Características de la atención pediátrica ambulatoria de familias nativas y migrantes / Characteristics of pediatric outpatient care of Argentine native and immigrant families

Introducción: Los procesos migratorios han aumentado a nivel mundial por múltiples causas. En nuestro país un 4.5% de población es extranjera y el 69% proviene de países limítrofes. La ley de Migraciones N°25.871 garantiza el goce igualitario de derechos a migrantes extranjeros y argentinos. La comuna 8 (CABA) presenta 19.9% de población extranjera. Su primer Nivel de Atención está a cargo, entre otros, de los Centros de Salud y Acción Comunitaria N° 5 y 18. El Hospital Juan P. Garrahan es centro de derivación regional. El objetivo de la investigación fue describir las características de la respuesta del Sistema de Salud, específicamente, comparar el acceso al primer nivel de prevención y la satisfacción con la actividad asistencial entre familias migrantes extranjeras y nativas. Métodos: Estudio multicéntrico, observacional y de corte transversal a través de entrevistas semiestructuradas a familias migrantes extranjeras y nativas entre Julio 2014 y Junio 2015. Los resultados se expresaron en frecuencias y porcentajes en forma global y comparativa entre ambos grupos. Resultados: Se encuestaron 287 familias, 52% nativas y 48% migrantes extranjeras. Se encontró menor acceso a trabajo formal en las últimas. Ambos grupos presentaron dificultad en la obtención de turnos, percibiendo trato más amable las primeras y mayor comprensión de indicaciones las segundas. En la asistencia médica se halló menor posibilidad de cumplir con indicaciones en familias migrantes. Conclusión: Los resultados reflejan similares características de atención pediátrica ambulatoria para familias nativas y migrantes extranjeras (AU)

Introduction: Migration has increased worldwide due to multiple causes. In our country, foreigners account for 4.5% of the population of whom 69% come from neighboring countries. The Law of Migration N°25.871 guarantees equal rights for immigrants and Argentinians. In Commune 8 (City of Buenos Aires) 19.9% of the population is foreign born. Their primary care attention is covered by, among others, Health Care and Community Action Centers N° 5 and 18. Hospital Juan P. Garrahan is a regional referral center. The aim of this study was to describe the characteristics of the response of the Health Care System, specifically, comparing access to and satisfaction with first-level care and disease prevention among immigrant and native Argentinian families. Methods: A multicenter, observational, cross-sectional study was conducted through semi-structured interviews with immigrant and native Argentinian families between July 2014 and June 2015. Results were expressed in rates and percentages overall and comparing both groups. Results: 287 families were interviewed, 52% were native and 48% immigrants. Reduced access to formal employment was found in the latter group. Both groups reported difficulties in obtaining appointments, perceiving a more friendly treatment in the former and better understanding of the indications in the latter group. Regarding medical care, less possibilities to adhere to the indications were found in immigrant families. Conclusion: Our results show similar pediatric outpatient health-care characteristics for native and immigrant families (AU)

Malformación Vascular Linfática en un Recién Nacido / Vascular Lymphatic Malformation in a Newborn

Las malformaciones vasculares son enfermedades poco frecuentes que representan errores en el desarrollo de los vasos sanguíneos. Las malformaciones vasculares linfáticas (MVL) consisten en lesiones congénitas del sistema linfático compuestas por canales y cavidades de diferente tamaño que resultan en la acumulación de linfa. Las malformaciones macroquísticas se manifiestan como tumoraciones palpables, de consistencia blanda pero no compresible. La localización más frecuente es en la cabeza y el cuello Se presenta el caso de un neonato con una malformación vascular linfática localizada en zona postero-lateral de cuello. Se arribó al diagnóstico en base a la clínica y las características ecográficas. El tratamiento fue muy satisfactorio luego de dos procedimientos de escleroterapias, presentando una excelente evolución

Vascular malformations are rare conditions associated to anomalies in blood vessel development. Lymphatic vascular malformations are congenital lesions consisting of channels and sacs of different size caused by lymph fluid acumulation. Macrocystic vascular malformations present as non-compresible soft tissue masses. They are generally found withinthe head and neck (70%-80%). We present the case of a newborn with a lymphatic vascular malformation in the posterior cervical área. The diagnosis was made on the basis of clinical and ultrasound findings. Sclerotherapy was succesful wihout signs of recurrence

Foreign meat identification by DNA breed assignment for the Chinese market.

