Oral manifestations in patients with coronavirus disease 2019 (COVID-19) identified using text mining: an observational study.

Text mining enables search, extraction, categorisation and information visualisation. This study aimed to identify oral manifestations in patients with COVID-19 using text mining to facilitate extracting relevant clinical information from a large set of publications. A list of publications from the open-access COVID-19 Open Research Dataset was downloaded using keywords related to oral health and dentistry. A total of 694,366 documents were retrieved. Filtering the articles using text mining yielded 1,554 oral health/dentistry papers. The list of articles was classified into five topics after applying a Latent Dirichlet Allocation (LDA) model. This classification was compared to the author's classification which yielded 17 categories. After a full-text review of articles in the category "Oral manifestations in patients with COVID-19", eight papers were selected to extract data. The most frequent oral manifestations were xerostomia (n = 405, 17.8%) and mouth pain or swelling (n = 289, 12.7%). These oral manifestations in patients with COVID-19 must be considered with other symptoms to diminish the risk of dentist-patient infection.

Presence of periodontal pathogenic bacteria in blood of patients with coronary artery disease.

It has been hypothesised that oral bacteria can migrate, through the blood, from the mouth to the arterial plaques, thus exacerbating atherosclerosis. This study compared bacteria present in the peripheral blood of individuals with and without coronary artery disease (CAD). RNA sequences obtained from blood were downloaded from GEO (GSE58150). Eight patients with coronary artery calcification (CAC) scoring > 500 and eight healthy individuals were analysed. After conducting quality control, the sequences were aligned to the hg38 reference genome using Hisat2. Bacterial taxa were analysed by inputting the unmapped sequences into Kraken. Ecological indices were calculated using Vegan. The package DESeq2 was used to compare the counts of bacteria per standard rank between groups. A total of 51 species were found only in patients with CAD and 41 were exclusively present in healthy individuals. The counts of one phylum, one class, three orders, two families and one genus were significantly different between the analysed groups (p < 0.00032, FDR < 10%), including the orders Cardiobacteriales, Corynebacteriales and Fusobacteriales. Twenty-three bacterial species belonging to the subgingival plaque bacterial complexes were also identified in the blood of individuals from both the groups; Fusobacterium nucleatum was significantly less frequent in patients with CAD (p = 0.0012, FDR = 4.8%). Furthermore, the frequency of another 11 bacteria differed significantly among patients with CAD than that among healthy individuals (p < 0.0030, FDR < 10%). These bacteria have not been previously reported in patients with atherosclerosis and periodontitis. The presence of members of the subgingival plaque bacterial complexes in the blood of patients with CAC supports the hypothesis that the periodontopathogens can be disseminated through the blood flow to other body parts where they may enhance inflammatory processes that can lead to the development or exacerbation of atherosclerosis.

A nearby transiting rocky exoplanet that is suitable for atmospheric investigation.

Spectroscopy of transiting exoplanets can be used to investigate their atmospheric properties and habitability. Combining radial velocity (RV) and transit data provides additional information on exoplanet physical properties. We detect a transiting rocky planet with an orbital period of 1.467 days around the nearby red dwarf star Gliese 486. The planet Gliese 486 b is 2.81 Earth masses and 1.31 Earth radii, with uncertainties of 5%, as determined from RV data and photometric light curves. The host star is at a distance of ~8.1 parsecs, has a J-band magnitude of ~7.2, and is observable from both hemispheres of Earth. On the basis of these properties and the planet's short orbital period and high equilibrium temperature, we show that this terrestrial planet is suitable for emission and transit spectroscopy.

BRCA1 and BRCA2 mutations in a sample of breast and ovarian cancer families from the Colombian pacific / Mutaciones en los genes BRCA1 y BRCA2 en una muestra de familias con cáncer de mama y/u ovario del pacífico colombiano

