Intestinal ABC transporters: Influence on the metronomic cyclophosphamide-induced toxic effect in an obese mouse mammary cancer model.

Metronomic chemotherapy (MCT) is a cancer therapeutic approach characterized by low dose drug chronic administration and limited or null toxicity. Obesity-induced metabolic alterations worsen cancer prognosis and influence the intestinal biochemical barrier, altering the Multidrug resistance-associated protein 2 (Mrp2) and Multidrug resistance protein-1 (Mdr-1), efflux pumps that transport chemotherapeutic drugs. Obesity and cancer are frequent co-morbidities; thus, our aim was to evaluate the effectiveness and toxicity of MCT with cyclophosphamide (Cy) in obese mice with metabolic alterations bearing a mammary adenocarcinoma. Simultaneously, the expression and activities of intestinal Mrp2 and Mdr-1 were assessed. CBi male mice, were fed with chow diet (C) or diet with 40 % of fat (HFD). After 16 weeks, metabolic alterations were confirmed by biochemical and morphological parameters. At that time-point, HFD group showed decreased expressions of Mrp2 mRNA (53 %) as well as Mdr-1a and Mdr-1b (42 % and 59 %, respectively), compared to C (P < 0.05). This result correlated with decreased intestinal Mrp2 and Mdr-1 efflux activities (64 % and 45 %, respectively), compared to C (P < 0.05). Ultimately, mice were challenged with M-406 mammary adenocarcinoma; when the tumor was palpable, mice were distributed into 4 groups. The % inhibition of tumor growth with Cy (30 mg/kg/day) in C + Cy was higher than that of HFD + Cy (P = 0.052). Besides, it was observed a 21 % diminution in body weight and leukopenia in the HFD + Cy group. Conclusion: Obesity-induced metabolic alterations impair intestinal Mrp2 and Mdr-1 functions, bringing about increments in Cy absorption, leading to toxicity; in addition, the antitumor effectiveness of MCT decreased in obese animals.

Apexification with a bioceramic reparative cement: a case report.

The aim of this case report is to describe the treatment of a maxillary right central incisor with pulpal necrosis and incomplete root formation. The 14-year-old patient had experienced trauma to both maxillary central incisors approximately 2 years earlier. Therapy consisted of apexification with a bioceramic reparative cement to form an apical plug. After the clinical and radiographic evaluations, the clinician opened the crown, performed the chemical-mechanical preparation, and placed calcium hydroxide-based medication. At the next appointment, 24 days later, the intracanal medication was removed through passive ultrasonic instrumentation; the canal was dried; and the bioceramic cement was inserted into the apical portion with the aid of a mineral trioxide aggregate holder. A sterile cotton ball, moistened with distilled water, was used to maneuver the material in the apical region, and a periapical radiograph was exposed to confirm the correct placement of the bioceramic reparative cement. The canal was filled with gutta percha cones and a bioceramic root canal sealer. All procedures were performed with the aid of microscopic magnification. Clinical and radiographic evaluations at the 18-month follow-up visit showed that the treated tooth was asymptomatic, suggesting that the bioceramic reparative cement is effective for apexification.

Iron-based nanoparticles prepared from yerba mate extract. Synthesis, characterization and use on chromium removal.

Iron-based nanoparticles were synthesized by a rapid method at room temperature using yerba mate (YM) extracts with FeCl3 in different proportions. Materials prepared from green tea (GT) extracts were also synthesized for comparison. These materials were thoroughly characterized by chemical analyses, XRD, magnetization, SEM-EDS, TEM-SAED, FTIR, UV-Vis, Raman, Mössbauer and XANES spectroscopies, and BET area analysis. It was concluded that the products are nonmagnetic iron complexes of the components of the extracts. The applicability of the materials for Cr(VI) (300 µM) removal from aqueous solutions at pH 3 using two Cr(VI):Fe molar ratios (MR), 1:3 and 1:0.5, has been tested. At Cr(VI):Fe MR = 1:3, the best YM materials gave complete Cr(VI) removal after two minutes of contact, similar to that obtained with commercial nanoscale zerovalent iron (N25), with dissolved Fe(II), and with a likewise prepared GT material. At a lower Cr(VI):Fe MR (1:0.5), although Cr(VI) removal was not complete after 20 min of reaction, the YM nanoparticles were more efficient than N25, GT nanoparticles and Fe(II) in solution. The results suggest that an optimal Cr(VI):Fe MR ratio could be reached when using the new YM nanoparticles, able to achieve a complete Cr(VI) reduction, and leaving very low Cr and Fe concentrations in the treated solutions. The rapid preparation of the nanoparticles would allow their use in removal of pollutants in soils and groundwater by direct injection of the mixture of precursors.