Methods for individual identification are usually employed for traceability, whereas breed identification is useful to detect commercial frauds. In this study, Chinese Yellow Cattle (CYC) samples plus data from six Bos taurus breeds, two Bos indicus breeds, and one composite breed were used to develop an allocation test based on 22 microsatellites. The test allowed discriminating all foreign breeds from the CYC, although some CYC individuals were wrongly allocated as Limousin or Holstein, probably due to the recent introduction of these breeds into China. In addition, CYC evidenced a previously reported Zebu cline (south-north) and a possible structure within the B. taurus component that should be confirmed. An independent test performed with meat samples of unknown breed origin from Argentina allocated 92% of them to either Angus, Hereford, or their crossbreed, but none was identified as CYC. We conclude that the test is a suitable tool to certify meat of foreign breed origin and to detect adulterations of CYC beef labeled as imported meat.

Haplotype determination of the upstream regulatory region and the second exon of the BoLA-DRB3 gene in Holstein cattle.

Polymorphisms of the BoLA-DRB3 gene are located primarily in the second exon [antigen binding site (ABS)] and, to a lesser extent, in the upstream regulatory region (URR). It can be hypothesised that exon 2 and the URR are under different types of natural selection. The aim of this work was to determine the URR-exon 2 haplotypes; 34 Holstein samples were genotyped by direct sequencing. A total of 7 URR alleles and 23 exon 2 alleles were detected, and 3 of the URR alleles were novel. Our results may suggest that no relationship exists between the URR and exon 2 of the BoLA-DRB3 gene (linkage disequilibrium P value > 0.05), most likely due to recombination over time. Our results also suggest that both regions of class II genes may be included in the development of new genotyping methods based on next-generation DNA sequencing technologies.

Association between BoLA-DRB3 and somatic cell count in Holstein cattle from Argentina.

Different studies have proved that the resistance/susceptibility to mastitis is genetically determined. The major histocompatibility complex in cows is known as bovine lymphocyte antigen (BoLA). Genes from the BoLA have been associated with the occurrence of infectious diseases such as mastitis and leukosis, especially the BoLA-DRB gene. The object of the present study was to detect associations between BoLA-DRB3 alleles and somatic cell count (SCC), as an indicator of resistance/susceptibility to mastitis in Holstein cattle (N = 123) from La Pampa, Argentina. Fisher's exact test and Woolf-Haldane odds ratio were applied to study the association between SCC and BoLA-DRB3 allele frequencies. Significant association was noted between BoLA-DRB3.2*23 and *27 alleles (p < 0.05) and protective or susceptibility effects, respectively. In addition, alleles BoLA-DRB3.2*20 and *25 exhibit suggestive association with high SCC (p < 0.1). These results were partially in agreement with data reported from Japanese Holstein cattle, but differed from those published by other authors. A possible explanation for the contrasting results could be that the mastitis is a multifactor disease caused by different pathogens. Moreover, most of the studies were carried out using PCR-RFLP method, which has less resolution than PCR-SBT because PCR-RFLP defined alleles included more than one sequenced alleles.

South American camelid illegal traffic detection by means of molecular markers.

South American camelids comprise the wild species guanaco and vicuña and their respective domestic relatives llama and alpaca. The aim of the present study was to determine by DNA analysis to which of these species belong a herd of camelids confiscated from a llama breeder but alleged to be alpacas by the prosecution, and to evaluate the usefulness of mitochondrial and autosomal DNA markers to solve judicial cases involving camelid taxa. Cytochrome b and cytochrome oxidase I mitochondrial genes and 7 STR were analyzed in 25 confiscated samples. Mitochondrial results were inconclusive because 18 of the sequestered samples presented haplotypes that corresponded to the guanaco haplogroup and the remaining seven belonged to a vicuña linage. Microsatellite data of casework samples and llama reference samples revealed different genetic profiles by the presence of private alleles at two microsatellites suggesting that the confiscated animals could be alpaca, or at least alpaca hybrids instead of pure llama.