Abstract Introduction: Breast cancer is the most common neoplasia of women from all over the world especially women from Colombia. 5%­10% of all cases are caused by hereditary factors, 25% of those cases have mutations in the BRCA1/BRCA2 genes. Objective: The purpose of this study was to identify the mutations associated with the risk of familial breast and/or ovarian cancer in a population of Colombian pacific. Methods: 58 high-risk breast and/or ovarian cancer families and 20 controls were screened for germline mutations in BRCA1 and BRCA2, by Single Strand Conformation Polymorphism (SSCP) and sequencing. Results: Four families (6.9%) were found to carry BRCA1 mutations and eight families (13.8%) had mutations in BRCA2. In BRCA1, we found three Variants of Uncertain Significance (VUS), of which we concluded, using in silico tools, that c.81­12C>G and c.3119G>A (p.Ser1040Asn) are probably deleterious, and c.3083G>A (p.Arg1028His) is probably neutral. In BRCA2, we found three variants of uncertain significance: two were previously described and one novel mutation. Using in silico analysis, we concluded that c.865A>G (p.Asn289Asp) and c.6427T>C (p.Ser2143Pro) are probably deleterious and c.125A>G (p.Tyr42Cys) is probably neutral. Only one of them has previously been reported in Colombia. We also identified 13 polymorphisms (4 in BRCA1 and 9 in BRCA2), two of them are associated with a moderate increase in breast cancer risk (BRCA2 c.1114A>C and c.8755­66T>C). Conclusion: According to our results, the Colombian pacific population presents diverse mutational spectrum for BRCA genes that differs from the findings in other regions in the country.

Resumen Introducción: El cáncer de mama es la neoplasia más común en mujeres de todo el mundo, y, también de Colombia. 5% a 10% de todos los casos son causados por factores hereditarios; 25% de estos casos tienen mutaciones en los genes BRCA1/BRCA2. Objetivo: El propósito de este estudio fue el de identificar mutaciones asociadas con riesgo de cáncer de mama y/u ovario familiar en pacientes del pacífico colombiano. Métodos: Fueron revisados para mutaciones en BRCA1 y BRCA2 de línea germinal mediante SSCP y secuenciación 58 familias de alto riesgo para cáncer de mama y/u ovario y 20 controles Resultados: cuatro familias (6.9%) presentaron mutaciones en BRCA1 y ocho familias (13.8%) en BRCA2. En BRCA1, encontramos tres variantes de significado clínico desconocido (VUS), de las cuales concluimos, usando herramientas bioinformáticas, que c.81­12C>G y c.3119G>A (p.Ser1040Asn) son probablemente deletéreas, y c.3083G>A (p.Arg1028His) es probablemente neutral. En BRCA2, encontramos tres VUS: una mutación nueva y dos previamente descritas, usando análisis bioinformáticos, concluimos que c.865A>G (p.Asn289Asp) y c.6427T>C (p.Ser2143Pro) son probablemente deletéreas y c.125A>G (p.Tyr42Cys) es probablemente neutral. Solo una de ellas ha sido reportada previamente en Colombia. También identificamos 13 polimorfismos (4 en BRCA1 y 9 en BRCA2), dos de ellos asociados con un moderado incremento del riesgo para cáncer de mama (BRCA2 c.1114A>C and c.8755­66T>C). Conclusión: de acuerdo con nuestros resultados, la población del suroccidente colombiano presenta un espectro mutacional diverso para los genes BRCA que difiere de lo encontrado en otras regiones del país.

BRCA1 and BRCA2 mutations in a sample of breast and ovarian cancer families from the Colombian pacific.

INTRODUCTION: Breast cancer is the most common neoplasia of women from all over the world especially women from Colombia. 5%-10% of all cases are caused by hereditary factors, 25% of those cases have mutations in the BRCA1/BRCA2 genes. OBJECTIVE: The purpose of this study was to identify the mutations associated with the risk of familial breast and/or ovarian cancer in a population of Colombian pacific. METHODS: 58 high-risk breast and/or ovarian cancer families and 20 controls were screened for germline mutations in BRCA1 and BRCA2, by Single Strand Conformation Polymorphism (SSCP) and sequencing. RESULTS: Four families (6.9%) were found to carry BRCA1 mutations and eight families (13.8%) had mutations in BRCA2. In BRCA1, we found three Variants of Uncertain Significance (VUS), of which we concluded, using in silico tools, that c.81-12C>G and c.3119G>A (p.Ser1040Asn) are probably deleterious, and c.3083G>A (p.Arg1028His) is probably neutral. In BRCA2, we found three variants of uncertain significance: two were previously described and one novel mutation. Using in silico analysis, we concluded that c.865A>G (p.Asn289Asp) and c.6427T>C (p.Ser2143Pro) are probably deleterious and c.125A>G (p.Tyr42Cys) is probably neutral. Only one of them has previously been reported in Colombia. We also identified 13 polymorphisms (4 in BRCA1 and 9 in BRCA2), two of them are associated with a moderate increase in breast cancer risk (BRCA2 c.1114A>C and c.8755-66T>C). CONCLUSION: According to our results, the Colombian pacific population presents diverse mutational spectrum for BRCA genes that differs from the findings in other regions in the country.

