Effect of urban vs. rural residence on the association between atopy and wheeze in Latin America: findings from a case-control analysis.

BACKGROUND: The association between atopy and asthma is attenuated in non-affluent populations, an effect that may be explained by childhood infections such as geohelminths. OBJECTIVE: To investigate the association between atopy and wheeze in schoolchildren living in urban and rural areas of Ecuador and examine the effects of geohelminths on this association. METHODS: We performed nested case-control studies among comparable populations of schoolchildren living in rural communities and urban neighbourhoods in the Province of Esmeraldas, Ecuador. We detected geohelminths in stool samples, measured recent wheeze and environmental exposures by parental questionnaire, and atopy by specific IgE (sIgE) and skin prick test (SPT) reactivity to aeroallergens. RESULTS: Atopy, particularly sIgE to house dust mite (HDM), was more strongly associated with recent wheeze in urban than rural schoolchildren: (urban, adj. OR 5.19, 95% CI 3.37-8.00, P < 0.0001; rural, adj. OR 1.81, 95%CI 1.09-2.99, P = 0.02; interaction, P < 0.001). The population fractions of wheeze attributable to atopy were approximately two-fold greater in urban schoolchildren: SPT to any allergen (urban 23.5% vs. rural 10.1%), SPT to HDM (urban 18.5% vs. rural 9.6%), and anti-HDM IgE (urban 26.5% vs. rural 10.5%), while anti-Ascaris IgE was related to wheeze in a high proportion of rural (49.7%) and urban (35.4%) children. The association between atopy and recent wheeze was attenuated by markers of geohelminth infections. CONCLUSIONS: Our data suggest that urban residence modifies the association between HDM atopy and recent wheeze, and this effect is explained partly by geohelminth infections.

Disinfection of an advanced primary effluent using peracetic acid or ultraviolet radiation for its reuse in public services.

The disinfection of a continuous flow of an effluent from an advanced primary treatment (coagulation-flocculation-sedimentation) with or without posterior filtration, using either peracetic acid (PAA) or ultraviolet (UV) radiation was studied. We aimed to obtain bacteriological quality to comply with the microbiological standard established in the Mexican regulations for treated wastewater reuse (NOM-003-SEMARNAT-1997), i.e., less than 240 MPN (most probable number) FC/100 mL. The concentrations of PAA were 10, 15, and 20 mg/L, with contact times of 10, and 15 min. Fecal coliforms (FC) inactivation ranged from 0.93 up to 6.4 log units, and in all cases it reached the limits set by the mentioned regulation. Water quality influenced the PAA disinfection effectiveness. An efficiency of 91% was achieved for the unfiltered effluent, as compared to 99% when wastewater was filtered. UV radiation was applied to wastewater flows of 21, 30 and 39 L/min, with dosages from 1 to 6 mJ/cm². This treatment did not achieve the bacteriological quality required for treated wastewater reuse, since the best inactivation of FC was 1.62 log units, for a flow of 21 L/min of filtered wastewater and a UV dosage of 5.6 mJ/cm².

Ovine ear model for fully endoscopic stapedectomy training.

Endoscopic surgery of the middle ear is progressively gaining the interest of otologists, as technological advances have overcome some of its main drawbacks. The long learning curve required to master this technique, urges the search for models to practice it. After the validation of sheep's ear as a proper training model for microscopic stapedectomy, our objective is to demonstrate its adequacy for practicing stapes surgery but performed through a fully endoscopic approach. Endoscopic stapedectomy was performed by two surgeons in 40 sheep ears (20 specimens each). To analyze the effects of the learning curve on surgical success, complication rates and surgical time reduction, the sample was divided in two groups: group 1 being the first ten procedures of each surgeon, and group 2 the second set of stapedectomies. The impact of the operated side and the resection of the chordal spine were also studied. No statistically significant differences were found considering the operated side. A statistically significant improvement in some of the surgical steps was demonstrated comparing both groups and also after the resection of the chordal spine. Mean surgical time declined from 38 to 31.5 min (p < 0.05). Using this model for endoscopic stapedectomy, a learning curve was objectively demonstrated, along with other subjective appreciations such as improvement in depth perception and one-hand instrument handling. We believe that sheep ear is an optimal model for endoscopic middle ear surgery, as it allows for the acquisition of the skills required to master this technique.

Effects of geohelminth infection and age on the associations between allergen-specific IgE, skin test reactivity and wheeze: a case-control study.

