Detection of Salmonella enterica in Magellanic penguins (Spheniscus magellanicus) of Chilean Patagonia: evidences of inter-species transmission.

Patagonia in southern South America is among the few world regions where direct human impact is still limited but progressively increasing, mainly represented by tourism, farming, fishing and mining activities. The sanitary condition of Patagonian wildlife is unknown, in spite of being critical for the assessment of anthropogenic effects there. The aim of this study was the characterization of Salmonella enterica strains isolated from wild colonies of Magellanic penguins (Spheniscus magellanicus) located in Magdalena Island and Otway Sound, in Chilean Patagonia. Eight isolates of Salmonella were found, belonging to Agona and Enteritidis serotypes, with an infection rate of 0·38%. Resistance to ampicillin, cefotaxime, ceftiofur and tetracycline antimicrobials were detected, and some of these strains showed genotypic similarity with Salmonella strains isolated from humans and gulls, suggesting inter-species transmission cycles and strengthening the role of penguins as sanitary sentinels in the Patagonian ecosystem.

Dialing for doctors: Secret shopper study of Arizona methadone and buprenorphine providers, 2022.

INTRODUCTION: Methadone and buprenorphine are effective and safe treatments for opioid use disorder (OUD) and also reduce overdose and all-cause mortality. Identifying and reaching providers of medication for opioid use disorder (MOUD) has proven difficult for prospective patients and researchers. OBJECTIVES: To assess the accuracy of government-maintained lists of Arizona (AZ) providers prescribing MOUD, and the extent to which these providers are accessible for treatment. METHODS: A two-phase study used a listing of 2376 AZ MOUD providers obtained from the U.S. Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration. Phase 1 assessed the accuracy of the listing using internet confirmatory research from May-October 2022. Phase 2 used the resulting list of 838 providers to assess provider availability, type of MOUD treatment provided, and accepted payment through secret shopper calls between November 16 and 30, 2022. RESULTS: Just over half (52.2 %, n = 1240) of providers were removed from the original listing during Phase 1. One quarter (25.9 %) were no longer in practice. Among the 833 eligible for the secret shopper Phase 2 study, 36.6 % (n = 307) were reached and identified as providing MOUD. A vast majority (88.1 %) of MOUD providers indicating treatment type were accepting new patients, however methadone was identified far more frequently than was likely permitted or provided for OUD. Providers were 5.5 times more likely to accept new patients if they accepted cash payment for services, and 4.9 times more likely if they accepted Medicaid. Rural areas remained underserved. CONCLUSIONS: The active population of MOUD providers is far smaller than surmised. DEA and SAMHSA provider listings are not sufficiently accurate for survey research sampling. Other means of representative sampling will need to be devised, and trusted lists of providers for prospective patients should be promoted, publicly available, and regularly maintained for accuracy. Providers that offer treatment should assure that public-facing staff have basic information about the practice, the treatment offered, and conditions for taking new patients. Concerted efforts must assure rural access at the most local levels to reduce patient travel burden.

Furoxan derivatives as cytotoxic agents: preliminary in vivo antitumoral activity studies.

Furoxan derivatives with in vitro cytotoxic activity were investigated as antitumoral agents in vivo. The compounds were tested in murine models of both CCRFS-180 II sarcoma and mammary adenocarcinoma. Two of the furoxan derivatives considered here, 3-formyl-4-phenyl-1,2,5-oxadiazole N2-oxide and 3-carbonitrile-4-phenyl-1,2,5-oxadiazole N2-oxide, present in vivo antitumoral activity. They were able to produce more than 90% of tumoral necrosis under the experimental protocol of administration and posology employed. NO-releasing capacity of furoxans may explain the anti-neoplastic activity of these compounds.

Phlebotomine sandflies in Venezuela: review of the verrucarum species group (in part) of Lutzomyia (Diptera: Psychodidae) with description of a new species from Lara.

