Presence of the Eucalyptus snout beetle in Ecuador and potential invasion risk in South America.

Eucalyptus snout beetles are a complex of at least eight cryptic species (Curculionidae: Gonipterus scutellatus complex), native to mainland Australia and Tasmania, that defoliate Eucalyptus trees and are considered important pests. Since the 19th century, three species of the complex have been introduced to other continents. Here, we document the presence of Eucalyptus snout beetles in Ecuador. We used DNA data for species identification and unambiguously demonstrated that the Ecuadorian specimens belong to the species Gonipterus platensis, which has low genetic diversity compared with other species in the complex. We analyzed G. platensis' potential distribution in South America with ecological niche models and found several areas of high to intermediate climatic suitability, even in countries where the pest has not been registered, like Peru and Bolivia. Accurate identification of species in the G. scutellatus complex and understanding of their potential distribution are essential tools for improved management and prevention tactics.

Los gorgojos del eucalipto son un complejo de al menos ocho especies crípticas (Curculionidae: complejo Gonipterus scutellatus), nativos de Australia continental y Tasmania, que defolian árboles de eucalipto y son considerados como plagas de importancia. Desde el siglo 19, tres especies de este complejo se han introducido a otros continentes. En este trabajo reportamos la presencia de gorgojos del eucalipto en Ecuador. Usamos datos genéticos para la identificación específica y demostramos claramente que los especímenes ecuatorianos pertenecen a la especie Gonipterus platensis, la cual tiene baja diversidad genética comparada con otras especies en el complejo. Analizamos la distribución potencial de G. platensis en América del Sur con modelos de nicho ecológico y encontramos varias áreas con idoneidad ambiental alta a intermedia, incluso en países donde esta especie no ha sido registrada, como Perú y Bolivia. La correcta identificación de las especies del complejo Gonipterus scutellatus y una mejor comprensión de su distribución potencial constituyen herramientas fundamentales para optimizar medidas de manejo y prevención.

Reattachment of Fractured Tooth Fragment by Multidisciplinary Treatment Approach.

Dental anterior fractures are common injuries, especially in those who practice extreme sports. This report describes a 25-year-old Bolivian patient who attended our private dental clinic in La Paz, Bolivia after experiencing an accident during downhill mountain biking. An intraoral examination revealed a fracture line on the buccal side in the middle third of the coronal portion of the right central maxillary incisor which extended towards the proximal and lingual sides. Multidisciplinary treatment, including crown lengthening, osteotomy, root canal treatment, fiberglass post insertion, and reattachment of the fracture segment was performed. A follow-up examination at 10 months later revealed that the tooth was completely reestablished both functionally and esthetically and that there was no periapical pathosis or discomfort. This outcome suggests that if a patient seeks a dental consultation soon after a complex crown-root fracture has occurred, and if the broken tooth segment is available, then reattachment offers an economical and simple treatment option which will allow immediate restoration of functionality and esthetic standards. Continued follow-up should form part of such a treatment plan to allow long-term pulp vitality and periodontal health status to be monitored.

Molecular phylogeny of Neotropical Parrot Snakes (Serpentes: Colubrinae: Leptophis) supports underestimated species richness.

Tetrapod taxa with broad geographic distributions across the Neotropics are often composed of multiple evolutionary lineages. In this paper, we present the most complete phylogeny of Leptophis to date and assess morphology-based species limits within the broadly distributed green parrot snake Leptophis ahaetulla sensu lato, which occurs from Mexico to Argentina. Although L. ahaetulla sensu stricto, L. nigromarginatus and L. occidentalis were recovered as paraphyletic, tree topology tests failed to reject their monophyly. Monophyly of L. bocourti, L. coeruleodorsus, L. cupreus, L. depressirostris, L. marginatus, L. riveti and L. sp. nov. was strongly supported. Our phylogenetic trees support recognition of multiple species within Leptophis ahaetulla sensu lato and suggest that color evolution and the uplift of the Andes played an important role in the diversification of parrot snakes.