BACKGROUND: Most childhood asthma in poor populations in Latin America is not associated with aeroallergen sensitization, an observation that could be explained by the attenuation of atopy by chronic helminth infections or effects of age. OBJECTIVE: To explore the effects of geohelminth infections and age on atopy, wheeze, and the association between atopy and wheeze. METHODS: A case-control study was done in 376 subjects (149 cases and 227 controls) aged 7-19 years living in rural communities in Ecuador. Wheeze cases, identified from a large cross-sectional survey, had recent wheeze and controls were a random sample of those without wheeze. Atopy was measured by the presence of allergen-specific IgE (asIgE) and skin prick test (SPT) responses to house dust mite and cockroach. Geohelminth infections were measured in stools and anti-Ascaris IgE in plasma. RESULTS: The fraction of recent wheeze attributable to anti-Ascaris IgE was 45.9%, while those for SPT and asIgE were 10.0% and 10.5% respectively. The association between atopy and wheeze was greater in adolescents than children. Although Anti-Ascaris IgE was strongly associated with wheeze (adj. OR 2.24 (95% CI 1.33-3.78, P = 0.003) and with asIgE (adj. OR 5.34, 95% CI 2.49-11.45, P < 0.001), the association with wheeze was independent of asIgE. There was some evidence that the association between atopy and wheeze was greater in uninfected subjects compared with those with active geohelminth infections. CONCLUSIONS AND CLINICAL RELEVANCE: Atopy to house dust mite and cockroach explained few wheeze cases in our study population, while the presence of anti-Ascaris IgE was an important risk factor. Our data provided only limited evidence that active geohelminth infections attenuated the association between atopy and wheeze in endemic areas or that age modified this association. The role of allergic sensitization to Ascaris in the development of wheeze, independent of atopy, requires further investigation.

Acinetobacter baumannii infections in a tertiary care hospital in Mexico over the past 13 years.

BACKGROUND: Acinetobacter baumannii has evolved from an opportunistic pathogen into a common and persistent nosocomial bacterium capable of causing severe infections during endemic and epidemic periods. METHODS: The study period extended from January 1999 to December 2011 and involved patients hospitalized at the Hospital Civil de Guadalajara, Fray Antonio Alcalde, Jalisco, Mexico. From each patient, a single isolate was obtained, and a total of 3,680 unique isolates were collected. Susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. RESULTS: A. baumannii has disseminated throughout the Hospital Civil de Guadalajara, Fray Antonio Alcalde, since 1999. A. baumannii isolates obtained from patients treated in the adult intensive care unit represent the majority of the isolates that have been collected. In addition, A. baumannii was isolated from the adult neurosurgical ward and the adult internal medicine ward, and these isolates were frequently obtained from secretions. A persistent decrease in the susceptibility of A. baumannii isolates to meropenem (92% in 1999 to 12% in 2011), imipenem and amikacin has been observed. CONCLUSIONS: A. baumannii became an endemic nosocomial pathogen during the study period at the Hospital Civil de Guadalajara, Fray Antonio Alcalde, and has exhibited a persistent decrease in susceptibility to all categories of antimicrobial agents over the past 13 years.

Long-term periodic anthelmintic treatments are associated with increased allergen skin reactivity.

BACKGROUND: The low prevalence of allergic disease in the rural tropics has been attributed to the protective effects of chronic helminth infections. There is concern that treatment-based control programmes for these parasites may lead to an increase in the prevalence of allergic diseases. OBJECTIVE: We measured the impact of 15-17 years of anthelmintic treatment with ivermectin on the prevalence of allergen skin test reactivity and allergic symptoms in school-age children. METHODS: The prevalence of allergen skin test reactivity, exercise-induced bronchospasm and allergic symptoms was compared between school-age children living in communities that had received community-based treatments with ivermectin (for onchocerciasis control) for a period of 15-17 years with those living in geographically adjacent communities that had received no ivermectin. RESULTS: The prevalence of allergen skin test reactivity was double in children living in treated communities compared with those in untreated communities (16.7% vs. 8.7%, adjusted OR 2.10, 95% CI 1.50-2.94, P<0.0001), and the effect was mediated partly by a reduced prevalence of Trichuris trichiura among treated children. Ivermectin treatments were associated with an increased prevalence of recent eczema symptoms (adjusted OR 2.24, 95% CI 1.05-4.78, P=0.04) but not symptoms of asthma or rhino-conjunctivitis. The effect on eczema symptoms was not associated with reductions in geohelminth infections. CONCLUSION: Long-term periodic treatments with ivermectin were associated with an increased prevalence of allergen skin test reactivity. There was some evidence that treatment was associated with an increased prevalence of recent eczema symptoms but not those of asthma or rhino-conjunctivitis.

