Molecular screening of tick-borne microorganisms in ticks from rural areas of Panama, with the first record of Ehrlichia minasensis in Rhipicephalus microplus from Central America.

During a molecular screening of rickettsial, borrelial and protozoal agents in ticks from rural areas of Panama, we detected DNA of Rickettsia amblyommatis in four Amblyomma mixtum collected from horses in a locality in Los Santos province. Ehrlichia minasensis and Anaplasma marginale were identified from three and two Rhipicephalus microplus, respectively, collected on cows from Chiriqui province. No DNA from other tick-borne agents was found. These results increase the information of R. amblyommatis and A. marginale in Panama, and also mark the first record of E. minasensis in Central America.

Ticks infesting humans in Central America: A review of their relevance in public health.

Ticks are blood-sucking arthropods that parasitize most groups of terrestrial or semiaquatic vertebrates. Humans are accidental hosts to the ticks; however, in humans the ticks can cause damages varying from simple irritation to severe allergies, toxicosis, paralysis, and the transmission of pathogens, some of which can be fatal. Central America represents a narrow isthmus between North and South America and is considered a biodiversity hotspot. The importance of tick-borne diseases in this region is manifested by fatal outbreaks caused by Rickettsia rickettsii, severe and mild cases of other rickettsioses, ehrlichiosis, and tick-borne relapsing fevers, in addition to cases paralysis and strong allergic reactions. Even so, this information is scarce in most countries of this region, and there are no epidemiological data. In this article we present a review of the ticks that parasitize humans in Central America, covering data from the 19th Century to the present day. Of nearly 80 tick species reported in Central America, 28 species are reported on humans. This list includes species that thrive within homes, grazing areas and, to a lesser extent, in wild environments, both in lowland and high mountain forests. The most important genus in this region is Amblyomma, followed by Rhipicephalus and Ornithodoros, and to a lesser extent Haemaphysalis, Ixodes and Dermacentor. These data provide information on the tick species most commonly associated with humans in Central America, and highlight the potential for tick-borne diseases in wild, rural and urban regions.

Rickettsia amblyommatis isolated from Amblyomma mixtum (Acari: Ixodida) from two sites in Panama.

Rickettsia amblyommatis is widely distributed in the Americas, and has been reported to infect different species of ticks within its distribution. In Panama, R. amblyommatis is the most common Rickettsia and its presence was molecularly detected in nine species of ticks and one flea species. This work described the isolation of R. amblyommatis in Vero cells by shell vial technique, from Amblyomma mixtum ticks collected from a captive tapir from Gamboa (Colon province), and a horse from El Valle de Antón (Cocle province). These represent the first isolations of R. amblyommatis in Panama.

Molecular screening for tick-borne bacteria and hematozoa in Ixodes cf. boliviensis and Ixodes tapirus (Ixodida: Ixodidae) from western highlands of Panama.

The first molecular screening for Rickettsia, Anaplasma, Ehrlichia, Borrelia, Babesia and Hepatozoon was carried out in questing Ixodes cf. boliviensis and Ixodes tapirus from Talamanca Mountains, Panama, using specific primers, sequencing and phylogeny. Phylogenetic analyses for the microorganisms in Ixodes cf. boliviensis confirmed the presence of Rickettsia sp. strain IbR/CRC endosymbiont (26/27 ticks), three genotypes of the Borrelia burgdorferi (sensu lato) complex (4/27 ticks), Babesia odocoilei (1/27 ticks), and Hepatozoon sp. (2/27 ticks), tentatively designated Hepatozoon sp. strain Chiriquensis. Phylogenetic analyses for the microorganisms in I. tapirus revealed an undescribed Rickettsia sp., tentatively designated Rickettsia sp. strain Itapirus LQ (6/6 ticks), and Anaplasma phagocytophilum (2/6 ticks). To the best of our knowledge, this is the first report of B. burgdorferi (s.l.) complex, A. phagocytophilum, B. odocoilei, and Hepatozoon sp. in Ixodes ticks from Central America, and also the first detection of Rickettsia spp. in Ixodes species in Panama. In light of the importance of these findings, further studies are needed focusing on the role of I. tapirus and I. cf. boliviensis as vectors, and the vertebrates acting as reservoirs.

