RESUMENLas enfermedades transmitidas por alimentos (ETA) y otras enfermedades entéricas infecciosas ocurren a menudo como brotes y son causa de morbilidad y mortalidad en todo el mundo. En el Perú, son un importante problema de salud pública y son causados por una gran variedad de agentes infecciosos. Para la investigación epidemiológica se utiliza una variedad de métodos de tipificación. Una de las herramientas más importantes en la subtipificación molecular de patógenos bacterianos es la técnica de la electroforesis en campo pulsado (PFGE), que es un método altamente resolutivo que permite la discriminación entre diferentes aislamientos bacterianos epidemiológicamente relacionados. El Instituto Nacional de Salud (INS) del Perú integra las redes WHO Global Foodborne Infections Network y la Red PulseNet América Latina y Caribe, con quienes comparte los perfiles genéticos de las cepas patógenas aisladas, permitiendo comparar los genotipos de cepas semejantes halladas en diferentes países y reconocer la ocurrencia de brotes epidémicos en la región, fortaleciendo el sistema de vigilancia epidemiológica regional y generando una rápida respuesta conjunta entre países. Se presenta la experiencia de los dos últimos años sobre los avances en la utilización de estas herramientas estratégicas que nos ha permitido caracterizar patrones de genotipo de principales patógenos implicados en ETA a partir de aislamientos recuperados de la red de laboratorios del Perú. Palabras clave: Vigilancia Epidemiológica; Enfermedades Transmitidas por Alimentos, Electroforesis en Gel de CampoPulsado; Brotes; Perú (fuente: DeCS BIREME). EXPERIENCES IN THE EPIDEMIOLOGICAL SURVEILLANCE OF FOODBORNE PATHOGENS BY PULSED FIELD GEL ELECTROPHORESIS (PFGE) IN PERU ABSTRACTFoodborne diseases and other enteric infections often occur as outbreaks and cause morbidity and mortality all over the world. In Perú, they represent a serious public health problem, and are caused by a great variety of infectious agents. For epidemiological research, a wide array of typification methods are used. One of the most important tools for the molecular subtyping of bacterial pathogens is the Pulsed Field Gel Electrophoresis (PFGE), which is a highly precise method that allows the discrimination between different bacterial isolates which are epidemiologically related. The Instituto Nacional de Salud del Perú (INS) is part of the WHO Global Foodborne Infections Network (WHO-GFN) and of the PulseNet Latin American and Caribbean Net (PN-AL & C), with whom it shares the genetic profiles of the isolated pathogenic strains, so that it is possible to compare de genotypes of similar strains found in different countries and to identify the occurrence of epidemic outbreaks in the region, strengthening the regional system of epidemiological surveillance and generating a rapid, coordinated response between the countries. We present the two last years´ experience including the advances in the use of these strategic tools that have allowed us to characterize genotype patterns implicate...

RESUMENAmelogénesis imperfecta (AI) describe defectos en el esmalte derivados de mutaciones genéticas que se manifiestan en anormalidades estructurales en la dentición temporal y permanente. A pesar del amplio conocimiento que aumenta día tras día a nivel mundial sobre las mutaciones genéticas asociadas a la AI, existe poca investigación en su efecto sobre la calidad de vida de los pacientes. El objetivo de este estudio es determinar, en un cohorte de pacientes costarricenses afectados por esta patología, la percepción emocional sobre su calidad de vida que esta condición ha generado. Miembros de varias familias portadoras de AI se entrevistaron y sus experiencias sirvieron de base para desarrollar un instrumento (cuestionario), el cual se utilizó para evaluar el impacto de este padecimiento, en su calidad de vida. Se incluyeron 18 personas afectadas de AI, provenientes de 17 familias. Los resultados más relevantes revelaron que un 100 % de los participantes han sufrido burlas y rechazo; 77.8 % se mostraron preocupados por la herencia a sus hijos; 66.7 % les preocupa el costo del tratamiento; 89 % le atribuyen alta importancia a sus dientes, siendo no estadísticamente significativo por sexo (p = 0.732). El estudio indica que los profesionales en Odontología deben entender la AI no solo como un defecto en la estructura del esmalte dental, que demanda un manejo clínico especializado, sino como una condición que causa impacto negativo en la calidad de vida de quienes la padecen. Esto se debe considerar en la comunicación e interacción del profesional, los sujetos afectados y sus familias. PALABRAS CLAVEAmelogénesis imperfecta, Percepción emocional, Autoestima, Familias costarricenses. ODOVTOS-International Journal of Dental SciencesABSTRACT "Amelogenesis imperfecta" (AI) (prevalence up to 1 in 700) describes largely Mendelian enamel defects arising from gene mutations that present as structural abnormalities of the temporary and permanent teeth as a result of defective enamel formation. AI has a wide range of clinical presentations and phenotypes and affects both sexes. Despite increasing knowledge of the genetic mutations underlying AI there has been little research focussing on the effect of AI on the quality of life of AI patients. This study aimed to investigate the effects of AI on patient quality of life in a Costa Rican AI cohort. Affected family members were interviewed and their experiences used to develop an instrument (questionnaire) that was subsequently used to evaluate the impact of AI on their quality of life. 18 AI patients from 17 families were included in the study. Our findings showed that 100% had been teased and had suffered social rejection; 77.8% were concerned about their children´s inheritance and 66.7 % were concerned by the cost of treatment; 89% placed a high importance on their teeth. Results were not statistically significant when sorted by sex (p = 0.732). The results of this study indicate that dental professionals need to understand AI not only as defective tooth enamel structure d...