Combined strategy for removal of Reactive Black 5 by biomass sorption on Macrocystis pyrifera and zerovalent iron nanoparticles.

Reactive Black 5, RB5, has been used as a model azo dye to evaluate the removal efficiency of sorption on Macrocystis pyrifera biomass (Mpyr) and commercial zerovalent iron nanoparticles (nZVI) in individual and combined treatments. The best conditions for the treatment with the isolated materials were first determined, and then, in series and combined treatments were performed under these conditions, achieving removal efficiencies higher than 80% of the initial dye concentration. Strengths and weaknesses of all removal strategies (individual, in series and combined) are analyzed regarding the application on real effluents. Mpyr efficiently adsorbed RB5, but also increased the total organic content by partial dissolution of components of the algal biomass. Removal experiments with commercial nZVI were also efficient but liberated Fe to the solution, and sulfanilic acid was observed after the treatment as a product of RB5 degradation. In contrast, after the Mpyr treatment, no sulfanilic acid was detected, suggesting that sulfanilic acid is efficiently adsorbed by the biomass. The best condition was the integrated use of Mpyr and nZVI, with a remarkable removal efficiency (69-80%) obtained after only 1 h of treatment. Finally, nZVI were successfully immobilized in Mpyr, and the hybrid material was used to remove RB5 in continuous flow experiments at pH 3, obtaining a removal capacity of 39.9 mg RB5 g-1 after a total processed volume of 630 mL of [RB5]0 = 100 mg L-1.

Relationship between antibiotic residues and occurrence of resistant bacteria in Nile tilapia (Oreochromisniloticus) cultured in cage-farm.

The aim of this study was to investigate the relationship between antibiotic residues found in the muscle of cage-farm-raised Nile tilapia (Oreochromisniloticus), the occurrence of resistant bacteria, and the sanitary practices adopted by farmers in Ilha Solteira reservoir, Brazil. Nine fish (three small fish, 40-200 g; three medium-sized fish, 200-500 g; and three large fish, 500-800 g) were collected from four cage farms every three months from April 2013 to January 2014. Ten antibiotic residues were determined using liquid chromatography-mass spectrometry, and bacteria were isolated and tested for antibiotic resistance to determine the multiple antibiotic resistance (MAR) index. Only three antibiotics (oxytetracycline, tetracycline, and florfenicol) were detected in the muscle of Nile tilapia, and their residues were the highest in small fish; however, the MAR index was higher in large fish. In addition, a direct positive relationship between the MAR index and the concentration of antibiotic residues in Nile tilapia was found. Overall, the adoption of prophylactic management practices improved the sanitary status of cage farms, reducing bacterial infections and hampering the development of antibiotic-resistant bacteria.

Benznidazole modulates cell proliferation in acute leukemia cells.

CONTEXT: We have previously reported that benznidazole (BZL), known for its trypanocidal action, has anti-proliferative activity against different cell lines like HeLa and Raw 264.7 among others. At the moment, it has not been reported if the anti-proliferative effect of BZL is similar for non-adherent hematopoietic cells like was reported for adherent cancer cell lines. OBJECTIVE: We aimed to investigate the efficacy of BZL on the growth of the leukemic cell lines THP-1 and OCI/AML3. MATERIALS AND METHODS: We evaluated cell proliferation by [³H]-thymidine incorporation and MTT reduction as well as cell death by lactate dehydrogenase (LDH) activity. We assessed apoptosis by flow cytometry for detection of annexin V-positive and propidium iodide-negative cells, along with nuclear morphology by diamidino-2-phenolindole (DAPI) staining. Western blot studies were performed to evaluate changes in cell cycle proteins in BZL-treated cells. RESULTS: BZL significantly reduced proliferation of both cell lines without inducing cell death. Likewise it produced no significant differences in apoptosis between treated cells and controls. In addition, flow cytometry analysis indicated that BZL caused a larger number of THP-1 cells in G0/G1 phase and a smaller number of cells in S phase than controls. This was accompanied with an increase in the expression of the CDK inhibitor p27 and of cyclin D1, with no significant differences in the protein levels of CDK1, CDK2, CDK4, cyclins E, A and B as compared to controls. CONCLUSION: BZL inhibits the proliferation of leukemic non-adherent cells by controlling cell cycle at G0/G1 cell phase through up-regulation of p27.

