Pathogenicity of microsclerotia from Metarhizium robertsii against Aedes aegypti larvae and antimicrobial peptides expression by mosquitoes during fungal-host interaction.

Aedes aegypti is a vector of various disease-causing arboviruses. Chemical insecticide-based methods for mosquito control have increased resistance in different parts of the world. Thus, alternative control agents such as the entomopathogenic fungi are excellent candidates to control mosquitoes as part of an ecofriendly strategy. There is evidence of the potential of entomopathogenic fungal conidia and blastospores for biological control of eggs, larval and adult stages, as well as the pathogenicity of fungal microsclerotia against adults and eggs. However, there are no studies on the pathogenicity of microsclerotia against either aquatic insects or insects that develop part of their life cycle in the water, such as the A. aegypti larvae. In this study, we assayed the production of microsclerotia and their pathogenicity against A. aegypti larvae of two isolates of Metarhizium robertsii, i.e., CEP 423 isolated in La Plata, Argentina, and the model ARSEF 2575. Both isolates significantly reduced the survival of A. aegypti exposed to their microsclerotia. The fungus-larva interaction resulted in a delayed response in the host. This was evidenced by the expression of some humoral immune system genes such as defensins and cecropin on the 9th day post-infection, when the fungal infection was consolidated as a successful process that culminates in larvae mortality. In conclusion, M. robertsii microsclerotia are promising propagules to be applied as biological control agents against mosquitoes since they produce pathogenic conidia against A. aegypti larvae.

Age-Appropriate Wisdom? : Ethnobiological Knowledge Ontogeny in Pastoralist Mexican Choyeros.

We investigate whether age profiles of ethnobiological knowledge development are consistent with predictions derived from life history theory about the timing of productivity and reproduction. Life history models predict complementary knowledge profiles developing across the lifespan for women and men as they experience changes in embodied capital and the needs of dependent offspring. We evaluate these predictions using an ethnobiological knowledge assessment tool developed for an off-grid pastoralist population known as Choyeros, from Baja California Sur, Mexico. Our results indicate that while individuals acquire knowledge of most dangerous items and edible resources by early adulthood, knowledge of plants and animals relevant to the age and sex divided labor domains and ecologies (e.g., women's house gardens, men's herding activities in the wilderness) continues to develop into middle adulthood but to different degrees and at different rates for men and women. As the demands of offspring on parents accumulate with age, reproductive-aged adults continue to develop their knowledge to meet their children's needs. After controlling for vision, our analysis indicates that many post-reproductive adults show the greatest ethnobiological knowledge. These findings extend our understanding of the evolved human life history by illustrating how changes in embodied capital and the needs of dependent offspring predict the development of men's and women's ethnobiological knowledge across the lifespan.

Adulticidal Activity of Metarhizium anisopliae s.l. (Hypocreales: Clavicipitaceae) Native Strains From Argentina Against Aedes aegypti (Diptera: Culicidae).

The adulticidal activity of six fungal strains of Metarhizium anisopliae (Metschn.) Sorokin s.l. (Hypocreales: Clavicipitaceae) against Aedes aegypti (L.) (Diptera: Culicidae) was assessed. These strains (CEP 085, CEP 087, CEP 120, CEP 350, CEP 404, and CEP 423) were isolated from soil samples or nondipteran hosts collected from areas in Argentina where Ae. aegypti is distributed. Bioassays were performed with four conidial concentrations plus a control of each fungal strain to determine the lethal concentrations (LC50/LC90), the median survival times (ST50), the mean percentage of the surviving individuals, and the mean percentage of mycotized cadavers. The strains were able to infect and kill adult Ae. aegypti. Significant differences were found among the LC50 values, with CEP 423 as the most virulent strain with the lowest LC50 (2.4 × 106 conidia/ml). At 1 × 107 conidia/ml: no significant differences were found in the Kaplan-Meier survival functions among the strains; the ST50 ranged from 5 (CEP 085) to 8 d (CEP 350); and the mean percentage of the surviving adults was between 13.3 (CEP 085, CEP 350 and CEP 423) and 46.7% (CEP 087). Significant differences were also found among strains in the mean percentage of cadavers with fungal sporulation. Strain CEP 423 produced the highest percentage of mycotized adults (70%). The concentration of the inoculum significantly affected the survival of individuals and the percentage of mycotized cadavers within each strain. Metarhizium anisopliae s.l. CEP 423 was selected as the most promising candidate for further research aiming to develop a mycoinsecticide against Ae. aegypti.