The series townsendi and verrucarum of the verrucarum species group of the phlebotomine genus Lutzomyia França are reviewed. Lutzomyia nadiae, new species, from the mountains of Yacambú, Lara State, is described. Distribution maps, illustrated keys, notes on medical importance, taxonomy, and ecology are presented for species in these series known from Venezuela.

First Report of Pseudomonas syringae pv. tomato Race 1 on Tomato in California.

Symptoms of bacterial speck have occurred sporadically in California since 1993 on tomato (Lycopersicon esculentum) cultivars that possess the PTO gene for resistance to Pseudomonas syringae pv. tomato race 0. In 1998, the disease was found on numerous cultivars resistant to race 0 in fields throughout the Sacramento Valley. In several fields, it caused severe defoliation of tomato seedlings. Symptoms included dark brown to black leaf and stem lesions surrounded by yellow halos. Seven isolates were identified as P. syringae pv. tomato based on analysis of whole cell fatty acids (MIDI, Newark, DE; similarity indices of 0.746 to 0.710), carbon utilization profile (Biolog, Hayward, CA; similarity indices of 0.556 to 0.840), and LOPAT results: levan production (+), oxidase reaction (-), potato soft rot (-), arginine dihydrolase production (-), and tobacco hypersensitivity (+) (2). The isolates were identified as race 1 by inoculating greenhouse-grown tomato plants of cv. Ontario 7710, which possesses the PTO gene, and cv. H1916, which is susceptible to both known races of P. syringae pv. tomato. At least eight plants of each cultivar were inoculated with each isolate. Plants were inoculated by spraying leaves with a bacterial suspension mixed with Carborundum or puncturing leaves with needles dipped in the bacterial suspension (107 cells per ml). Controls were inoculated with water. All plants inoculated with the bacteria developed speck symptoms in 6 days. The bacteria were reisolated from all inoculated plants and confirmed as strains of P. syringae pv. tomato. This is the first documentation of P. syringae pv. tomato race 1 in California. This race was previously reported in Canada in 1986 (1). References: (1) M. B. Lawton and B. H. MacNeill. Can. J. Plant Pathol. 8:85, 1986. (2) R. A. Lelliott et al. J. Appl. Bacteriol. 29:470, 1966.

Partial Characterization of Two Whitefly-Transmitted Geminiviruses Infecting Tomatoes in Venezuela.