Ornithodoros capensis sensu stricto (Ixodida: Argasidae) in Coiba National Park: first report for Panama, with notes on the O. capensis group in Panamanian shores and Costa Rica.

Ornithodoros capensis sensu lato (s.l.) is a morphologically similar group of soft ticks that parasitizes mostly seabirds in continental and offshore territories worldwide. Ornithodoros capensis sensu stricto (s.s.) has been previously recorded in many islands and coastal localities along the American continent; however, some records from Central America remain obscure. In this work we performed morphological and molecular analyses on soft ticks collected in Coiba National Park, an archipelago located in the Pacific Ocean off the coast of Panama, confirming the occurrence of O. capensis s.s. in this country for the first time. In addition, a morphological examination of museum specimens collected in Costa Rica, and a further locality in Panama, confirmed that O. capensis s.l. is established in the former country, and that its distribution along Panamanian shores is likely larger.

Características clínicas y para clínicas de los pacientes con fiebre manchada por Ricketts ia ricketts ii en Panamá (1950­-1951; 2004­-2017) / Clinical and para clinical characteristics of patients with fevers potted by Rickettsiarickettsii in Panama (1950­1951; 2004­2017)

La fiebre manchada causada por Ric ketts ia ric ketts iies por mucho la enfermedad transmitida por garrapatas más importante en América Latina y una de las zoonosis más relevante del continente. En Panamá esto es notorio si se considera que los casos confirmados de la misma se han registra­ do en dos series: 1950­1951, donde se presentaron cinco casos, donde los dos primeros fueron re­ sultaron fatales, y de 2004­2017, donde se confirmaron 10 casos, con nueve fallecimientos. A pes ar de lo anterior, la fiebre manchada causada por Rrickettsii es una enfermedad de baja preva­lencia y está dentro de las enfermedades desatendidas. El diagnóstico oportuno de Rrickettsii en personas afectadas por la misma, incrementa la posibilidad de sobrevivencia del paciente; sin em­bargo, a pesar de su alto porcentaje de mortalidad, esta enfermedad es poco reconocida y no se cuenta con sospecha clínica. Con el objetivo de presentar sus características clínicas en Panamá, se analizan individualmente cada reportes de caso, incluyendo datos etarios , de localidad, sínto­mas descritos, análisis aplicados y tratamiento.

The spotted fever caused by Ric ketts ia rickettsii is by far the most important tick­borne disease in Latin America and one of the most important zoonoses in the continent. In Panama this is notorious if it is considers that the confirmed cases have been registered in two series: 1950­1951, with five cas es and two fatal; and 2004­2017, with 10 cases and nine deaths. Despite the above, spotted fe­ver caused by R. rickettsii is a disease of low prevalence and is among the neglected diseases. The timely diagnosis of Rrickettsii in people affected by it, increases the possibility of survival of the pa­tient; however, despite its high mortality rate, this disease is poorly recognized and there is no clini­ cal suspicion. In order to present their clinical characteristics in Panama, each reports of case is analyzed individually, including age, location, symptoms described, applied analysis and treatmen

In vitro Validation of Quantitative Light-Induced Fluorescence for the Diagnosis of Enamel Fluorosis in Permanent Teeth.

This study aimed to validate quantitative light-induced fluorescence (QLF) as a diagnostic tool for mild and moderate enamel fluorosis in permanent teeth, comparing it to visual diagnosis and histological assessment completed using polarized light microscopy (PLM). The buccal surfaces of 139 teeth were visually classified using the Thylstrup and Fejerskov Index (TFI) into sound (TFI 0; n = 17), mild (TFI 1-2; n = 69), and moderate (TFI 3-4; n = 43) fluorosis. Fluorosis was then assessed with QLF (variables ΔF, A, and ΔQ at 5-, 15-, and 30-radiance thresholds) using as reference areas the entire surface and a region of interest (ROI), identified as the most representative region of a fluorosis lesion. PLM images of longitudinal thin sections including the ROI were assessed for histological changes. Correlations among TFI, PLM, and QLF were determined. A receiver-operating characteristic curve was conducted to determine QLF's diagnostic accuracy when compared to the TFI and PLM assessments. This was used to assess the probability that the images were correctly ranked according to severity as determined by PLM and TFI. A positive correlation was found between QLF and PLM, and between QLF and TFI. QLF showed the highest sensitivity and specificity for the diagnosis of mild fluorosis. There was also a strong agreement between TFI and PLM. The selection of a ROI resulted in a stronger correlation with TFI and PLM than when the entire surface was used. The study results indicate that defining an ROI for QLF assessments is a valid method for the diagnosis of mild and moderate enamel fluorosis.

