An international breeding project using a wild potato relative Solanum commersonii resulted in two new frost-tolerant native potato cultivars for the Andes and the Altiplano.

This breeding project, initiated at the United States Potato Genebank (USPG) in collaboration with Peruvian partners Instituto Nacional de Innovacion Agraria (INIA), International Potato Center, Peru (CIP), and local farmers, sought to enhance cold hardiness and frost tolerance in native potato cultivars in Peru. The Andes and Altiplano are often affected by frost, which causes significant reduction in yield; creating varieties with superior resilience is a critical undertaking. The goal was to transfer outstanding non-acclimated cold tolerance and acclimation capacity found in wild potato species Solanum commersonii (cmm). Breeding families segregating for cold hardiness were created using (a) a somatic hybrid cmm + haploid Solanum tuberosum (tbr) (cv. Superior, US variety from Wisconsin) as male and (b) seven cultivars native to Peru of the species S. tuberosum sbsp. andigenum (adg) as females. All plant materials were part of the USPG germplasm collection. Sexual seeds of each family were sent to Peru for evaluations under the natural conditions of the Andean highlands and Altiplano. The plants were assessed for their response to frost, and genotypes showing exceptional tolerance were selected. Plants were also evaluated for good tuber traits and yield. Initial planting involving ~2,500 seedlings in five locations resulted in selecting 58 genotypes with exceptional frost tolerance, good recovery capacity after frost, and good tuber traits. Over the years, evaluations continued and were expanded to replicated field trials in the harsher conditions of the Altiplano (Puno). All trials confirmed consistency of frost tolerance over time and location, tuber quality, and yield. After 8 years, two advanced clones were considered for cultivar release because of their exceptional frost tolerance and superior field productivity that outyielded many of the established cultivars in the region. In November 2018, a new native cultivar named Wiñay, a Quechua word meaning "to grow" was released in Peru. In 2022, a second cultivar followed with the name Llapanchispaq (meaning "for all of us"). This project evidenced that a multinational and all-encompassing approach to deploy valuable genetic diversity can work and deliver effective results. This is even more significant when outcomes can promote food security and sustainability in very vulnerable regions of the world.

Collecting wild potato species (Solanum sect. Petota) in Peru to enhance genetic representation and fill gaps in ex situ collections.

Crop wild relatives (CWRs) are important sources of novel genes, due to their high variability of response to biotic and abiotic stresses, which can be invaluable for crop genetic improvement programs. Recent studies have shown that CWRs are threatened by several factors, including changes in land-use and climate change. A large proportion of CWRs are underrepresented in genebanks, making it necessary to take action to ensure their long-term ex situ conservation. With this aim, 18 targeted collecting trips were conducted during 2017/2018 in the center of origin of potato (Solanum tuberosum L.), targeting 17 diverse ecological regions of Peru. This was the first comprehensive wild potato collection in Peru in at least 20 years and encompassed most of the unique habitats of potato CWRs in the country. A total of 322 wild potato accessions were collected as seed, tubers, and whole plants for ex situ storage and conservation. They belonged to 36 wild potato species including one accession of S. ayacuchense that was not conserved previously in any genebank. Most accessions required regeneration in the greenhouse prior to long-term conservation as seed. The collected accessions help reduce genetic gaps in ex situ conserved germplasm and will allow further research questions on potato genetic improvement and conservation strategies to be addressed. These potato CWRs are available by request for research, training, and breeding purposes under the terms of the International Treaty for Plant Genetic Resources for Food and Agriculture (ITPGRFA) from the Instituto Nacional de Innovacion Agraria (INIA) and the International Potato Center (CIP) in Lima-Peru.

High flow nasal cannula versus standard low flow nasal oxygen during flexible bronchoscopy in children: A randomized controlled trial.