High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador.

Bacterial vaginosis (BV) is a common clinical syndrome, but data are scarce on the BV prevalence in tropical regions among sexually active and virgin adolescents. To estimate the prevalence of BV among adolescent girls in an Ecuadorian coastal town, girls were asked to complete a questionnaire on risk factors for BV and vaginal samples were examined. Bacterial vaginosis was present in 31.5% of 213 girls, and the prevalence was similar in self-reported virgin and sexually active girls (OR 1.06, 95% CI, 0.51-2.21, P = 0.88), although the power of this analysis was limited. The prevalence of BV was high among Ecuadorian adolescent girls, and did not appear to be associated with sexual activity.

What functional proteomic and biochemical analysis tell us about animal stress in beef?

Animal management practices may influence the animal's susceptibility to stress, with detrimental effects on the ultimate meat quality. In this field, proteomics is a promising tool that reveals the biological pathways underpinning the effect of animal's pre-slaughter stress (PSS) on the ultimate meat quality. The objective of this work was to study the effect of a pre-slaughter procedure that may promote stress, such as mixing unfamiliar animals during the transport and lairage period, on the post-mortem muscle proteome of young bulls reared under two different farm management systems (Intensive or Extensive). Comparative proteomics and biochemical analysis reveal the effect of PSS on biochemical pathways involved in the meat colour development, muscle redox status, energy metabolism and autophagy. This work highlights the potential of some muscle proteins such as Beclin-1 (autophagy marker), CKM (biomarker of energy transduction) and proteins of the energy metabolism (ALDOA, PYGM, PGM1, PKM, GPI) as potential biomarkers to discriminate beef samples according to the incidence of PSS. SIGNIFICANCE: Meat scientists are interested in the study of individual animal-based measurements that allow the detection of stress situations which could have negative effects on meat quality. In this context, the mechanisms underlying the adverse effects of pre-slaughter stress on the post-mortem muscle metabolism need to be elucidated in order to understand how animal stress may influence the conversion of muscle into meat. In this work, the study of proteome changes in the post-mortem muscle has allowed the identification of significant biomarkers of these processes that could be used as tools for detecting inappropriate strategies that may induce increased animal stress and, in consequence, may compromise the ultimate beef quality.

Cochlear obliteration following a translabyrinthine approach and its implications in cochlear implantation.

The most frequent sequelae following a translabyrinthine approach for vestibular schwannoma resection is complete hearing loss on the affected side. Such patients could benefit from a cochlear implant, provided that two essential requisites are met before surgery: a preserved cochlear nerve and a patent cochlea to accommodate the electrode array. The goal of our study is to determine the prevalence and extent of cochlear ossification following a translabyrinthine approach. Postoperative MRI of 41 patients were retrospectively reviewed. Patients were classified according to the degree of cochlear obliteration into three groups (patent cochlea, partially obliterated cochlea and totally obliterated cochlea). The interval between surgery and the first MRI was studied as well as its relationship with the rate of cochlear ossification. At first postoperative MRI (mean interval of 20 months), 78% of patients showed some degree of cochlear ossification. Differences were found in the time interval between surgery and first MRI for each group, showing a smaller interval of time the patent cochlea group (p > 0.05). When MRI was performed before the first year after surgery, a larger rate of patent cochlea was found (p > 0.05). The present study suggests that cochlear ossification is a time-depending process, whose grounds are still to be defined.

Alum recovery and wastewater sludge stabilization with sulfuric acid.

Coagulation-flocculation is used to remove helminth ova from wastewater intended for agricultural reuse. Nevertheless, it has the drawback of producing a large amount of sludge which together with the chemicals used to treat the wastewater increases the operating cost. This can be overcome by recovering and recycling the aluminium contained in the sludge. This paper presents how an acid recovery process was applied to an Advanced Primary Treatment (APT) sludge to partially treat it and to reduce its quantity. This is a method applied several decades ago in water sludge that has not been used in secondary wastewater sludge to recover aluminium and to inactivate microorganisms. By adding sulphuric acid to a 6%TS sludge, more than 70% of the aluminium added during the coagulation flocculation process was recovered when a pH of 2 was maintained during 30 minutes and at 300 rpm of mixing conditions. This way the sludge was reduced by 45% in volume and by 63% by mass, inactivating 5 logs of faecal coliforms and 68% of helminth ova. Due to the lower alum consumption, the operating cost of the APT is reduced by 3.78 US$/1,000 m(3).

