First national survey of the diagnosis of Helicobacter pylori infection in Clinical Microbiology Laboratories in Spain. / Primera encuesta nacional sobre el diagnóstico de la infección por Helicobacter pylori en los laboratorios de microbiología clínica en España.

INTRODUCTION: The aim of this study was to know, through a national survey, the methods and techniques used for the diagnosis of Helicobacter pylori (Hp) in the different Clinical Microbiology Services/Laboratories in Spain, as well as antibiotic resistance data. METHODS: The survey requested information about the diagnostic methods performed for Hp detection in Clinical Microbiology laboratories, including serology, stool antigen, culture from gastric biopsies, and PCR. In addition, the performance of antibiotic susceptibility was collected. Data on the number of samples processed in 2016, positivity of each technique and resistance data were requested. The survey was sent by email (October-December 2017) to the heads of 198 Clinical Microbiology Laboratories in Spain. RESULTS: Overall, 51 centers from 29 regions answered the survey and 48/51 provided Hp microbiological diagnostic testing. Concerning the microbiological methods used to diagnose Hp infection, the culture of gastric biopsies was the most frequent (37/48), followed by stool antigen detection (35/48), serology (19/48) and biopsy PCR (5/48). Regarding antibiotic resistance, high resistance rates were observed, especially in metronidazole and clarithromycin (over 33%). CONCLUSION: Culture of gastric biopsies was the most frequent method for detection of Hp, but the immunochromatographic stool antigen test was the one with which the largest number of samples were analyzed. Nowadays, in Spain, it concerns the problem of increased antibiotic resistance to 'first-line' antibiotics.

Preclinical Evaluation of the Antimicrobial-Immunomodulatory Dual Action of Xenohormetic Molecules against Haemophilus influenzae Respiratory Infection.

Chronic obstructive pulmonary disease (COPD) is characterized by abnormal inflammation and impaired airway immunity, providing an opportunistic platform for nontypeable Haemophilus influenzae (NTHi) infection. In this context, therapies targeting not only overactive inflammation without significant adverse effects, but also infection are of interest. Increasing evidence suggests that polyphenols, plant secondary metabolites with anti-inflammatory and antimicrobial properties, may be protective. Here, a Cistus salviifolius plant extract containing quercetin, myricetin, and punicalagin was shown to reduce NTHi viability. Analysis of these polyphenols revealed that quercetin has a bactericidal effect on NTHi, does not display synergies, and that bacteria do not seem to develop resistance. Moreover, quercetin lowered NTHi airway epithelial invasion through a mechanism likely involving inhibition of Akt phosphorylation, and reduced the expression of bacterially-induced proinflammatory markers il-8, cxcl-1, il-6, pde4b, and tnfα. We further tested quercetin's effect on NTHi murine pulmonary infection, showing a moderate reduction in bacterial counts and significantly reduced expression of proinflammatory genes, compared to untreated mice. Quercetin administration during NTHi infection on a zebrafish septicemia infection model system showed a bacterial clearing effect without signs of host toxicity. In conclusion, this study highlights the therapeutic potential of the xenohormetic molecule quercetin against NTHi infection.

Comportamiento alimentario y bienestar psicológico en población universitaria en el norte de Chile / Food behavior and psychological well-being in university population in the north of Chile

Se ha reportado que el contexto universitario propicia un hábito alimentario inadecuado, orientado al consumo de alimentos de conveniencia caracterizados por ser de bajo costo, hipercalóricos, altos en grasas saturadas y de escaso valor nutritivo lo que aumenta el riesgo de desarrollar enfermedades crónicas no transmisibles. En este contexto, la evidencia refiere que algunos indicadores psicológicos como mayores niveles de satisfacción vital y apoyo familiar se relacionan con una dieta de mayor calidad al mismo tiempo que es asociada a un menor índice de masa corporal. Sin embargo, existe un vacío teórico respecto a las distintas caracterizaciones de comportamientos alimentarios que guían la toma de decisiones relacionadas con las preferencias y consumo de alimentos en población universitaria. El objetivo de esta investigación fue analizar la relación existente entre caracterizaciones de comportamiento alimentario con el bienestar psicológico de estudiantes universitarios en el norte de Chile. La muestra estuvo compuesta por 647 estudiantes residentes en las ciudades de Arica y Antofagasta, el promedio de edad fue de 22 años, se utilizó el cuestionario de bienestar psicológico de Carol Ryff y el cuestionario holandés de conductas alimentarias. Los resultados indican que la ingesta emocional tiene el mayor efecto sobre el bienestar psicológico relacionándose significativa y negativamente con todas sus dimensiones, la tendencia restrictiva se asoció con autoaceptación, relaciones positivas y autonomía, finalmente la ingesta externa no reportó ningún efecto sobre el bienestar psicológico. Es necesario generar más evidencia de la relación entre variables psicológicas y alimentación(AU)