Downregulation of intestinal multidrug resistance transporter 1 in obese mice: Effect on its barrier function and role of TNF-α receptor 1 signaling.

OBJECTIVES: Multidrug resistance transporter 1 (Mdr-1) is a relevant component of the intestinal transcellular barrier that decreases absorption of oral drugs, thus modulating their bioavailability. Obese patients with metabolic disorders take medications that are subjected to intestinal metabolism and the Mdr-1-dependent barrier. This study evaluated the effect of a high-fat diet (HFD; 40% fat for 16 wk) on Mdr-1 expression and transport activity in C57BL/6 (C57) male mice. Comparable studies were performed in tumor necrosis factor α (TNF-α) receptor 1 knockout mice (R1KO) to delineate a possible role of TNF-α signaling. METHODS: mRNA expression was evaluated by real-time polymerase chain reaction and protein levels by western blotting and immunohistochemistry. Mdr-1 activity was assessed using the everted intestinal sac model, with rhodamine 123 as the substrate. Statistical comparisons were made using the Student t test or one-way analysis of variance followed by the post hoc Tukey test. RESULTS: Mdr-1 protein, as well as its corresponding Mdr1a and Mdr1b mRNA, was decreased in C57-HFD mice compared with controls. Immunohistochemical studies confirmed downregulation of Mdr-1 in situ. These results correlated with a 48% decrease in the basolateral to apical transport of rhodamine 123. In contrast, R1KO-HFD modified neither intestinal Mdr-1 mRNA nor its protein expression or activity. In addition, C57-HFD showed elevated intestinal TNF-α mRNA and protein (enzyme-linked immunosorbent assay) levels, whereas R1KO-HFD was undetectable or had a lower increase, respectively. CONCLUSIONS: This study demonstrated an impairment of the Mdr-1 intestinal barrier function induced by HFD as a consequence of downregulation of both Mdr-1 gene homologues, resulting in impaired Mdr-1 protein expression. Inflammatory response mediated by TNF-α receptor 1 signaling was likely involved.

A high corticosterone/DHEA-s ratio in young rats infected with Trypanosoma cruzi is associated with increased susceptibility.

We have previously established that young male rats are more susceptible to the effects of Trypanosoma cruzi infection than adult rats. To explore underlying age-associated differences in disease outcome, we simultaneously assessed hormone levels and cytokine release throughout the acute infection period in young and adult rats infected with T. cruzi. Young rats were inoculated with 1 x 10(6) and adult rats with 7 x 10(6) blood trypomastigotes, according to their relative body weight. At zero, seven, 14, 21 and 28 days after infection, blood was collected for the determination of gonadal and adrenal hormones, tumor necrosis factor α (TNF-α), interleukin (IL)-10 and specific IgM and IgG subtypes. Young animals displayed significantly higher parasitaemia values and an endocrine pattern that was characterised by elevated values in corticosterone (CT) and the CT/dehydroepiandrosterone-sulfate ratio, which favours immunosuppression and susceptibility. In contrast, adult male rats were able to restrict the parasite burden, which likely resulted from increased IgG antibody synthesis and oestradiol levels. Adult rats also showed a reduced TNF-α/IL-10 ratio and less tissue damage. We conclude that young animals exhibited increased vulnerability to T. cruzi infection compared with adults and this is associated with an unsuitable immunoendocrine milieu.

Assessment of the Arsenic Removal From Water Using Lanthanum Ferrite.

