Tracing the evolution of the chikungunya virus in Argentina, 2016-2023: independent introductions and prominence of Latin American lineages.

Chikungunya virus (CHIKV) has emerged as a significant public health concern due to its rapid spread and potential for causing debilitating epidemics. In Argentina, the virus has garnered attention since its introduction to the Americas in 2013, due to its growing incidence and impact in neighbouring countries. Here we present a comprehensive analysis of the spatiotemporal dynamics of CHIKV in Argentina, focusing on the evolutionary trajectory of its genetic variants. Through a combination of active surveillance, screening of historical and recent samples, and whole-genome sequencing, we traced the evolutionary history of CHIKV lineages circulating within the country. Our results reveal that two distinct genotypes circulated in Argentina: The Asian lineage during the 2016 epidemic and the ECSA lineage in 2023. This distribution reflects the dominance of particular variants across Latin America. Since 2023, the ECSA lineage has led to a surge in cases throughout the Americas, marking a significant shift. The replacement of lineages in the American region constitutes a major epidemiological event, potentially affecting the dynamics of virus transmission and the clinical outcomes in impacted populations. The spatiotemporal analysis highlights CHIKV's distribution across Argentina and underscores the significant role of human mobility, especially when considering recent epidemics in neighbouring countries such as Paraguay and Uruguay, which have facilitated the spread and introduction of the viral strain into different districts. By integrating epidemiological data with genomic insights, we elucidate the patterns of virus dissemination, highlighting key areas of transmission and potential factors contributing to its spread.

Needle tract seeding and malignant transformation of hepatocellular adenoma into well-differentiated hepatocellular carcinoma in a dog.

An 11-year-old neutered female Golden Retriever was referred for investigation of marked increases in liver enzyme activities. Abdominal ultrasound revealed a large pedunculated liver mass. Diagnosis of hepatocellular adenoma (HCA) was made when the mass was excised after a first unsuccessful attempt through ultrasound-guided core-needle biopsy. One and a half years after presentation, a nodule embedded between muscles of the abdominal wall appeared. The mass was first diagnosed as a well-differentiated hepatocellular carcinoma (HCC) through cytologic examination, which was later confirmed with histopathology. Ki 67 immunostaining of the abdominal wall nodule showed an increased immunoreactivity compared with the liver mass. Therefore, the present case documents the first needle-tract seeding of a hepatocellular epithelial tumor with possible malignant transformation of HCA into a well-differentiated HCC in a dog.

Review and statistical analysis of clinical management of feline leishmaniosis caused by Leishmania infantum.

BACKGROUND: There is limited information about feline leishmaniosis (FeL) management in clinical practice. Leishmania infantum is the species of Leishmania most frequently reported in both dogs and cats in countries of the Mediterranean region (henceforth 'Mediterranean countries'), Central and South America, and Iran. This study was conducted to provide veterinary clinicians with an updated overview of evidence-based information on leishmaniosis in cats. METHODS: A review was performed using PubMed, Science Direct, Google Scholar and Web of Science. Case reports of FeL caused by L. infantum were sought for the period 1912 to 1 June 2021. RESULTS: Sixty-three case reports are included in this review. Fifty-nine out of the 63 cats were from Europe, mostly from Mediterranean countries (88.9%). Most of them were domestic short-haired cats (90%) with a mean age of 7.9 years, and had access to the outdoors (77.3%). Sixty-six percent of the cats had comorbidities, of which feline immunodeficiency virus infection was the most frequent (37.7%). Dermatological lesions (69.8%) was the most frequent clinical sign, and hyperproteinemia (46.3%) the most frequent clinicopathological abnormality. Serology was the most performed diagnostic method (76.2%) and was positive for 93.7% of cats. Medical treatment was applied in 71.4% of cats, and allopurinol was the most used drug (74.4%). Survival time was greater for treated cats (520 days; 71.4% of cats) than non-treated cats (210 days; 25.4%). CONCLUSIONS: The majority of the cats had comorbidities, of which feline immunodeficiency virus was the most frequent. Dermatological lesions were frequently reported, and systemic clinical signs and clinicopathological abnormalities were also common. Serology may be useful for the diagnosis of FeL in clinical practice, and a positive titer of ≥ 1/40 may be a useful cut-off for sick cats. The reported treatments and dosages varied, but there was a good clinical response and longer survival in most of the cats treated with allopurinol monotherapy.