It has been reported that the university context fosters an inadequate eating habit, oriented to the consumption of convenience foods characterized by being low cost, hypercaloric, high in saturated fat and low nutritional value, which increases the risk of developing chronic noncommunicable diseases. In this context, the evidence refers that some psychological indicators such as higher levels of life satisfaction and family support are related to a higher quality diet while being associated with a lower body mass index. However, there is a theoretical gap regarding the different characterizations of eating behaviors that guide decision making regarding food preferences and consumption in the university population. The objective of this research was to analyze the relationship between characterizations of eating behavior with the psychological well-being of university students in northern Chile. The sample consisted of 647 students residing in the cities of Arica and Antofagasta, the average age was 22 years, the Carol Ryff psychological well-being questionnaire and the Dutch food behavior questionnaire were used. The results indicate that emotional intake has the greatest effect on psychological well-being by being significantly and negatively related to all its dimensions, the restrictive tendency was associated with self-acceptance, positive relationships and autonomy; finally, external intake did not report any effect on psychological well-being. It is necessary to generate more evidence of the relationship between psychological variables and food(AU)

Efectos Adversos del Tratamiento con Vigabatrina en Síndrome de West: reporte de 2 casos / Adverse Effects of Vigabatrin Use for West Syndrome treatment: a report of 2 Clinical Cases

El síndrome de West (SW) es un síndrome epiléptico de la infancia temprana. Dentro de los fármacos de primera línea utilizados para su tratamiento se encuentran la hormona adrenocorticotropa (ACTH) y Vigabatrina. Estudios sugieren igual efectividad en el uso a largo plazo de ambos para controlar el SW. En Chile, el uso de Vigabatrina ha aumentado dada su mayor disponibilidad, facilidad de uso y menor costo. Se describen 2 casos clínicos presentando complicaciones agudas infrecuentes secundarias a su uso. Ambos pacientes con antecedentes de SW y trisomía 21. Primer caso: Lactante de 11 meses que inicia tratamiento con 100 mg/kg/día de Vigabatrina a los 7 meses, aumentando a 150 mg/kg/día por mala respuesta. Evolucionó con un síndrome extrapiramidal, con alteraciones radiológicas características. Segundo caso: Lactante de 7 meses, que tras iniciar tratamiento con vigabatrina (100 mg/kg/día) desarrolla rash facial sugerente de hipersensibilidad a fármacos antiepilépticos (FAEs), sin compromiso mucoso ni alteraciones sistémicas. Ambas regresan a su basal luego de suspensión o disminución de dosis del medicamento. Destaca la importancia de la monitorización de efectos adversos en el uso de FAEs y atender la aparición de reacciones poco conocidas. Las alteraciones imagenológicas por Vigabatrina son conocidas, no así el síndrome extrapiramidal asociado (primer caso). Por otra parte, las reacciones cutáneas están ampliamente descritas para múltiples FAEs, pero no para Vigabatrina (segundo caso). Dado el uso frecuente de Vigabatrina para tratar SW y otras epilepsias, es fundamental conocer y manejar reacciones adversas poco conocidas como las aquí presentadas. Palabras claves: Síndrome de West, Síndrome de Down, espasmos infantiles, vigabatrina, reacciones adversas, toxicidad, alergia, rash.