The catalytic performance of a perovskite-type lanthanum ferrite LaFeO3 to remove arsenic from water has been investigates for the first time. LaFeO3 was prepared by citrate auto-combustion of dry gel obtained from a solution of the corresponding nitrates poured into citric acid solution. Kinetic studies were performed in the dark with As(V) and in the dark and under UV-C irradiation at pH 6-7 with As(III) (both 1 mg L-1 ), and As : Fe molar ratios (MR) of 1 : 10 and 1 : 100 using the LaFeO3 catalyst. As(V) was removed from solution after 60 min in the dark in 7 % and in 47 % for MR=1 : 10 and MR=1 : 100, respectively, indicating the importance of the amount of the iron material on the removal. Oxidation of As(III) in the dark was negligible after 60 min in contact with the solid sample, but complete removal of As(III) was observed within 60 min of irradiation at 254 nm, due to As(III) photooxidation to As(V) and to As(III) sorption to a minor extent. Morphological and microstructural studies of the catalyst complement the catalytic testing. This work demonstrates that LaFeO3 can be used for the removal of As(III) from highly arsenic contaminated water.

Experience at the Department of Pediatrics of a private facility in the Metropolitan Area of Buenos Aires during the COVID-19 pandemic. / Experiencia de un servicio de pediatría del ámbito privado del área metropolitana de Buenos Aires durante la pandemia por COVID-19 Daniel R. Capra, Gabriela Ucha, Enrique.

INTRODUCTION: Health care workers experience a tremendous strain while performing their activities, very frequently leading to stress, burnout syndrome, and psychopathological impact. The COVID-19 pandemic may cause physicians to suffer these effects even to a greater extent. Our objective was to describe the frequency of stress, burnout syndrome, anxiety, and depression during the pandemic, and analyze the associations with different independent outcome measures. METHODS: Observational, cross-sectional study conducted 2 months after the lockdown was established in Argentina. Clinical specialists, surgeons, emergency physicians, and those with no direct contact with patients were surveyed using a sociodemographic questionnaire and 3 self-administered inventories: Health Professions Stress Inventory, Maslach Burnout Inventory, and Hospital Anxiety and Depression Scale. RESULTS: The prevalence of stress was 93.7 % (95 % confidence interval [CI]: 90.33-96.2), burnout syndrome 73.5 % (95 % CI: 68.2-78.4), anxiety 44 % (95 % CI: 38.4-49.8), and depression 21.9 % (95 % CI: 17.3-26.9). No association was observed between the frequency and medical specialty. The frequency of burnout syndrome, anxiety, and depression was significantly higher among residents and physicians working in the emergency department. ConcluSions: Residents and emergency physicians working 24-hour shifts showed significantly higher percentages of burnout syndrome, anxiety, and depression compared to staff and head physicians. These findings may be associated with a higher workload and less experience. It is compulsory to take preventive and therapeutic measures to protect those in the pandemic front line.

Introducción. A fin de 2019 se identificó una nueva variedad de coronavirus causante de COVID-19 que alcanzó categoría de pandemia. En Argentina, el área metropolitana de Buenos Aires (AMBA) concentra alrededor del 37 % de la población total y el mayor número de casos diagnosticados. El objetivo de este estudio fue describir las características clínicoepidemiológicas de los pacientes con COVID-19 y describir el impacto en el funcionamiento del Servicio de Pediatría de una institución privada de la zona. Métodos. Diseño retrospectivo, observacional, desarrollado en una institución de la zona oeste del AMBA entre el 12 de marzo y el 31 de agosto de 2020. Se incluyeron todos los menores de 16 años con diagnóstico de COVID-19. Se registraron características demográficas, epidemiológicas, clínicas, indicación de internación/control ambulatorio, número de consultas externas, internación por infecciones virales estacionales, licenciamiento del personal, modificación del número de camas y de las actividades de los profesionales. Resultados. Hubo 5454 consultas ambulatorias pediátricas totales, sospecha de COVID-19 en 753/5 454 (13,8 %), se confirmaron 152/753 (20,2 %). Mediana de edad 82 meses (rango intercuartílico: 20,5-147 m), el 50 % fueron varones. La fiebre fue el síntoma más frecuente. Se internaron 22/152 (14,5 %). Las consultas disminuyeron el 87 %, no hubo internación por infecciones virales estacionales y el 52,9 % (91/172) del personal fue licenciado. Conclusiones. La mayoría de los casos fueron leves y la fiebre fue el principal síntoma. Observamos un notable impacto en el funcionamiento del servicio en cuanto al recurso humano. Destacamos la necesidad de la organización logística del servicio para enfrentar esta contingencia.