[Covid-19 pandemic impact in pediatricians: stress factors and their consequences]. / El impacto de la epidemia Covid-19 en los pediatras: factores estresantes y sus consecuencias.

Previous studies have demonstrated that the COVID-19 pandemic has had negative psychological consequences on healthcare professionals, however, specific data on pediatricians are scarce. Ob jective: To evaluate anxiety among pediatricians after the first COVID-19 wave as well as to identify possible related risk factors. MATERIAL AND METHOD: A cross-sectional multicentric survey study was designed and sent to Spanish pediatricians through the Asociación Española de Pediatría's e-mail lists. Demographic, socio-familial, occupational, emotional self-perception, psychosomatic symptoms, smoking, alcohol, and psychotropic drugs use data were collected. The State-Trait Anxiety Scale (STAI) was included, and its association with qualitative and quantitative variables of the sample was studied. RESULTS: 440 surveys were registered. 42.2% of the participants expressed moderate-intense anxiety symptomatology according to the Anxiety-State scale and 26.9% on the Anxiety-Trait scale. Isolation at home was associated with a higher score on both scales. A change in the work situation of the cohabitant resulted in a higher score on the Anxiety-State scale. 41.1% of the respondents clas sified the psychological impact suffered as mild, 50% as moderate, and 8.9% as severe. Up to 71.8% of the participants manifested some psychosomatic symptoms, with a linear association between the concurrence of symptoms and higher scores on the two scales. CONCLUSIONS: After the first pandemic wave, pediatricians have suffered anxiety, causing physical and emotional discomfort. Personal sit uations were the main source of concern. Likewise, the presence of several somatic symptoms was associated with higher levels of anxiety.

Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis.

Regional and national legislation mandates the disclosure of "priority" allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen ("may contain") labels (PAL) that are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and nonuniformity in the use of PAL by food businesses. One potential solution would be to establish internationally agreed "reference doses," below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to a low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at a low-level allergen exposure.

Is proteinuria a rare condition in apparently healthy and sick cats? A feline practice experience (2007-2018).

Background: Proteinuria is assumed to be less frequent in cats than in dogs and is mainly associated with chronic kidney disease (CKD). Aim: The current study aimed to evaluate and compare urine protein-to-creatinine (UPC) values retrospectively in cats visited for comprehensive annual health check or for presenting systemic clinical signs related to CKD. Methods: UPC ratio was retrospectively evaluated in 112 owned cats, out of which 51 (45.5%) were apparently healthy cats according to their owners who visited for comprehensive annual health checks and 61 (54.5%) sick cats, presenting systemic clinical signs suggesting CKD, such as weight loss or polyuria/polydipsia, among others. Results: Based on UPC, the present study found that 54.5% of all cats included were borderline proteinuric or proteinuric, having increased UPC (UPC ≥ 0.2), with 35.7% included in the sick group and 18.7% in the health-check group. Increased UPC was also statistically associated with azotemia and isosthenuria (urinary-specific gravity between 1,008 and 1,035) in both sick and health-check groups of cats. Conclusion: Independent of the reason for their medical visit, it could be concluded that borderline proteinuria and proteinuria were statistically mainly related to CKD in cats. Furthermore, the measurement of UPC could be very useful in the detection and management of CKD in apparently healthy cats during a medical visit for annual health check irrespective of the age.

Alucinosis peduncular: descripción de un caso y revisión del tema / Peduncular hallucinosis: a case report and topic review / Alucinose peduncular: descrição de um caso e revisão do assunto

La alucinosis peduncular es el término utilizado para describir una forma rara de alucinaciones visuales complejas, vívidas, coloridas y generalmente recurrentes que ocurren en relación a lesiones del tronco encefálico y el tálamo. Es una patología infrecuente y su fisiopatología es controvertida. Describimos el caso de una mujer de 38 años con alucinosis peduncular asociada a compresión extrínseca del tronco encefálico secundaria a un schwannoma vestibular. Analizamos las características clínicas y los mecanismos fisiopatológicos subyacentes.