Natural occurrence in Argentina of a new fungal pathogen of cockroaches, Metarhizium argentinense sp. nov.

The aim of this study was to search for entomopathogenic fungi that infect wild cockroaches in forest ecosystems in two protected natural areas of Argentina. Two isolates of Metarhizium argentinense were obtained and identified from wild cockroaches (Blaberidae: Epilamprinae) through the use of morphological characteristics and molecular phylogenetic analyses. This novel species was found in Argentina and is a member of the Metarhizium flavoviride species complex. Phylogenetic analyses, based on sequence similarity analysis using internal transcribed spacer (ITS) and a set of four protein-coding marker sequences (EF1A, RPB1, RPB2 and BTUB), supported the status of this fungus as a new species. In addition, we tested the biological activity of the new species through assays against Blattella germanica nymphs and found that the two evaluated isolates were pathogenic. However, isolate CEP424 was more virulent and caused a confirmed mortality of 76 % with a median lethal time of 7.2 d. This study reports the southernmost worldwide location of a Metarhizium species that infects cockroaches and will help expand the knowledge of the biodiversity of pathogenic fungi of Argentine cockroaches.

Effect of UV-B Irradiation on Water-Suspended Metarhizium anisopliae s.l. (Hypocreales: Clavicipitaceae) Conidia and Their Larvicidal Activity in Aedes aegypti (Diptera: Culicidae).

Ultraviolet (UV) radiation is a key limiting factor for biological pest control with entomopathogenic fungi. While little is known about the impact of UV on Metarhizium anisopliae Metchnikoff (Sorokin) (Hypocreales: Clavicipitaceae) conidia in aquatic mosquito-breeding sites, this study determined the effect of UV-B on the viability and virulence of M. anisopliae sensu lato (s.l.) strain IP 46 in the laboratory against Aedes aegypti (L.) (Diptera: Culicidae) larvae. Conidia were treated in cups under defined water depths (0, 1, 2, and 3 cm) to six different UV-B doses (0, 0.657, 1.971, 3.942, 7.884, 11.826, or 15.768 kJ m-2) at 27 ± 2°C. The ability of treated conidia to germinate up to 24 h postexposure on PDAY + benomyl + chloramphenicol medium at 25 ± 1°C was adversely affected by higher doses of UV-B radiation regardless of the water depth. Germination, however, did not fall below 70% regardless of the test conditions. In fact, conidial virulence against second-instar larvae was not affected by either the water depth (F3,84 = 0.3, P = 0.85) or any tested levels of UV-B radiation (F6,21 ≤ 1.2, P ≥ 0.39) including those distinctly higher than might be expected for tropical sites. These findings strengthen previous observations that IP 46 has significant potential for use against A. aegypti larvae, even when exposed to elevated UV-B irradiance levels in the small breeding sites that are common for this important vector.

Concordance and correlation of activity indices in patients with rheumatoid arthritis in northwestern Colombia: A cross-sectional study.

AIM: To determine the correlation and concordance between different clinimetric scores in patients with rheumatoid arthritis in two high-complexity reference centers in northwestern Colombia. METHOD: A cross-sectional study in adults diagnosed with rheumatoid arthritis was conducted according to the 2010 American College of Rheumatology and European League Against Rheumatism Classification Criteria, between January and June, 2013. The correlation was evaluated using Spearman's correlation coefficient, and concordance with quadratic weighted kappa with the respective confidence intervals, for which patients were classified into different categories of disease activity. RESULTS: One hundred patients were included, of whom 83% were women; 58 and 75% received methotrexate and glucocorticoids, respectively. Most individuals were in remission or low activity. High correlations between Disease Activity Score of 28 joints - erythrocyte sedimentation rate (DAS28-ESR) values with DAS28 C-reactive protein and Simple Disease Activity Index (SDAI) with Clinical Disease Activity Index (P < 0.0001; r = 0.82 and r = 0.86, respectively) were observed; likewise, the scores obtained with different indices correlated well with gold standard values for remission (SDAI), where the correlation with DAS28-ESR was slightly lower. Excellent concordance among all clinimetric scores was observed, although it was lower among DAS28-ESR and SDAI. CONCLUSION: Clinimetric indices had high concordance and correlation, especially for rheumatoid arthritis patients in remission or low disease activity, without being interchangeable among them.