Multidrug resistance-associated protein 2 is negatively regulated by oxidative stress in rat intestine via a posttranslational mechanism. Impact on its membrane barrier function.

Oxidative stress (OS) is a key factor in the development of gastrointestinal disorders, in which the intestinal barrier is altered. However, the Multidrug resistance-associated protein 2 (Mrp2) status, an essential component of the intestinal transcellular barrier exhibiting pharmaco-toxicological relevance by limiting the orally ingested toxicants and drugs absorption, has not been investigated. We here evaluated the short-term effect of OS on Mrp2 by treatment of isolated rat intestinal sacs with tert-butyl hydroperoxide (TBH) for 30 min. OS induction by TBH (250 and 500 µM) was confirmed by increased lipid peroxidation end products, decreased reduced glutathione (GSH) content and altered antioxidant enzyme activities. Under this condition, assessment of Mrp2 distribution between brush border (BBM) and intracellular (IM) membrane fractions, showed that Mrp2 protein decreased in BBM and increased in IM, consistent with an internalization process. This was associated with decreased efflux activity and, consequently, impaired barrier function. Subsequent incubation with N-Acetyl-L-Cysteine (NAC, 1 mM) reestablished GSH content and reverted concomitantly the alteration in Mrp2 localization and function induced by TBH. Cotreatment with a specific inhibitor of classic calcium-dependent Protein Kinase C (cPKC) implicated this kinase in TBH-effects. In conclusion, we demonstrated a negative posttranslational regulation of rat intestinal Mrp2 after short-term exposition to OS, a process likely mediated by cPKC and dependent on intracellular GSH content. The concomitant impairment of the Mrp2 barrier function may have implications in xenobiotic absorption and toxicity in a variety of human diseases linked to OS, with notable consequences on the toxicity/safety of therapeutic agents.

[Argentine consensus of congenital toxoplasmosis]. / Consenso argentino de toxoplasmosis congénita 2020.

Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diagnosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.

La transmisión vertical de la infección por Toxoplasma gondii ocurre cuando la madre se infecta por primera vez en el transcurso del embarazo. El diagnóstico de la infección materna y la del recién nacido se logra con el conjunto de pruebas serológicas, hallazgos clínicos y ecográficos. El reconocimiento temprano de la infección materna permite un tratamiento que reduce la tasa de transmisión y el riesgo de daño en el producto de la concepción. El objetivo de este consenso de expertos fue revisar la literatura científica para actualizar las recomendaciones de práctica clínica respecto de la prevención, el diagnóstico y el tratamiento de la toxoplasmosis congénita en nuestro país.

Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection.

OBJECTIVE: To determine the frequency of abnormal findings on evaluation of neonates with congenital CMV infection who have a normal physical examination STUDY DESIGN: Retrospective, 2-center study (1996-2017) that reviewed results of complete blood cell count and platelets, serum alanine aminotransferase (ALT) and bilirubin concentrations, eye examination, cranial ultrasonography or other neuroimaging, and brainstem evoked responses performed on neonates with congenital CMV infection and a normal physical examination RESULTS: Of 34 infants with congenital CMV infection and a normal physical examination, 56% (19/34) had ≥1 abnormality: 39%, elevated ALT concentration; 45%, abnormal neuroimaging (five, lenticulostriate vasculopathy; six, intraventricular hemorrhage; four, calcifications); 12%, anemia; 16%, thrombocytopenia; and 3%, chorioretinitis. Seven (21%) infants had sensorineural hearing loss, and 18 infants received antiviral therapy. CONCLUSION: Some infants with congenital CMV infection and a normal physical examination had abnormalities on laboratory or neuroimaging evaluation, which in some cases prompted antiviral treatment.

Reversion of down-regulation of intestinal multidrug resistance-associated protein 2 in fructose-fed rats by geraniol and vitamin C: Potential role of inflammatory response and oxidative stress.

