Una encuesta del European Board of Ophthalmology (EBO) reveló diferencias significativas en la formación quirúrgica de los residentes en oftalmología en Europa, entre ellos una disparidad entre los sexos y variaciones en la experiencia en cirugía de catarata (CC). Este estudio es sobre la muestra española de la encuesta y su objetivo es presentar y analizar las peculiaridades de la formación oftalmológica en España dentro del contexto europeo, así como discutir formas de armonizar y mejorar esa formación en toda la UE. Analizamos datos de participantes españoles en los exámenes del EBO, definiendo subgrupos por Comunidades Autónomas. El cuaestionario fue respondido por 93 de 135 encuestados (68,9%). El 60,2% había hecho el examen EBO entre 2021-2022, siendo la mayoría mujeres (65,59%) con edad media de 31 años. El 91,4% eran diestros, procedentes de 13 de las 17 comunidades autónomas españolas, aunque mayoritariamente de la Comunidad Valenciana, Comunidad de Madrid y Cataluña. El 16,1%, el 3,2% y el 8,7% de los encuestados dijeron haber realizado 10 o más sesiones de formación sobre ojos de animales, ojos sintéticos y con simulador de realidad virtual, respectivamente. Esta formación se correlacionó con una mayor autoconfianza en la solución de rotura capsular posterior durante la cirugía (p = 0,025). Todos los encuestados afirmaron haber realizado ya etapas de la CC. El número medio de operaciones reportado fue de 181,6 con disparidades regionales. Se observa una diferencia significativa entre los sexos en contra de las mujeres (-28,3%, p = 0,03). Los oftalmólogos en España, mucho más que en otros países europeos, tienen mayores oportunidades de formación quirúrgica con un número de cirugías durante la residencia que casi triplica la de los otros. Las mujeres españolas refieren, al igual que sus colegas de otros países de la UE, estar en desventaja en oportunidades de aprendizaje de la cirugía de cataratas. La Simulation Based Medical Education (SBME) permite responder al déficit de adiestramiento y complementa la formación sobre pacientes. Aunque demostramos correlación significativa entre el número de procedimientos realizados y la confianza en sí mismo para operar casos simples, la SBME sería una herramienta complementaria en la autoconfianza ante el enfoque de complicaciones como la rotura capsular. España adopta masivamente el modelo que hemos llamado de «cirugía para todos», a pesar de la subrepresentación de las mujeres en este ámbito, subrayando una necesidad de cambio cultural que la SBME podría facilitar. A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe, including a disparity between the sexes and a variation in the experience on cataract surgery (CC) between them. This study is about the Spanish sub-cohort of the survey, and its objective is to present and analyse the peculiarities of ophthalmology training in Spain within the European context, as well as discussing ways to harmonise and improve that training throughout the EU. We analyse data of the Spanish participants in the EBO exams, defining subgroups by the Autonomous Communities existing in Spain. 93 of 135 requested participants (68.9%) responded. A 60.2% passed the EBO exam between 2021-2022, being mostly women (65.59%) aged 31 years old on average. The 91.4% were right-handed, coming from 13 of the 17 Spanish autonomous communities, although mostly from the Community of Valencia, Madrid and Catalonia. Respectively, 16.1%, 3.2% and 8.7% of the respondents said they have completed 10 or more training sessions on animal eyes, synthetic eyes and through the virtual reality simulator. This training was correlated with greater self-confidence in the management of a posterior capsular tear during surgery (p 0.025). All respondents manifested to have already performed stages of the CC. The average number of operations reported was 181.6 with regional disparities. A significant difference is observed between the sexes against women (-28.3%, p 0.03). Ophthalmologists in Spain, much more than other European countries, have greater opportunities for surgical training, with surgical procedures during the residency, that nearly triples those made by the others. Spanish women refer, like their European colleagues, to be in disadvantage in learning opportunities about cataract surgery. The Simulation Based Medical Education (SBME) allows to respond to the training deficit and complements the training on the patient. Although we demonstrate a significant correlation between the number of procedures carried out and self-confidence to operate simple cases, the SBME would be a complementary tool in self-confidence in front of a complication like capsular rupture. Spain massively adopts the model named by us "surgery for all", despite the underrepresentation of women in this area, emphasising a need for cultural change that the SBME could facilitate.
Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients.We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment.Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7 mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (p = 0.64), and (OR: 1.69, 95%CI 0.47-6.02).The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.