Whitefly-transmitted geminiviruses can cause significant yield losses on tomatoes (Lycopersicon esculentum Mill.) in Venezuela. To identify the geminivirus(es) infecting tomatoes in Venezuela, 20 tomato samples from commercial tomato fields in four states and one weed (Euphorbia heterophylla L.) sample were examined for geminivirus infection. All samples showed symptoms generally associated with geminivirus infection, including golden or yellow mosaic, mottling, crumpling and/or distortion of leaves, and, in some cases, stunted and distorted growth. Through the use of squash blot hybridization analysis and a general probe for Western Hemisphere whitefly-transmitted geminiviruses (4), geminivirus nucleic acids were detected in 19 of 20 tomato samples and the weed sample. No samples were infected with tomato yellow leaf curl virus (TYLCV), based on squash blot hybridization analysis with a TYLCV-specific probe. With polymerase chain reaction (PCR) and degenerate primers for whitefly-transmitted geminiviruses (PAL1v1978 and PAR1c496) (4), an approximately 1.2-kb DNA-A fragment was amplified from the 19 squash blot-positive tomato samples and from the weed sample. No DNA fragment was amplified from any samples when TYLCV-specific primers (PTYC1v2406 and PTYIRc287) (3) were used. PCR-amplified DNA-A fragments from four samples representing four different states [Monagas (5L), Guarico (3M), Aragua (3R), and Portuguesa (2U)] were cloned and sequenced. Partial AC1, AV1, and complete common region (CR) sequences of the 5L, 3M, and 2U DNA-A fragments were 92 to 93, 93, and 95 to 97% identical, respectively, indicating that these were DNA-A clones of the same virus. Furthermore, these sequences were 91 to 92, 92 to 95, and 93 to 95% identical, respectively, to sequences of homologous regions of potato yellow mosaic virus (PYMV), indicating that these tomato-infecting geminiviruses are isolates or strains of PYMV. The partial AC1, AV1, and complete CR sequences of the 3R DNA-A fragment were 79, 95, and 77% identical to those of 5L, 3M, and 2U clones, respectively, suggesting that this is a different geminivirus. These sequences were 75 to 87, 82 to 88, and 73 to 81% identical, respectively, to sequences of homologous regions of other tomato geminiviruses, including tomato golden mosaic from Brazil, tomato mottle from Florida, and tomato leaf crumple from Mexico. The bipartite nature of the geminiviruses that were present in the 5L, 3M, 3R, and 2U samples was suggested by the amplification of a DNA-B fragment with degenerate DNA-B primers (PBL1v2040 and PCRc1) (4). These results suggest at least two distinct bipartite Western Hemisphere whitefly-transmitted geminiviruses are associated with tomato virus diseases in Venezuela, and that one of these (sample 3R) may be an undescribed geminivirus. The sequence of the DNA-A fragment from the weed sample was not closely related to the tomato-infecting geminiviruses and, therefore, this weed was not an alternate host of these viruses. Furthermore, because PYMV has been shown to infect tomatoes and cause yellow mosaic symptoms (1), it would be of interest to determine the relationship of PYMV and tomato yellow mosaic geminivirus (ToYMV), which has been reported infecting tomatoes in Venezuela (2), but has not been characterized on the molecular level. References: (1) A. K. Buragohain et al. J. Gen. Virol. 75:2857, 1994. (2) R. C. de Uzcátegui and R. Lastra. Phytopathology 68:985, 1978. (3) M. K. Nakhla et al. Phy-topathol. Mediterr. 32:163, 1993. (4) M. R. Rojas et al. Plant Dis. 77:340, 1993.

[The endocrine capacity of the mammalian blastocyst. II. Biosynthesis and estrogen metabolism]. / Capacidad endócrina del blastocisto de mamífero. II. Biosíntesis y metabolismo estrogénico.

Among the studies realized in preimplanted embryos, draw attention to its endocrine capacity to synthesize steroid hormones: progesterone, progestins and several estrogens, which may influence locally the properties of the oviduct and endometrium creating and appropriate environment for its nutrition, migration and further development in order to let its implantation in the maternal uterus. Among the steroids secreted by the conceptus, estrogens are of special interest because of their potential importance in the biochemical events associated with the process of implantation. The purpose of this review is to contribute to the knowledge of the biosynthesis and metabolism of estrogens realized by the early embryo.

Hemangiomatosis hepática en lactantes: diagnóstico y evolución. “Hospital J. M. de los Ríos”. Caracas - Venezuela / Hemangiomatosis liver in infants: diagnosis and evolution

Las lesiones vasculares hepáticas en niños son raras pero no infrecuentes en gastroenterología pediátrica. Los hemangiomas son los tumores hepáticos vasculares más frecuentes en la infancia, la mayoría de curso benigno, algunos, incluyendo el hemangioendotelioma infantil, tienen potencial maligno. La clínica predominante es hepatomegalia, dolor abdominal, hemangiomas cutáneos e insuficiencia cardíaca congestiva; y menos frecuente esplenomegalia, ictericia, ascitis, hemorragia digestiva y anemia. Se presentan 5 lactantes entre 1 y 4 meses con diagnóstico de hemangiomatosis hepática; en tres de ellos su diagnóstico fue incidental a través de ecografía, uno presentó aumento de volumen abdominal progresivo y otro hepatomegalia; tres presentaron hemangiomas en piel. Todos cursaron con anemia. Se realizó ecografía describiéndose hepatomegalia, con múltiples imágenes redondeadas, hipoecoicas, de diferentes tamaños, en ambos lóbulos hepáticos; Tomografía axial computada abdominal: hepatomegalia con compromiso de ambos lóbulos, ocupados por áreas nodulares hipodensas. Fueron evaluados por los servicios de endocrinología, cardiología, gastroenterología y cirugía pediátrica. En uno se realizó biopsia hepática. Recibieron tratamiento con prednisona 3 - 4 mg/kg/día con descenso progresivo de la misma, seguimiento clínico y ecográfico durante 1 año. Cuatro pacientes respondieron al tratamiento, evidenciándose disminución e incluso desaparición en tres pacientes de los hemangiomas, y uno no respondió, asociándose propanolol.