Infección del torrente sanguíneo en pacientes receptores de trasplante de precursores hematopoyéticos. Siete años de experiencia con adultos y niños / Bloodstream infection in patients receiving hematopoietic stem cell transplant. Seven years of experience with adults and children

Resumen Introducción: La infección del torrente sanguíneo es una complicación usual, que puede comprometer la vida de los pacientes que recibieron trasplante de precursores hematopoyéticos. Objetivo: Analizar las características de las infecciones del torrente sanguíneo en receptores de trasplante de precursores hematopoyéticos. Materiales y Métodos: Estudio observacional, retrospectivo. Se revisaron los registros de 451 pacientes (trasplantes autólogos y alogénicos), desde enero de 2009 a octubre de 2015. Resultados: Hubo 99 hemocultivos positivos en 73 pacientes con infección del torrente sanguíneo (16%). Mortalidad atribuible a causas infecciosas: 17%. De las 99 infecciones sanguíneas, 63% fueron provocados por bacilos gramnegativos (Escherichia coli 45%, Klebsiella spp 23%, Pseudomonas spp 11%, Acinetobacter spp 6% y otros bacilos gramnegativos 15%), 33% por cocáceas grampositivas, 3% por hongos y 1% por bacilos grampositivos. Se observó resistencia a ciprofloxacina (81%), piperacilina/tazobactam (48%), Enterobacteriaceae productoras de β-lactamasa de espectro extendido (BLEE) (40%), cefepime (39%) y ausencia de resistencia a amikacina. Discusión: Existe mayor frecuencia de infección por bacilos gramnegativos, con un importante porcentaje de aislados multi-resistentes, y consecuente, alta resistencia al tratamiento antimicrobiano empírico.

Background: Bloodstream infection is a common complication, which can be life-threatening for hematopoietic stem cells transplant recipients. Objective: To analyze the characteristics of bloodstream infections in hematopoietic stem cell transplant recipients. Materials and Methods: Observational, retrospective study. We reviewed the records of 451 patients (autologous and allogeneic transplants) from January 2009 to October 2015. Results: 99 positive blood cultures in 73 patients with bloodstream infection (16%) were found. Mortality attributable to infectious causes was 17%. From the 99 bloodstream infection, 63% were caused by gram-negative bacilli (Escherichia coli 45%, Klebsiella spp 23%, Pseudomonas spp 11% Acinetobacter spp % and other bacilli 15%), 33% by gram-positive cocci, 3% by fungi and 1% by gram-positive bacilli. The gram-negative bacilli were ciprofloxacin resistant (81%), piperacillin/tazobactam resistant (48%), extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae (40%), cefepime resistant (39%) and there was no resistance noted to amikacin. Discussion: There is a higher frequency of gram-negative bacilli infection, with a high percentage of multiresistant microorganisms and high resistance to empirical antibiotic treatment.

Prevalencia de fibrilación auricular y características de la fibrilación auricular no valvular en la población general. Registro AFINVA / Prevalence of atrial fibrillation and features of non-valvular atrial fibrillation in general population

Resumen Fundamento y objetivos: La fibrilación auricular es la arritmia mantenida más común. El estudio pretende conocer la prevalencia de fibrilación auricular en la población general, y evaluar las características y el manejo de los casos con fibrilación auricular no valvular. Métodos: Estudio transversal exploratorio en una muestra de la población de un Departamento de Salud (n = 30.024) de sujetos mayores de 18 años con diagnóstico electrocardiográfico de fibrilación auricular en la historia clínica electrónica de atención primaria. Se analizan características clínicas, manejo y tratamiento. Resultados: De un total de 629 pacientes con diagnóstico de fibrilación auricular, lo que representa una prevalencia del 2,1% (8,06% en > 65 años), fueron seleccionados para el estudio 505 casos con fibrilación auricular no valvular. La edad media fue 77,4 ± 10 años, 55% mujeres. Se objetivó cardiopatía estructural en el 32% de casos e insuficiencia cardiaca en el 29,5%. El 72% de pacientes recibía tratamiento anticoagulante, 60% con antivitamina K y 12% con anticoagulantes directos. Entre los primeros, solo el 53% mantenía un tiempo en rango terapéutico ≥ 65% según el método de Rosendaal. La forma de presentación persistente-permanente fue más frecuente (60,8%), seguida de la paroxística (39,2%). Conclusiones: La prevalencia de fibrilación auricular fue del 2,1%, aumentando con la edad, con elevada proporción de cardiopatía concomitante. La proporción de pacientes anticoagulados y la calidad de la anticoagulación son deficientes, revelándose así la necesidad de mejor monitorización y mayor utilización de nuevos anticoagulantes directos en los casos indicados.