BACKGROUND: Hypoxemia is the most frequent complication of fiberoptic bronchoscopy (FB) in children. Guidelines recommend oxygen supplementation and conventional nasal prongs (NC) are used for this purpose. The aim of this study was to evaluate if the use of high-flow nasal cannula therapy (HFNC) in children undergoing FB result in a lower incidence of hypoxemia than standard oxygen administration. METHODS: Patients aged 1 month-16 years undergoing elective FB were included in a prospective randomized controlled, nonblinded, single-center clinical trial and randomly assigned to receive oxygen via NC or HFNC. Patients' baseline characteristics were recorded pre-bronchoscopy. The primary outcome was oxygen desaturation during the procedure defined as saturation less than 94%. RESULTS: An intention to treat analysis for 53 patients receiving NC and 51 receiving HFNC, showed HFNC patients were less likely to have hypoxemia than were NC patients (p = .011), with an absolute risk reduction of 0.27 (95% confidence interval [CI]: 0.08-0.45) and a number needed to treat of 3.75 (95% CI: 2.22-12.04). Moderate hypoxemia (SpO2 ≥ 90% and <94%, and <60 s) was observed significantly less often with HFNC than with NC (p = .012). Severe hypoxemia (SpO2 < 90% and >30 s) was not different between groups. Patients undergoing bronchoalveolar lavage (BAL) presented fewer desaturations with HFNC (p = .0003). CONCLUSIONS: HFNC offers optimized oxygenation during elective FB with a significant reduction in desaturations and can be considered for oxygen administration, especially when BAL is performed.

COVID-19 y embarazo: caso clínico de presentación crítica, inflamación placentaria y transmisión vertical fetal demostrada / COVID-19 and pregnancy: clinical case of critical presentation, placental inflammation and demonstrated fetal vertical transmission

ANTECEDENTES: La pandemia global de COVID-19 llega al continente americano en marzo del año 2020 y en menos de dos meses reúne a más de la mitad de los casos a nivel global. OBJETIVO: Caso clínico de una mujer embarazada con una presentación crítica de COVID-19 y embarazo a las 25 semanas de gestación, en el contexto del peak de la pandemia en Chile en el otoño del año 2020. CASO CLÍNICO: El 20 de junio de 2020, una mujer de 34 años, con 25 semanas de embarazo, es trasladada desde Hospital de San Bernardo a Clínica Las Condes en Santiago, Chile, con un cuadro de 10 días de evolución de COVID-19, que evoluciona a una situación crítica con insuficiencia respiratoria severa. Ingresa a unidad de cuidados intensivos para ventilación mecánica. Las imágenes de radiología simple y de tomografía axial computarizada de tórax demuestran una neumopatía bilateral con imágenes características opacidades en vidrio esmerilado, asociado a engrosamiento intersticial, imágenes descritas previamente como características para COVID-19. La paciente permanece en unidad de cuidados intensivos en ventilación mecánica por siete días, con evolución favorable posterior, mejoría del cuadro séptico y alta después de 22 días de hospitalización. El parto ocurre en forma espontánea a las 38 semanas, la madre y el recién nacido evolucionan en buen estado general. El examen histopatológico placentario demuestra compromiso inflamatorio vellositario y los exámenes de anticuerpos en sangre del recién nacido demuestran la presencia de anticuerpos del tipo IgG e IgM. Se trata de uno de los pocos casos demostrados reportados de transmisión transplacentaria vía sanguínea de SARS-CoV-2 de la madre al recién nacido.

BACKGROUND: The global COVID-19 pandemic reaches the American continent in March 2020 and in less than two months it brings together more than half of the cases globally.OBJECTIVE: The clinical case of a 25-week pregnant woman with a critical presentation of COVID-19 and pregnancy at 25 weeks of gestation, is presented in the context of the peak of the pandemic in Chile in the fall of 2020. CLINICAL CASE: On June 20, 2020, a 34-year-old woman, 25 weeks pregnant, is transferred from Hospital de San Bernardo to Clinica Las Condes in Santiago, Chile, with a ten-day evolution of a COVID-19 that evolves to critical with severe respiratory failure. She is admitted to the intensive care unit for mechanical ventilation. Chest computerized axial tomography images demonstrate bilateral pneumopathy with characteristic images of ground-glass opacities, associated with interstitial thickening, images previously described as characteristics for COVID-19. The patient remains in the intensive care unit on mechanical ventilation for seven days, with subsequent favorable evolution, improvement of the septic condition, and discharge after 22 days of hospitalization. Delivery occurs at 38 weeks, the mother and the newborn evolve in good general condition. The placental histopathological examination demonstrates villous inflammatory involvement, and the newborn's blood tests show the presence of IgG and IgM antibodies. It is one of the few reported cases of transplacental transmission of SARS-CoV-2 from the mother to the newborn.

[Use of mass spectrometry for rapid diagnosis of positive blood cultures: Validation of a local algorythm]. / Utilización de espectrometría de masas para la identificación precoz de hemocultivos positivos: Validación de un algoritmo local.

