Syndromic surveillance at a long term shelter for persons displaced by hurricanes Katrina and Rita conducted by the San Antonio Metropolitan Health District

Background. Beginning September 2, 2005, San Antonio area shelters received approximately 12,700 evacuees from Hurricane Katrina. Two weeks later, another 12,000 evacuees from Hurricane Rita arrived. By mid-October, 2005, the in-shelter population was 1,000 people. There was concern regarding the potential for spread of infectious diseases in the shelter. San Antonio Metropolitan Health District (SAMHD) established a syndromic surveillance system with Comprehensive Health Services (CHS) who provided on-site health care. CHS was in daily contact with SAMHD to report symptoms of concern until the shelter closed December 23, 2005. ^ Study type. The objective of this study was to assess the methods used and describe the practical considerations involved in establishing and managing a syndromic surveillance system, as established by the SAMHD in the long-term shelter clinic maintained by CHS for the hurricane evacuees. ^ Methods. Information and descriptive data used in this study was collected from multiple sources, primarily from the San Antonio Metropolitan Health District’s 2006 Report on Syndromic Surveillance of a Long-Term Shelter by Hausler & Rohr-Allegrini. SAMHD and CHS staff ensured that each clinic visit was recorded by date, demographic information, chief complaint and medical disposition. Logs were obtained daily and subsequently entered into a Microsoft Access database and analyzed in Excel. ^ Results. During a nine week period, 4,913 clinic visits were recorded, reviewed and later analyzed. Repeat visits comprised 93.0% of encounters. Chronic illnesses contributed to 21.7% of the visits. Approximately 54.0% were acute care encounters. Of all encounters, 17.3% had infectious disease potential as primarily gastrointestinal and respiratory syndromes. Evacuees accounted for 86% and staff 14% of all visits to the shelter clinic. There were 782 unduplicated individuals who sought services at the clinic, comprised of 63% (496) evacuees and 36% (278) staff members. Staff were more likely to frequent the clinic but for fewer visits each. ^ Conclusion. The presence of health care services and syndromic surveillance provided the opportunity to recognize, document and intervene in any disease outbreak at this long-term shelter. Constant vigilance allowed SAMHD to inform and reassure concerned people living and working in the shelter and living outside the shelter.^

Usage of Urinary Antigen Test for Legionella on diagnosed community-acquired pneumonia in San Antonio hospitals

Purpose. To evaluate the use of the Legionella Urine Antigen Test as a cost effective method for diagnosing Legionnaires’ disease in five San Antonio Hospitals from January 2007 to December 2009. ^ Methods. The data reported by five San Antonio hospitals to the San Antonio Metropolitan Health District during a 3-year retrospective study (January 2007 to December 2009) were evaluated for the frequency of non-specific pneumonia infections, the number of Legionella Urine Antigen Tests performed, and the percentage of positive cases of Legionnaires’ disease diagnosed by the Legionella Urine Antigen Test.^ Results. There were a total of 7,087 cases of non-specific pneumonias reported across the five San Antonio hospitals studied from 2007 to 2009. A total of 5,371 Legionella Urine Antigen Tests were performed from January, 2007 to December, 2009 across the five San Antonio hospitals in the study. A total of 38 positive cases of Legionnaires’ disease were identified by the use of Legionella Urinary Antigen Test from 2007-2009.^ Conclusions. In spite of the limitations of this study in obtaining sufficient relevant data to evaluate the cost effectiveness of Legionella Urinary Antigen Test in diagnosing Legionnaires’ disease, the Legionella Urinary Antigen Test is simple, accurate, faster, as results can be obtained within minutes to hours; and convenient because it can be performed in emergency room department to any patient who presents with the clinical signs or symptoms of pneumonia. Over the long run, it remains to be shown if this test may decrease mortality, lower total medical costs by decreasing the number of broad-spectrum antibiotics prescribed, shorten patient wait time/hospital stay, and decrease the need for unnecessary ancillary testing, and improve overall patient outcomes.^

The prevalence of periodontal disease in Mexican American vs European American elderly in three distinct socio-economic communities in San Antonio, Texas