Intestinal multidrug resistance-associated protein 2 is an ABC transporter that limits the absorption of xenobiotics ingested orally, thus acting as essential component of the intestinal biochemical barrier. Metabolic Syndrome (MetS) is a pathological condition characterized by dyslipidemia, hyperinsulinemia, insulin resistance, chronic inflammation, and oxidative stress (OS). In a previous study we demonstrated that MetS-like conditions induced by fructose in drinking water (10% v/v, during 21 days), significantly reduced the expression and activity of intestinal Mrp2 in rats. We here evaluated the potential beneficial effect of geraniol or vitamin C supplementation, natural compounds with anti-inflammatory and anti-oxidant properties, in reverse fructose-induced Mrp2 alterations. After MetS-like conditions were induced (21 days), animals were cotreated with geraniol or vitamin C or vehicle for another 14 days. Decreased expression of Mrp2 protein and mRNA due to fructose administration was reversed by geraniol and by vitamin C, consistent with restoration of Mrp2 activity evaluated in everted intestinal sacs. Concomitantly, increased intestinal IL-1ß and IL-6 levels induced by fructose were totally and partially counterbalanced, respectively, by geraniol administration. The intestinal redox unbalance generated by fructose was improved by geraniol and vitamin C, as evidenced by decreasing lipid peroxidation products and activity of Superoxide Dismutase and by normalizing glutathione reduced/oxidized glutathione ratio. The restoration effects exhibited by geraniol and vitamin C suggest that local inflammatory response and OS generated under MetS-like conditions represent important mediators of the intestinal Mrp2 down-regulation. Additionally, both agents could be considered of potential therapeutic value to preserve Mrp2 function under MetS conditions.

Clinical and parasitological evaluation of dogs naturally infected by Leishmania (Leishmania) chagasi submitted to treatment with meglumine antimoniate.

Aiming to evaluate the efficacy of the treatment of canine visceral leishmaniasis, to verify the occurrence of a possible disease relapse, and to search for the presence of the parasites after the end of the treatment, seven dogs naturally infected by Leishmania (Leishmania) chagasi were used. The dogs were subjected to a treatment with 75 mg/kg meglumine antimoniate subcutaneously every 12 h for 21 days, and followed-up for a period of 6 months. During the whole experimental period the animals wore deltamethrin collars and were kept in a screened kennel to avoid reinfection. Lymph node and bone marrow aspiration biopsy was carried out to search for the parasite at seven moments: before the treatment, 30, 60, 90, 120, 150 and 180 days after the start of the treatment. After the end of the experiment all dogs were humanely euthanized. Then, spleen and liver "imprints" and in vitro cultures were carried out to search for amastigote forms of the parasite. During the treatment all animals presented remission of symptoms. However, two dogs were observed to present new symptoms in the course of the experiment. At the end of the experiment, the presence of amastigote forms of the parasite was evidenced in five of the seven dogs. This enabled us to conclude that the treatment promoted clinical cure but did not eliminate the parasites completely.

Intestinal multidrug resistance-associated protein 2 is down-regulated in fructose-fed rats.

Expression and activity of jejunal multidrug resistance-associated protein 2 (Mrp2) and glutathione-S-transferase (GST) were examined in fructose fed Wistar rats, an experimental model of metabolic syndrome. Animals were fed on (a) control diet or (b) control diet plus 10% w/vol fructose in the drinking water. Mrp2 and the α class of GST proteins as well as their corresponding mRNAs were decreased, suggesting a transcriptional regulation by fructose. Confocal microscopy studies reaffirmed down-regulation of Mrp2. Everted intestinal sacs were incubated with 1-chloro-2,4-dinitrobenzene in the mucosal compartment, and the glutathione-conjugated derivative, dinitrophenyl- S-glutathione (DNP-SG; model Mrp2 substrate), was measured in the same compartment to estimate Mrp2 activity. Excretion of DNP-SG was substantially decreased by fructose treatment, consistent with simultaneous down-regulation of Mrp2 and GST. In addition, the effect of fructose on intestinal barrier function exerted by Mrp2 was evaluated in vivo using valsartan, a recognized Mrp2 substrate of therapeutic use. After intraduodenal administration as a bolus, intestinal absorption of valsartan was increased in fructose-drinking animals. Fructose administration also induced oxidative stress in intestinal tissue as demonstrated by significant increases of intestinal lipid peroxidation end products and activity of the antioxidant enzyme superoxide dismutase, by a decreased GSH/GSSG ratio. Moreover, fructose treatment conduced to increased intestinal levels of the proinflammatory cytokines IL-ß1 and IL-6. Collectively, our results demonstrate that metabolic syndrome-like conditions, induced by a fructose-rich diet, result in down-regulation of intestinal Mrp2 expression and activity and consequently in an impairment of its barrier function.