Mass spectrometry (MS) is used in identification of positive blood culture, a contribution in the clinical management of septic patients. The protocol is labor intensive and disrupts the normal workflow in a clinical laboratory. We intended to make rapid diagnosis by using MS directly from shortly incubated blood agar plates (4 to 6 hours) comparing with results of the conventional method (MC). We worked in parallel 145 positive blood cultures, with correct identification by short method in 79% of cases. We observed better yield with non carbon bottles and with gramnegative rods. With this information we designed a rapid identification algorithm using MS, which allows advancing diagnosis in 12-16 hours, without increasing to the costs or work load, since extraction protocol is not used.

Utilización de espectrometría de masas para la identificación precoz de hemocultivos positivos: Validación de un algoritmo local / Use of mass spectrometry for rapid diagnosis of positive blood cultures: Validation of a local algorythm

Mass spectrometry (MS) is used in identification of positive blood culture, a contribution in the clinical management of septic patients. The protocol is labor intensive and disrupts the normal workflow in a clinical laboratory. We intended to make rapid diagnosis by using MS directly from shortly incubated blood agar plates (4 to 6 hours) comparing with results of the conventional method (MC). We worked in parallel 145 positive blood cultures, with correct identification by short method in 79% of cases. We observed better yield with non carbon bottles and with gramnegative rods. With this information we designed a rapid identification algorithm using MS, which allows advancing diagnosis in 12-16 hours, without increasing to the costs or work load, since extraction protocol is not used.

Espectrometría de masas (EM) es utilizada en identificación de hemocultivo positivo (HMP), constituyendo un aporte en el manejo clínico de paciente séptico. El protocolo de identificación directa es ultra laborioso, interrumpiendo el flujo de trabajo normal del laboratorio. Con el objetivo de hacer identificación rápida, utilizamos EM a partir de placas de agar sangre con incubación breve (4 a 6 h), comparando resultados con el método convencional en HMP. Se trabajó 145 frascos de HMP, identificando correctamente por método acortado 79% de los microorganismos. El rendimiento fue mejor en frascos sin carbón activado y en la identificación de bacilos gramnegativo. Con esta información, diseñamos algoritmo para la identificación precoz de hemocultivo positivo mediante EM, procesando a ciegas a las 4 a 6 h de incubación, lo que permite adelantar el diagnóstico en 12-16 h respecto del método tradicional, sin aumentar los costos ni la carga de trabajo, ya que no se utiliza protocolo de extracción.

Ex situ conservation priorities for the wild relatives of potato (solanum L. Section petota).

Crop wild relatives have a long history of use in potato breeding, particularly for pest and disease resistance, and are expected to be increasingly used in the search for tolerance to biotic and abiotic stresses. Their current and future use in crop improvement depends on their availability in ex situ germplasm collections. As these plants are impacted in the wild by habitat destruction and climate change, actions to ensure their conservation ex situ become ever more urgent. We analyzed the state of ex situ conservation of 73 of the closest wild relatives of potato (Solanum section Petota) with the aim of establishing priorities for further collecting to fill important gaps in germplasm collections. A total of 32 species (43.8%), were assigned high priority for further collecting due to severe gaps in their ex situ collections. Such gaps are most pronounced in the geographic center of diversity of the wild relatives in Peru. A total of 20 and 18 species were assessed as medium and low priority for further collecting, respectively, with only three species determined to be sufficiently represented currently. Priorities for further collecting include: (i) species completely lacking representation in germplasm collections; (ii) other high priority taxa, with geographic emphasis on the center of species diversity; (iii) medium priority species. Such collecting efforts combined with further emphasis on improving ex situ conservation technologies and methods, performing genotypic and phenotypic characterization of wild relative diversity, monitoring wild populations in situ, and making conserved wild relatives and their associated data accessible to the global research community, represent key steps in ensuring the long-term availability of the wild genetic resources of this important crop.

Thrombocytosis and hematocrit as prognostic factors in renal carcinoma.