Hepatic vascular lesions in children are rare but not uncommon in pediatric gastroenterology. Hemangiomas are the most common vascular liver tumors in childhood, most benign course, some, including infantile hemangioendothelioma, have malignant potential. The clinical manifestations are hepatomegaly, abdominal pain, cutaneous hemangiomas and congestive heart failure and less frequent splenomegaly, jaundice, ascites, gastrointestinal bleeding and anemia. We present five infants between 1 and 4 months with a diagnosis of hepatic hemangiomatosis, in three of them the diagnosis was made incidentally by ultrasonography, showed a progressive increase in abdominal volume and a hepatomegaly, three had skin hemangiomas. All of them presented with anemia. Hepatomegaly describing ultrasound was performed, with multiple images rounded, hypoechoic, of different sizes in both lobes, abdominal computed tomography: hepatomegaly with involvement of both lobes, occupied by hypodense nodular areas. Services were assessed by endocrinology, cardiology, gastroenterology and pediatric surgery. In one a liver biopsy was performed. Treated with prednisone 3-4 mg / kg / day with gradual decrease of the same, clinical and ultrasound for 1 year. Four patients responded to treatment, demonstrating decreased or even disappeared in three patients with hemangiomas, and one did not respond, associating propranolol.

Fibrosis quística: Complicaciones y enfermedades asociadas

La fibrosis quística es un desorden heredado recesivo el cual se produce por una mutación en el brazo largo del cromosoma 7; alcanzando incidencia entre 1 en 2500 a en 4000 recién nacidos, en Latinoamérica la edad media al diagnostico es de 3,72 años. A medida que la supervivencia ha mejorado se presentan complicaciones como son pancreatitis, cirrosis, osteopenia diabetes, pólipos, entre otros y se han observado algunas enfermedades asociadas como es el caso de la enfermedad celiaca. El propósito del presente estudio fue determinar las complicaciones y enfermedades asociadas en un grupo de 68 pacientes que acudieron a consulta en el hospital J. M. de los Ríos desde enero de 1985 a marzo de 2005. Se pudo observar que el 64.7% de los pacientes presentaron complicaciones y/o enfermedades asociadas principalmente: reflujo gastroesófagico, acidosis tubular renal e hipercalciuria, y como enfermedades asociadas: enfermedad celiaca, epilepsia, anemia drepanocítica y vitiligo.

Cystic fibrosis is a recessive inherited disorder which takes place by a mutation in the long arm of chromosome 7; reaching an incidence between 1 in 2500 to 1 in 4000 new born, in Latin America the average age of diagnosis is 3.72 years. At the same time as their survival has improved they have presented complications as pancreatitis, cirrhosis, osteopenia diabetes, polyps, among others, in addition some other diseases have been associated to it as is the case of celiac disease, of which there are only 15 cases reported in literature. The intention of the present study was to determine the complications and diseases associated in a group of 68 patients who came to consultation at the Hospital J. M de los Rios from January 1985 to March 2005. It was possible to determine that 64.7% of the patients presented complications and/or associated diseases mainly: gastroesophageal reflux, renal tubular acidosis and hyrpercalciuria, and as associated diseases: celiac disease, epilepsy, drepanocytic anemia and vitiligo.