Experiencia de un servicio de pediatría del ámbito privado del área metropolitana de Buenos Aires durante la pandemia por COVID-19 / Experience at the Department of Pediatrics of a private facility in the Metropolitan Area of Buenos Aires during the COVID-19 pandemic

Introducción. A fin de 2019 se identificó una nueva variedad de coronavirus causante de COVID-19 que alcanzó categoría de pandemia. En Argentina, el área metropolitana de Buenos Aires (AMBA) concentra alrededor del 37 % de la población total y el mayor número de casos diagnosticados. El objetivo de este estudio fue describir las características clínico-epidemiológicas de los pacientes con COVID-19 y describir el impacto en el funcionamiento del Servicio de Pediatría de una institución privada de la zona. Métodos. Diseño retrospectivo, observacional, desarrollado en una institución de la zona oeste del AMBA entre el 12 de marzo y el 31 de agosto de 2020. Se incluyeron todos los menores de 16 años con diagnóstico de COVID-19. Se registraron características demográficas, epidemiológicas, clínicas, indicación de internación/control ambulatorio, número de consultas externas, internación por infecciones virales estacionales, licenciamiento del personal, modificación del número de camas y de las actividades de los profesionales. Resultados. Hubo 5454 consultas ambulatorias pediátricas totales, sospecha de COVID-19 en 753/5 454 (13,8 %), se confirmaron 152/753 (20,2 %). Mediana de edad 82 meses (rango intercuartílico: 20,5-147 m), el 50 % fueron varones. La fiebre fue el síntoma más frecuente. Se internaron 22/152 (14,5 %). Las consultas disminuyeron el 87 %, no hubo internación por infecciones virales estacionales y el 52,9 % (91/172) del personal fue licenciado. Conclusiones. La mayoría de los casos fueron leves y la fiebre fue el principal síntoma. Observamos un notable impacto en el funcionamiento del servicio en cuanto al recurso humano. Destacamos la necesidad de la organización logística del servicio para enfrentar esta contingencia.

Introduction. Towards the end of 2019, a novel coronavirus that causes COVID-19 was identified and became a pandemic. In Argentina, approximately 37 % of the total population lives in the Metropolitan Area of Buenos Aires (AMBA), where most cases have been diagnosed. The objective of this study was to describe the clinical and epidemiological characteristics of COVID-19 patients and the impact on the operations of the Department of Pediatrics of a private facility located in the AMBA. Methods. Retrospective, observational study conducted at a facility in the west of AMBA between March 12th and August 31st, 2020. All patients younger than 16 years diagnosed with COVID-19 were included. Demographic, epidemiological, and clinical characteristics; indication for hospitalization/outpatient follow-up; number of outpatient visits; hospitalization due to seasonal viral infections; staff on leave; changes in bed availability and health care providers' activities were recorded. Results. There were 5454 pediatric outpatient visits, COVID-19 was suspected in 753/5454 (13.8 %) and 152/753 (20.2 %) were confirmed cases. Their median age was 82 months (interquartile range: 20.5-147 months); 50 % were males. Fever was the most common symptom. In total, 22/152 (14.5 %) patients were hospitalized. Outpatients visits decreased by 87 %; there were no hospitalizations due to seasonal viral infections; and 52.9 % (91/172) of staff took a leave. Conclusions. Most cases were mild, and fever was the main symptom. The department operations were considerably affected in terms of human resources. It is worth noting the need for a logistic organization at the Department of Pediatrics to face such contingency.

