patients switching to another anti-TNF agent had recurrence of psoriasis. In most patients, the anti-TNF therapy could be maintained. To assess the relationship between the genetic and phenotypic factors linked to the cytochrome P enzyme system and the response to the antimalarial drugs chloroquine, amodiaquine, mefloquine, and proguanil, as well as to determine how certain biological and social factors of the host influence the behavior of this enzymatic complex.

The search included only articles published in Spanish, English, and Portuguese on or before 30 June that dealt with only four antimalarial drugs: Some genetic factors linked to human cytochrome P mainly its polymorphism , as well as other biological and social factors the presence of disease itself, or of inflammation and infection, the use of antimalarials in their various combinations, and the patient's nutritional status influence the behavior of this complex enzymatic system.

It has only been in the last decade that the genetics of the cytochromes has been explored and that the mechanisms underlying some therapeutic interactions and aspects of drug metabolism have been uncovered, making it possible to characterize the biotransformation pathway of amodiaquine and chloroquine. Hopefully new research will help answer the questions that still remain, some of which pertain to the metabolism of other. La media total de encuestados fue de To describe clinical and radiological features of patients with pleural mesothelioma, according to main histological types.

Clinical records of inpatients admitted with diagnosis of pleural mesothelioma to the Instituto Nacional de Enfermedades Respiratorias in the last 11 years, were reviewed. We analyzed 85 cases confirmed by immunohistochemistry. The most frequent histological type was epithelial Comparison between epithelial and sarcomatous types showed no differences in age Our results suggest that clinical and radiological features of epithelial and sarcomatous histological types are very similar.

Additionally, we found a high frequency of epithelial mesothelioma, which contrasts with findings from other countries, suggesting that the type of asbestos or other factors involved in the development of pleural mesothelioma differ from those existing in other regions of the world. Several outbreaks of Enterovirus 68 EV-D68 have recently been reported in the USA and Canada, causing substantial hospitalisation of children with severe respiratory disease. The acute flaccid paralysis detected in the USA and Canada among children with EV-D68 infection has raised concerns about the aetiological role of this EV serotype in severe neurological disease.

In October , enteroviruses were detected in respiratory samples collected from five hospitalised patients, children and adults. Phylogenetic analysis of partial VP1 sequences confirmed that the detected enteroviruses belonged to the D68 serotype, which were also similar to strains reported in USA However, all five patients developed respiratory symptoms, but only one required ICU admission. None of the patients described had symptoms of neurological disease. Other considerations related to the detection methods used for the diagnosis of respiratory enteroviruses are also discussed.

In conclusion, additional evidence has been provided that supports the role of EV-D68 in respiratory infections in hospitalised patients. Health-care associated infections are an important public health problem worldwide. The rates of health-care associated infections are indicators of the quality of health care. The infection control activities related to prevention of transmission of hospital microorganisms can be grouped in 4 mayor areas: Hand hygiene and the correct use of gloves are the most important measures to prevent health-care associated infections and to avoid the dissemination of multidrug-resistant microorganisms.

Continuous educational activities aimed at improving adherence to hand hygiene are needed. Periodical assessment of adherence to hand hygiene recommendations with feed-back have been shown to provide sustained improvement. Several complementary activities are being evaluated, including skin decolonization prior to certain surgeries, a package of measures in patients with central venous catheters or mechanical ventilation, and universal body hygiene with chlorhexidine.

The present area of discussion concerns in which situations and in which groups would such measures be effective and efficient. High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease. This patient had a documented chronic hepatitis E with progression to cirrhosis.

An analysis was performed on patients on follow-up. Of all the patients, were classified as progressors and 46 as long-term non-progressors LTNPs. Who and how many of the potential users would be willing to pay the current or a lower price of the HIV self-test? The opinion of participants in a feasibility study of HIV self-testing in Spain. In a street-based testing program, participants in a feasibility self-test study answered the question, "What would be the maximum price you would be willing to pay for a similar test to this one so you can use it at your convenience?

In the logistic regression, paying more was associated with being tested outside the campuses and having paid or been paid for sex. In Spain, self-testing would not have an impact unless it became more affordable to potential users. The marketing authorization of a new medicinal product is the first step before being placed on the market, and includes the full investigation programme. In order to ensure their quality, safety and efficacy, medicinal products are closely regulated from their initial phases of investigation to their use in clinical practice.

For registration purposes, the results of all the clinical and preclinical studies, along with quality data and the description of the manufacturing process should be submitted. All information collected is presented for review by the competent authority. The European Medicines Agency regulates the registration of medicines in Europe, and national agencies in each EU member state are responsible for the assessment of the marketing authorisation application.