Hard ticks (Acari: Ixodidae) of livestock in Nicaragua, with notes about distribution.

We document the species of ticks that parasitize livestock in Nicaragua. The study was based on tick collection on cattle and horses from 437 farms in nine departments. Of 4841 animals examined (4481 cows and 360 horses), 3299 were parasitized, which represent 68 % of the bovines and 67 % of the equines in study: 59 cows and 25 horses were parasitized by more than one species. In addition, 280 specimens of the entomological museum in León were examined. The ticks found on cattle were Rhipicephalus microplus (75.2 % of the ticks collected), Amblyomma mixtum (20.8 %), A. parvum (2.6 %), A. tenellum (0.7 %), A. maculatum (0.7 %). While the ticks collected from the horses were: Dermacentor nitens (41.5 %), A. mixtum (31.7 %), R. microplus (13.8 %), A. parvum (6.5 %), A. tenellum (3.3 %), D. dissimilis (2.4 %) and A. maculatum (0.8 %).

A Randomized Controlled Trial of a Mobile Health Intervention to Promote Self-Management After Lung Transplantation.

Lung transplant recipients are encouraged to perform self-management behaviors, including (i) monitoring health indicators, (ii) adhering to their regimen, and (iii) reporting abnormal health indicators to the transplant coordinator, yet performance is suboptimal. When hospital discharge was imminent, this two-group trial randomized 201 recipients to use either the mobile health (mHealth) intervention (n = 99) or usual care (n = 102), to compare efficacy for promoting self-management behaviors (primary outcomes) and self-care agency, rehospitalization, and mortality (secondary outcomes) at home during the first year after transplantation. The mHealth intervention group performed self-monitoring (odds ratio [OR] 5.11, 95% confidence interval [CI] 2.95-8.87, p < 0.001), adhered to medical regimen (OR 1.64, 95% CI 1.01-2.66, p = 0.046), and reported abnormal health indicators (OR 8.9, 95% CI 3.60-21.99, p < 0.001) more frequently than the usual care group. However, the two groups did not differ in rehospitalization (OR 0.78, 95% CI 0.36-1.66, p = 0.51) or mortality (hazard ratio 1.71, 0.68-4.28, p = 0.25). The positive impact of the mHealth intervention on self-management behaviors suggests that the intervention holds promise and warrants further testing.

High-throughput transformation pipeline for a Brazilian japonica rice with bar gene selection.

The goal of this work was to establish a transformation pipeline for upland Curinga rice (Oryza sativa L. ssp. japonica) with bar gene selection employing bialaphos and phosphinothricin as selection agents. The following genes of interest: AtNCED3, Lsi1, GLU2, LEW2, PLD-alpha, DA1, TOR, AVP1, and Rubisco were cloned into the binary vector p7i2x-Ubi and were transferred into Agrobacterium strain EHA 105. Embryogenic calli derived from the mature embryos were transformed, and transgenic cells and shoots were selected on the medium supplemented with bialaphos or phosphinothricin (PPT) using a stepwise selection scheme. Molecular analyses were established using polymerase chain reaction and Southern blot for the bar gene and the NOS terminator. Overall, 273 putative transgenic plants were analyzed by Southern blot with 134 events identified. In total, 77 events had a single copy of the transgene integrated in the plant genome while 29 events had two copies. We tested backbone integration in 101 transgenic plants from all constructs and found 60 transgenic plants having no additional sequence integrated in the plant genome. The bar gene activity was evaluated by the chlorophenol red test and the leaf painting test using phosphinothricin with several transgenic plants. The majority of T0 plants carrying the single copy of transgene produced T1 seeds in the screen house.