INTRODUCCIÓN: El cáncer de mama es la neoplasia más común en mujeres de todo el mundo, y, también de Colombia. 5% a 10% de todos los casos son causados por factores hereditarios; 25% de estos casos tienen mutaciones en los genes BRCA1/BRCA2. OBJETIVO: El propósito de este estudio fue el de identificar mutaciones asociadas con riesgo de cáncer de mama y/u ovario familiar en pacientes del pacífico colombiano. MÉTODOS: Fueron revisados para mutaciones en BRCA1 y BRCA2 de línea germinal mediante SSCP y secuenciación 58 familias de alto riesgo para cáncer de mama y/u ovario y 20 controles. RESULTADOS: cuatro familias (6.9%) presentaron mutaciones en BRCA1 y ocho familias (13.8%) en BRCA2. En BRCA1, encontramos tres variantes de significado clínico desconocido (VUS), de las cuales concluimos, usando herramientas bioinformáticas, que c.81­12C>G y c.3119G>A (p.Ser1040Asn) son probablemente deletéreas, y c.3083G>A (p.Arg1028His) es probablemente neutral. En BRCA2, encontramos tres VUS: una mutación nueva y dos previamente descritas, usando análisis bioinformáticos, concluimos que c.865A>G (p.Asn289Asp) y c.6427T>C (p.Ser2143Pro) son probablemente deletéreas y c.125A>G (p.Tyr42Cys) es probablemente neutral. Solo una de ellas ha sido reportada previamente en Colombia. También identificamos 13 polimorfismos (4 en BRCA1 y 9 en BRCA2), dos de ellos asociados con un moderado incremento del riesgo para cáncer de mama (BRCA2 c.1114A>C and c.8755­66T>C). CONCLUSIÓN: de acuerdo con nuestros resultados, la población del suroccidente colombiano presenta un espectro mutacional diverso para los genes BRCA que difiere de lo encontrado en otras regiones del país.

Boceprevir plus pegylated interferon/ribavirin to re-treat hepatitis C virus genotype 1 in HIV-HCV co-infected patients: final results of the Spanish BOC HIV-HCV Study.

INTRODUCTION: Boceprevir (BOC) was one of the first oral inhibitors of hepatitis C virus (HCV) NS3 protease to be developed. This study assessed the safety and efficacy of BOC+pegylated interferon-α2a/ribavirin (PEG-IFN/RBV) in the retreatment of HIV-HCV co-infected patients with HCV genotype 1. METHODS: This was a phase III prospective trial. HIV-HCV (genotype 1) co-infected patients from 16 hospitals in Spain were included. These patients received 4 weeks of PEG-IFN/RBV (lead-in), followed by response-guided therapy with PEG-IFN/RBV plus BOC (a fixed 44 weeks was indicated in the case of cirrhosis). The primary endpoint was the sustained virological response (SVR) rate at 24 weeks post-treatment. Efficacy and safety were evaluated in all patients who received at least one dose of the study drug. RESULTS: From June 2013 to April 2014, 102 patients were enrolled, 98 of whom received at least one treatment dose. Seventy-three percent were male, 34% were cirrhotic, 23% had IL28b CC, 65% had genotype 1a, and 41% were previous null responders. The overall SVR rate was 67%. Previous null-responders and cirrhotic patients had lower SVR rates (57% and 51%, respectively). Seventy-six patients (78%) completed the therapy scheme; the most common reasons for discontinuation were lack of response at week 12 (12 patients) and adverse events (six patients). CONCLUSIONS: Response-guided therapy with BOC in combination with PEG-IFN/RBV led to an overall SVR rate of 67%, but an SVR rate of only 51% in patients with cirrhosis. The therapy was generally well tolerated. Although the current standards of care do not include BOC+PEG-IFN/RBV, the authors believe that this combination can be beneficial in situations where new HCV direct antiviral agent interferon-free therapies are not available yet.

Safe Reduction in CD4 Cell Count Monitoring in Stable, Virally Suppressed Patients With HIV Infection or HIV/Hepatitis C Virus Coinfection.