To facilitate the development of clinical programmes, there is a common framework for the evaluation of an antibacterial, which includes guidelines and an addendum, detailing the specific requirements that must be carried out in clinical trials to assess the efficacy and safety for most of the infections. Serological diagnosis of mumps: Value of the titration of specific IgG. A study was made of serum samples from 85 mumps cases confirmed by PCR in saliva and 2, controls of the general population of the Region of Madrid.

The IgM detection was positive in 21 cases sensitivity of Among 42 patients immunised with at least one dose of measles mumps, rubella vaccine IgM was detected in 4 cases. The detection of high titres of IgG against mumps could improve the IgM results in vaccinated people. Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models. We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics.

A time series study of resistant community-acquired E. A Poisson regression model was constructed to estimate the trend and seasonality of E.

A significant increasing trend in mean E. Seasonal resistance to ciprofloxacin and amoxicillin-clavulanic acid was significantly higher in autumn-winter. The general features of the epidemiology and ecology of hepatitis E virus in Spain are already known after 20 years of investigations.

Genotype 3 strains, mainly from sub-genotype 3f, circulated among swine livestock and certain wild mammals, and would be sporadically transmitted to humans through direct contact with the reservoirs or by consumption of foods derived from them. Bivalve shellfish contaminated by hepatitis E virus from sewage could also play a role in transmission. From the, approximately, cases of acute hepatitis E recorded in the international literature, males older than 40 years, suffering a mild, locally acquired disease predominate. In addition, hepatitis E might be more frequent in the North of the country than in other regions.

Although the disease does not usually have a great clinical relevance, the occasional finding of cases of fulminant hepatitis, and of ribavirin-resistant, chronic hepatitis E virus infections among the immunocompromised would recommend the surveillance of the infection by the public health authority and a better implementation of specific diagnostic procedures in clinical laboratories. A safe an easy method for building consensus HIV sequences from massively parallel sequencing data. To show how to generate a consensus sequence from the information of massive parallel sequences data obtained from routine HIV anti-retroviral resistance studies, and that may be suitable for molecular epidemiology studies.

Molecular evolutionary genetics analysis MEGA was used for phylogenetic studies. Migrants represent around one third of patients newly diagnosed with HIV in Spain and they constitute a population with higher vulnerability to its negative consequences due to the socio-cultural, economical, working, administrative and legal contexts. Migrants are diagnosed later, which worsens their individual prognosis and facilitates the maintenance of the HIV epidemic. In spite of the different barriers they experience to access healthcare in general, and HIV-related services in particular, access to antiretroviral treatment has been similar to that of the autochthonous population.

However, benefits of treatment have been not, with women in general and men from Sub-Saharan Africa exhibiting the worse response to treatment. We need to proactively promote earlier diagnosis of HIV infection, the adoption of preventive measures to avoid new infections, and to deliver accessible, adapted and high-quality health-care.

To describe linkage to care among new HIV diagnoses in Spain; and to estimate factors associated to linkage to care within three months after diagnosis. The distribution of the time elapsing between the date of HIV diagnosis and the date of first determination of CD4 considered to be the date of linkage to care was calculated among new HIV diagnoses in in the seven Autonomous Regions participating, where data on date of CD4 count was available. Factors associated to correct linkage to care were estimated using logistic regression. A total of new HIV diagnoses were included.

The main difference with respect to the previous document concerns recommended initial ART regimens, only three of which are maintained as preferential. Other differences concern the section on switching ART in patients with suppressed viral replication, which now includes new two- and three-drug regimens, and the antiretroviral drugs recommended for pregnant women and patients with tuberculosis. A recommendation has also been added for patients who present with acute HIV infection after pre-exposure prophylaxis. Protease and reverse transcriptase HIV-1 sequences provide useful information for patient clinical management, as well as information on resistance to antiretrovirals.

The aim of this study is to evaluate transmission events, transmitted drug resistance, and to georeference subtypes among newly diagnosed patients referred to our center. A study was conducted on patients diagnosed between and in Southern Spain. The results showed patients clustered into 77 different transmission events. Urban areas from Granada, and the coastal areas of Almeria and Granada showed the greatest subtype heterogeneity.

Five clusters were formed by more than 10 patients, and 15 clusters had transmitted drug resistance. The study data demonstrate how the phylogenetic characterization of transmission clusters is a powerful tool to monitor the spread of HIV, and may contribute to design correct preventive measures to minimize it. Level of impact on the public health of universal human immunodeficiency virus screening in an Emergency Department. A convenience sample was used, depending on nurse availability in the ED.