West Syndrome is an epileptic syndrome which typically presents in early childhood. In regard to treatment, the first line includes adrenocorticotropic hormone (ACTH) and Vigabatrin. Studies suggest similar response in the long term to both treatments. In Chile, Vigabatrin is being used more frequently as it is more available, of easier administration and lower cost. We present in the following report 2 clinical cases that presented acute infrequent complications secondary to its use in patients with both Down and West Syndrome. First case: 11-month-old infant who was initially treated with 100mg/kg/day of Vigabatrin at 7 months of age and increased to 150mg/kg/day due to lack of response. She evolved with an extrapyramidal syndrome with radiological manifestations. The second case: 7-month old toddler who initiated treatment with 100mg/kg/day of Vigabatrin and developed a facial rash, suggestive of hypersensitivity to antiepileptic drugs, with no mucosal or systemic involvement. Both patients returned to their previous condition shortly after Vigabatrin was decreased or discontinued. We emphasize the importance of the early monitorization of adverse effects in the use of antiepileptic drugs and awareness of less common reactions. Radiological findings associated with the use of Vigabatrin are well known, but not the clinical evolution with symptomatic extrapyramidal symptoms, as in the first case. Allergic reactions to the use of antiepileptic drugs have also been reported to several drugs, but not to Vigabatrin (second case). As Vigabatrin is being used more frequently to treat WS and other epilepsies it is important to know and manage uncommon adverse reactions as the ones presented in this report. Keywords: West Syndrome, Down Syndrome, infantile spasms, vigabatrin, adverse reactions, toxicity, allergy, rash

Non-pigmented rapidly growing mycobacteria smooth and rough colony phenotypes pathogenicity evaluated using in vitro and experimental models.

Non-pigmented rapidly growing mycobacteria (NPRGM) are widely distributed in water, soil and animals. It has been observed an increasing importance of NPRGM related-infections, particularly due to the high antimicrobial resistance. NPRGM have rough and smooth colony phenotypes, and several studies have showed that rough colony variants are more virulent than smooth ones. However, other studies have failed to validate this observation. In this study, we have performed two models, invitro and in vivo, in order to assess the different pathogenicity of these two phenotypes. We used collection and clinical strains of Mycobacteriumabscessus, Mycobacterium fortuitum and Mycobacteriumchelonae. On the invitro model (macrophages), phagocytosis was higher for M. abscessus and M. fortuitum rough colony variant strains when compared to smooth colony variants. However, we did not find differences with colonial variants of M. chelonae. Survival of Galleriamellonella larvae in the experimental model was lower for M. abscessus and M. fortuitum rough colony variants when compared with larvae infected with smooth colony variants. We did not find differences in larvae infected with M. chelonae.Results of our in vivo study correlated well with the experimental model. This fact could have implications on the interpretation of the clinical significance of the NPRGM isolate colonial variants.

Caracterización de la cultura de seguridad en función del tipo de tarea que desempeñan los trabajadores / Characterization of safety culture by job tasks performed by workers

En el presente estudio se investigaron las diferencias existentes entre las distintas dimensiones que componen el instrumento de percepción de Cultura Positiva de Fernández-Montes dentro de una organización en función de las áreas de negocio que existen en la misma. El estudio es transversal y la muestra estuvo formada por 490 personas de los cuales el 64,7% eran hombres y el 35,3% mujeres y con edades que fluctuaban entre los 18 y 64 años participaron voluntariamente en el estudio. Se encontraron buenos indicadores de confiabilidad del instrumento y principalmente cuatro diferencias estadísticamente significativas en las dimensiones que tienen que ver principalmente con los procesos básicos de los sistemas de gestión de seguridad en la organización, por ejemplo Formación sobre riesgos laborales, Planificación Preventiva, Planificación de la emergencia y por último Actitud de la dirección hacia la gestión. Se invita a realizar estudios para relacionar los indicadores de accidentalidad y la cultura de seguridad positiva para poder prevenir por medio de estas intervenciones(AU)

We investigated differences among the different dimensions that make up the Perception of Positive Culture developed by Fernández-Montes, for use in organizations by their different business areas. The sample for this cross-sectional study consisted of 490 people, 64.7% of whom were men and 35.3% women, ranging in age from 18 to 64 years, and who participated voluntarily in the study. The reliability of the instrument was good. There were four statistically significant differences in the dimensions, dealing mainly with the basic processes of the organizational safety management systems: training on occupational risks, preventive planning, emergency response planning, management attitudes on management. We encourage the use of this safety culture instrument in other studies(AU)

Inactivation of the Thymidylate Synthase thyA in Non-typeable Haemophilus influenzae Modulates Antibiotic Resistance and Has a Strong Impact on Its Interplay with the Host Airways.