Peduncular hallucinosis is a clinical condition characterized by vivid, colorful, complex visual hallucinations that often recur in time and are described in association with midbrain and thalamic lesions. It is a rare phenomenon and its precise pathophysiology is unknown. We describe the case of a 38-year-old woman who developed peduncular hallucinosis in relation to extrinsic compression of the midbrain secondary to a vestibular schwannoma. Clinical features and underlying pathophysiological mechanisms are discussed.

A alucinose peduncular é o termo usado para descrever uma forma rara de alucinações visuais complexas, vívidas, coloridas e geralmente recorrentes que ocorrem em relação às lesões do tronco encefálico e do tálamo. É uma patologia infreqüente e sua fisiopatologia é controversa. Descrevemos o caso de uma mulher de 38 anos de idade com alucinose peduncular associada à compressão extrínseca do tronco encefálico secundária ao schwannoma vestibular. Analisamos as características clínicas e os mecanismos fisiopatológicos subjacentes.

[Combined Preimplantation Genetic Testing for Aneuploidy and Monogenic Disease in a Mexican Family Affected by X-linked Hypohidrotic Ectodermal Dysplasia].

Background: Hypohidrotic ectodermal dysplasia (HED) is a genetic skin condition presenting as hypohidrosis, hypodontia, and hypotrichosis, resulting in an important burden for affected families. The most common form of HED has an X-linked inheritance and female carriers have the option of prenatal or preimplantation genetic testing (PGT) to avoid transmission of the disease. A combined PGT for a mutation in EDA gene and aneuploidies in a Mexican carrier of X-linked HED is reported. Materials and Methods: Ovarian stimulation and assisted reproduction procedures were performed in a private academic medical center. PGT for a novel c.707-1G>A (rs886039466) mutation in EDA gene and chromosomal aneuploidies was performed by massive parallel and Sanger sequencing. Results: In the first PGT, the transfer of two blastocysts did not result in a pregnancy. An accumulative stimulation approach was decided to improve pregnancy chances for a second PGT procedure. Three ovarian stimulations were performed and 10 blastocysts coming from fresh and vitrified oocytes were genetically analyzed. A single embryo transfer produced a healthy non-carrier euploid girl. Discussion: PGT combining aneuploidy and mutation analyses is an alternative for female carriers of X-linked and other Mendelian disorders in Latin-American countries. In the era of genomic and personalized medicine, medically assisted reproduction techniques, such as PGT, are shifting from only infertility to preventive genetics.

Food Allergen Labeling: A Latin American Approach.

Food allergy is a public health concern almost all over the world. Although most of the countries that regulate the declaration of allergens in prepackaged foods include the list recommended by the Codex Alimentarius, some countries have added other allergens to this list due to prevalence data and regional incidence, whereas others have incorporated exceptions for some products derived from allergenic foods. Within this context, the situation in Latin America regarding these regulations is diverse. Data about prevalence of food hypersensitivity are very limited in the region. The countries that have established regulations are Brazil, Colombia, Costa Rica, Guatemala, Honduras, El Salvador, Nicaragua, Chile, Mexico, and Venezuela. Argentina has approved a regulation for the labeling of food allergens in November 2016. It only needs to be published in the Official Bulletin to go into effect. All countries follow the Codex list that includes latex and excludes sulfites, except Brazil. On the other hand, Argentina is the only country that includes exceptions. As for the methodologies for the detection of allergens in foods, this issue is a serious problem for both the food industry and control laboratories. Available methodologies are based mainly on commercial ELISA kits; currently, there are no Latin American companies that produce them, so ELISA kits are expensive and their acquisition is complicated. There is an initiative in Argentina to address all these gaps in the region through the Platform of Food Allergens (PFA), a nonprofit organization that integrates health professionals, patients, representatives of the food industry, government, and scientists. The different actions carried out by the PFA have made it possible to contact different scientific groups from other Latin American countries in order to expand this initiative and thereby promote and strengthen both public and private capacities in the region.