Three new species of frogs of the genus Pristimantis (Anura, Strabomantidae) with a redefinition of the P. lacrimosus species group.

A new phylogeny for the Pristimantis lacrimosus species group is presented, its species content reviewed, and three new species described from the eastern slopes of the Ecuadorian Andes. Our phylogeny includes, for the first time, samples of P. aureolineatus, P. bromeliaceus, and P. lacrimosus. The morphology of hyperdistal subarticular tubercles is also assessed among 21 species of Pristimantis. The P. lacrimosus species group is composed of 36 species distributed in the Chocó, Guiana, and Amazon regions of tropical South America with a single species reaching Central America. Ancestral area reconstruction indicates that, despite its high diversity in the Amazon region, the P. lacrimosus group originated in the Pacific basin, Chocó region of Ecuador and Colombia. Pristimantis amaguanae sp. nov. is most closely related to P. bromeliaceus. It differs from P. bromeliaceus by being smaller, having transversal dark bands in the hindlimbs (absent or faint in P. bromeliaceus) and the absence of discoidal fold (present in P. bromeliaceus). Pristimantis nankints sp. nov. and P. romeroae sp. nov. are part of a clade of predominantly light-green frogs that includes P. acuminatus, P. enigmaticus, P. limoncochensis, and P. omeviridis. Pristimantis nankints sp. nov. and P. romeroae sp. nov. can be distinguished from all of them by the presence of a dark dorsolateral stripe that borders a light green band on a green background. Hyperdistal tubercles are present in all examined species of the P. lacrimosus species group and its sister clade. Species with hyperdistal tubercles are characterized by having relatively long terminal phalanges and narrow T-shaped expansion at the end of the terminal phalange. We discuss the phylogenetic distribution of these characters and their potential diagnostic significance.

High Phenotypic and Genotypic Diversity of Enterococcus faecium from Clinical and Commensal Isolates in Third Level Hospital.

Background: The use of antimicrobials and myeloablative chemotherapy regimens has promoted multiresistant microorganisms to emerge as nosocomial pathogens, such as vancomycin-resistant Enterococcus faecium (VREfm). We described a polyclonal outbreak of bloodstream infection caused by Efm in a hemato-oncological ward in Mexico. Our aim was to describe the clonal complex (CC) of the Efm strains isolated in the outbreak in comparison with commensal and environmental isolates. Methodology: Sixty Efm clinical, environmental, and commensal strains were included. We constructed a cladogram and a phylogenetic tree using Vitek and Multilocus sequence typing data, respectively. Results: We reported 20 new sequence types (ST), among which 17/43 clinical isolates belonged to CC17. The predominant ST in the clinical strains were ST757, ST1304, ST412, and ST770. Neither environmental nor commensal isolates belonged to CC17. The phylogeny of our collection shows that the majority of the clinical isolates were different from the environmental and commensal isolates, and only a small group of clinical isolates was closely related with environmental and commensal isolates. The cladogram revealed a similar segregation to that of the phylogeny. Conclusions: We found a high diversity among clinical, environmental, and commensal strains in a group of samples in a single hospital. Highest diversity was found between commensal and environmental isolates.

A polyclonal outbreak of bloodstream infections by Enterococcus faecium in patients with hematologic malignancies.