Estimación de la ingesta de calcio y fosfato a partir de bebidas analcohólicas / Calcium and phosphate intake from analcoholic beverages

El calcio (Ca) es un nutriente crítico para la salud, especialmente en los períodos de crecimiento. Sin embargo, la mayoría de los individuos argentinos no alcanzan la ingesta diaria recomendada. Por su parte, el fósforo (P) es un nutriente cuya ingesta suele estar por encima de la recomendada. Este tipo de desequilibrio en la ingesta de ambos nutrientes conlleva a una pérdida de masa ósea. El consumo de bebidas analcohólicas (BA) se ha incrementado en los últimos años, sobre todo en la población infantil, desplazando el consumo de agua y lácteos. El objetivo de este trabajo fue estimar el aporte de Ca y P a partir de BA diferentes de agua. Se evaluaron 59 muestras, cuya mediana y rango de Ca fue de 7,74 [0,00 a 111,29] mg/l y de P 55,17 [0,16 a 957,00] mg/l. Los jugos en polvo son los que mayor contenido de Ca presentaron y las bebidas deportivas aquellas donde se halló el mayor contenido de P. Considerando un consumo de 500 ml/día de BA se estarían incorporando 3,87 mg Ca y 27,59 mg P. El creciente consumo de BA, su bajo contenido de Ca y la concomitante reducción del consumo de lácteos contribuyen a una inadecuada ingesta de Ca. (AU)

Calcium (Ca) is a critical nutrient, especially during periods of growth. However, the majority of Argentine individuals do not reach the recommended daily intake. On the other hand, phosphorus (P) is a nutrient with an intake usually above the recommended values. This type of imbalance between the intake of the nutrients leads to loss of bone mass. Soft drinks consumption (BA) has increased in recent years, especially in children, displacing the consumption of water and dairy products. The aim of this work was to estimate the Ca and P content in BA other than water. 59 samples were evaluated, with a median and range of Ca of 7.74 [0.00 to 111.29] mg/l and of P of 55.17 [0.16 to 957.00] mg/l. Powdered juices are the ones with the highest Ca content, and sports drinks are the beverages in which the highest P content was found. Based on a BA consumption of 500 ml/day, 3.87 mg Ca and 27.59 mg P would be incorporated. Therefore, the increased consumption of BA, their low Ca content, and the concomitant reduction in dairy consumption contribute to an inadequate intake of Ca. (AU)

Consenso Argentino de toxoplasmosis congénita 2020 / Argentine Consensus of congenital toxoplasmosis

Resumen La transmisión vertical de la infección por Toxoplasma gondii ocurre cuando la madre se infecta por primera vez en el transcurso del embarazo. El diagnóstico de la infección materna y la del re cién nacido se logra con el conjunto de pruebas serológicas, hallazgos clínicos y ecográficos. El reconocimiento temprano de la infección materna permite un tratamiento que reduce la tasa de transmisión y el riesgo de daño en el producto de la concepción. El objetivo de este consenso de expertos fue revisar la literatura científica para actualizar las recomendaciones de práctica clínica respecto de la prevención, el diagnóstico y el tratamiento de la toxoplasmosis congénita en nuestro país.

Abstract Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diag nosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.

Ectoparasites of Nile tilapia (Oreochromis niloticus) in cage farming in a hydroelectric reservoir in Brazil.

For this study, we performed a parasitological analysis of cage-cultured Nile tilapia (Oreochromis niloticus) from the Água Vermelha Reservoir, Southeastern Brazil, and verified relationships with limnological data, seasonality, and fish growth phase. From March 2010 to March 2011, sixty-three specimens of O. niloticus in three growth phases (i.e., initial, intermediate, and final) were collected. All fish specimens were infested with at least one ectoparasite species (prevalence = 100%). Five species of protozoans (Trichodina compacta, Trichodina magna, Ichthyophthirius multifiliis, Piscinoodinium pillulare, and Epistylis sp.) and five species of monogenoids (Cichlidogyrus halli, Cichlidogyrus thurstonae, Cichlidogyrus sp. 1, Scutogyrus longicornis, and Gyrodactylus sp.) were observed. The abundance of Trichodina spp. and the prevalence of Epistylis sp. were higher in the dry season, and the prevalence of C. halli was higher in the rainy season. For the majority of ectoparasites found in this study, fish in the intermediate and final phases had higher parasitism rates than those in the initial phase. The data presented may help fish farmers to understand the parasite dynamics of the fish species studied in cage-farming systems.