Influencia de reguladores de crecimiento sobre el establecimiento de cultivos in vitro de Salvia hispanica L. ("chía") y sobre su contenido de ácidos grasos / Influence of growth regulators on the establishment of in vitro cultures of Salvia hispanica L. ("chia") and its content of fatty acids

Salvia hispanica L. (Labiateae), comúnmente conocida como "chía", es una especie herbácea anual cuyo cultivo está ampliamente extendido por América del Sur. Es utilizada como cultivo industrial y para la ela-boración de alimentos funcionales por su contenido en proteínas, antioxidantes, fibras y lípidos esenciales. El aceite de sus semillas contiene la mayor proporción (68 %) de omega-3 que cualquier fuente vegetal conocida. El objetivo de este trabajo fue establecer cultivos in vitro de "chía" y analizar la influencia de diferentes reguladores de crecimiento sobre la inducción de callos, sobre el crecimiento de estos y sobre su contenido de ácidos grasos. Se iniciaron cultivos de callos in vitro a partir de explantos de tallos sin nudos y de hojas de plántulas axénicas de 20 días de edad, utilizando 3 tratamientos de reguladores de crecimiento diferentes. El medio Murashige & Skoog modificado (MSRT) con el agregado de ácido 2,4-diclorofenoxia-cético (2,4-D) a una concentración de 2,25 µM y un fotoperíodo de 16 horas fueron las condiciones óptimas para la inducción de callos. Para el mantenimiento de los callos el tratamiento más adecuado resultó ser bencilaminopurina (BAP) a una concentración de 1 µM. La cinética de crecimiento se caracterizó por un período de latencia hasta el día 20 de cultivo, seguido de un período de crecimiento exponencial entre los días 20 y 54. El tratamiento con 2,4-D (2,25 µM) mostró la más alta velocidad específica de crecimiento (0,22 ± 0,01 /día), el tiempo de duplicación más bajo (31,51 ± 1,00 día) y la mayor biomasa máxima (1,46 ± 0,01 g PF). El contenido de ácidos grasos en los callos de "chía" fue 0,83 % en promedio de todos los tratamientos después de 6 meses en cultivo y no mostró variaciones significativas (0,2 % - 0,3 %) entre los tratamientos aplicados (p < 0,05). (AU)

[Comparison fracture risk calculated by FRAX tool]. / Comparación del riesgo de fractura calculado con la herramienta FRAX con y sin densitometría ósea en un gruop de mujeres mexicanas.

BACKGROUND: The FRAX tool allows calculate the 10 year probability of fracture risk in men and women. OBJECTIVE: To compare the 10 years fracture risk calculated with the FRAX tool using or not bone densitometry. MATERIAL AND METHODS: A prospective, cross-sectional, open a comparative study was done with 40-80-year-old women, who were evaluated with bone densitometry. To calculate the fracture risk the FRAX tool was used with and without bone densitometry in each patient. Both results were compared with Mann-Whitney U test. RESULTS: The mean age was 54.2 ± 8.7 years. The median of the FRAX calculated risks without using bone densitometry was for major fracture 2.4 (1-12) and hip 0.3 (0-5.2). The calculated risks using bone densitometry was for major fracture 2.3 (1.2-11) and for hip 0.2 (0-3.6), without statistically significant differences among them. The calculated T score with FRAX was -1.0 (-2.7 ± 1.9). CONCLUSIONS: The results obtained with the FRAX tool using or not bone densitometry were similar. These findings will allow using this instrument in a greater number of patients.