OBJECTIVE: To examine the connection between preoperative thrombocytosis and hematocrit and survival in a group of patients operated for renal cell carcinoma. METHODS: Retrospective study with descriptive and statistical analysis of 139 patients with renal cell carcinoma treated surgically over the last 4 years in our Urology clinical unit. 116 (83,45%)were diagnosed at a localized clinical stage, whereas 23 (16,54%) presented as locally advanced or metastatic disease. We collected data about survival and time on surveillance, imaging and histological characteristics of the tumor and analytical parameters. Data were analyzed by the SPSS statistical software. RESULTS: The average platelet count and hematocrit before surgery were 260,930 cells/mm3 and 41.10%, respectively. We found a statistical correlation between platelet count at the time of diagnosis and survival. Patients with platelet counts higher than 350,000 cells/mm3 had a poor survival (OR: 2.94; CI 95% 1.04- 8.27). We also found that patients with high hematocrit at diagnosis presented a lower risk of death (OR: 0.92; CI 95% 0.85- 0.99). The global survival at the end of the study was 88.4%. Multivariate analysis did not show any significant result because of the low number of deaths. CONCLUSION: The presence of high platelet count or low hematocrit correlate with poor survival in a group of surgically treated renal cell carcinoma patients. Nevertheless more studies with longer surveillance and higher number of patients are needed.

Manejo laparoscópico transperitoneal de la enfermedad litiásica: experiencia en un hospital de tercer nivel / Transperitoneal laparoscopic management of urinary tract stone disease: experience in a third level hospital

OBJETIVO: Analizar la relación existente entre trombocitosis y hematocrito prequirúrgicos y supervivencia en nuestra serie de pacientes tratados quirúrgicamente por adenocarcinoma renal.MÉTODO: Estudio retrospectivo con análisis descriptivo estadístico de 139 pacientes intervenidos quirúrgicamente en nuestro servicio en los últimos 4 años por adenocarcinoma renal. 116 (83,45%) presentaban al diagnóstico un estadio clínico localizado, y 23 (16,54%) un estadio localmente avanzado o metastásico. Fueron recogidos datos relativos a tiempo de seguimiento y supervivencia, características iconográficas e histológicas del tumor y parámetros analíticos. Los datos fueron analizados con estadístico SPSS.RESULTADOS: El recuento plaquetario medio previo a la intervención quirúrgica fue de 260930 cels/mm3. El hematocrito medio prequirúrgico fue de 41,10%. Se encontró una relación estadísticamente significativa (p=0,04) entre el recuento plaquetario al diagnóstico y la supervivencia. Pacientes con recuentos plaquetarios superiores a 350000/mm3 presentaban una supervivencia más baja (OR: 2,94; IC 95% 1,04- 8,27). Se objetivó una relación significativa (p=0,049) entre el hematocrito al diagnóstico y la supervivencia. A mayor hematocrito disminuyó el riesgo de muerte (OR: 0,92; IC 95% 0,85- 0,99). La supervivencia global en nuestro grupo fue del 88,4%. El análisis multivariante de la misma no arrojó datos estadísticamente significativos debido al escaso número de éxitus.CONCLUSIONES: La presencia de recuentos plaquetarios elevados o niveles de hematocrito bajos al diagnóstico se relacionan, en esta serie y de forma no independiente, con una disminución de la supervivencia en nuestro grupo de pacientes intervenidos por adenocarcinoma renal. Serían necesarios estudios con mayor seguimiento y muestras más amplias para aseverar estos hallazgos(AU)

OBJECTIVE: To examine the connection between preoperative thrombocytosis and hematocrit and survival in a group of patients operated for renal cell carcinoma.METHODS: Retrospective study with descriptive and statistical analysis of 139 patients with renal cell carcinoma treated surgically over the last 4 years in our Urology clinical unit. 116 (83,45%) were diagnosed at a localized clinical stage, whereas 23 (16,54%) presented as locally advanced or metastatic disease. We collected data about survival and time on surveillance, imaging and histological characteristics of the tumor and analytical parameters. Data were analyzed by the SPSS statistical software.RESULTS: The average platelet count and hematocrit before surgery were 260,930 cells/mm3 and 41.10%, respectively. We found a statistical correlation between platelet count at the time of diagnosis and survival. Patients with platelet counts higher than 350,000 cells/mm3 had a poor survival (OR: 2.94; CI 95% 1.04- 8.27). We also found that patients with high hematocrit at diagnosis presented a lower risk of death (OR: 0.92; CI 95% 0.85- 0.99). The global survival at the end of the study was 88.4%. Multivariate analysis did not show any significant result because of the low number of deaths.CONCLUSION: The presence of high platelet count or low hematocrit correlate with poor survival in a group of surgically treated renal cell carcinoma patients. Nevertheless more studies with longer surveillance and higher number of patients are needed(AU)

Quantitative gene expression analysis in a brain slice model: influence of temperature and incubation media.