BACKGROUND: It has been suggested that routine CD4 cell count monitoring in human immunodeficiency virus (HIV)-monoinfected patients with suppressed viral loads and CD4 cell counts >300 cell/µL could be reduced to annual. HIV/hepatitis C virus (HCV) coinfection is frequent, but evidence supporting similar reductions in CD4 cell count monitoring is lacking for this population. We determined whether CD4 cell count monitoring could be reduced in monoinfected and coinfected patients by estimating the probability of maintaining CD4 cell counts ≥200 cells/µL during continuous HIV suppression. METHODS: The PISCIS Cohort study included data from 14 539 patients aged ≥16 years from 10 hospitals in Catalonia and 2 in the Balearic Islands (Spain) since January 1998. All patients who had at least one period of 6 months of continuous HIV suppression were included in this analysis. Cumulative probabilities with 95% confidence intervals were calculated using the Kaplan-Meier estimator stratified by the initial CD4 cell count at the period of continuous suppression initiation. RESULTS: A total of 8695 patients were included. CD4 cell counts fell to <200 cells/µL in 7.4% patients, and the proportion was lower in patients with an initial count >350 cells/µL (1.8%) and higher in those with an initial count of 200-249 cells/µL (23.1%). CD4 cell counts fell to <200 cells/µL in 5.7% of monoinfected and 11.1% of coinfected patients. Of monoinfected patients with an initial CD4 cell count of 300-349 cells/µL, 95.6% maintained counts ≥200 cells/µL. In the coinfected group with the same initial count, this rate was lower, but 97.6% of coinfected patients with initial counts >350 cells/µL maintained counts ≥200 cells/µL. CONCLUSIONS: From our data, it can be inferred that CD4 cell count monitoring can be safely performed annually in HIV-monoinfected patients with CD4 cell counts >300 cells/µL and HIV/HCV-coinfected patients with counts >350 cells/µL.

Core amino acid variation at position 110 is associated with sustained virological response in Caucasian patients with chronic hepatitis C virus 1b infection.

The aim of this study was to analyze the impact of core variations on sustained virological response (SVR) to pegylated interferon plus ribavirin (PEG-IFN/RBV) and its association with predictive factors of response in Caucasian patients infected with genotype 1 hepatitis C virus (HCV-1). Full-length core sequences were analyzed in 100 Caucasian HCV-1-infected patients who received therapy with PEG-IFN/RBV. The associations between variations in the core protein and SVR, as well as with predictors of SVR, were analyzed. Variations at core 62, 70 and 110 were selected as candidates. There were almost no variations at these positions among patients harboring HCV-1a. However, they were identified in 10 (30.3 %), 21 (63.6 %) and 13 (39.4 %) subjects with HCV-1b, respectively. Among the HCV-1b patients, 39.1 % individuals carrying core R62 and 70 % subjects with core R62G showed SVR (p = 0.141), and 66.7 % of HCV-1b patients harboring core R70 and 38.1 % with core R70Q achieved SVR (p = 0.157), whereas the rate of SVR was 70 % for individuals with core T110 and 15.4 % for those with core T110N (p = 0.004). No statistical interaction between core variations and IL28B genotype was observed. Patients with R70 showed higher median (interquartile range) baseline plasma levels of low-density-lipoprotein cholesterol (LDL-C) than those with R70Q (96 [86-118] mg/dL vs. 76 [54-88] mg/dL, p = 0.014). We concluded that a substitution at core 110 is associated with a lower rate of SVR in Caucasian HCV-1b-infected patients receiving PEG-IFN/RBV. Furthermore, the variation at the core 70 position is related to plasma levels of LDL-C in these patients.

Hepatitis anictérica como manifestación de sífilis congénita / Anicteric Hepatitis as Congenital Syphilis Manifestation

La sífilis congénita es un problema de salud pública mundial, la mayoría de los neonatos infectados no presenta manifestaciones clínicas de la enfermedad y la determinación de Ig M específica utilizada para el diagnóstico es de bajo rendimiento, por lo que el diagnóstico en el recién nacido depende del diagnóstico de sífilis en la gestante. Presentamos la historia clínica de una recién nacida, hija de una madre con sífilis gestacional inadecuadamente tratada. Durante su hospitalización se evidenció compromiso hepático con aumento de la aspartato amino transferasa e hiperbilirrubinemia con aumento de la fracción conjugada. Se descartó compromiso de SNC. Los cultivos para gérmenes comunes de sangre y orina fueron negativos. Las determinaciones de Ig M para CMV, rubeola, toxoplasma , Herpes I y II fueron negativas. Las ecografías transfontanelar, cardiaca, renal y de vías urinarias y hepatobiliar fueron normales. Durante la hospitalización, a los 9 días de vida presentó un episodio de infección bacteriana asociada. Recibió tratamiento con penicilina cristalina durante 14 días con normalización de los niveles de bilirrubina y de aspartato aminotransferasa. El seguimiento clínico y serológico a los 3 meses de edad mostró patrón de crecimiento y desarrollo normal y VDRL no reactiva.