Background: Salmonellosis is a universal zoonosis, causing frequent outbreaks of foodborne illness; Salmonella enterica is the species with the highest prevalence, a progressive increase in its resistance to antimicrobials is described. Aim: To determine the frequency of serovars and antimicrobial resistance patterns in S. enterica isolates submitted to the National Institute of Health, Lima, Peru. Methods: This is a cross-sectional study. All strains referred as part of national laboratory-based surveillance between 2012 and 2015 were included in the study. Strains were confirmed by conventional tests and serotyped by the Kauffmann-White scheme; antimicrobial susceptibility and confirmation of the BLEE phenotype was performed according to the method of Kirby-Bauer and Jarlier's method. Results: A total of 540 strains of S. enterica were included in the study, where 96% (520/540) corresponded to human strains and 4% (20/540) to non-human strains (birds, food and environmental). In human samples, the most frequent serovar was S. Infantis (57%), followed by S. Enteritidis (27%) and S. Typhimurium (6%). High resistance to nitrofurantoin (74%), nalidixic acid (64%), ciprofloxacin (63%), tetracycline (63%), ampicillin (56%), sulfamethoxazole-trimethoprim (56%), cefotaxime (53%) and chloramphenicol (50%) was detected. In non-human samples, the most frequent serotype was S. Infantis (45%), followed by S. Typhimurium (40%) and S. Enteritidis (10%); a high resistance to nalidixic acid (55%), ciprofloxacin (45%), sulfamethoxazole-trimethoprim (40%), nitrofurantoin (40%), tetracycline (40%) was found. 65% of all strains had resistance to more than two antibiotics, 43,3% were ESBL producers and 99% of these had resistance between six and eight antibiotics. Conclusions: We found a high frequency of S. Infantis producing ESBL with multi-resistance to the antimicrobials in human and nonhuman samples received by the National Institute of Health.

Estrategias docentes que mediaron en el aprendizaje de la lectoescritura en estudiantes con discapacidad múltiple del Centro de Educación Especial Carlos Luis Valle Masís, Costa Rica ResumenEste artículo es el producto de un Seminario de Graduación para optar por la Licenciatura en Educación Especial con énfasis en Discapacidad Múltiple de la Universidad de Costa Rica, cuyo objetivo principal fue analizar las estrategias docentes utilizadas en la enseñanza de la lectoescritura de estudiantes con discapacidad múltiple.La investigación se orientó en una perspectiva cualitativa con un diseño fenomenológico. Se trabajó con ocho docentes del Centro de Educación Especial Carlos Luis Valle Masis, en Costa Rica, que a lo largo de sus carreras profesionales, habían enseñado a leer y escribir con éxito a estudiantes con esta condición. El análisis de la información se realizó mediante la triangulación al comparar los datos obtenidos de distintas fuentes (ocho docentes), mediante dos técnicas (entrevista y autoreporte), y basadas en la secuencia de acciones a seguir en el análisis fenomenológico de los datos obtenidos en una entrevista propuesta por Mari, Bo y Climent (2010).Los resultados muestran que para que el estudiantado con discapacidad múltiple pueda acceder al aprendizaje de la lectoescritura, es necesario la presencia de tres condiciones: las características del profesorado, las particularidades del estudiantado y el sistema de apoyos. En lo que respecta a las estrategias, es decir, las acciones que se realizan para el alcance de objetivos del proceso educativo, el profesorado destaca tres aspectos básicos: un diagnóstico exhaustivo, la selección del método a partir de las características del estudiantado y la adaptación de la técnica al sistema de comunicación particular.Palabras clave: discapacidad múltiple, lectura, escritura, enseñanza, aprendizaje, comunicación alternativa. AbstractThis article is the result of a Graduation Seminar to obtain the degree of bachelor in Special Education, focused on Multiple Disabilities of the University of Costa Rica which main objective was to analyze the teaching strategies of literacy acquisition of multi disabled students.The research was oriented toward a qualitative perspective with a phenomenological design. It was held with the cooperation of eight teachers of the Special Education Center Carlos Luis Valle Masís, in Costa Rica, who along their careers had successfully instructed students, under this condition, in reading and writing. The analysis of the information was triangulated by comparing the data obtained from different sources (eight teachers), by means of two research techniques (interview and self-report), and based on the sequence of actions to be followed in the phenomenological analysis of the data collected in an interview proposed by Mari, Bo and Climent (2010).The results show that in order for the students with multiple disabilities to have access to literacy acquisition, it is necessary to meet three conditions: the characteristics of the teaching bo...

Foodborne diseases and other enteric infections often occur as outbreaks and cause morbidity and mortality all over the world. In Perú, they represent a serious public health problem, and are caused by a great variety of infectious agents. For epidemiological research, a wide array of typification methods are used. One of the most important tools for the molecular subtyping of bacterial pathogens is the Pulsed Field Gel Electrophoresis (PFGE), which is a highly precise method that allows the discrimination between different bacterial isolates which are epidemiologically related. The Instituto Nacional de Salud del Perú (INS) is part of the WHO Global Foodborne Infections Network (WHO-GFN) and of the PulseNet Latin American and Caribbean Net (PN-AL & C), with whom it shares the genetic profiles of the isolated pathogenic strains, so that it is possible to compare de genotypes of similar strains found in different countries and to identify the occurrence of epidemic outbreaks in the region, strengthening the regional system of epidemiological surveillance and generating a rapid, coordinated response between the countries. We present the two last years´ experience including the advances in the use of these strategic tools that have allowed us to characterize genotype patterns implicated in foodborne diseases from isolates recovered in the laboratory network of Peru.