Abstract Background and objectives: Atrial fibrillation is the most common type of constant arrhythmia. The study aims to know the prevalence of atrial fibrillation in the general population and to assess the features and management of non-valvular atrial fibrillation. Methods: Cross-sectional exploratory study of a population sample from a Health department (n=30.024) of individuals over 18 years with electrocardiographic diagnosis of atrial fibrillation in the primary care electronic medical records. Clinical features, management and treatments are analyzed. Results: Out of a total of 629 patients with an atrial fibrillation diagnosis, which represents a 2.1% prevalence (8.06% in >65 years), 505 cases with non-valvular atrial fibrillation were selected for the study. Average age was 77.4 ± 10 years, 55% female patients. Structural heart disease was detected in 32% of the cases, and cardiac failure in 29.5% of the cases. 72% of the patients were receiving anticoagulation therapy, 60% with antivitamin K drugs and 12% with direct anticoagulants. Among the former group, only 53% kept a time within the therapeutic range ≥65% according to the Rosendaal method. The most frequent presentation was persistentpermanent (60.8%), followed by paroxysmal (39.2%). Conclusions: Prevalence of atrial fibrillation was 2.1%, increasing with age, with a high proportion of accompanying heart disease. The proportion of anticoagulated patients and the quality of anticoagulation were poor, thus revealing the need for improved monitoring and wider use of new direct anticoagulants in the indicated cases.

[Bloodstream infection in patients receiving hematopoietic stem cell transplant. Seven years of experience with adults and children]. / Infección del torrente sanguíneo en pacientes receptores de trasplante de precursores hematopoyéticos. Siete años de experiencia con adultos y niños.

BACKGROUND: Bloodstream infection is a common complication, which can be life-threatening for hematopoietic stem cells transplant recipients. OBJECTIVE: To analyze the characteristics of bloodstream infections in hematopoietic stem cell transplant recipients. MATERIALS AND METHODS: Observational, retrospective study. We reviewed the records of 451 patients (autologous and allogeneic transplants) from January 2009 to October 2015. RESULTS: 99 positive blood cultures in 73 patients with bloodstream infection (16%) were found. Mortality attributable to infectious causes was 17%. From the 99 bloodstream infection, 63% were caused by gram-negative bacilli (Escherichia coli 45%, Klebsiella spp 23%, Pseudomonas spp 11% Acinetobacter spp % and other bacilli 15%), 33% by gram-positive cocci, 3% by fungi and 1% by gram-positive bacilli. The gram-negative bacilli were ciprofloxacin resistant (81%), piperacillin/tazobactam resistant (48%), extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae (40%), cefepime resistant (39%) and there was no resistance noted to amikacin. DISCUSSION: There is a higher frequency of gram-negative bacilli infection, with a high percentage of multiresistant microorganisms and high resistance to empirical antibiotic treatment.

Allogeneic hematopoietic stem cell transplantation in adults with myelodysplastic syndrome: Experience of the Argentinean Group of Bone Marrow Transplantation (GATMO).

INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (AHSCT) is a curative approach for patients with myelodysplastic syndrome (MDS). METHODS: In this multicenter retrospective study, we analyzed the outcome of adult patients with MDS who underwent AHSCT in Argentina and evaluated the prognostic factors associated with progression-free survival (PFS), overall survival (OS), cumulative incidence (CI) of relapse, and non-relapse mortality (NRM). RESULTS: We analyzed data from 87 adults (median age: 43 years, range 18-66) who underwent SCT after myeloablative (n = 60) or non-myeloablative conditioning (n = 27), and from related (n = 62) or unrelated (n = 25) donors. For all patients, unadjusted 4-year PFS and OS were 37% and 38%, respectively; no significant differences were found between recipients of related or unrelated donors. One-year CI of relapse and NRM were 21% and 20%, respectively. In the multivariate analysis, intermediate disease risk index (DRI) and acute graft versus host disease AGVHD of all grades (I-IV) were independent variables associated with better PFS and lower relapse CI; only intermediate DRI was associated with better OS. CONCLUSIONS: AHSCT is a feasible procedure in Argentina, with more than 30% of the patients achieving long-term survival. Recipients with unrelated donors had at least similar outcome than those with related donors. DRI may be useful to identify patients at higher risk of relapse after transplantation.