Questing Amblyomma mixtum and Haemaphysalis juxtakochi (Acari: Ixodidae) Infected with Candidatus "Rickettsia amblyommii" from the Natural Environment in Panama Canal Basin, Panama.

This work emphasizes the detection of Candidatus "Rickettsia amblyommii" in questing Haemaphysalis juxtakochi and Amblyomma mixtum. From February 2009 to December 2012, questing ticks were collected from the vegetation and leaf-litter of four protected forests and two grassy areas around the Panama Canal basin. DNA was extracted from Amblyomma mixtum, Amblyomma naponense, Amblyomma oblongoguttatum, Amblyomma pecarium, Amblyomma tapirellum, Haemaphysalis juxtakochi, and unidentified immature Amblyomma. Specific primers of citrate synthase gene gltA were used to detect and identify the rickettsiae. Amplicons with the expected band size were purified and sequenced. DNA of C. "R. amblyommii" was found in A. mixtum, H. juxtakochi and Amblyomma immatures. To our knowledge, these finding represent the first report of C. "R. amblyommii" in free-living ticks in the wilderness of Central America.

Some ecological aspects of free-living Haemaphysalis juxtakochi Cooley, 1946 (Acari: Ixodidae) in Panama / Algunos aspectos ecológicos de fases de vida libre de Haemaphysalis juxtakochi Cooley, 1946 (Acari: Ixodidae) en Panamá

Objective. To describe the seasonal variation and perform a comparative analysis on habitat preference of Haemaphysalis juxtakochi in Panama. Materials and methods. Ticks were collected from the vegetation, using a white cloth, between January 2009 and March 2010, in four site located in Summit Municipal Park (SMP), two in wooded area (WA) and two in grasslands (GR).The ticks were determined as larvae, nymphs and adults of H. juxtakochi. The number of ticks collected in each area was employed to describe the seasonal distribution of both immature and adult stages, and the non-parametric Mann-Whitney U test. Results. A total of 2.338 ticks in WA and 560 ticks in GR were collected. The major peak of adults from May to July, nymphs peaked from January to April and the peak of larvae abundance from December and January. There was a significant difference in the number of ticks collected in the two areas for each tick stage (larvae, mean number (MN) in WA 120.14, MN in GR 57.07, P: 0.02; nymphs, MN in WA 46.42, MN in GR 16.38, P: 0.018; adults, MN in WA 6.64, MN in GR 1.78, P: 0.02). Conclusions. The results suggest that H. juxtakochi maintains a one-year cycle in the study areas. This cycle would be characterized by the immature population peaks in the dry season; while adults are distributed throughout year, with a peak in the transition from the rainy and dry. Moreover, H. juxtakochi was more abundant in forests than in grasslands, which could lead to a better adaptation to forested conditions.

Objetivo. Describir la variación estacional y realizar un análisis comparativo de la preferencia de hábitat de H. juxtakochi en Panamá. Materiales y métodos. Se recolectaron mensualmente garrapatas de la vegetación utilizando una tela blanca, entre enero de 2009 y marzo de 2010 en cuatro sitios establecidos en el Parque Municipal Summit (PMS), dos en área de pastizales (AP) y dos en área boscosa (AB). Las garrapatas fueron identificadas como larva, ninfa y adulto de H. juxtakochi. El número de garrapatas recolectadas en cada área fue empleado para describir la distribución estacional de ambos estadios inmaduros y adultos, y se compararon con la prueba no paramétrica Mann-Whitney U. Resultados. Se recolectó un total de 2.338 garrapatas en AP y 560 garrapatas en AB. El mayor pico de garrapatas adultas fue de mayo hasta julio, los picos de ninfas fueron de enero hasta abril y los picos de abundancia de larvas desde diciembre hasta enero. Hubo diferencias significativas en el número de garrapatas recolectadas en las dos áreas para cada estadio (número promedio de larvas en AB 120.14, en AP 57.07, P: 0.02; número promedio de ninfas en AB 46.42, en AP 16.38, P:0.018; número promedio de adultos en AB 6.64, en AP 1.78, P: 0.02). Conclusiones. Los resultados sugieren que H. juxtakochi mantiene un ciclo de un año en las áreas de estudio. Este ciclo estaría caracterizado por picos poblacionales de ejemplares inmaduros en la época seca; mientras que los adultos se distribuyen a lo largo de todo año, con un pico en la transición entre la época lluviosa y seca. Por otra parte, H. juxtakochi fue más abundante en bosques que en pastizales, lo cual podría suponer mejores adaptaciones a condiciones boscosas.