Congenital syphilis is a global public health problem. The majority of infected children have no clinical manifestations of the disease and the specific IgM determination in newborns has low diagnostic performance. The diagnosis depends mostly of the diagnosis in mothers before birth. We report a newborn that was inadequately treated prenatally. At birth, the liver involvement was detected, with increase in aspartate amino transferase and of conjugated fractions of bilirubin. CNS involvement was ruled out and cultures of blood and urine were negative for bacteria. Determinations for IgM of CMV, rubella, toxoplasmosis and herpes I and II, were negative. Transfontanellar, heart, kidney, urinary tract and hepatobiliary ultrasound examinations were normal. Crystalline penicillin treatment for 14 days was undertaken, obtaining normal levels of bilirubin and aspartate aminotransferase at the end of treatment. The clinical and serological follow-up after 3 months showed a normal growth and development pattern with non-reactive VDRL tests.

Effects of the genetic pattern defined by low-density lipoprotein receptor and IL28B genotypes on the outcome of hepatitis C virus infection.

The aim of this study was to assess the impact of the genetic pattern (GP) defined by the single nucleotide polymorphisms (SNPs) rs14158 of low-density lipoprotein receptor (LDLR) and rs12979860 of interleukin-28B (IL28B) genes on the outcome and features of hepatitis C virus (HCV) infection in patients with and without human immunodeficiency virus (HIV) coinfection. 314 HIV/HCV-coinfected and 109 HCV-monoinfected patients treated with pegylated interferon (Peg-IFN) plus ribavirin (RBV), as well as 51 patients with HCV spontaneous clearance (SC), were included. Variations in both SNPs were determined by the TaqMan polymerase chain reaction (PCR) assay. In the 286 patients chronically infected by HCV genotypes 1 or 4, both rs14158 CC and rs12979860 CC were associated with a higher rate of sustained virological response (SVR), and these effects were complementary in both HCV-monoinfected and HIV/HCV-coinfected patients. Thus, 24 % of patients with rs14158/rs12979860 TT-TC/TT-TC, 33 % with TT-TC/CC, 44.2 % with CC/TT-TC, and 75.8 % harboring CC/CC attained SVR (p < 0.001). SC was associated with the IL28B genotype (66.7 % CC in SC vs. 42.6 % among those with chronic infection, p < 0.001) but not with the LDLR genotype. There was no association between GP and the plasma level of alanine aminotransferase (ALT) or the presence of advanced fibrosis. There is a complementary effect between the IL28B and LDLR genotypes on the probability of achieving SVR after Peg-IFN/RBV therapy in patients with HCV 1 or 4. Thus, the predictive value of IL28B genotype is modulated by the LDLR genotype in both HCV-monoinfected and HIV/HCV-coinfected patients. This complementary effect of both genotypes is also observed on the plasma levels of low-density lipoprotein cholesterol (LDL-C).

Evaluación de la reproducción inducida de nicuro Pimelodus blochii (Telostei: Pimelodidae) utilizando diferentes inductores hormonales / Evaluation of induced breeding of Pimelodus blochii nicuro (telostei, pimelodidae) using different inducing hormone

Objetivo. Evaluar el efecto de dos inductores hormonales en la reproducción inducida de nicuro Pimelodus blochii. Materiales y métodos. Para los procesos experimentales fueron utilizados adultos sexualmente maduros, sometidos a tres tratamientos aplicados vía intramuscular, en dosis única de 0.25 mL/kg Ovaprim® (OVAP) (T1), 0.5 mL/kg de OVAP (T2) y 6.25 mg/kg de Extracto de Hipófisis de Carpa (EHC) (T3), para este último tratamiento la inyección fue dividida en 20 y 80%, con un intervalo de 12 h entre aplicaciones. Previo a la extracción de los gametos, los animales fueron tranquilizados por inmersión en una solución de Metanosulfonato de Tricaina (90 mg/L). El desempeño reproductivo fue evaluado mediante el índice de ovulación (hembras ovuladas/hembras tratadas), fecundidad absoluta (Fa) (ovocitos/hembra), fecundidad relativa (Fr) en función del número de ovocitos desovados por gramo de peso. La fecundación se realizó en seco y seis horas post-fecundación (HPF) se determinó la tasa de fertilidad. Resultados. La ovulación (ºh) para el T1 fue a las 297.1±30.0, T2 294.6±32.9 y T3 247.3±13.1 ºh. En todos los tratamientos se obtuvieron hembras ovuladas, donde los mayores índices de ovulación fueron obtenidos con Ovaprim® (T1 y T2) con 36.4 y 50%, respectivamente. Las tasas de fecundación obtenidas fueron mayores a un 50%, para el tratamiento 1 y 2, con valores de 74.5 y 32.7%, respectivamente. Conclusiones. El uso de inductores hormonales puede ser efectivo para garantizar la reproducción inducida del nicuro, en dosis única de 0.25 y 0.5 mL/kg de Ovaprim®.

