الملخص
ABSTRACT Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries.
الملخص
The aqueous standard extract of Mangifera indica L stem bark (MSBE) is used as a food supplement in Cuba. In this study, the genotoxic effect of MSBE was measured using different variants of the in vitro Comet assay in human lymphocytes and rat hepatocytes incubated with MSBE at 37C for 1 hour. Lymphocytes were incubated with MSBE for the subcellular (at two different pH conditions) and the standard Comet assays, in presence of catalase or S9 microsomal fraction. Hydrogen peroxide, benzo(a)pirene and UV radiation were used as positive controls. Results from standard and subcellular Comet assays clearly showed that MSBE (50 ug/mL) induced primary DNA damage to lymphocytes. This genotoxic effect was slightly reduced when lymphocytes were incubated with MSBE plus catalase, which suggests that hydrogen peroxide is involved in this DNA injury. S9 fraction also decreased MSBE-induced damage to DNA in human lymphocytes. Not genotoxic effect was observed when rat hepatocytes were exposed at MSBE, suggesting that the metabolic activity can be involved in the elimination of the DNA damage generated by the MSBE. In conclusion, MSBE causes primary DNA injury of human lymphocytes in vitro Comet assay, but not in rat hepatocytes in similar conditions.
El extracto acuoso de la corteza de Mangifera indica L. (MSBE) es usado como suplemento alimenticio en Cuba. En este estudio se determinaron los efectos genotóxicos de MSBE mediante diferentes variantes del ensayo Cometa in vitro en linfocitos humanos y hepatocitos de rata incubados con MSBE a 37C por 1 hora. Los linfocitos fueron incubados con MSBE para la realización de los ensayos Cometa subcelular (a dos condiciones de pH diferentes) y estándar, en presencia de catalasa o fracción microsomal S9. Peróxido de hidrógeno, benzo(a)pireno y radiación UV fueron usados como controles positivos. Los resultados de los ensayos Cometa, tanto subcelular como estándar, mostraron que MSBE (50 ug/mL) indujo daño primario al ADN de los linfocitos. Este efecto genotóxico fue ligeramente reducido cuando las células fueron incubadas con MSBE más catalasa, lo que sugiere que el peróxido de hidrógeno está involucrado en este daño al ADN. La fracción S9 también decreció el daño inducido por MSBE al ADN en linfocitos humanos. No fueron observados efectos genotóxicos cuando los hepatocitos de rata fueron expuestos a MSBE, sugiriendo que la actividad metabólica pudiera estar involucrada en la eliminación del daño al ADN generado por MSBE. En conclusión, MSBE causa daño primario al ADN de linfocitos humanos en el ensayo Cometa in vitro, pero no en hepatocitos de rata bajo condiciones similares.
الموضوعات
Humans , Male , Rats , Plant Extracts/pharmacology , Mangifera/pharmacology , Mangifera/chemistry , Catalase , Comet Assay , DNA Damage , Genotoxicity , Hepatocytes , Lymphocytes , Rats, Sprague-Dawley , Cell Survivalالملخص
Two cases of hepatitis E that were assisted in our Unit of Hepatology and Liver Transplantation are described in this article. The first patient had prior hepatic involvement and therefore a more severe course, whereas the second case, with normal liver function, only developed a self-limited acute hepatitis.
الموضوعات
Hepatitis E/diagnosis , Acute Disease , Chronic Disease , Hepatitis E/virology , Humans , Aged , Male , Middle Aged , Hepatitis E virusالملخص
Los traumas penetrantes cardiacos constituyen uno de los cuadros más dramáticos que pueden presentarse en la sala de urgencia por su alta letalidad, sólo un rápido traslado al centro asistencial, un diagnóstico precoz y una toracotomía de urgencia, puede aumentar la supervivencia. Se presentó un paciente operado en el Hospital Territorial Docente Pedro Betancourt, de Jovellanos, en mayo del 2004, de una herida ventricular izquierda, logrando su supervivencia...
Penetrating cardiac trauma is one of the most dramatic features that could assist the urgency service because of its high lethality. Only a fast delivery of the patient to a health care institution, a precocious diagnostic and an urgent thoracotomy might increase survival. We present a patient operated in the Teaching Territorial Hospital Pedro Betancourt, Jovellanos, in May 2004, for a left ventricular injury, achieving his survival...
الموضوعات
Humans , Male , Adult , Heart Injuries/surgery , Heart Injuries/diagnosis , Heart Injuries/epidemiology , Thoracotomy/methods , Heart Ventricles/injuries , Intensive Care Unitsالملخص
La infección por el virus de hepatitis A (HAV) es endémica en Argentina. El uso de técnicas moleculares permitió extender la detección del RNA del HAV en sueroy heces en pacientes con diferentes presentaciones clínicas. Comparamos la sensibilidad del protocolo de RT-PCR que usamos con cebadores dirigidos a distintas regiones del genoma, resultando la detección de la región VP3 C terminal la más sensible. Se obtuvieron prospectivamente muestras de suero y materia fecal de 20 niños con hepatitis aguda autolimitada por HAV. El RNA del HAV fue detectado en 18/20 niños en muestras basales y en 19/20 sumando una muestra posterior. El RNA del HAV fue detectable en 9/20 acientes hasta 30 días en suero; en materia fecal en 2/20 hasta 60 días y en 1/20 hasta 90 días. La secuencia genómica para la región VP1/2A en 8 muestras demostró que todas pertenecían al subgenotipo IA, aunque eran diferentes entre sí. Solo en 1/11 niños con falla hepatica fulminante fue posible la detección del RNA del HAV utilizando la región VP3 C terminal y el genotipo fue I. La reciente introducción de la vacunación universal en niños de 1 año de edad en Argentina podría disminuir drásticamente la circulación del virus, emergiendo nuevas fuentes de infección y permitiendo la introducción de nuevos genotipos. Las técnicas moleculares aplicadas al estudio de la historia natural de la infección y a la vigilancia epidemiológica contribuyenal control y la toma de decisiones eficientes en políticas de Salud Pública.