Antibacterial treatment with cotrimoxazol (TxS), a combination of trimethoprim and sulfamethoxazole, generates resistance by, among others, acquisition of thymidine auxotrophy associated with mutations in the thymidylate synthase gene thyA, which can modify the biology of infection. The opportunistic pathogen non-typeable Haemophilus influenzae (NTHi) is frequently encountered in the lower airways of chronic obstructive pulmonary disease (COPD) patients, and associated with acute exacerbation of COPD symptoms. Increasing resistance of NTHi to TxS limits its suitability as initial antibacterial against COPD exacerbation, although its relationship with thymidine auxotrophy is unknown. In this study, the analysis of 2,542 NTHi isolates recovered at Bellvitge University Hospital (Spain) in the period 2010-2014 revealed 119 strains forming slow-growing colonies on the thymidine low concentration medium Mueller Hinton Fastidious, including one strain isolated from a COPD patient undergoing TxS therapy that was a reversible thymidine auxotroph. To assess the impact of thymidine auxotrophy in the NTHi-host interplay during respiratory infection, thyA mutants were generated in both the clinical isolate NTHi375 and the reference strain RdKW20. Inactivation of the thyA gene increased TxS resistance, but also promoted morphological changes consistent with elongation and impaired bacterial division, which altered H. influenzae self-aggregation, phosphorylcholine level, C3b deposition, and airway epithelial infection patterns. Availability of external thymidine contributed to overcome such auxotrophy and TxS effect, potentially facilitated by the nucleoside transporter nupC. Although, thyA inactivation resulted in bacterial attenuation in a lung infection mouse model, it also rendered a lower clearance upon a TxS challenge in vivo. Thus, our results show that thymidine auxotrophy modulates both the NTHi host airway interplay and antibiotic resistance, which should be considered at the clinical setting for the consequences of TxS administration.

The effect of late infection and antibiotic treatment on capsular contracture in silicone breast implants: A rat model.

BACKGROUND: The effect of late infection on capsular contracture has yet to be established, leaving a gap in clinical guidelines for the treatment patients with breast implants. This trial is the first to assess if the treatment of these infections can reverse this effect in an in vivo rat model and whether late distant infections increase the incidence of capsular contracture. MATERIALS AND METHODS: Three groups of female Wistar rats (n = 42) received two silicone implants in separate dorsal, subcutaneous pockets. All groups except control underwent injection of a human strain of methicillin-sensitive Staphylococcus aureus (MSSA) at least 30 days after implantation, allowing for physiologic capsule formation. The infection group received a peritoneal injection, inducing a transient bacteremia, the treated group received a course of antibiotics following bacterial inoculation, and a final group received no intervention and served as control. RESULTS: Implants were removed 4 months after insertion, and capsules measured for thickness and sent for bacterial quantification. Compared to both the control and treated groups, capsule thickness in the infection group was statistically greater (p < 0.05), a difference not observed between treated and control groups. In addition, a statistically significant positive correlation was found between capsule thickness and bacterial count (R = 0.614, p < 0.01). CONCLUSIONS: The difference in thickness between the control capsules and those from the infection group is an indication that bacterial contamination of a capsule from a remote late infection may increase the incidence of capsular contracture suggesting that treating late infections could in fact prevent capsular contracture.

Genome Expression Profiling-Based Identification and Administration Efficacy of Host-Directed Antimicrobial Drugs against Respiratory Infection by Nontypeable Haemophilus influenzae.