Valoración del conocimiento del autoexamen de mama en mujeres en edad reproductiva del Policlínico Bernardo Posse / Assessment of the knowledge of breast self-test in reproductive age women at Bernardo Posse Policlinics

Introducción: el Cáncer de Mama constituye la localización más frecuente entre las neoplasias malignas que afectan a la mujer. Mediante acciones de salud encaminadas a la divulgación y enseñanza del autoexamen de mama, en especial, a través del trabajo del médico de la familia, se evitará la progresión de esta enfermedad. Objetivo: identificar el grado de conocimiento de la técnica de auto examen de mama de las pacientes en edad reproductiva. Pacientes y métodos: estudio longitudinal, descriptivo en una muestra aleatoria de 80 mujeres mayores de 15 años de un grupo básico de trabajo de tres consultorios médicos. Se aplicó encuesta, en la que se recogen variables como distribución por grupos de edades, conocimiento del autoexamen, vías de adquisición del mismo y su calidad. Resultados: el 55 % de las mujeres referían tener conocimiento de la técnica del autoexamen con predominio de las mayores de 40 años, resultando los medios de difusión la vía de mayor información sobre la misma aunque con mejor calidad la realizaban las que lo recibían a través del equipo básico de salud. Conclusiones: a pesar de existir alto porcentaje de mujeres que refieren conocimiento del autoexamen de mama hay deficiencias en la labor de promoción y prevención por parte del equipo básico de salud al no ser la vía más frecuente de obtener la información las pacientes. Recomendaciones: Intensificar la labor educativa del médico y enfermera de la familia desde edades tempranas de la mujer.

Introduction: breast cancer constitutes the most frequent disease among the malignant neoplasia that affects women. The progression of the disease will be avoided by means of health actions that are directed to the divulge and teaching of the breast self-examination technique especially through the doctor family's work. Objective: to evaluate the patients´ knowledge of the breast self-examination technique of the patients in reproductive age. Patients and method: a descriptive and longitudinal study was done in an at random sample of 80 women over 15 years from a basic group of work of three consulting offices. A survey was performed in which variables such as: distribution by group of age, knowledge of the breast self-examination technique, ways of getting it, and its quality were collected. Results: the 55.0 % of the women referred having knowledge of the breast self-examination technique with the prevalence of women over 40 years; resulting the mass media the main way of acquiring information about it, although there was a high quality of the technique in those women who performed it through the basic group of work. Conclusions: in spite of the existence of a high percentage of women who refer having knowledge of the breast self-examination technique, there are deficiencies in the promotion and prevention labour by the basic health team because it is not the most frequent way the patients get the information. Recommendations: to intensify the nurse and the family doctor's educative work about the breast self-examination technique since early ages.

Sibilancias recurrentes en el niño / Recurrent wheezes in the child

Los objetivos de esta investigación fueron identificar algunas características y factores de riesgo en niños con sibilancias recurrentes, un decenio después del primer episodio de bronquiolitis aguda por virus sincitial respiratorio. Se realizó un estudio descriptivo retrospectivo, de tipo longitudinal, con 34 niños que se clasificaron en sibilantes transitorios y sibilantes persistentes. Se identificaron factores de riesgo y factores socioeconómicos y ambientales. Se realizaron pruebas cutáneas de sensibilidad con aeroalergenos. Se observaron sibilancias persistentes en 22 pacientes (64,7 por ciento) y sibilancias transitorias en 12 (35,3 por ciento). El antecedente atópico familiar màs frecuente fue el asma bronquial, con predominio en los niños con sibilancias persistentes (68,1 por ciento). El destete precoz constituyó el antecedente personal más frecuente. El hábito de fumar y la asistencia a círculos infantiles fueron los factores de riesgo socioeconómicos y ambientales que predominaron (63,6 por ciento y 59 por ciento, respectivamente), en especial en niños con sibilancias persistentes. Requirieron atención en la Unidad de Terapia Intensiva Polivalente 6 niños sibilantes persistentes (27,2 por ciento) y solo 1 niño (8,3 por ciento) sibilante transitorio necesitó admisión en dicha unidad. Las pruebas cutáneas de aeroalergenos fueron positivas en 7 niños sibilantes permanentes (31,8 por ciento) y en 1 de los sibilantes transitorios (8,3 por ciento). Las sibilancias recurrentes en el niño después de un primer episodio de bronquiolitis por virus sincitial respiratorio están generalmente asociadas a factores de riesgo, en especial al antecedente atópico familiar y al hábito de fumar. Es muy importante reconocer tempranamente a los niños con riesgo de presentar asma persistente atópica e intervenir terapéuticamente con el fin de evitar el deterioro de la función pulmonar.