History and selection imprinting on genetic relationships among bovine breeds analyzed trough five genes related with marbling.

Many candidate genes have been suggested as responsible for marbling in beef cattle, for instance diacylglycerol O-acyltransferase 1, thyroglobulin, growth hormone, leptin and stearoyl CoA desaturase. The objective of the present work was to evaluate the polymorphisms of five SNPs of these candidate genes in 389 animals of 18 Bos Taurus and Bos indicus breeds. The obtained results were compared with ones previously obtained with STRs and loci related to milk production in these populations. Moreover we analyzed whether the phylogenies reconstructed using SNPs associated with marbling resulted in the known tree topology. The tree constructed with UPGMA, using genetic distance D(A), exhibit a topology partially consistent with the historical origin of breeds. The result observed in the Correspondence Analysis coincided with the topology of the UPGMA tree. This work allowed us to evaluate the five SNPs genetic diversity and to demonstrate that the grouping of the breeds may be the result of its history, selection process, or both at once.

Characterization and validation of bovine gonadotripin releasing hormone receptor (GNRHR) polymorphisms.

Gonadotropin releasing hormone and its receptor (GNRHR) play a critical role in sexual differentiation and reproduction. Available evidence shows a strong genetic component in the timing of puberty. In bovines, there are significant differences within and among beef breeds in the time when bulls reach puberty. Despite its economic importance, there are not many SNPs or genetic markers associated with this characteristic. The aims of the study were to identify DNA polymorphism in the bovine GNRHR by re-sequencing analysis, determine haplotype phases, and perform a population study in a selected tag SNP in six breeds. Eight SNPs were detected, including: one in the Upstream Regulatory Region (URR), five in the coding regions, and two in non-coding regions. This polymorphism level corresponds to one variant every 249.4bp and a global nucleotide diversity of 0.385. Two haplogroups comprising nine haplotypes and two linkage blocks were detected. Despite 5 tag SNPs were required to capture all variability, just one SNP allowed to define both haplogroups, and only two SNPs were needed to differentiate the most common haplotypes. An additional taq SNP was necessary to identify both URR variants. Allele-frequency analysis of a selected taq SNP among breeds showed a geographical cline. European Bos taurus breeds had lower frequencies of the C allele than B. indicus type cattle, while Creole cattle and Wagyu breeds had intermediate frequency. There was a significant correlation between frequency profile and timing of puberty among the studied breeds, which seems to suggest that genetic variation within bovine GNRHR gene could explain at least part of the reported variability.

Effect of consanguinity on Argentinean Angus beef DNA traceability.

Since the 1990s several authors have envisaged the use of DNA to certify meat origin. Two major parameters must be assessed before a DNA based traceability protocol can be implemented in the food chain: (i) the information content of a DNA marker set in a specific livestock breed or group of breeds; (ii) the minimum number of DNA markers needed to obtain a statistically acceptable match probability. The objective of the present work was to establish the effect of different levels of inbreeding in the matching efficiency, and the minimum number of microsatellite markers needed, in a DNA based meat traceability program, starting from an 11-microsatellite marker panel. Samples were obtained from beef production farms in South America, where animals are typically bred under pasture-based extensive conditions. Three groups of animals with different consanguinity rates were sampled. Exclusion power (Q) was higher than 0.999998 and match probability lower than 3.01E-08, for the whole set of markers within each group. Both values were affected by consanguinity. To reach a two mismatch criteria exclusion power (Q(2)) of 99.99, six markers were needed in unrelated animals whereas seven markers were needed in related animals. To reach Q(2)=99.9999, 8 and 10 microsatellite markers, respectively, were needed. In general, one or two more microsatellite markers were needed to identify consanguineous animals. This study proved the DNA marker set used to be suitable for the identification of the meat from all slaughtered animals in Argentina, per week, month, and year.