Correlación entre la fiebre y la frecuencia respiratoria en menores de 5 años / Correlation between fever and respiratory rate in children under 5 years of age

Introducción: Entre los efectos de la fiebre está el incremento de la frecuencia respiratoria (FR) hasta alcanzar rangos de generar taquipnea. El diagnóstico de neumonía según la OMS basado en la presencia de taquipnea puede sobreestimarse durante la fiebre. El objetivo de este estudio fue determinar la correlación entre fiebre y FR en niños febriles menores de 5 años. Pacientes y Método: Estudio prospectivo de correlación en niños entre 2 y 60 meses. Se midió FR y temperatura corporal al ingreso a Servicio de Urgencia y luego de recibir acetaminofén. Se calculó la correlación entre el cambio de temperatura y el cambio en la FR. Se determinó la frecuencia de taquipnea al ingreso y al normalizar la temperatura. Resultados: 362 pacientes fueron incluidos, media 23,7 meses (DE 16,1). La FR en menores de un año disminuyó 12,9 respiraciones por minuto (DE 6,7) al normalizar temperatura; en mayores, disminuyó 10,7 respiraciones por minuto (DE 5,2). El coeficiente r² entre temperatura y FR fue 0,08 para menores de un año y 0,11 para mayores. De los niños que estaban taquipneicos, 57 por ciento no lo estaban al normalizar la temperatura. Conclusiones: Se recomienda reevaluar la FR de todo niño febril luego de normalizar su temperatura antes de definir taquipnea.

Introduction: Increased body temperature results in raised respiratory rate (RR) leading to tachypnea. According to World Health Organization (WHO), the diagnosis of pneumonia based on the presence of tachypnea can be overestimated during fever. The aim of this study is to determine the correlation between fever and RR in febrile children under five years of age. Patients and Method: A prospective study of correlation in children between 2 and 60 months was performed. RR and body temperature were measured on Emergency Room admission and after receiving acetaminophen. The correlation between the temperature change and the change in the RR was calculated. The frequency of tachypnea at admission and after normalizing the temperature was determined. Results: 362 patients were included, mean age 23.7 months old. RR in children under one year of age decreased 12.9 breaths per minute after normalizing the temperature, in older than one year of age, it decreased 10.7 breaths per minute. The r² coefficient between temperature and RR was 0.08 for children under one year and 0.11 for older. Among the children who were tachypneic, 57 percent did not present this condition after normalizing the temperature. Conclusions: It is recommended to reevaluate RR in all febrile children after normalizing the temperature and before diagnosing tachypnea.

Ticks (Ixodida) on humans from central Panama, Panama (2010-2011).

From January 2010 to December 2011, a total of 138 cases of ticks feeding on humans were reported from 11 locations in central Panama. Five of these locations were situated in forest environments, three in rural landscapes and three in urban areas. The ticks were submitted to the Gorgas Memorial Institute, where nine species were identified among 65 specimens: Amblyomma cajennense s.l., A. dissimile, A. naponense, A. oblongoguttatum, A. ovale, A. sabanerae, A. tapirellum, Haemaphysalis juxtakochi and Rhipicephalus sanguineus s.l. The remaining 73 specimens consisted of unidentified immature ticks, all belonging to the genus of Amblyomma. Rhipicephalus sanguineus s.l. was the species most frequently associated with humans, particularly in urban environments. In rural landscapes, tick bites were most often caused by A. cajennense s.l., whereas A. tapirellum was the species most often found parasitizing humans in forest environments. These data provide information on the tick species most commonly associated with humans in forested environments, rural areas and cities around the Panama Canal.