The objectives of this research were to identify some characteristics and risk factors in children with recurrent wheezes 10 years after the first episode of acute bronchiolitis caused by respiratory syncytial virus. A descriptive retrospective longitudinal study was conducted among 34 children that were classified as transient wheezing and persistent wheezing. Risk, socioeconomic and environmental factors were identified. Skin sensitive tests with aeroallergens were performed. Persistent wheezes were observed in 22 patients (64,7 percent) and transient wheezes in 12 (35,3 percent). The most common atopic family history was bronchial asthma with predominance in children with persistent wheezes (68,1 percent). Early weaning was the most frequent personal history. Smoking and the attendance to day care centers were the prevailing socioeconomic and environmental risk factors (63,6 percent and 59 percent, respectively), specially in children with persistent wheezes. Six persistent wheezing children (27,2 percent) required attention at the Polivalent Intensive Care Unit, whereas only one transient wheezing child (8,3 percent) had to be admitted in that unit. The aeroallergen skin-prick tests yielded positive in 7 permanent wheezing children (31,8 percent) and in 1 transient wheezing child (8,3 percent). The recurrent wheezes in the child after a first episode of bronchiolitis due to respiratory syncytial virus are generally associated with risk factors, particularly to the atopic family history and smoking. It is very important to early identify the children at risk for presenting atopic persistent asthma and to take therapeutic measures in order to prevent the deterioration of the pulmonary function.

[Hepatic fasciolasis diagnosed in state phase]. / Fasciolosis hepática diagnosticada en fase de estado.

INTRODUCTION: Hepatic fasciolosis is a zoonosis that accidentally can invade the human. REPORT OF A CASE: 62 years old male, farmer, lives in a rural community in Tehuacan, Puebla, Mexico. His living space is not provided with running water nor drainage. He has contact with sheep and bovines. Started presenting symptoms two years before. Suffered from myalgia, joint pain, fever of 38 degrees C and epigastric pain that radiated the hypocondrium and the right shoulder. He had diarrhea five times in 24 hours as well as lack of appetite that lead to a weight loss of 20 kilograms in two years. He was hospitalized and the physical examination revealed diminished muscular mass, right hypocondrium pain and hepatomegaly of 3 cm below costal margin. He said he ate watercress (Nasturium officinalis) two or three times a week. Blood test revealed erythrocytes of 3.6 x 105 mm3; hemoglobin of 11.9 g/dL; hematocrit of 30%; leukocytes 8950 mm3; neutrophils 65%; lymphocytes of 30%; eosinophils of 3%; monocytes of 1% and basophiles of 1%. Globular sedimentation was 83 mm and hemoglobin concentration was 33. Liver test results were normal and mycobacterium in fecal samples was negative, but stool detection tests revealed eggs of Fasciola hepatica. The diagnosis was hepatic fasciolosis in its biliar stage. Dehidrohemetine (1.5 mg/kg) was administered during 10 days. Symptoms disappeared within 48 hours. CONCLUSION: The lack of knowledge about fasciolosis makes it hard to diagnose it. The publication of case reports must help to facilitate its diagnosis.

Medicina preventiva geriátrica en la atención primaria de salud / Geriatric preventive medicine in primary health care

Se realizó un estudio de carácter retrospectivo, observacional y analítico con una muestra tomada al azar de 500 pacientes dentro del grupo etário de 65 años y más incluidos en el grupo I de la dispensarización del paciente en la Atención Primaría de Salud, del área poblacional atendida por el Policlínico Docente “Bernardo Posse” en San Miguel del Padrón. En él se da a conocer de forma general el estado de salud de la población estudiada y las medidas preventivas y curativas adoptadas