The rapid diagnostic capacities of laboratories in Mali have been an essential element in the response to COVID-19. The University Clinical Research center (UCRC) diagnosed the first cases of Mali COVID-19.The objective was to describe the contribution of the UCRC in the diagnosis of Covid-19 and to clinically and epidemiologically characterize the patients tested in the UCRC laboratory.A cross-sectional study was conducted during eight months of intense activity. The samples were sent from the National Institute of Public Health (INSP) to the UCRC.The UCRC tested 12,406 contacts and suspected samples and confirmed the diagnosis in 1091 patients, or 9%. The most common symptoms were cough (48.78%), headache (34.14%), fatigue / weakness (34.14%), while (33.33%) of the patients were asymptomatic. The sample positivity rate among new cases decreased from May to September 2020, despite almost 230% of the number of samples tested.The laboratory played a major role in the response and there may be a low transmission of the virus in the Malian community.Les capacités de diagnostic rapide des laboratoires au Mali ont été un élément essentiel dans la riposte contre la COVID-19. Le Centre Universitaire de Recherche Clinique (UCRC)a diagnostiqué les premiers cas du Mali.Etait de décrire l'apport de l'UCRC dans le diagnostic de la Covid-19 et de caractériser cliniquement et épidémiologiquement les patients testés au laboratoire de l'UCRC.Une étude transversale a été conduite pendant huit mois d'activité intense. Les échantillons ont été envoyés de l'Institut National de Santé Publique (INSP) à l'UCRC.L'UCRC a testé 12 406 échantillons contacts et suspects et a confirmé le diagnostic chez 1091 patients soit 9%. Les symptômes les plus rencontrés ont été la toux (48,78%), les maux de tête (34,14%), la fatigue/faiblesse (34,14%), tandis que (33,33%) des patients étaient asymptomatiques. Le taux de positivité des échantillons a diminué entre mai et août et avec une légère diminution en septembre 2020,avec près de 230% du nombre d'échantillons testés.Le laboratoire a joué un grand rôle dans la riposte et il y'aurait une faible transmission du virus dans la communauté Malienne.
People with Latent tuberculosis infection (LTBI) remain the reservoir of tuberculosis. One-third to 1/4 of the world's population is infected. Its reactivation is due to factors that disrupt the host's immune response. Recent findings showed that
Tuberculosis (TB) is caused by Mycobacterium tuberculosis complex (MTBC), however, the distribution and frequency of MTBC lineages and sublineages vary in different parts of the globe. Mycobacterium africanum , a member of MTBC is responsible for a large percentage of TB cases in West Africa, however, it is rarely identified outside of this part of the World. Whether or not differential HLA polymorphism (an important host factor) is contributing to the geographic restriction of M. africanum to West Africa is unknown. Here, we conducted a cohort study in Mali of newly diagnosed individuals with active pulmonary TB and normal healthy controls. The MTBC isolates were spoligotyped to determine the TB study groups ( M. tuberculosis sensu stricto LAM10 and M. africanum ), and HLA typing was performed on peripheral blood. Unlike previous reports on other populations, we found that HLA class‐I alleles were significantly associated with active TB disease in this population. HLA‐B alleles ( B*07:02 , B*08:01 , B*14:02 , B*15:03 , B*15:10 , B*18:01 , B*42:01 , B*42:02 , B*51:01 and B*81:01 ) were significantly associated with M. africanum (40%‐45%) and M. tuberculosis (75%) compared with healthy controls. Many HLA‐A alleles ( A*02:05 , A*34:02 , A*66:01 and A*68:02 ) were also associated with both TB groups (65%‐70%). However, many class II HLA‐DR variants were found to be associated with M. tuberculosis but not M. africanum with the exception of the DRB1*03:01 , which was associated with both groups. The differential HLA distribution observed in this study might be at least partially responsible for the geographical restriction of M. africanum infections to West Africa.