We describe the RNA integrity (28S/18S ratio) and the messenger RNA (mRNA) expression of genes encoding glyceraldehyde 3-phosphate dehydrogenase (GAPDH), microtubule-associated serine/threonine kinase 2 (Mast2), and beta-actin in cortical brain slices incubated for up to 24h in Ringer's solution and Dulbecco's modified Eagle's medium (DMEM) at 25 and 37 degrees C. Our data reveal an optimal temporal working window between 1 and 6h when slices are incubated in Ringer's solution at 25 degrees C that allows experiments related to gene expression dynamics to be performed more suitably than those carried out at 37 degrees C. In addition, we show that reference gene expression may be modified in dynamic experiments and may compromise studies of gene expression.

Perfil población consultante en Policlínico de ETS, Consultorio Nº 1, Los Andes, 2001-2003 / Profile of consulting population at the sexually transmitted diseases (STD) polyclinic, dispensary Nº 1, Los Andes, 2001-2003

El objetivo fue caracterizar al grupo de pacientes inscritos en el policlínico de enfermedades de transmisión sexual (ETS) de esta provincia, determinando factores de riesgo, patologías de mayor prevalencia y cobertura de tratamiento en la atención primaria. Estudio descriptivo realizado en el Centro de Salud Cordillera Andina durante julio de 2004. Se recolectaron datos de 254 fichas, correspondientes al total de pacientes inscritos alguna vez en el programa desde el año 2001 al 2003. Las variables estudiadas fueron: edad al ingreso al programa; sexo; ocupación; domicilio; escolaridad; orientación sexual; número de parejas y uso de preservativo; consumo de alcohol y drogas; exámenes clínicos; diagnóstico principal y tratamiento. La edad promedio de ingreso fue de 30 años, el 78% de los pacientes correspondían al sexo masculino. De ellos un 38,1% era obrero, con una menor frecuencia de otras ocupaciones; sólo 47% completó la enseñanza media. Respecto a los hábitos: 8,6% refería orientación homo/bisexual; 48,9% tuvo 2- 4 parejas el último año; 57% nunca usó preservativo, 75,3% consumía alcohol y 39% otras drogas. De los diagnósticos realizados la gonorrea ocupó el 36,9%, la uretritis no gonocócica el 30,6%, y la sífilis el 18,9%. Se logra caracterizar esta población observándose una franca mayoría del sexo masculino, mientras entre las mujeres hay una frecuencia relativa de dueñas de casa. Destacan los elevados porcentajes de promiscuidad, consumo de alcohol y drogas, el bajo uso del preservativo y la baja escolaridad.

The objective was that of characterizing the group of patients registered at the Sexually Transmitted Disaeases (STD) Polyclinic of this province, determining risk factors, higher prevalence pathologies and treatment coverage in primary care. This is a descriptive studycarried out in the Cordillera Andina Health Center during July 2004. Data were collected from 254 medical record cards corresponding to the total number of patients registered in the program at any time from 2001 to 2003. The variables studied were: age at insertion into the program; sex; occupation; place of residence; schooling; sexual orientation; number of couples and use of preservatives; alcohol and drug consumption; clinical examinations; principal diagnosis and treatment. The average age of insertion was 30 years; 78% of the patients being males. Of these, 38.1% were manual workers with a lower frequency of other occupations; only 47% had completed middle school. As far as habits are concerned: 8.6% admitted homosexual/bisexual orientation; 48.9% had 2-4 couples during the last year; 57% never used a preservative, 75.3% consumed alcohol and 395 other drugs. Of diagnoses performed, gonorrhea was 36.9%, nongonococcal urethritis, 30.65 and syphilis, 18.9%. Characterization of this population is accomplished, finding in it a clear majority of males, while among women there is a relative frequency of housewives. High percentages of promiscuity, alcohol and drug consumption, low use of preservatives and low schooling stand out.

El papel del psiquiatra en el Hospital General / The role of psychiatrist in the General Hospital

El avance de la medicina hace que cada vez el médico se vea en la nesecidad de trabajar en equipo. Hoy en día en el hospital general el psiquiatra debe formar parte del grupo de especialistas que trabaja en la atención del paciente hospitalizado con el fin de brindar una atención integral. Es indispensable el tratamiento de los transtornos psicológicos que puedan presentar los pacientes para mejorar la evolución y el pronóstico de ciertas enfermedades.