Participants signed an informed consent. Results were confirmed by conventional methods. In this update, antiretroviral therapy ART is recommended for all patients infected by type 1 human immunodeficiency virus HIV The reasons and criteria for switching ART are presented both for patients with an undetectable PVL and for patients who experience virological failure, in which case the rescue regimen should include 3 or at least 2 drugs that are fully active against HIV.

The specific criteria for ART in special situations acute infection, HIV-2 infection, pregnancy and comorbid conditions tuberculosis and other opportunistic infections, kidney disease, liver disease, and cancer are updated. Initial ART should comprise three drugs, namely, two nucleoside reverse transcriptase inhibitors NRTI and one drug from another family. The reasons and criteria for switching ART are presented both for patients with an undetectable PVL and for patients who experience virological failure, in which case the rescue regimen should include three or at least two drugs that are fully active against HIV.

This consensus document is an update of metabolic disorders and cardiovascular risk CVR guidelines for HIV-infected patients. A healthy lifestyle is recommended, no smoking and at least 30min of aerobic exercise daily. In diabetic patients the same treatment as non-HIV infected patients is recommended. In HIV-patients with diabetes or metabolic syndrome and elevated transaminases with no defined etiology, the recommended is to rule out a hepatic steatosis Recommendations for action in hormone alterations are also updated. These new guidelines update previous recommendations regarding all those metabolic disorders involved in CVR.

Hormone changes and their management and the impact of metabolic disorders on the liver are also included. The strength and grade of the recommendation varies with clinical circumstances, number of CD4 cells, comorbid conditions and prevention of transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load. Initial ART should always comprise a combination of 3 drugs, including 2 nucleoside reverse transcriptase inhibitors and a third drug from a different family non-nucleoside reverse transcriptase inhibitor, protease inhibitor, or integrase inhibitor.

This update presents the causes and criteria for switching ART in patients with undetectable plasma viral load and in cases of virological failure. An update is also provided for the specific criteria for ART in special situations acute infection, HIV-2 infection, and pregnancy and with comorbid conditions tuberculosis or other opportunistic infections, kidney disease, liver disease, and cancer.

Latin America is undergoing the epidemiologic transition that occurred earlier in developed countries, and is likely to face a gigantic epidemic of heart disease in the next few years unless urgent action is taken. The first essential component of any effective cardiovascular disease CVD control program is to establish reliable estimates of cardiovascular disease-related morbidity and mortality. However, such data from population-based studies in Latin America are still lacking.

Its population is comparable to the rest of the Peruvian urban population and closely resembles other Latin American populations in countries such as Bolivia and Ecuador. Variability of nutrients intake, lipid profile and cardiovascular mortality among geographical areas in Spain: It has often been suggested that cardiovascular mortality and their geographical heterogeneity are associated with nutrients intake patterns and also lipid profile.

The mean age of patients who died from cardiovascular causes 32 in all was The consumption of nutrients and the lipid profile by geographical area, studied by geospatial models, showed that the east and southern area of the country had the highest fat intake coupled to a high rate of unhealthy lipid profile. It was concluded that the spatial geographical analysis showed a relationship between high fat intake, unhealthy lipid profile and cardiovascular mortality in the different geographical areas, with a high variability within the country.

Seroprevalence surveys enable the level of endemicity of hepatitis A HAV to be assessed. The aim of this study was to estimate the seroprevalence SP antibody against HAV by age group, and compare it with those obtained in previous surveys. The target population consists of residents from 2 to 60 years old in the Community of Madrid. Two-stage cluster sampling was performed with stratification of first stage units. After signing the informed consent, a serum sample was extracted from each participant and sociodemographic data were collected by a questionnaire.

SP antibodies to hepatitis A is The SP increases with age. It is higher in the population from more endemic countries and people with less education and lower social class. In relation to the previous survey, SP increased in the population under 30 years old, and a decline after that age is observed. If only the autochthonous population and from countries with very low endemicity is observed, the increase is statistically significant in the years age group. Our region has a very low level of endemicity thus, following the recommendations of WHO, vaccination should be targeted at specific risk groups.

The susceptibility breakpoint tends to identify the fully susceptible population, which probably lacks any specific resistance mechanism. The analysis of MIC distributions for different homogeneous populations same species is used to define breakpoints for susceptibility. The resistance breakpoint is based on pharmacological and clinical data obtained when the corresponding antibiotic is administered with a conventional schedule. Implementing and expanding HIV testing in immigrant populations in Europe: Comparing guideline's recommendations and expert's opinions.