A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe, including a disparity between the sexes and a variation in the experience on cataract surgery (CC) between them. This study is about the Spanish sub-cohort of the survey, and its objective is to present and analyse the peculiarities of ophthalmology training in Spain within the European context, as well as discussing ways to harmonise and improve that training throughout the EU. We analyse data of the Spanish participants in the EBO exams, defining subgroups by the Autonomous Communities existing in Spain. 93 of 135 requested participants (68.9%) responded. A 60.2% passed the EBO exam between 2021-2022, being mostly women (65.59%) aged 31 years old on average. The 91.4% were right-handed, coming from 13 of the 17 Spanish autonomous communities, although mostly from the Community of Valencia, Madrid and Catalonia. Respectively, 16.1%, 3.2% and 8.7% of the respondents said they have completed 10 or more training sessions on animal eyes, synthetic eyes and through the virtual reality simulator. This training was correlated with greater self-confidence in the management of a posterior capsular tear during surgery (p .025). All respondents manifested to have already performed stages of the CC. The average number of operations reported was 181.6 with regional disparities. A significant difference is observed between the sexes against women (−28.3%, p 0.03). Ophthalmologists in Spain, much more than other European countries, have greater opportunities for surgical training, with surgical procedures during the residency, that nearly triples those made by the others. Spanish women refer, like their European colleagues, to be in disadvantage in learning opportunities about cataract surgery. The Simulation Based Medical Education (SBME) allows to respond to the training deficit and complements the training on the patient. Although we demonstrate a significant correlation between the number of procedures carried out and self-confidence to operate simple cases, the SBME would be a complementary tool in self-confidence in front of a complication like capsular rupture. Spain massively adopts the model named by us "surgery for all", despite the underrepresentation of women in this area, emphasising a need for cultural change that the SBME could facilitate. Una encuesta del European Board of Ophthalmology (EBO) reveló diferencias significativas en la formación quirúrgica de los residentes en oftalmología en Europa, incluyendo una disparidad entre los sexos y variaciones en la experiencia en cirugía de catarata (CC) entre ellos. Este estudio es sobre la muestra española de la encuesta, su objetivo es presentar y analizar las peculiaridades de la formación oftalmológica en España dentro del contexto europeo, así como discutir formas de armonizar y mejorar esa formación en toda UE. Analizamos datos de participantes españoles en los exámenes del EBO, definiendo subgrupos por Comunidades Autónomas. 93 de 135 encuestados (68,9%) respondieron el cuestionario. El 60,2% había hecho el examen EBO entre 2021-2022, siendo la mayoría mujeres (65,59%) con edad media de 31 años. El 91,4% eran diestros, procedentes de 13 de las 17 comunidades autónomas españolas, aunque mayoritariamente de la Comunidad Valenciana, Comunidad de Madrid y Cataluña. El 16,1%, el 3,2% y el 8,7% de los encuestados dijeron haber realizado 10 o más sesiones de formación sobre ojos de animales, ojos sintéticos y con simulador de realidad virtual respectivamente. Esta formación se correlacionó con una mayor autoconfianza en la solución de rotura capsular posterior durante la cirugía (p .025). Todos los encuestados afirmaron haber realizado ya etapas de la CC. El número medio de operaciones reportado fue de 181,6 con disparidades regionales. Se observa una diferencia significativa entre los sexos en contra de las mujeres (-28.3%, p 0.03). Los oftalmólogos en España, mucho más que en otros países europeos, tienen mayores oportunidades de formación quirúrgica con un número de cirugías durante la residencia que casi triplica la de los otros. Las mujeres españolas refieren, al igual que sus colegas de otros países de la UE, estar en desventaja en oportunidades de aprendizaje de la cirugía de cataratas. La Simulation Based Medical Education (SBME) permite responder al déficit de formación y complementa la formación sobre pacientes. Aunque demostramos correlación significativa entre el número de procedimientos realizados y la confianza en sí mismo para operar casos simples, la SBME sería una herramienta complementaria en la autoconfianza ante el enfoque de complicaciones como la rotura capsular. España adopta masivamente el modelo que hemos llamado de "cirugía para todos", a pesar de la subrepresentación de las mujeres en este ámbito, subrayando una necesidad de cambio cultural que la SBME podría facilitar.
Background: Despite recent advances in the development of more sensitive technologies for the diagnosis of tuberculosis (TB), in resource-limited settings, the diagnosis continues to rely on sputum smear microscopy. This is because smear microscopy is simple, cost-efficient and the most accessible tool for the diagnosis of TB. Our study evaluated the performance of light-emitting diode fluorescence microscopy (LED-FM) using auramine/rhodamine (auramine) and the fluorescein di-acetate (FDA) vital stain in the diagnostic of pulmonary TB in Bamako, Mali. Methods: Sputum smear microscopy was conducted using the FDA and auramine/rhodamine staining procedures on fresh samples using LED-FM to evaluate the Mycobacterium TB (MTB) metabolic activity and to predict contagiousness. Mycobacterial culture assay was utilized as a gold standard method. Results: Out of 1401 TB suspected patients, 1354 (96.65%) were retrieved from database, which were MTB complex culture positive, and 47 (3.40%) were culture negative (no mycobacterial growth observed). Out of the 1354 included patients, 1343 (95.86%), were acid-fast bacillus (AFB) positive after direct FDA staining, 1352 (96.50%) AFB positive after direct Auramine, and 1354 (96.65%) AFB positive with indirect auramine after digestion and centrifugation. Overall, the FDA staining method has a sensitivity of 98.82%, while the sensitivity of Auramine with direct observation was 99.48%, and 99.56% with the indirect examination. Conclusion: This study showed that, using fresh sputum both auramine/rhodamine and FDA are highly sensitive methods in diagnosing pulmonary TB and could be easily used in countries with limited resource settings.