Purpose of the Study: This study evaluated the prevalence of periodontal disease between Mexican American elderly and European American elderly residing in three socio-economically distinct neighborhoods in San Antonio, Texas. ^ Study Group: Subjects for the original protocol were participants of the Oral Health: San Antonio Longitudinal Study of Aging (OH: SALSA), which began with National Institutes of Health (NIH) funding in 1993 (M.J. Saunders, PI). The cohort in the study was the individuals who had been enrolled in Phases I and III of the San Antonio Heart Study (SAHS). This SAHS/SALSA sample is a community-based probability sample of Mexican American and European American residents from three socio-economically distinct San Antonio neighborhoods: low-income barrio, middle-income transitional, and upper-income suburban. The OH: SALSA cohort was established between July 1993 and May 1998 by sampling two subsets of the San Antonio Heart Study (SAHS) cohort. These subsets included the San Antonio Longitudinal Study of Aging (SALSA) cohort, comprised of the oldest members of the SAHS (age 65+ yrs. old), and a younger set of controls (age 35-64 yrs. old) sampled from the remainder of the SAHS cohort. ^ Methods: The study used simple descriptive statistics to describe the sociodemographic characteristics and periodontal disease indicators of the OH: SALSA participants. Means and standard deviations were used to summarize continuous measures. Proportions were used to summarize categorical measures. Simple m x n chi square statistics was used to compare ethnic differences. A multivariable ordered logit regression was used to estimate the prevalence of periodontal disease and test ethnic group and neighborhood differences in the prevalence of periodontal disease. A multivariable model adjustment for socio-economic status (income and education), gender, and age (treated as confounders) was applied. ^ Summary: In the unadjusted and adjusted model, Mexican American elderly demonstrated the greatest prevalence for periodontitis, p < 0.05. Mexican American elderly in barrio neighborhoods demonstrated the greatest prevalence for severe periodontitis, with unadjusted prevalence rates of 31.7%, 22.3%, and 22.4% for Mexican American elderly barrio, transitional, and suburban neighborhoods, respectively. Also, Mexican American elderly had adjusted prevalence rates of 29.4%, 23.7%, and 20.4% for barrio, transitional, and suburban neighborhoods, respectively. ^ Conclusion: This study indicates that the prevalence of periodontal disease is an important oral health issue among the Mexican American elderly. The results suggest that the socioeconomic status of the residential neighborhood increased the risk for severe periodontal disease among the Mexican American elderly when compared to European American elderly. A viable approach to recognizing oral health disparities in our growing population of Mexican American elderly is imperative for the provision of special care programs that will help increase the quality of care in this minority population.^

Fatty acids and intact polar lipids of laminated microbial sediments from St. Peter Ording, German Wadden Sea

Hidden for the untrained eye through a thin layer of sand, laminated microbial sediments occur in supratidal beaches along the North Sea coast. The inhabiting microbial communities organize themselves in response to vertical gradients of light, oxygen or sulfur compounds. We performed a fine-scale investigation on the vertical zonation of the microbial communities using a lipid biomarker approach, and assessed the biogeochemical processes using a combination of microsensor measurements and a 13C-labeling experiment. Lipid biomarker fingerprinting showed the overarching importance of cyanobacteria and diatoms in these systems, and heterocyst glycolipids revealed the presence of diazotrophic cyanobacteria even in 9 to 20 mm depth. High abundance of ornithine lipids (OL) throughout the system may derive from sulfate reducing bacteria, while a characteristic OL profile between 5 and 8 mm may indicate presence of purple non-sulfur bacteria. The fate of 13C-labeled bicarbonate was followed by experimentally investigating the uptake into microbial lipids, revealing an overarching importance of cyanobacteria for carbon fixation. However, in deeper layers, uptake into purple sulfur bacteria was evident, and a close microbial coupling could be shown by uptake of label into lipids of sulfate reducing bacteria in the deepest layer. Microsensor measurements in sediment cores collected at a later time point revealed the same general pattern as the biomarker analysis and the labeling experiments. Oxygen and pH-microsensor profiles showed active photosynthesis in the top layer. The sulfide that diffuses from deeper down and decreases just below the layer of active oxygenic photosynthesis indicates the presence of sulfur bacteria, like anoxygenic phototrophs that use sulfide instead of water for photosynthesis.