BACKGROUND: Enterococcus faecium causes bloodstream infection (BSI) in patients with hematologic malignancies (HMs). We studied the clinical features and outcomes of patients with HM with vancomycin-sensitive E faecium (VSE) and vancomycin-resistant E faecium (VRE) BSI and determined the genetic relatedness of isolates and circumstances associated with the upsurge of E faecium BSI. METHODS: Case-control study of patients with HM and E faecium-positive blood culture from January 2008-December 2012; cases were patients with VRE and controls were VSE isolates. The strains were tested for Van genes by polymerase chain reaction amplification and we performed pulsed-field gel electrophoresis to determine genetic relatedness. RESULTS: Fifty-eight episodes of E faecium BSI occurred: 35 sensitive and 23 resistant to vancomycin. Mortality was 46% and 57%, attributable 17% and 40%, respectively. Early stage HM was associated with VSE (P = .044), whereas an episode of BSI within the 3 months before the event (P = .039), prophylactic antibiotics (P = .013), and vancomycin therapy during the previous 3 months (P = .001) was associated with VRE. The VanA gene was identified in 97% of isolates studied. E faecium isolates were not clonal. CONCLUSIONS: E faecium BSI was associated with high mortality. This outbreak of VRE was not clonal; it was associated with antibiotic-use pressure and highly myelosuppressive chemotherapy.

[Prognostic role of NT-proBNP in emergency department in the elderly with acute heart failure]. / El papel pronóstico del NT-proBNP en el anciano con insuficiencia cardiaca aguda en urgencias.

OBJECTIVE: To determine prognostic role of NT-proBNP as predictor of 30 day-mortality and readmission in the elderly with acute heart failure (AHF) treated in Spanish Emergency Departments (EDs), and to analyse the confounding factors when the NT-proBNP value is interpreted. MATERIAL AND METHODS: A multicentre and multi-purpose cohort study with prospective follow-up was conducted on all patients aged 65 years or older with AHF treated in Spanish EDs. The variables recorded include demographic characteristics, comorbidity, details of episode, and NT-proBNP value. The outcome variables were 30 day-mortality and readmission. An NT-proBNP ≥ 5,180 pg/ml was adopted as the cut-off limit. The statistical package SPSS 18.0 was used to analyse the data. RESULTS: A total of 585 patients were included, with a mean age of 80.4 (SD: 6.9) years old. The cut-off NT-proBNP ≥ 5,180 pg/ml was independently associated with a severely impaired glomerular filtration (<30 ml/h) (P < .001) and severe episode (NYHA II-IV) (P = .012). The NT-proBNP area under curve (AUC) for 30 day-mortality was 0.71 (CI 95%: 0.63-0.77; P < .001) and for 30 day-readmission, was 0.50 (CI 95%: 0.45-0.56; P = .846). A multivariable analysis showed that the cut-off NT-proBNP ≥ 5,180 pg/ml was an independent factor associated with 30 day-mortality in the elderly with AHF attended in Spanish EDs. CONCLUSIONS: The NT-proBNP value is associated with short-term mortality in the elderly with AHF attended in the EDs independently of the presence of confounding factors, such as the severity of the episode and glomerular filtration reduction, but not with 30 day-readmission.

Factores que Influyen en la obesidad infantil (Estudio realizado en niños de 6 a 8 años) / Factors that influence youth obesity

El presente trabajo da como resultado una incidencia de obesidad infantil de 15,90 por ciento de la poblacion elegida, de esto el 53,5 por ciento pertenecen a escuelas particulares y el restante al sector fiscal. De este modo se considera que la funcion del personal de salud y del gobierno mismo no solo deberia ser la atencion a niñas que padecen de algun tipo de desnutricion, sino que tambien debe valorarse a los niños con sobrepeso y mas aun a los que presentan obesidad, para ello, resulta importante buscar estrategias y normas nacionales con el fin de ralizar una deteccion temprana y por supuesto evitar la obesidad cronica que puede llevar a complicaciones mayores

Brucellosis in Mexico: current status and trends.

Traditionally, Mexico has been recognized as endemic with brucellosis. The improvements in diagnostics techniques and vaccination strategies and the enforcement of a national eradication policy have contributed significantly to making progress in the control of brucellosis. The current status of brucellosis and its risk factors, in the different production species as well as in human population is reviewed. Also the trends in control and eventual eradication strategies and perspectives for the near future of Mexico are presented.