Therapies that are safe, effective, and not vulnerable to developing resistance are highly desirable to counteract bacterial infections. Host-directed therapeutics is an antimicrobial approach alternative to conventional antibiotics based on perturbing host pathways subverted by pathogens during their life cycle by using host-directed drugs. In this study, we identified and evaluated the efficacy of a panel of host-directed drugs against respiratory infection by nontypeable Haemophilus influenzae (NTHi). NTHi is an opportunistic pathogen that is an important cause of exacerbation of chronic obstructive pulmonary disease (COPD). We screened for host genes differentially expressed upon infection by the clinical isolate NTHi375 by analyzing cell whole-genome expression profiling and identified a repertoire of host target candidates that were pharmacologically modulated. Based on the proposed relationship between NTHi intracellular location and persistence, we hypothesized that drugs perturbing host pathways used by NTHi to enter epithelial cells could have antimicrobial potential against NTHi infection. Interfering drugs were tested for their effects on bacterial and cellular viability, on NTHi-epithelial cell interplay, and on mouse pulmonary infection. Glucocorticoids and statins lacked in vitro and/or in vivo efficacy. Conversely, the sirtuin-1 activator resveratrol showed a bactericidal effect against NTHi, and the PDE4 inhibitor rolipram showed therapeutic efficacy by lowering NTHi375 counts intracellularly and in the lungs of infected mice. PDE4 inhibition is currently prescribed in COPD, and resveratrol is an attractive geroprotector for COPD treatment. Together, these results expand our knowledge of NTHi-triggered host subversion and frame the antimicrobial potential of rolipram and resveratrol against NTHi respiratory infection.

Relationship between azithromycin susceptibility and administration efficacy for nontypeable Haemophilus influenzae respiratory infection.

Nontypeable Haemophilus influenzae (NTHI) is an opportunistic pathogen that is an important cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). COPD is an inflammatory disease of the airways, and exacerbations are acute inflammatory events superimposed on this background of chronic inflammation. Azithromycin (AZM) is a macrolide antibiotic with antibacterial and anti-inflammatory properties and a clinically proven potential for AECOPD prevention and management. Relationships between AZM efficacy and resistance by NTHI and between bactericidal and immunomodulatory effects on NTHI respiratory infection have not been addressed. In this study, we employed two pathogenic NTHI strains with different AZM susceptibilities (NTHI 375 [AZM susceptible] and NTHI 353 [AZM resistant]) to evaluate the prophylactic and therapeutic effects of AZM on the NTHI-host interplay. At the cellular level, AZM was bactericidal toward intracellular NTHI inside alveolar and bronchial epithelia and alveolar macrophages, and it enhanced NTHI phagocytosis by the latter cell type. These effects correlated with the strain MIC of AZM and the antibiotic dose. Additionally, the effect of AZM on NTHI infection was assessed in a mouse model of pulmonary infection. AZM showed both preventive and therapeutic efficacies by lowering NTHI 375 bacterial counts in lungs and bronchoalveolar lavage fluid (BALF) and by reducing histopathological inflammatory lesions in the upper and lower airways of mice. Conversely, AZM did not reduce bacterial loads in animals infected with NTHI 353, in which case a milder anti-inflammatory effect was also observed. Together, the results of this work link the bactericidal and anti-inflammatory effects of AZM and frame the efficacy of this antibiotic against NTHI respiratory infection.

Conocimiento sobre seguridad del paciente por personal de enfermería del Hospital Militar Dr. Alejandro Dávila Bolaños, Managua, Nicaragua, Diciembre 2014 / Patient safety knowledge by nursing staff of the Dr. Alejandro Dávila Bolaños Military Hospital, Managua, Nicaragua, December 2014

La seguridad del paciente está relacionada con los conocimientos que poseen las personas en su práctica para garantizar que no experimentará daño innecesario o potencial asociado a la atención en salud. Este estudio describe los resultados sobre conocimiento que posee el personal de enfermería en el Hospital Militar Escuela Dr. Alejandro Dávila Bolaños sobre seguridad del paciente. Diseño: Estudio descriptivo, con diseño transversal, exploratorio, realizado durante el mes de Diciembre 2014. La muestra estuvo constituida por 287 profesionales y técnicos en enfermería que aceptaron participar voluntariamente y cumplieron los requisitos de inclusión planteados. La medición se realizó con el instrumento "Conocimiento sobre seguridad del paciente ". El cuestionario fue auto administrado después de informar el propósito y cumplir las consideraciones éticas. Resultados: El nivel de conocimiento sobre los conceptos de seguridad del paciente es insuficiente en el personal de enfermería del Hospital Militar Dr. Alejandro Dávila Bolaños, este hallazgo era de esperar dado que es un tema que se está introduciendo en el hospital y servirá como línea de base para desarrollar un plan de trabajo con miras a mejorar y elevar este conocimiento