Effect of ultraviolet-A radiation on the production of Leptolegnia chapmanii (Saprolegniales: Saprolegniaceae) zoospores on dead Aedes aegypti (Diptera: Culicidae) larvae and their larvicidal activity.

Impact of UV-radiation in entomopathogens in aquatic environments remains little investigated. The present study reports on the effect of UV-A on the larvicidal activity of Leptolegnia chapmanii zoospores in Aedes aegypti; on the production of zoospores in larvae killed by the pathogen and then exposed to UV-A; and on the activity of these zoospores against healthy larvae. Whereas the virulence of free zoospores in A. aegypti larvae was affected by a UV-A exposure time longer than 10min, production of zoospores in larvae and their virulence were not hampered at a maximal 8h exposure of dead larvae to UV-A. Findings suggest that dead larvae and zoosporangia provide a certain protection to zoospores against UV-A and emphasize the susceptibility of free encysted zoospores to such radiation.

Allogeneic hematopoietic stem cell transplantation in pediatric myelodysplastic syndromes: a multicenter experience from Argentina.

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (AHSCT) represents the only curative treatment for the majority of pediatric patients with Myelodysplastic Syndrome (MDS). We aimed to evaluate overall survival (OS), disease-free survival (DFS), non-relapse mortality (NRM) and relapse incidence in children who underwent AHSCT for MDS in six institutions from Argentina. PROCEDURE: A retrospective analysis of 54 AHSCT was carried out in 52 patients (mean age: 9 years; range: 2-19; 35 males). RESULTS: MDS subtypes were refractory cytopenia of childhood (RCC) (n: 26, 50%), refractory anemia with excess blasts (RAEB) (n: 9, 18%), RAEB in transformation (RAEB-T) (n: 8, 15%) and juvenile myelomonocytic leukemia (JMML) (n: 9, 17%). At time of transplant, seven (13%) patients transformed to acute myeloid leukemia (AML) and two patients with RCC to RAEB. Donors were related in 32 cases (59%) and the stem cells source was: bone marrow (63%), peripheral blood (26%), and umbilical cord blood (11%). Five-year DFS and OS were 50% and 55% respectively; and for patients with JMML, 57% and 67% respectively. Cumulative incidence of NRM and relapse were 27% and 21% respectively. In the multivariate analysis, umbilical cord blood (HR 4.07; P = 0.025) and age ≥ 9 years at transplantation (HR 3.28; P = 0.017) were associated with lower OS; age and graft-versus-host disease (GVHD) had a higher NRM. CONCLUSIONS: In our series, more than half of the patients achieved long term OS with AHSCT. Less toxic conditioning regimens or more intensive GVHD prophylaxis could lead to better results in some children.

Soluble fractalkine in the plasma of fibromyalgia patients.

Fibromyalgia is a form of non-articular rheumatism in which inflammatory cytokines seem to be involved. However, there is still no analytical specific diagnostic criterion for this disease. The aim was to examine a possible role of fractalkine as a biomarker in fibromyalgia. Plasma levels of soluble fractalkine were compared between women diagnosed with fibromyalgia (n=17) and healthy women (n=10) as controls. Fractalkine released by monocytes was also evaluated. Fibromyalgia patients showed lower plasma fractalkine than healthy women. Since most inflammatory pathologies show elevated plasma levels of soluble fractalkine, the results may contribute towards a differential diagnosis for fibromyalgia.

A simple method for the detection of Leptolegnia chapmanii from infected Aedes aegypti larvae.