Immigrant populations, especially those from endemic countries, living in the European Union EU suffer a disproportionate burden of HIV, delayed diagnosis and poorer access to antiretroviral treatment. While International Organisations are developing recommendations aimed at increasing the uptake of HIV testing, the feasibility and real outcomes of these measures remain unexplored.

The aim of this review was, firstly to identify the recommendations of the main International Organisations IO on HIV testing in immigrants. Secondly, to describe the challenges for implementing and expanding HIV testing and counselling interventions targeting immigrants by interviewing key informants. The importance of HIV testing in immigrants is discussed, along with the appropriateness of universal HIV testing approaches vs most at risk targeted approaches. Also addressed is, pre- and post-HIV test counselling characteristics and community initiatives suitable to reach this population and, finally the legal issues regarding access to treatment for illegal immigrants.

The selection of multiresistant microorganisms, as a side-effect of the use of antimicrobials, together with the lack of new therapeutic drugs expected in the near future, forces to a rational use of antibiotics. Different methods have been used to study the factors that lead to its emergence and spread, such as in vitro and animal models, and resistance prevention studies mutant selection window.

Unusual presence of the immune evasion gene cluster in livestock-associated MRSA of lineage CC causing peridural and psoas abscesses in a poultry farmer. To characterize a methicillin-resistant Staphylococcus aureus MRSA isolate responsible for an aggressive infection peridural and psoas abscess secondary to haematogenous septic arthritis in a poultry farmer. Molecular characterization was performed, including spa- and multilocus sequence typing of the isolate, assessment of its resistance phenotype and detection of tetracycline resistance and of virulence and immune evasion cluster IEC genes were performed.

It would represent an evolutionary step towards LA-MRSA-CC's adaptation to human hosts, and might enhance its invasiveness and ability to be transmitted to humans. They have established a series of recommendations on the prevention of the most prevalent infections in these patients, the use of vaccines, the control measures of vascular catheter infection and prevention of infections before certain surgical procedures.

Also the criteria for management of febrile neutropenia and the use of colony-stimulating factors were revised. Finally they provide a series of recommendations for the treatment of cancer patients with severe infection. The document is completed with a series of measures for the control of hospital infection. The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus HPV infection is involved in its pathogenesis.

The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January to December The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. A high frequency of anal dysplasia and presence of HPV in cytology The Infection Committee and antimicrobial use].

The antibiotic policy is the set of strategies and activities undertaken to organize the antimicrobial treatment in the hospital, and achieve health outcomes for patients. The basic principles are to be direct evidence-based medicine, local epidemiology and freedom for prescribing physicians.

An antibiotic policy is now more necessary than ever for clinical, epidemiological and economic reasons. The Infection Committee is responsible for the antibiotics policy in hospitals. Its functions as an advisory body to the medical directorate are the analysis of the epidemiology of the infections in the center, measures for its prevention and control, improving the appropriate use of antimicrobials, training, and knowledge production. To achieve clinical, environmental and economic policy objectives of antibiotics is not easy. The agreement of hundreds of professionals for recommendations on indications, dosage and duration of antibiotic treatment, based on the best scientific evidence and local guides is complex, but it can be done.

The key to this is that the Infection Committee develops antimicrobial stewardship through a multidisciplinary team and professional leadership, and has the institutional support to ensure that the proper use of antimicrobials is a priority for the center, and therefore of each of the services involved, and that the team has the resources for antimicrobial stewardship.

Strategies for the cure of HIV infection. The disadvantages of the long-term administration of antiretroviral therapy as well as the huge number of affected persons have placed the cure of HIV as a primary goal of Public Health. HIV may persist in the organism by at least four mechanisms: Several strategies directed against these mechanisms have been developed.

With all this, a complete eradication of HIV has been achieved in a patient using the transplantation of haemopoietic stem cells that were resistant to HIV-infection, and there are examples of functional cure either spontaneously elite controllers or after antiretroviral therapy post-treatment controllers. However, no strategies have been successful in reducing the reservoir size, nor in achieving constant, uniform remissions. The failure of isolated strategies makes it likely that the combination of several of them may be the future solution.

Calaméo - America Sin Nombre 20

Microbiological diagnosis of human papilloma virus infection. Infection with human papillomavirus HPV is the leading cause of sexually transmitted infection worldwide. This virus generally causes benign lesions, such as genital warts, but persistent infection may lead to cervical cancer, anal cancer, vaginal cancer, and oropharyngeal cancer, although less frequently.