Objective. Evaluate the effect of two hormonal inducers in induced breeding of nicuro Pimelodus blochii. Materials and methods. The experimental process used sexually mature adults exposed to three intramuscular treatments, a single dose of 0.25 mL/g Ovaprim® (OVAP) (T1), 0.5 mL/kg of OVAP (T2) and 6.25 mg/kg of pituitary carp extract (EPC) (T3), for the latter treatment the injection was divided into 20 and 80%, with an interval of 12 hours between applications. Prior to the removal of gametes, the animals were tranquilized by immersion in a Tricaine Methanesulfonate (90 mg/L) solution. Reproductive performance was evaluated using ovulation rates (females ovulated/treated females), fertility (Fa) (eggs/female), relative fertility (Fr) depending on the number of eggs spawned per gram of weight. The dry method of fertilization was used and the fertility rate was determined six hours post-fertilization (HPF). Results. The Ovulation (ºh) was: for T1 297.1±30.0, T2 294.6±32.9 and T3 247.3±13.1ºh. Ovulated females were obtained in all treatments, where the highest rates of ovulation were obtained with Ovaprim ® (T1 and T2) with 36.4 and 50% respectively. Fertilization rates were higher than 50% for treatments 1 and 2, with values of 74.5 and 32.7% respectively. Conclusions. The use of hormonal inducers may be effective to ensure nicuro induced reproduction with a single dose of 0.25 and 0.5 mL/kg Ovaprim®.

Prevalencia y severidad de las lesiones precursoras de malignidad en una área de alto riesgo de cáncer gástrico. Pasto 2012 / Prevalence and severity of gastric cancer precursor lesions in a high risk area

Las lesiones precursoras de malignidad (gastritis crónica atrófica, metaplasia intestinal y displasia leve), según lo demuestran múltiples estudios, están claramente relacionadas con el riesgo que presentan como predictoras del cáncer gástrico y más aún en nuestra región considerada como de alto riesgo de esta patología. Se realizó un estudio prospectivo descriptivo con 212 pacientes entre 11 y 89 años de edad procedentes de la zona amarilla del departamento de Nariño, atendidos en el Centro de Investigaciones de Enfermedades Digestivas (CIED) del Centro Hospital La Rosa dependiente de la ESE Pasto Salud a quienes se tomaron 7 biopsias de mucosa gástrica sometidas a un procesamiento y coloración especial de Giemsa modificado para detectar lesiones precursoras de malignidad y presencia de Helicobacter Pylori. La prevalencia para gastritis crónica atrófica antrocorporal fue de 38,6%, metaplasia intestinal 24,4% y displasia leve 1,5%; presencia de infección para Helicobacter pylori en gastritis crónica atrófica 73,5%, para metaplasia intestinal 52% y displasia leve 100%; en relación a la severidad de las lesiones precursoras de malignidad de acuerdo a la escala de OLGA, 11,5% se clasificó como estadios III y IV; a excepción de un solo caso clínico todos fueron Helicobacter Pylori positivos. Se pone en consideración de la comunidad médica el protocolo del CIED para seguimiento y vigilancia de las lesiones precursoras de malignidad tratando de demostrar que la mayor estrategia sigue siendo la prevención para el control del cáncer gástrico en las regiones de alto riesgo.