Significant progress in developing Leptolegnia chapmanii as a biological control agent against mosquitoes will be accelerated by improved and simpler methods to detect and to isolate this virulent and rapidly lethal watermold from field-collected mosquito larvae. To date, however, this oomycete has remained understudied and little used. This study presents a simplified method to detect Leptolegnia in infected Aedes aegypti larvae. The development of L. chapmanii inside mosquitoes is easily monitored when pathogen-treated larvae are quasi-immobilized for an initial 48 h in the water film on plates of water agar amended with antibiotic (chloramphenicol, 0.5-1 g/L) and fungicide (thiabendazole, 4-8 g/L) and then transferred to a larger volume of water for an additional 48 h. Surprisingly, chloramphenicol stimulated oosporogenesis by L. chapmanii. The method permits processing of large numbers of A. aegypti and other culicid larvae and is useful for both obtaining new strains and also monitoring the efficacy of L. chapmanii during field tests.

First record of a mosquito iridescent virus in Culex pipiens L. (Diptera: Culicidae).

The mosquito iridescent viruses (MIVs) are large icosahedral DNA viruses that replicate and assemble in the cytoplasm of the host. Paracrystalline arrangements of virions that accumulate in the cytoplasm produce an iridescent color that is symptomatic of acute infections. In August 2010, we found larvae of Culex pipiens with these symptoms in suburban ditches around the city of La Plata, Argentina. Electron microscope studies, DNA sequencing, and phylogenetic analysis of the major capsid protein confirmed this as the first record of an MIV in C. Pipiens.

Native Argentinean cyclopoids (Crustacea: Copepoda) as predators of Aedes aegypti and Culex pipiens (Diptera: Culicidae) mosquitoes

Copepods from La Plata, Argentina were investigated to characterize the local community of larvivorous copepods inhabiting mosquito breeding sites and to identify new predator species of the mosquitoes which occur in artificial containers, Aedes aegypti and Culex pipiens. Diversity of larvivorous cyclopoids was highest in permanent pools. Predation by sex and age, selectivity on mosquito species, and daily predation rate during five days were studied for Acanthocyclops robustus, Diacyclops uruguayensis, Macrocyclops albidus and Mesocyclops longisetus. Female copepods presented the highest predatory capacity. No predatory preference for mosquito species was found. According to overall predation potential, copepods were ranked as follows: D. uruguayensis < A. robustus < M. albidus < M. longisetus. Copepod tolerance to desiccation and capacity to survive in water from artificial containers were also evaluated. D. uruguayensis and A. robustus survived under dry conditions, but D. uruguayensis showed lower survival in water from cemetery flower vases. M. albidus did not survive under dry conditions and did not tolerate water extracted from artificial containers. M. longisetus survival was not severely reduced after desiccation or breeding in water from flower vases. The Neotropical cyclopoids D. uruguayensis and A. robustus can be considered good candidates and merit further research as biological control agents for mosquitoes. Rev. Biol. Trop. 57 (4): 1059-1068. Epub 2009 December 01.

Se hizo una prospección de copépodos en La Plata, Argentina, con los objetivos de caracterizar la comunidad local de copépodos larvívoros en sitios de cría de mosquitos, e identificar nuevas especies depredadoras de los mosquitos de contenedores artificiales Aedes aegypti y Culex pipiens. La diversidad de ciclopoides larvívoros fue máxima en charcos permanentes. Se examinó la depredación por sexos y edad, la selectividad por especies de mosquito, y la tasa de depredación diaria durante cinco días en Acanthocyclops robustus, Diacyclops uruguayensis, Macrocyclops albidus y Mesocyclops longisetus. Los copépodos hembra presentaron la capacidad depredadora más alta. No se encontró preferencia por alguna especie de mosquito. De acuerdo al potencial de depredación en general, los copépodos se ordenan así: D. uruguayensis < A. robustus < M. albidus < M. longisetus. También se evaluó la tolerancia a la desecación del hábitat y la capacidad de resistir en agua de contenedores artificiales. D. uruguayensis y A. robustus sobrevivieron en condiciones de sequía, pero D. uruguayensis presentó menor supervivencia en agua de floreros de cementerio. M. albidus no sobrevivió condiciones de sequía y no toleró el agua extraída de contenedores artificiales. Los ciclopoides neotropicales D. uruguayensis and A. robustus son buenos candidatos y merecen investigación ulterior como agentes de control biológico de mosquitos.

Clinical significance of V617F mutation of the JAK2 gene in patients with chronic myeloproliferative disorders.