Fibrosis quística y colonización bacteriana del tracto respiratorio

La Fibrosis Quística es un trastorno genético debido a una mutación en el cromosoma 7, el cual codifica a la proteína (CFTR) que interviene en el transporte de iones en las células epiteliales. Las infecciones pulmonares son causadas por una gran variedad de gérmenes no habituales; que complican y cronifican su evolución. El objetivo del presente estudio fue conocer la presencia de gérmenes en el tracto respiratorio de los pacientes con FQ con manifestaciones de insuficiencia pancreática y diferentes estados nutricionales. Se revisaron 68 historias de pacientes con diagnóstico de FQ controlados en el Servicio de Gastroenterología del Hospital J.M. de los Ríos, 45/68 (66,2%) eran sexo masculino y 23/68 (33,8%) femenino. Se excluyeron 28/68 pacientes en quienes desconocemos reportes del estudio bacteriológico. En 30/40 pacientes se encontró crecimiento microbiano en vías aéreas; principalmente Pseudomona aeruginosa 15/30 (50%) y Staphylococcus aureus 15/30 (50%). Actualmente desde el punto de vista nutricional 9/30(30%) se encuentran en zona critica, 7/30 (23,2%) normal y 6/30(20%) desnutrición grave. La correlación entre germen aislado y estado nutricional no fue estadísticamente significativa (p>0.5). En conclusión, las infecciones respiratorias en pacientes con FQ de afectación mixta son causadas por colonización de gérmenes oportunistas ocasionando daño pulmonar progresivo, independientemente del estado nutricional, ameritando manejo respiratorio agresivo y nutricional oportuno.

Cystic fibrosis is a genetic disorder due to a mutation in chromosome 7, which codifies the protein (CFTC) that takes part in the ion transport in the epithelial cells. The pulmonary infections are caused by a great variety of unusual germs; that complicate and prolong its development. The objective of the present study was to acknowledge the presence of germs in respiratory tract of the patients with CF with manifestations of pancreatic insufficiency and different nutritional states. 68 histories of patients with diagnosis of CF controlled at the Service of Gastroenterology of the J.M. de los Rios Hospital were reviewed., 45/68 (66.2%) were male and 23/68 (33.8%) female. 28/68 patients were excluded in which we did not know the reports of the bacteriological study. In 30/40 patients had microbial growth in airways; mainly Pseudomona aeruginosa 15/30 (50%) and Staphylococcus aureus 15/30 (50%). At the moment from a nutritional point of view 9/30 (30%) are at the critic zone, 7/30 (23.2%) normal and 6/30 (20%) show serious undernourishment. The correlation between isolated germ and nutritional state was not statistically significant (p>0.5). In conclusion, respiratory infections in patients with CF of mixed affectation are caused by colonization of opportunistic germs causing progressive pulmonary damage, independently of the nutritional state, requiring opportune aggressive respiratory and nutritional handling.

Rol de la cirugía en la pancreatitis aguda / Surgery role in acute pancreatitis

Se analizó los resultados de la cirugía en 111 enfermos operados en alguna fase de la evolución de una pancreatitis aguda; en 71 casos se trató de una pancreatitis aguda edematosa y en 40 de una pancreatitis aguda necrohemorrágica. Sólo en 20 casos no se demostró litiasis biliar asociada; el 90% de los enfermos con pancreatitis aguda edematosa fueron operados por error o duda diagnóstica. El 25% de los enfermos con pancreatitis aguda necrohemorrágica requirieron entre 1 y 3 re-exploraciones quirúrgicas. La mortalidad global fue de 17,1%, con un 7% en pancreatitis aguda edematosa y un 35% en pancreatitis aguda necrohemorrágica. Las principales causas de muerte fueron falla orgánica múltiple y sepsis. Hubo correlacion entre el número de índices de Ranson presentes y la gravedad de la pancreatitis.