Atrophic chronic gastritis (ACG), intestinal metaplasia (IM) and mild dysplasia (MD)) are all precursor lesions which have been clearly demonstrated by many studies to be related to risks for development of gastric cancer (GC). This is especially true in our region which is considered to be a high risk area for this disease. We conducted a prospective study of 212 patients between the ages of 11 and 89 years who were from the yellow zone of Nariño. Patients were cared for in the Centro de Investigaciones de Enfermedades Digestivas (CIED - Center for the Investigation of Digestive Diseases) at the Centro Hospital la Rosa which is part of the public health care system of Pasto. Seven gastric mucosa biopsies were taken from each subject and stained with specially modified Giemsa stain to detect precursor lesions and the presence of Helicobacter pylori. The prevalence of ACG was 38.6%, the prevalence of IM was 24.4%, and the prevalence of MD was 1.5%. Prevalence of H. pylori infections among patients with ACG was 73.5% while among patients with IM it was 52%, but prevalence rose to 100% among patients with MD. When severity of precursor lesions on the OLGA-staging (Operative Link for Gastritis Assessment) scale was 11.5%, lesions were classified as stage III and IV. With one exception, all of these patients were H. pylori positive. We would like to ask the medical community to consider CIED's Follow-up and Monitoring Protocol for precursor lesions in order to demonstrate that the best strategy continues to be GC prevention in high risk regions.

Efficacy of chronic hepatitis C therapy with pegylated interferon and ribavirin in patients on methadone maintenance treatment.

A considerable number of patients undergoing methadone maintenance treatment (MMT) are not considered for treatment against hepatitis C virus (HCV) infection due to a possible lower adherence and efficacy in this population. We aimed to compare the response rates to HCV treatment in patients with or without MMT. HCV-infected patients who initiated pegylated interferon plus ribavirin were included in this prospective cohort study. The relation between sustained virologic response (SVR) and MMT was analyzed. A total of 214 patients were included in the study [81 (37.9%) with and 133 (62.1%) without MMT]. No differences in HCV and interleukin 28B (rs12979860) genotype distribution were observed between the two groups. Of these patients, 103 (48.1%) achieved SVR. Among the patients who received MMT, 39 (48.1%) reached SVR compared to 64 (48.1%) subjects without MMT (p = 0.99). The frequency of voluntary drop-out and treatment discontinuations due to adverse events was comparable between the patients with and without MMT [10 (12.3%) versus 14 (10.5%), p = 0.68, and 4 (4.9%) versus 9 (6.8%), p = 0.59, respectively]. The efficacy of HCV therapy in MMT patients is similar to that found in subjects not taking methadone. MMT patients should be equally considered for treatment with pegylated interferon plus ribavirin in HCV-infected patients.

Hiperamonemia neonatal causada por defectos del ciclo de la urea / Neonatal hyperammonemia in urea cycle disorders patients

Los defectos del ciclo de la úrea se deben a deficiencias de diferentes enzimas; las manifestaciones clínicas son similares y están relacionadas con la hiperamonemia. Se presentan las historias clínicas de tres neonatos a término, sin evidencia de alteración al nacimiento. Se les detectó hiperamonemia y se sospechó enfermedad metabólica. La cromatografía de aminoácidos sugirió defectos del ciclo de la úrea. El manejo incluyó dieta con restricción de proteínas, administración de benzoato de sodio, exsanguinotransfusión y diálisis peritoneal pese a lo cual fallecieron. Se revisan las causas de hiperamonemia en el neonato y se propone una secuencia para su diagnóstico.

Determinación del gen aac(6´)-aph(2´´) asociado con resistencia a aminoglucósidos en cepas de Staphylococcus coagulasa negativa en una unidad neonatal en Bogotá / Detection of gene aac(6´)-aph(2´´) in associated with aminoglucosides resistance in Staphylococcus coagulase-negative strains isolates from one neonatal unit in Bogota

Antecedentes. La causa más común de resistencia a antibióticos aminoglucósidos en bacterias Gram positivas, especialmente en S. epidermidis, es la enzima modificante AAC(6’)-APH(2"), capaz de acetilar y fosforilar un amplio rango de antibióticos. Objetivo. Determinar la presencia del gen aac(6’)-aph(2") en cepas de Staphylococcus coagulasa negativa aisladas en infecciones neonatales, e investigar la concordancia con las pruebas de sensibilidad in-vitro.Material y métodos. Se determinó la presencia del gen aac(6’)-aph(2") en 63 cepas de estafilococos coagulasa negativa provenientes de hemocultivos y puntas de catéter, de la Unidad de Neonatología del Instituto Materno Infantil, en Bogotá. Resultados. Staphylococcus epidermidis fue el germen más frecuente y el gen aac(6’)-aph(2") estaba presente en 55 (87,3%) cepas; de éstas, 42 (73,4%) cepas provenían de hemocultivos y 13 (23,6%) cepas de punta de catéter. La susceptibilidad a gentamicina se determinó mediante concentración inhibitoria mínima y para amikacina por difusión en disco. No se encontró asociación estadísticamente significativa entre la presencia del gen aac(6’)-aph(2") y la resistencia a gentamicina y amikacina. Conclusión. La presencia del gen aac(6’)-aph(2") de resistencia a aminoglucósidos es muy alta en cepas de Staphylococcus epidermidis. Diferencias en la expresión del gen pueden explicar parcialmente la falta de consistencia con las pruebas de susceptibilidad utilizadas en la clínica.