Effects of poor hygiene on cytokine phenotypes in children in the tropics.

We describe immune phenotypes (innate and adaptive cytokines) according to environmental exposure using latent class analysis. A total of 310 schoolchildren living in Ecuador were assayed for spontaneous cytokine production as well as mitogen (SEB)-stimulated cytokines in whole blood cultures. We collected data on environmental exposures by questionnaire and on intestinal parasites by examination of stool samples. Latent class analysis (LCA) was used to group children according to their innate (IL-6, IL-8, IL-10 and TNF-α) and adaptive (IL-5, IL-13, IL-17, IFN-γ and IL-10) cytokine profile. We also conducted multiple-group LCA and LCA with covariates to evaluate the effect of predictors on profile membership. We identified both hyporesponsive and Th2-modified immune phenotypes produced by peripheral blood leukocytes (PBLs) that were associated with intestinal worms and birth order, providing insights into how poor hygiene mediates immunologic effects on immune-mediated diseases.

Effect of indoor residual spraying of DDT and bendiocarb on the feeding patterns of Anopheles pseudopunctipennis in Mexico.

Intense and persistent use of DDT for malaria control has increased resistance and induced exophilic behavior of Anopheles pseudopunctipennis. An evaluation of bendiocarb and DDT to control this species in Sinaloa, Mexico, showed that, in spite of DDT-resistance, both insecticides produced similar effects. Feeding patterns were analyzed to explain these results. Resting mosquitoes were collected over the dry and wet seasons. Anophelines were tested in an ELISA to determine the source of the meals. The human blood index (HBI) ranged from 3.3 to 6.8% in DDT- and from 12.7 to 26.9% in bendiocarb-sprayed houses. Irritability and repellency in DDT-sprayed houses could explain the reduced HBI. In contrast, bendiocarb produced higher mortality. These effects could have affected different components of the vectorial capacity and similarly reduced malaria.

[Casuistic revision of adrenal pathology during last 23 years]. / Revisión casuística de la patología adrenal durante los últimos 23 años.

We present a casuistic revision of adrenal pathology, which was studied in our service during the period January 1977-July 2000. We reviewed 59.069 biopsies and 2.674 autopsies and we 84 cases. founded with the following findings: Primary tumors 25% Secundary tumors 51% Infectious diseases 11% Miscellaneous 12% Unsuitable for diagnosis 1% Hyperplasias, adenomas, pheochromocy-tomas, neuroblastoma, adenocarcinoma are included within primary tumors. The metastasic tumors corresponded to: lung, pancreas, mammary gland, kidney and carcinomas; endometrial adenocarcinoma, lymphoma, melanoma, hepatocarcinoma, gastric carcinoma, testicular teratocarcinoma, skin epidermoid carcinoma, uterus choriocarcinoma and a primary germinal tumor of the thymus. Within infectious diseases we founded tuberculosis, histoplasmosis, cryptococosis, hydatidosis. Miscellaneous included hematoma, hemorrhage, pseudocyst, Disseminated Intravascular Coagulation (DIC), athrophy, Wegener's granulomatosis, myelolipoma, hemorrhagic necrosis. There was only one case which was unsuitable for diagnosis due to insufficient material.

Study of variability in antioxidant composition and fatty acids profile of Longissimus dorsi and Serratus ventralis muscles from Iberian pigs reared in two different Montanera seasons.

This investigation was designed to evaluate the effects of variations in antioxidant and fatty acids composition of acorns and grass from two Montanera (free-range system and feeding based on acorns and grass) seasons (2006/07 and 2007/08) on the antioxidant composition and fatty acids profile of m. Longissimus dorsi (LD) and m. Serratus ventralis (SV) from Iberian pigs reared under these Montanera seasons. Acorn and grass composition was affected by Montanera season and consequently, LD and SV muscles showed different contents of α-tocopherol, total phenols, hydrophilic and lipophilic antioxidant activity and fatty acid profile, according with the composition of acorns and grass ingested. Results suggest a lack of uniformity in meat quality between different seasons. This could be due to the variable nature of extensive pig production as reflected in the variability in the composition of the diet (acorns and grass).

Effect of production system on physical-chemical, antioxidant and fatty acids composition of Longissimus dorsi and Serratus ventralis muscles from Iberian pig.