[Preoperative embolisation with absorbable gelatine sponge in intracranial meningiomas]. / Embolización preoperatoria con esponja de gelatina absorbente en meningiomas intracraneales.

AIMS: The purpose of this study was to evaluate the benefits of preoperative embolisation with an absorbable gelatine sponge in selected intracranial meningiomas. PATIENTS AND METHODS: We performed a retrospective study of a series of 33 patients who had undergone surgery for meningiomas with a diameter of over 4 cm between the years 2000 and 2007. Two groups were analysed: group A (n = 16) with preoperative embolisation and group B (n = 17) without it. Eligibility criteria for embolisation were: exclusive or predominant irrigation through the external carotid artery, high tumour flow and pronounced vascularisation through the pial branches. The location of the lesion was evaluated preoperatively; blood losses, number of units of blood transfused, surgery time and surgeon's opinion were evaluated intraoperatively. RESULTS: A statistically significant difference was found between the group of embolised patients and those who had not been embolised as far as surgery time (217.5 +/- 69.61 versus 291.76 +/- 56.94 min; p =< 0.002) and blood loss (613.75 +/- 231.42 versus 987.65 +/- 206.68 mL; p => 0.001) were concerned. A positive coloration (r = 0.568; p = 0.001) was found between surgery time and blood loss. No statistically significant relation was observed between age and the number of units of blood transfused. Embolisation was considered to be beneficial by 75% of surgeons. CONCLUSIONS: Preoperative embolisation with an absorbable gelatine sponge in patients with intracranial meningiomas with a diameter above 4 cm and exclusive or predominant irrigation by the external carotid artery is effective and safe; it also reduces intraoperative bleeding and surgery time.

Analysis of a polymorphism in the DGAT1 gene in 14 cattle breeds through PCR-SSCP methods.

The diacylglycerol O-acyltransferase (DGAT1) is a microsomal enzyme that catalyzes the final step of triglyceride synthesis. Recent work have evidenced a significant association between lysine at amino acid position 232 with elevated milk fat content, while an alanine at this position is associated with lowered milk fat content. The aim of the present work was to develop a simple and inexpensive PCR-SSCP assay in order to discriminate the CG/AA alleles in exon 8 of the DGAT1 gene. In addition, this method was used to analyze the polymorphism of the DGAT1 through PCR-SSCP methods in 14 populations of cattle from Argentine, Bolivia and Uruguay. The PCR primers were designed from GenBank reported sequences. In this study, we found three PCR-SSCP variants, which were denominated from "A" to "C". However, DNA sequencing analysis showed that "A" variant corresponded with the A allele, while both "B" and "C" observed pattern have the motif AA at positions 10,433-10,434 (K allele), being two alternative conformations of the same DNA sequence. Both variants were detected within each breed with the exception of Hereford, and the heterozygosity varied between 0.000 and 0.524. The gene frequency analysis evidenced significant differences among the studied breeds (F(ST) = 0.325, p = 0.000). European Bos taurus breeds, with the exception of Jersey breed, showed the lowest frequency of the K allele, while highest K allele frequencies were harboured by Bos indicus type cattle. In addition, unselected South American Creole cattle breeds and the synthetic Brangus breed had intermediate allele frequencies.

New polymorphisms for the BoLA-DRB3 upstream regulatory region.

Two new alleles, named BoLA-DRB3-P*06 and BoLA-DRB3-P*07, have been identified for the upstream regulatory region of the BoLA-DRB3 gene. The 228-bp nucleotide sequences of the promoter comprising the W, X, Y, CAAT and TATA regulatory boxes were analysed. The BoLA-DRB3-P*06 exhibits one insertion between the W and X boxes, and one transition between the X and Y boxes. On the other hand, the BoLA-DRB3-P*07 showed one insertion in the X box.