Background. The most common cause of resistance to aminoglucosides is the acetilation and phosphorilation of the antibiotic by the enzyme AAC(6’)APH(2"). Objetive. To determine the presence of the gene aac(6’)-aph(2") in strains of coagulase-negative Staphylococci isolated from infected neonates and to investigate the concordance with the susceptibility tests in-vitro. Materials and methods. the aac(6’)-aph(2") gene was determined in 63 coagulase-negative Staphylococci strains isolated from blood cultures and catheter tips obtained from the neonatal care unit at the Instituto Materno Infantil in Bogotá, Colombia. Results. Staphylococcus epidermidis was the most frequently identified microorganism. The aac(6’)-aph(2") gene was detected in 55 out of 63 strains (73,43%), 42 strains (87,5%) isolated from blood cultures, and 13 strains (23,6%) isolated from catheter tips. Susceptibility to gentamycin was determined by minimum inhibitory concentration, and susceptibility to amikacin by the disk diffusion antibiotic sensitivity test. There was no a significant statistical association between the presence of the gene and the microbial susceptibility to either gentamycin or amikacin. Conclusion. The presence of the aac(6’)-aph(2") gene in strains of Staphylococcus epidermidis is very high. Differences in the expression of the gene might explain some cases of inconsistency with the susceptibility tests.

Encefalopatía neonatal. Algo mas que asfixia al nacer / Neonathal encefhalopathy something more that perinatal asphysia

La hiperglicinemia no cetósica (HGNC) es un error innato del metabolismo, de carácter recesivo, debido a un defecto en el sistema de clivaje, que ocasiona acumulación de glicina en la sangre y en el sistema nervioso central, donde activa dos receptores diferentes. El receptor localizado en la médula espinal, inhibitorio, provoca la apnea y el hipo de estos pacientes. El receptor cortical, excitatorio, produce la lesión cerebral y las convulsiones. Se presenta la historia de un recién nacido masculino, a término, que se torna encefalopático en los primeros días de vida. No presentó hipoglicemia, acidosis metabólica, cetosis ni hiperamonemia. La ecografía transfontanelar fue normal. A los seis días ameritó ventilación mecánica. La cromatografía en capa fina mostró banda de glicina en plasma y orina. El paciente recibió manejo con benzoato de sodio, diazepam y restricción proteica. A los 20 días de vida presentó mejoría neurológica y salió del hospital a los 42 días de vida con igual manejo. El estudio de acilcarnitinas en sangre por tandem-masas hecho en Santiago de Compostela fue normal. La cuantificación de aminoácidos hecha en el CEDEM mostró aumento de los niveles de glicina en plasma y LCR y la relación glicina LCR / plasma confirmó el diagnóstico de hiperglicinemia no cetósica típica. Se revisan las causas de encefalopatía neonatal y se plantea una secuencia para el diagnóstico.

Enzyme activities and chemical changes in wet olive cake after treatment with Pleurotus ostreatus or Eisenia fetida.

A laboratory experiment was conducted to evaluate the enzyme activities and chemical changes recorded in a recalcitrant phenolic-rich waste after treatment with Pleurotus ostreatus or Eisenia fetida. The waste used was wet olive cake (alperujo in Spanish), a waste produced in huge amounts by the olive oil industry. Both P. ostreatus and E. fetida were very effective in removing phenolic compounds, the initial concentration in the wet olive cake being reduced in both cases by around 90%. Laccase and manganese peroxidase activities were measured in the growth medium of P. ostreatus, and catechol 2,3 dioxygenase activity was only detected in the waste treated with Eisenia; these could be the main factors responsible for the oxidation of phenolic compounds. Increases of dehydrogenase and beta-glucosidase activities were detected in the degraded wet olive cake by fungi or earthworms. In comparison with the natural wet olive cake, the degraded products had lower total organic carbon and humic acid contents but were rich in nitrogen and other nutrients, having lower C:N ratios. In addition, the toxicity of the wet olive cake against the seeds of Lepidium sativum significantly decreased after degradation. The low toxicity as well as moderate stability and maturity recorded in the wet olive cake treated with P. ostreatus or E. fetida imply that these products could be used as soil amendments.