The effect of three production systems of Iberian pigs namely Montanera (free-range system and feeding based on acorns and grass), Recebo (free-range system and nutrition based in combination of acorns, grass and mixed feeds) and Intensive (confinement with mixed feeds) on some quality traits of Longissimus dorsi (LD) and Serratus ventralis (SV) muscles were studied. Muscles from pigs raised in the Montanera system showed significantly higher CIE L(∗), a(∗) and b(∗) values and higher haem pigment content than those from Intensive system. Similarly, muscles from pigs raised in the Montanera system had significantly higher contents of α and γ-tocopherol and phenolic compounds contents and higher lipophilic and hydrophilic activity antioxidant than those from pigs raised in the Intensive system. Fatty acids profiles from Montanera pigs had significantly higher monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids and lower saturated fatty acids (SFA) than those from pigs raised in the Intensive system. In relation to muscle effect, LD showed lower intramuscular fat (IMF), α-tocopherol, phenolic compounds, lipid oxidation and PUFA, but higher MUFA than SV.

A laboratory approach to the control of cocaine in Bolivia.

Of the 4,196 samples of drugs seized and analysed at the Toxicology Laboratory of the National Bureau for the Control of Dangerous Substances during the period 1975-1982, 3,768 samples (89.8 per cent) contained coca paste, cocaine hydrochloride or related substances. Most of the samples analysed contained coca paste and came from La Paz, Santa Cruz and Cochabamba. With a slight exception in 1980, the number of samples increased steadily over an eight-year period. The increase in the number of seizures of cocaine-related substances was a result of the growth in the illicit production of these substances, which began to assume larger dimensions in 1976. In many areas, coca-paste and cocaine-related problems are growing out of all proportion. The smoking of cigarettes that contain a mixture of tobacco and coca paste, popularly known as pitillos, is the most common form of drug abuse.

Comparative use of bendiocarb and DDT to control Anopheles pseudopunctipennis in a malarious area of Mexico.

The state of Sinaloa has one of the highest and most persistent malaria transmission levels in Mexico. Due to this situation, with resistance of the vector Anopheles pseudopunctipennis Theobald to DDT, the carbamate insecticide bendiocarb was evaluated as an alternative to DDT for residual house-spraying in village-scale trials during 1985-87. Application rates of the active ingredient per square metre of sprayable surface (ai/m2) were 0.4 g bendiocarb 80% wettable powder (80WP) and 2 g DDT 75% WP. Both insecticides failed to control mosquito populations. Human-bait mosquito densities were not altered as a result of insecticide spraying and human-bait collected mosquito mortality rates were low, suggesting little pre-biting insecticide contact due to avoidance or insufficient resting time indoors. Lower densities of indoor-resting mosquitoes were observed with DDT as opposed to bendiocarb treated houses. Anopheline mortality was higher (98-100%) when exposed for 1 h to 1% bendiocarb in standard WHO susceptibility tests and wall bioassays. Mortality-rates of 15-48% due to 1 h exposure to 4% DDT indicated that this insecticide may continue to be partially effective. House curtain and mark-recapture mosquito studies indicated that DDT produced higher excito-repellency than bendiocarb, as reflected by more mosquito landings but lower feeding rates, shorter resting period and earlier exit time from DDT sprayed houses. In the absence of insecticide, more than 50% of blood-fed An.pseudopunctipennis females exited from houses within 2-4 h of release, showing exophilic behaviour. The outdoor/indoor density ratio indicated that the majority were exophagic. These behavioural characteristics limit the usefulness of any residual insecticide against An.pseudopunctipennis.

Diagnosis of lung carcinoid with cutaneous hyperpigmentation eight years after bilateral adrenalectomy.

A 26-yr-old male was submitted to bilateral adrenalectomy in 1977 for Cushing's syndrome. Some months later he developed intense skin hyperpigmentation together with increased ACTH levels (149 to 4000 ng/l). The sellar region was always normal in X-ray studies. In April 1985, when the patient complained of chest pain, a chest x-ray showed a polycyclic mass in the upper left lobe of the lung. ACTH ranged from 20,000 to 100,000 ng/l, with no response to CRF or cyproheptadine administration. Urinary 5-OH-indolacetic acid was negative. Thoracotomy was performed in July 1985 with resection of two intrapulmonary masses. Histologic study demonstrated a carcinoid tumor, with positive neuron-specific enolase and ACTH immunochemical stain. ACTH concentration in tumoral tissue was 91 pg/g tissue. After surgery ACTH fell dramatically to 37 ng/l, and has remained at this level since then, associated with resolution of the skin hyperpigmentation.