α-Lactoalbúmina como ingrediente de fórmulas infantiles

La α-lactoalbúmina es la principal proteína del lactosuero en la leche materna, alcanzando una concentración de 2,44 g/L en la leche madura. Su principal función es la síntesis de lactosa a partir de glucosa y galactosa en la glándula mamaria, aunque posee además otros efectos beneficiosos sobre la salud del lactante debido a su elevada proporción de aminoácidos esenciales (triptófano y cisteína). Según diversos estudios parece influir positivamente en la absorción de hierro en el intestino del niño, y en experimentos in vitro, unida al ácido oleico (complejo HAMLET), es efectiva frente a tumores celulares como el papiloma humano. El complejo HAMLET también presenta un claro efecto antimicrobiano frente a Streptococcus pneumoniae, Haemophilus influenzae, cepas enteropatógenas de Escherichia coli y Salmonella thypimurium, sin embargo no se ha demostrado que durante la digestión de la leche materna se forme dicho complejo en el tracto digestivo del lactante. El desarrollo de fórmulas infantiles destinadas a la alimentación del niño durante el primer año de vida ha mejorado considerablemente en las últimas décadas intentando no sólo adecuar la concentración de nutrientes a los requerimientos del lactante, sino también adicionando compuestos bioactivos de diferente naturaleza, como la α-lactoalbúmina, con el objetivo de alcanzar los efectos funcionales que se producen en los niños alimentados con leche materna.

α-Lactalbumin as an ingredient of infant formula. α-lactalbumin is the main whey protein in human milk rising 2,44 g/L in mature milk. It has a key function in the synthesis of lactose from glucose and galactose in the mammary gland although this compound has also other beneficial effects on the infant health due to the high proportion of essential aminoacids (tryptophan and cysteine). It seems also to increase iron absorption in the digestive track, and in in vitro experiments, linked to oleic acid (HAMLET complex), has shown anticarcinogenic effects against cellular tumor such as human papilloma. In addition, this complex has been reported to exhibit antimicrobial properties against Streptococcus pneumoniae,Haemophilus influenzae, enteropathogenic strains of Escherichia coli and Salmonella thypimurium. However, the in vivo synthesis of HAMLET complex during milk digestion has not been proved yet. Infant formula have been improved considerably during the last decades not only adapting nutrient concentrations to infants requirements but also by the addition of new bioactive ingredients such as α-lactalbumin, to have the same functional effect as in breast fed babies.

[Alpha-Lactalbumin as an ingredient of infant formula]. / Alpha-Lactoalbúmina como ingrediente de fórmulas infantiles.

Alpha-Lactalbumin is the main whey protein in human milk rising 2,44 g/L in mature milk. It has a key function in the synthesis of lactose from glucose and galactose in the mammary gland although this compound has also other beneficial effects on the infant health due to the high proportion of essential aminoacids (tryptophan and cysteine). It seems also to increase iron absorption in the digestive track, and in in vitro experiments, linked to oleic acid (HAMLET complex), has shown anticarcinogenic effects against cellular tumor such as human papilloma. In addition, this complex has been reported to exhibit antimicrobial properties against Streptococcus pneumoniae, Haemophilus influenzae, enteropathogenic strains of Escherichia coli and Salmonella thypimurium. However, the in vivo synthesis of HAMLET complex during milk digestion has not been proved yet. Infant formula have been improved considerably during the last decades not only adapting nutrient concentrations to infants requirements but also by the addition of new bioactive ingredients such as alpha-lactalbumin, to have the same functional effect as in breast fed babies.

Clasificación de niños colombianos con desnutrición según la referencia NCHS o el estándar OMS

Se realizó un estudio descriptivo para evaluar la concordancia en la clasificación de niños colombianos con desnutrición según la referencia del National Center for Health Statistics (NCHS) y los estándares de la Organización Mundial de la Salud (OMS). Participaron 660 niños entre 0 y 59 meses con desnutrición aguda moderada (P/TZ<-2) y grave (P/TZ<-3 o edematizados), en recuperación nutricional hospitalaria entre 2000 y 2009. Se analizaron los indicadores talla para la edad (T/E) al ingreso y peso para la talla al ingreso (P/Tin) y egreso (P/Teg). Se compararon medias con la prueba t de Student pareada; la concordancia entre NCHS y OMS se estimó con Coeficiente de Correlación Intraclase (CCI) y el Índice Kappa; se evaluó el cambio de clasificación de los niños según el instrumento utilizado, con prueba de McNemar. Los instrumentos mostraron alta concordancia en los indicadores T/E (CCI=0,988; k=0,866) y P/Tin (CCI=0,901; k=0,578). Del total de niños clasificados con T/E normal por NCHS, 10,4% se clasificaron con retraso del crecimiento según OMS. Al ingreso 64,0% de los niños presentó desnutrición aguda moderada según NCHS, de éstos 44,8% clasificaron con emaciación severa según OMS, en consecuencia aumentó la emaciación severa de 36,0% hasta 63,3% con OMS. De los niños que egresaron 5% necesitarían más días de hospitalización si hubieran sido evaluados con OMS. En conclusión los estándares OMS captan más niños desnutridos y formas más severas de emaciación y baja talla, con su uso se espera hospitalizar más niños para recuperación nutricional y por más días.