Validez y confiabilidad de la versión adaptada al español de la escala de dificultades de regulación emocional (DERS-E) en población chilena / Validity and reliability of the adapted spanish version of the difficulties in emotion regulation scale in chilean population

El objetivo de esta investigación fue examinar la confiabilidad y validez de la versión adaptada al español de la Escala de Dificultades de Regulación Emocional (DERS-E), en población chilena. Este es un instrumento de auto-reporte que evalúa las dificultades en el proceso de regulación emocional en adultos. El estudio se realizó a partir de dos muestras: la primera compuesta por 1018 estudiantes universitarios y la segunda por 1161 adultos de población general. Los participantes completaron el DERS-E y una medida de ajuste socioemocional a través del Outcome Questionnaire OQ-45.2. Los índices de confiabilidad fueron adecuados en ambas muestras y la estructura factorial congruente con la versión adaptada al español. Además, hubo diferencias en las dificultades de regulación emocional en función del ajuste socioemocional. Los resultados confirmaron que el DERS-E es un instrumento confiable y válido en la evaluación de las dificultades de regulación emocional en adultos.

This study sought to examine the validity and reliability of the Difficulties in Emotion Regulation Scale Spanish version (DERS-S) in chilean population. This is a self-report instrument that measures difficulties in emotion regulation in adults. Two samples were evaluated: one composed of 1018 university students and the second one composed of 1161 participants from general population. Individuals completed the DERSE and Outcome Questionnaire OQ-45.2. Reliability indices were adequate in both samples and the factor structure consistent with the spanish version adaptation. In addition, there were differences in emotional regulation difficulties according to socio-emotional adjustment. The results confirmed that the psychometric properties of the DERS-E make it a reliable and valid instrument to assess difficulties in emotion regulation.

Structural features governing the activity of lactoferricin-derived peptides that act in synergy with antibiotics against Pseudomonas aeruginosa in vitro and in vivo.

Pseudomonas aeruginosa is naturally resistant to many antibiotics, and infections caused by this organism are a serious threat, especially to hospitalized patients. The intrinsic low permeability of P. aeruginosa to antibiotics results from the coordinated action of several mechanisms, such as the presence of restrictive porins and the expression of multidrug efflux pump systems. Our goal was to develop antimicrobial peptides with an improved bacterial membrane-permeabilizing ability, so that they enhance the antibacterial activity of antibiotics. We carried out a structure activity relationship analysis to investigate the parameters that govern the permeabilizing activity of short (8- to 12-amino-acid) lactoferricin-derived peptides. We used a new class of constitutional and sequence-dependent descriptors called PEDES (peptide descriptors from sequence) that allowed us to predict (Spearman's ρ = 0.74; P < 0.001) the permeabilizing activity of a new peptide generation. To study if peptide-mediated permeabilization could neutralize antibiotic resistance mechanisms, the most potent peptides were combined with antibiotics, and the antimicrobial activities of the combinations were determined on P. aeruginosa strains whose mechanisms of resistance to those antibiotics had been previously characterized. A subinhibitory concentration of compound P2-15 or P2-27 sensitized P. aeruginosa to most classes of antibiotics tested and counteracted several mechanisms of antibiotic resistance, including loss of the OprD porin and overexpression of several multidrug efflux pump systems. Using a mouse model of lethal infection, we demonstrated that whereas P2-15 and erythromycin were unable to protect mice when administered separately, concomitant administration of the compounds afforded long-lasting protection to one-third of the animals.

Non-O1 Vibrio cholerae inguinal skin and soft tissue infection with bullous skin lesions in a patient with a penis squamous cell carcinoma.

Vibrio spp. is a pathogen rarely isolated in cancer patients, and in most cases it is associated with haematological diseases. Cutaneous manifestations of this organism are even rarer. We report a case of Non-O1 Vibrio cholerae inguinal skin and soft tissue infection presenting bullous skin lesions in a young type II diabetic patient with a penis squamous cell carcinoma having a seawater exposure history.