Gene frequency distribution of the BoLA-DRB3 locus in Saavedreño Creole dairy cattle.

The objective of this study is to describe the gene frequency distribution of the bovine lymphocyte antigen (BoLA)-DRB3 locus in Saavedreño Creole dairy cattle and to compare it with previously reported patterns in other cattle breeds. One hundred and twenty-five Saavedreño Creole dairy cattle were genotyped for the BoLA-DRB3.2 allele by polymerase chain reaction and restriction fragment length polymorphism. Twenty-two out of 53 previously identified BoLA-DRB3.2 alleles were detected, with gene frequencies ranging from 0.4 to 16.8%. Seventy percent of the variation corresponded to the seven most frequent alleles (BoLA-DRB3.2*7, *8, *11, *16, *27, *36, and *37). The studied population exhibits a high degree of expected heterozygosity (he = 0.919). The FIS index did not show significant deviation from Hardy-Weinberg equilibrium. However, the neutrality test showed an even gene frequency distribution. This result could be better explained assuming balancing selection instead of neutral or positive selection for one or a few alleles. In conclusion, the results of this study demonstrated that BoLA-DRB3.2 is a highly polymorphic locus in Saavedreño Creole dairy cattle, with significant variation in allele frequency among cattle breeds.

Polymorphism in the bovine BOLA-DRB3 upstream regulatory regions detected through PCR-SSCP and DNA sequencing.

In the present work, we describe through polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and DNA sequencing the polymorphism within the URR-BoLA-DRB3 in 15 cattle breeds. In total, seven PCR-SSCP defined alleles were detected. The alignment of studied sequences showed six polymorphic sites (four transitions, one transversion and one deletion) in the interconsensus regions of the BoLA-DRB3 upstream regulatory region (URR), while the consensus boxes were invariant. Five out of six detected polymorphic sites were of one nucleotide substitution in the interconsensus regions. It is expected that these mutations do not affect significantly the level of expression. In contrast, the deletion observed in the sequence between CCAAT and TATA boxes could have some effect on affinity interactions between the promoter region and the transcription factors. The URR-BoLA-DRB3 DNA analyzed sequences showed moderate level of nucleotide diversity, high level of identity among them and were grouped in the same clade in the phylogenetic tree. In addition, the phylogenetic tree, the similarity analysis and the sequence structure confirmed that the fragment analyzed in this study corresponds to the URR-BoLA-DRB3. The functional role of the observed polymorphic sites among the regulatory motifs in bovine needs to be analyzed and confirmed by means of gene expression assays.

Patagonian Argentine Creole cattle polymorphism: comparison with North-West populations of this breed.

The relict Patagonian Argentine Creole cattle population consist of a small feral population (Los Glaciares population) that is geographically isolated in the South-West of Patagonia. In order to determine the level of genetic variability of this population, the polymorphism of eight structural genes and two microsatellites loci were studied using the polymerase chain reaction (PCR). In addition, genetic characterisation was used to compare Los Glaciares population and the ACc breed of cattle. Results obtained in this study show that the value of average heterozygosity of the studied loci for the Los Glaciares were not significantly different from the ACc. Furthermore, the data of this report were consistent with the hypothesis that Los Glaciares originated from ACc brought to the area by colonialists in the last century. Such data may be useful in formulating management plans for Feral Patagonian Creole cattle populations.

Analysis of genetic diversity and population structure in Argentine and Bolivian Creole cattle using five loci related to milk production