Hepatitis A virus (HAV) infection is endemic in Argentina. Molecular tools have allowed HAV RNA detection to be extent to sera and feces from patients with different clinical backgrounds. We compare the sensitivity of the RT-PCR protocol we follow using primers targeting different genomic regions and VP3 C terminal was the most sensitive. Sequential sera and fecal samples were obtained from 20 children with acute self limited Hepatitis A. HAV RNA was detectable in 18/20 children if sera and stool specimens were collected at the onset of symptoms and in 19/20 if a later sample was considered. HAV RNA was detectable in serum from 9/20 patients until day 30 and in feces from 2 patients until day 60 and until day 90 in one. Genomic sequences from VP1/2A region in 8 samples showed they all belong to subgenotype IA although they were different between them. HAV RNA was detectable only in 1/11 sera from children with acute liverfailure when VP3 C terminal fragment was searched and it belonged to genotype I. Universal vaccination in one year old children was recently implemented in Argentinaand it will dramatically enable the decrease of the viral circulation, making new sources of infection emerge and allowing the introduction of new genotypes. The application of molecular tools to the study of the natural history of infection and to the epidemiologicsurveillance may contribute to efficient control and lead to rational decisions in public health policies.
الموضوعات
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Feces/virology , Hepatitis A/diagnosis , Hepatovirus/isolation & purification , Viremia/virology , Virus Shedding , Acute Disease , Hepatitis A/complications , Hepatitis A/virology , Hepatovirus/genetics , Liver Failure, Acute/blood , Liver Failure, Acute/virology , Molecular Sequence Data , Oligonucleotide Probes , Prospective Studies , RNA, Viral/analysis , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and Specificity , Time Factorsالملخص
Las cepas de virus de hepatitis E (HEV) encontradas en casos esporádicos humanos y en cerdos en Argentina corresponden al genotipo 3. Se han descripto variantes de este genotipo asociadas a fallas hepáticas fulminantes (FHF) en adultos de Japón e Inglaterra. En Argentina el 30% de las FHF en adultos y en niños es de etiología desconocida. Para estudiar si el HEV podría ser el agente etiológico asociado a FHF en niños se analizaron el suero y/o la materia fecal de 35 niños (edad media 6 años, 20 mujeres, 15 varones) durante 2003 y 2004. El HEV RNA fue detectado por RT-nested PCR con cebadores dirigidos a las regiones ORF 1 y ORF 2. El HEV RNA pudo detectarse en 3 casos. Dos eran varones de 12 años residentes en la provincia de Buenos Aires y el tercero, una niña de 3 años de la provincia de Corrientes. El análisis de las secuencias muestra que las 3 variantes son distintas, pero pertenecen todas al genotipo 3 y están muy relacionadas a las cepas encontradas previamente en casos esporádicos en humanos y en cerdos de Argentina. Estos datos sugieren una posible relación entre FHF y HEV en niños de Argentina e indican la necesidad de considerar la infección con HEV en el diagnóstico diferencial de las FHF. Se necesitan más estudios que demuestren el verdadero impacto de esta infección y el beneficio potencial de na vacuna para HEV, actualmente en fase III.
Strains of hepatitis E virus (HEV) isolated from Argentinian patients with sporadic hepatitis, as well as from swine from Argentina, belong to genotype 3. HEV genotype 3 variants have been described associated with acute liver failure (ALF) in adults from Japan and the United Kingdom. In Argentina, 30% of ALF in adults and children are of unknown aetiology. To study if HEV could be an aetiological agent associated with ALF in children, serum and/or fecal samples from 35 children (mean age: 6 years, 20 female, 15 male) were analyzed during 2003 and 2004. HEV RNA was detected by RT-nested PCR with primers designed within ORF 1 and ORF 2 regions. HEV RNA could be detected in three cases. Two were 12-year-old boys from Buenos Aires province and the third was a 3- year-old girl from Corrientes province. Sequence analysis indicates that the three isolates are distinct from each other but all belong to genotype 3, exhibiting a close relationship with swine and human strains from sporadic cases of HEV, previously reported in Argentina. This data suggests a potential link between ALF and HEV in children in Argentina and indicates the need for the determination of HEV status in the differential diagnosis in ALF. Further studies would aid in determining the true impact of this infection in Argentina and the potential benefits of a vaccine against HEV, presently in phase III trials.