Comparative analysis of selected methods for the assessment of antimicrobial and membrane-permeabilizing activity: a case study for lactoferricin derived peptides.

BACKGROUND: Growing concerns about bacterial resistance to antibiotics have prompted the development of alternative therapies like those based on cationic antimicrobial peptides (APs). These compounds not only are bactericidal by themselves but also enhance the activity of antibiotics. Studies focused on the systematic characterization of APs are hampered by the lack of standard guidelines for testing these compounds. We investigated whether the information provided by methods commonly used for the biological characterization of APs is comparable, as it is often assumed. For this purpose, we determined the bacteriostatic, bactericidal, and permeability-increasing activity of synthetic peptides (n = 57; 9-13 amino acid residues in length) analogous to the lipopolysaccharide-binding region of human lactoferricin by a number of the most frequently used methods and carried out a comparative analysis. RESULTS: While the minimum inhibitory concentration determined by an automated turbidimetry-based system (Bioscreen) or by conventional broth microdilution methods did not differ significantly, bactericidal activity measured under static conditions in a low-ionic strength solvent resulted in a vast overestimation of antimicrobial activity. Under these conditions the degree of antagonism between the peptides and the divalent cations differed greatly depending on the bacterial strain tested. In contrast, the bioactivity of peptides was not affected by the type of plasticware (polypropylene vs. polystyrene). Susceptibility testing of APs using cation adjusted Mueller-Hinton was the most stringent screening method, although it may overlook potentially interesting peptides. Permeability assays based on sensitization to hydrophobic antibiotics provided overall information analogous - though not quantitatively comparable- to that of tests based on the uptake of hydrophobic fluorescent probes. CONCLUSION: We demonstrate that subtle changes in methods for testing cationic peptides bring about marked differences in activity. Our results show that careful selection of the test strains for susceptibility testing and for screenings of antibiotic-sensitizing activity is of critical importance. A number of peptides proved to have potent permeability-increasing activity at subinhibitory concentrations and efficiently sensitized Pseudomonas aeruginosa both to hydrophilic and hydrophobic antibiotics.

Ascaridiasis complicada: presentación de un caso / Complicated ascaridiasis: a case report

Estudio de observación directa sobre ascaridiasis complicada, con el objetivo de dar a conocer las complicaciones quirúrgicas que puede producir una infestación por áscaris. Se describe el caso de un infante masculino de 3 años de edad que ingresó al servicio de Cirugía General del Hospital del Niño “Dr. Francisco de Ycaza Bustamante”, con diagnóstico de abdomen agudo vs. íleo metabólico o medicamentoso; ingresa al quirófano donde se encontró necrosis distal del intestino delgado con áscaris en su interior.Conclusión: el Ascaris lumbricoides es un helminto muy infectante e invasivo y cuyas complicaciones pueden ser quirúrgicas, las que pueden producir la muerte.

Observational study on complications of Ascaridiasis infection with the objective to know the surgical complications that it can produce an infection bye ascaris.The case of a male infant of 3 years, who was admitted in the area of General Surgery at “Dr. Francisco de Ycaza Bustamante” Hospital, with diagnosis of acute abdomen vs. pharmacologic or metabolic ileo, the boy was taken to the surgery room where we observed distal necrosis of the small intestine with an ascaris.Conclusion: the Ascaris lumbricoides is a very dangerous parasite that leads to complications can be surgical and can lead to death.

[Calcification of the tunica vaginalis testis]. / Calcificación de la vaginal testicular.

OBJECTIVE: To describe a case of calcification of the tunica vaginalis testis. METHODS: A 66-year-old patient with right hydrocele and superficial carcinoma of the bladder who underwent TUR and was treated with mitomycin prophylactic instillations, is described. The patient presented a bulbar urethral stricture. A retrograde urethrogram demonstrated calcification of the tunica vaginalis testis. An ultrasound scan confirmed the diagnosis. RESULTS: The surgical and histopathological findings confirmed the diagnosis of hydrocele with calcification of the tunica vaginalis. CONCLUSIONS: Calcification of the tunica vaginalis testis is uncommon. It is therefore difficult to make the preoperative diagnosis, although radiological and ultrasound evaluation can be useful. The histopathological analysis confirmed the nature of the lesion in the case described herein.