Data from five protein-coding loci related to dairy production were used to study the genetic diversity and population structure of Argentine and Bolivian Creole cattle breeds. Genomic DNA was extracted from blood samples of six Creole cattle breeds: Argentine (n = 230), Patagonian (n = 25); "Saavedreño" (n = 140), "Chaqueño Boliviano" (n = 30), "Yacumeño" (n = 27), and "Chusco" (n = 11). kappa-casein, beta-lactoglobulin, growth hormone and prolactin were measured by PCR-RFLP, while alphaS1-casein was typed by PCR-ASO. The results are discussed, focusing on: historical origin, recent differentiation and selection events, Zebu gene introgression, and population structure. This work shows that: (i) For the studied genes, the observed gene frequency profiles of Argentine and Bolivian Creole cattle breeds were close to the data reported for Iberian breeds and for other South-American Creole cattle breeds which are historically related; (ii) although Zebu gene introgression has been reported at the studied loci, these breeds seem to be far from the Zebu gene frequency profiles; and (iii) the Argentine and Bolivian Creole cattle showed significant levels of subdivision, but each population has maintained its degree of genetic variability

Incidence of 1/29 translocation in Bolivian Creole and Brahman Yacumeño cattle.

In Bolivia, four different Creole cattle breeds can be found, as well as other European and Zebu breeds adapted to local environments. The relationship between the occurrence of the 1/29 translocation and subfertility is well known, and analysis of Y chromosome morphology is useful to determine a possible introgression with Bos indicus. The incidence of the 1/29 translocation was analyzed in four Bolivian Creole cattle breeds and the Brahman Yacumeño population, as well as on four farms with phenotypical Creole-type cattle. In 259 (164 dams and 95 sires) Bolivian Creole cattle, 10.42% of the individuals demonstrated the 1/29 translocation, with a variation from 0 to 28.20% between the breeds. In contrast, 43 (19 dams and 24 sires) Yacumeño Brahman and the Creole-type cattle did not show the centric fusion. The highly significant differences between Creole cattle breeds in relation to the incidence of 1/29 translocation could be a consequence of factors such as founder group, genetic drift, and selection. The low frequency observed in the Saavedreñio Creole dairy cattle might be explained by its breeding under a more intensive system, and selection according to milk yield and fertility traits. Finally, no relation between acrocentric Y chromosomes and 1/29 translocation was observed.

DNA typing in a cattle stealing case.

DNA profiling was used as probative evidence in a cattle stealing case. The carcasses of the dead animals were found from a report and a farmer recognized the remains as those corresponding to the stolen animals by the farm mark on the coat. Those remains were collected as reference samples. Meat pieces were sequestered from a butchery and then sent to our Laboratory by the Justice Department of Buenos Aires (Argentine) to perform a DNA comparative analysis with the reference. Matches were found between the evidences and the references, supporting the hypothesis that the meat pieces had been obtained from the stolen animals. The butcher was suspected of stealing animals but no direct incrimination had been made yet.

Indigenous domestic breeds as reservoirs of genetic diversity: the Argentinean Creole cattle.

Contrary to highly selected commercial breeds, indigenous domestic breeds are composed of semi-wild or feral populations subjected to reduced levels of artificial selection. As a consequence, many of these breeds have become locally adapted to a wide range of environments, showing high levels of phenotypic variability and increased fitness under natural conditions. Genetic analyses of three loci associated with milk production (alpha(S1)-casein, kappa-casein and prolactin) and the locus BoLA-DRB3 of the major histocompatibility complex indicated that the Argentinean Creole cattle (ACC), an indigenous breed from South America, maintains high levels of genetic diversity and population structure. In contrast to the commercial Holstein breed, the ACC showed considerable variation in heterozygosity (H(e)) and allelic diversity (A) across populations. As expected, bi-allelic markers showed extensive variation in He whereas the highly polymorphic BoLA-DRB3 showed substantial variation in A, with individual populations having 39-74% of the total number of alleles characterized for the breed. An analysis of molecular variance (AMOVA) of nine populations throughout the distribution range of the ACC revealed that 91.9-94.7% of the total observed variance was explained by differences within populations whereas 5.3-8.1% was the result of differences among populations. In addition, the ACC breed consistently showed higher levels of genetic differentiation among populations than Holstein. Results from this study emphasize the importance of population genetic structure within domestic breeds as an essential component of genetic diversity and suggest that indigenous breeds may be considered important reservoirs of genetic diversity for commercial domestic species.