A descriptive study was conducted to evaluate the concordance of National Center for Health Statistics reference (NCHS) used to classify undernourished children from Colombia with the WHO Child Growth Standards. We used data from children aged 6 to 59 months with acute malnutrition (Z <-2) and severe (Z <-3) who were admitted to the “Unidad Vida Infantil” nutrition program in Colombia. Indicators height-for-age, weight for-height were analyzed when they were admitted to the hospital and weight for-height leaving the hospital. A statistical method used to compare means was T-student. Correlation coefficient intraclass (CCI) and Kappa index evaluated the concordance between NCHS and OMS; McNemar method evaluated the changes on the nutritional classification for children according to growth devices used. Of the total number of children classified as normal by NCHS, 10.4% were classified as stunted by WHO. 64% of the children admitted to the hospital presented acute malnutrition according to NCHS, of these 44,8% presented severe emaciation according to OMS, indeed severe emaciation increased of 36,0% to 63,3% using OMS. 5% of children leaving the hospital could need to stay more days if they had been evaluated with OMS. Growth devices shown high concordance in height-for-age (CCI=0,988; k=0,866) and weight for-height (CCI=0,901; k=0,578). Concluded that OMS growth standards classified more malnourished children and more severe states, in addition more malnourished children could be hospitalized and they could stay more days.

Distribución de los ectoparásitos de Canis lupus familiaris L. (Carnivora: Canidae) de Panamá / Distribution of ectoparasites of Canis lupus familiaris L. (Carnivora: Canidae) from Panama

Objetive. To determine the distribution of ectoparasites in dogs in Panama. Materials and methods. There were surveyed 720 canines belonging to 57 communities. Results. The results showed that 84% of the dogs were infested with at least one species of ectoparasite. Dogs from lowlands showed a higher percentage of parasitism and a greater biodiversity of parasites than dogs from highlands. There were found seven species of ticks, four species of fleas, two species of lice, and one specie of botfly. The ticks Rhipicephalus sanguineus, Amblyomma cajennense, A. ovale and the flea Ctenocephalides felis were widespread; however Ixodes boliviensis and Pulex simulans showed a much narrower geographic distribution and they were found only in dogs from highlands. The flea species Rhopalopsyllus cacicus and the tick Haemaphysalis juxtakochi were found for the first time in panamanian dogs. Conclusions. The environmental situation in Panama, can encourage that wildlife ectoparasites parasitized dogs in absence of their native hosts. This condition may increase transmission risk of some diseases where the ticks and fleas are vectors.

Relationship between Serum Concentration of Uric Acid and Insulin Secretion among Adults with Type 2 Diabetes Mellitus.

To determine the relationship between serum concentrations of uric acid and insulin secretion with hyperglycaemic clamp technique among adults with type 2 diabetes mellitus (DM2) without hyperuricemia, we carried out a cross-sectional study on 45 patients of both gender. We observed correlation between uric acid with male gender r = 0.710 (P = 0.001). Also correlation between uric acid and total insulin secretion was positive r = 0.295 (P = 0.049). As well as a positive correlation adjusted for body mass index was demonstrated for the first, second, and total phases of insulin secretion, respectively, r = 0.438 (P = 0.022), r = 0.433 (P = 0.022), and r = 0.439 (P = 0.024). Serum concentration of uric acid showed a positive relationship with the total phase of insulin secretion; even in states prior to hyperuricemia, uric acid can play an important role in the function of the beta cell in patients with DM2.