Reflexiones sobre el proceso creador en Antonio Di Benedetto

Este trabajo se propone iluminar, a partir de los datos aportados en diversas entrevistas, algunos aspectos del proceso creador de Antonio Di Benedetto para contribuir a un mayor conocimiento de su poética, especialmente de las reflexiones sobre la creación. Se parte del núcleo autobiográfico para ahondar en los inicios de su actividad de escritor: los años de aprendizaje, la imitación de su madre, una innata narradora, y las influencias de las lecturas de los grandes maestros narradores. A continuación se profundiza en la importancia del silencio en la obra de Di Benedetto, tanto en su función temática como estilística, ya que éste es el núcleo de un decir riguroso, esencial, donde lo no dicho adquiere valor y peso en sí mismo. Finalmente se estudia la estrecha vinculación de sus obras con el particular momento vital, así como su insistente búsqueda de perfección, que lo llevan a explorar las posibilidades expresivas y comunicativas de las diversas modalidades de la ficción, como la narrativa experimental y la fantástica.

Elementos de la vanguardia surrealista en la obra de Antonio Di Benedetto

La complejidad de la literatura del escritor mendocino Antonio Di Benedetto, autor de novelas fundamentales en la literatura latinoamericana como Zama y El silenciero, es abordada, mediante el estudio comparativo, a través de los documentos producidos por el surrealismo. Del vínculo de los relatos del narrador cuyano con la vanguardia se desprende un análisis crítico de la realidad en la obra literaria, como así también de los límites de los postulados del movimiento de 1924 tomados como insumos en la obra de Di Benedetto. Por otro lado, se han estudiado las propuestas del poeta vinculado al surrealismo Antonin Artaud, para relacionarlas con los quiebres discursivos que se repiten a lo largo de la narrativa dibenedettiana.

La hispanidad y lo nacional en el pensamiento de Pablo Antonio Cuadra (Nicaragua, 1912, 2001)

Fil: Sarmiento, Alicia Inés. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras

Néspolo, Jimena. Ejercicios de pudor : sujeto y escritura en la narrativa de Antonio Di Benedetto. Buenos Aires, Adriana Hidalgo,2004, 390 p.

Fil: Niemetz, Diego. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras

Kafka en la obra de Antonio di Benedetto

La influencia de Kafka en los escritores argentinos del siglo XX es bien conocida y ha sido extenspmente estudiada especialmente en los autores centrales del canon literario, como son Borges y Sábato. Sin embargo. otros autores en los que se manifiesta dicha influencia son sistemáticamente excluidos de los estudios. Entre ellos se encuentra Antonio Di Benedetto. En el presente trabajo se analiza la presencia de una serie de motivos, caracterizados por la crítica como típicamente kajkianos en la novela más reconocida del mendocino: Zama. De esta manera se apunta a completar el panorama de la recepción de Kafka en la Argentina haciendo hincapié en la experiencia regional, que por su contexto especifico de producción es mucho más afin a la de Kafka que la de los escritores canónicos. Por otra parte, la detección y análisis de esos motivos constituyen una poderosa herramienta para el estudio de la obra dibenedettiana. pues no se trata meramente de la repetición de tópicos consagrados. sino de la manifestación de una experiencia muy personal del mundo.

Annabella (El pentágono) de Antonio Di Benedetto : aproximaciones a una poética de la ficción

A partir de la idea de que las obras literarias pueden instaurar, dentro de su propia estructura, claros y profundos planteos sobre conceptos como realidad, ficción, y verdad ficcional. se indaga la poética de la ficción que de modo implícito se inscribe en la obra de Antonio Di Benedetto, más precisamente en El pentágono; novela en forma de cuentos, texto de corte experimental publicado por vez primera en 1955, en el que se presta especial atención a las relaciones entre realidad y ficción, a la posibilidad de la ficción de instituir mundos diversos y a los límites y juegos especulares entre ambos dominios. Por otra parte, se observa, en la peculiar construcción de esta novela en forma de cuentos, una estructura que en sí misma es signo del concepto de ficción que domina la obra.