Enalapril oral en pacientes con comunicación interventricular sintomáticos / Oral enalapril in symptomatic patients with interventricular septal defect

Estudios en animales de experimentación y clínicos en el laboratorio de hemodinámica, han mostrado que los EICAs disminuyen el cortocircuito de izquierda a derecha en la comunicación interventricular (CIV). El objetivo del estudio es valorar los efectos del enalapril, a corto y mediano plazo, en pacientes con CIV sintomáticos y Qp:Qs mayor de 1.5:1 y compararlos con el tratamiento convencional de insuficiencia cardiaca congestiva (ICC) en niños. Se estudiaron 24 pacientes entre 3 meses y 8 años de edad. En cada grupo se estudiaron ocho pacientes. El grupo I fue tratado con enalapril, el grupo II con furosemida y digoxina y el grupo III con los tres medicamentos. Los controles se efectuaron al mes, tres y seis meses, En cada cita se evaluaron datos clínicos de ICC, peso, frecuencia cardiaca, tensión arterial, índice cardiotorácico y ecocardiograma con las mediciones de las cavidades cardiacas, tamaño de la CIV y parámetros hemodinámicos (Qp:Qs, PSAP, gradiente de la CIV, FEy FA). El análisisi estadístico se realizó por grupo y comparando los tres grupos. Los resultados mostraron un aumento de peso significativo (p<0.05) para los tres grupos. Además, se observó una disminución de la frecuencia cardiaca, Qp:Qs y PSAP en el grupo III. Sin embargo, al comparar los parámetros estudiados entre los grupos, el análisisi estadístico no mostró diferencias significativas. No se observaron efectos colaterales. El uso del enalpril, asociado con la furosemida y digoxima, puede ser de utilidad en los pacientes sintomáticos, en espera de la cirugía de cierre de la CIV

Flutter auricular asociado a un aneurisma del septum interatrial, sometido a ablación con radiofrecuencia / Atrial flutter associated to atrial septal aneurysm treated with radiofrequency ablation

Presentamos el caso de un adulto joven que inició con un flutter atrial (F1-A) tipo I, de difícil manejo farmacológico, en el cual el único hallazgo anormal documentado en un ecocardiograma fue la presencia de un aneurisma septal a nivel de la fosa oval. Durante un estudio electrofisiológico (EEF) de registró un F1A con ciclos atriales de 233 m seg para una frecuencia atrial de 257 lpm, con una conducción AV de 2:1 y 3:1. Las ondas de flutter fueron negativas en las derivaciones inferiores (II, III, a VF), sugiriendo una activación caudo-cefálica, característica del F1A tipo I (común). Esto fue confirmado mediante los registros intracavitarios de la secuencia de activación auricular. Se realizó un mapeo con el objeto de localizar la zona de conducción lenta e intentar la ablación con radiofrecuencia (RF). Se encontraron registros adecuados a nivel del istmo cavo-tricuspídeo, por lo que se procedió a la aplicación de la RF en esta zona. Después de las 10 primeras descargas de RF, el paciente continuaba con la taquiarritmia. Con estimulación atrial incremental se logró el arrastre del F1A, el cual fue suprimido. Después de 6 descargas más de RF en esa misma zona y durante ritmo sinusal, se intentó inducir de nuevo del F1A mediante estimulación eléctrica programada, sin lograrlo. Al final del procedimiento, el paciente quedó en ritmo sinusal, sin complicaciones. Un día después se escontraba asintomático, se egresó sin tratamiento antiarrítmico. Fue valorado por su médico tratante a los 15 días posteriores a la ablación, encontrándolo asintomático. Un mes después, la arritmia recurrió, por lo que se sometió a una segunda sesión exitosa de radiofrecuencia. Se hizó una revisión de la literatura acerca de los aneurismas atriales y algunas complicaciones asociadas a éstos (principalmente las arritmias supraventriculares). Así como del F1A tipo I, las técnicas para su mapeo y los resultados de la ablación en este tipo de arritmia