La operación de Hartmann en el Hospital de Temuco / Hartmannïs surgery at the Temuco hospital

El objetivo del trabajo es conocer en nuestro medio las principales indicaciones de la operación de Hartmann, su morbilidad y mortalidad y analizar si ha habido una sobreutilización de este procedimiento quirúrgico. Se estudió una serie de 60 pacientes, 35 hombres y 25 mujeres intervenidos en eI Hospital Regional de Temuco entre 1994 y 1999, cuyas edades fluctuaron entre 26 y 99 años, con un promedio de 62,2 años. Las principales indicaciones de la cirugía fueron: cáncer rectocolónico complicado (43,2 por ciento), vólvulo de sigmoides complicado (20 por ciento), diverticulitis complicada (11,6 por ciento) y trauma (8,3 por ciento). En el 76 por ciento de los casos fue necesario efectuar resección de colon. En cuanto a morbilidad las complicaciones locales se presentaron en el 33,2 por ciento, sepsis en el 10 por ciento, infarto miocárdico en el 6,7 por ciento y complicaciones sépticas intraabdominales en un 5 por ciento que fueron resueltas quirúrgicamente. La mortalidad de la serie fue de un 18,3 por ciento

Resultados alejados de la vagotomía superselectiva / Later results in highly selective vagotomy

Entre 1975 y 1980 se efectuó vagotomía supreselectiva en 97 enfermos portadores de úlcera duodenal. No hubo mortalidad operatoria. Dos enfermos fallecieron durante el seguimiento y otros 4 se perdieron, por lo que no se incluyeron en el presente estudio. Las secuelas alejadas más frecuentes fueron: desfagia en 16,5%, ectasia gástrica en 9% y diarrea en 7,7%. Se demostró úlcera duodenal recurrente en el 6,6,% y en un 4,4% hubo fuerte sospecha de recurrencia. De acuerdo a la clasificación clínica de Visick un 89% de los enfermos estaban en grado I y II al último control

Rol de la cirugía en la pancreatitis aguda necrohemorrágica / Role of surgery in the necrotizing hemorrhagic pancreatitis

Se analizan los resultados de la cirugía en 24 enfermos con pancreatitis aguda necrohemorrágica (PANH). No se demostró asociación con litiasis biliar en el 29,1% de los casos. La cirugía efectuada, de preferencia, fue drenaje de la vía biliar cuando existió litiasis, gastrostomía, yeyunostomía para alimentación enteral, aseo peritoneal y drenaje. En 6 enfermos se efectuaron una o más reintervenciones por abscesos pancreáticos y/o extrapancreáticos, secuestros, obstrucción intestinal y fístula de colon. La mortalidad fue de 37,5%, producida por falla multisistémica y sepsis. De acuerdo al criterio pronóstico de Ranson la mortalidad fue 100% con 5 signos presentes, 50% con 4 y 16% con 3

Experiencia clínica en la etapificación laparoscópica del cáncer gástrico / Clinical experience in the laparoscopic staging of gastric cancer

El cáncer gástrico (CG) es la primera causa de muerte por cáncer en Chile. Su tratamiento es esencialmente quirúrgico, completándose la etapificación mediante laparotomía exploradora (LE). Actualmente, la cirugía laparoscópica ha cambiado radicalmente en enfoque de la patología quirúrgica, siendo conocidas sus ventajas. El objetivo del presente trabajo es analizar la experiencia clínica y us utilidad en el uso de la laparoscopia diagnóstica (LD) en la etapificación de CG. Se estudiaron retrospectivamente 55 pacientes con diagnóstico anatomopatológico de adenocarcinoma gástrico, sometidos a LD entre mayo de 1993 y junio de 1995. La LD excluyó de cirugía a 18 pacientes (32,7 por ciento) y permitió indicar cirugía a 37 (67,3 por ciento). De estos últimos, se efectuó LE exclusiva en 13 (35,1 por ciento) y cirugía resectiva en 24 (64,9 por ciento)