OBJECTIVE: To determine the prevalence of JAK2 V617F mutation and its clinical correlation in patients with chronic myeloproliferative disorders (CMD): polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF). MATERIALS AND METHODS: Detection of JAK2 V617F mutation by allele specific-PCR. RESULTS: One hundred and three patients with CMD were included in the study. JAK2 V617F distribution was PV 40/45 (89%), ET 30/43 (69%), and IMF 7/15 (47%). In PV and ET patients only, 18 had thrombosis at diagnosis and 12 during follow-up (these were microvascular: 11, venous: 7 and arterial: 12); of these 28/70 (40%) were JAK2pos versus 2/18 (11%) JAK2neg; P=0.02. In a median of 4 years, two patients with PV JAK2pos evolved to myelofibrosis and one patient with PV presented in leukemic transformation (JAK2pos before and after transformation); six patients died: four patients with IMF and two patients with PV. CONCLUSIONS: We found an association between JAK2 V617F and thrombotic events in patients with PV and ET.

Prevalence and distribution of parasites and pathogens of triatominae from Argentina, with emphasis on Triatoma infestans and Triatoma virus TrV.

Chagas' disease is the most important endemic arthropod-zoonosis in Argentina with an estimated 1.6 million people infected with the causative agent Trypanosoma cruzi. Triatoma infestans is the main vector of Chagas' disease in Argentina. A survey for parasites and pathogens of Triatominae was conducted from August 2002 to February 2005. Collections of insects were made in domiciles, peridomiciles, and in the natural habitats of the Triatominae. Insects from these collections were dissected and their organs and tissues examined for flagellates. Frass from these insects was collected and examined for detection of the entomopathogenic virus Triatoma virus (TrV) using AC-ELISA and PCR. Triatominae belonging to four species, T. infestans (n=1646), Triatoma guasayana (n=4), Triatoma platensis (n=1) and Triatoma sordida (n=5) were collected from 62 sites located in 13 provinces of Argentina. Triatoma virus and two protozoan species, Blastocrithidia triatomae and T. cruzi, the etiological agent of Chagas disease, were found infecting Triatominae. The total prevalence of TrV in 1646 T. infestans analyzed by ELISA was 9.66% (159/1646) from 7 to 13 provinces where collections were made. Triatoma virus positive triatomines were found in 17 of 62 populations when examined by AC-ELISA but in 38 of 62 populations when PCR was used for detection. The prevalence of B. triatomae in T. infestans was 0.43% (7/1646), while the prevalence of T. cruzi was 1.3% (21/1646). This is the first study on the diversity, distribution and prevalence of flagellated protozoa and TrV of Triatominae in endemic Chagas' disease regions of Argentina.

Clinical outcome of patients with relapsed/refractory acute leukemia treated with FLAG-IDA regimen

Background: Patients with Refractory/Relapsed (RIR) acute leukemia (AL) have a poor prognosis. Objective: We aimed to evaluate the chemotherapy regimen fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) in patients with RIR AL. Patients: We studied 33 patients with R/R AL. Distribution of the AL subtype was: myeloblastic n=17 (52%), lymphoblastic n=14 (42%),) and biphenotypic n=2 (6%). Results: Complete remission (CR) was achieved in 15 cases (45.5%) and seven patients dead resulting in a mortality of 21.1%. In patients with hematological recovery the median time to neutrophils recovery (> 0.5 x 10º/1) was 24 days (range 10-38); platelet levels of more than 20 x 1Oº/l and 50 x 10º/1 were reached in a median time of 24 (range 17-44) and 27 days (range 18-51), respectively. After CR, five patients underwent allogeneic transplan- tation and 10 patients received a second course of FLAG – IDA. Ten out of 15 patients who achieved CR with FLAG-IDA relapsed at a median of 7.7 months (95% CI 1.8 to 13.6 months). Overall survival (OS) after FLAG-IDA in the surviving cohort had a median of 4 months. We found a significantly better OS in patients who received allogeneic transplantation post-FLAG-IDA than those who did not (median 11.4 months vs. 2.7 monthsj HR 0.29; 95% CI 0.1 to 0.6; p=0.017). Conclusions: In our series, FLAG-IDA demonstrated to be an effective salvage chemotherapy regimen, however, the benefit in survival of this rescue treatment was restrained to patients who unde.rwent al1ogeneic transplantation