Postreperfusion Syndrome in Patients Receiving Vasoactive Drugs During Liver Graft Reperfusion.

OBJECTIVES: The most widely used definition of postreperfusion syndrome in liver transplant is a 30% decrease in mean arterial pressure during the first 5 minutes after vascular unclamping. With these criteria, increased postoperative morbidity has been reported. Vasoactivedrugs couldpreventthis syndrome.Themain objective of our study was to determine the incidence and complications associated with postreperfusion syndrome inpatientswho receivedvasoactive support. MATERIALS AND METHODS: We studied 246 patients who received norepinephrine infusions to maintain mean arterial pressure ≥60 mm Hg and who were monitored with a Swan-Ganz catheter. Patients received a bolus of adrenaline after vascular unclamping in cases of insufficient response to norepinephrine. RESULTS: Among the study patients, 57 (23.17%) developed postreperfusion syndrome. Patients who developed postreperfusion syndrome did not present with morepostoperative complications interms ofrenal dysfunction (P = .69), repeat surgery (P = .15), graft rejection (P = .69), transplant replacement surgery (P = .76), hospital stay (P = .70), or survival (P = .17) compared with patients without postreperfusion syndrome. CONCLUSIONS: In patients who underwent orthotopic liver transplant, in whom vasoactive drugs were administered, a diagnosis of self-limited postreperfusion syndrome during the first 5 minutes after unclamping may not be associated with postoperative complications. The administration of vasoconstrictors may have a preventive effect on the postoperative complications associated with postreperfusion syndrome or they may mask the real incidence of postreperfusion syndrome. A broader definition of postreperfusion syndrome should be accepted.

Impact of graft reperfusion on cardiac function assessed by transesophageal echocardiography during liver transplantation: an observational retrospective study.

Cardiovascular instability is common during the reperfusion phase of orthotopic liver transplantation (OLT), and some patients experience a postreperfusion syndrome (PRS). However, there are no reports comparing the cardiac dysfunction between patients with PRS and those without. Thus, the aim of this study was to evaluate cardiac dysfunction in patients exhibiting PRS. This observational retrospective study included 34 patients who underwent OLT and were monitored with transesophageal echocardiography (TEE). The right ventricular/left ventricular (RV/LV) end diastolic area, tricuspid annular plane systolic excursion (TAPSE), left ventricular ejection fraction (LVEF) by Simpson method, pulsed Doppler of the mitral valve, and tissue Doppler motion of the mitral annulus were determined. Echocardiographic measurements were registered at the beginning of surgery and at 1 and 30 min after vascular unclamping. Patients with PRS (PRS group) were identified, and their echocardiographic parameters of ventricular function were compared with those in patients without PRS (non-PRS group). To check the evolution of diastolic-systolic dysfunction, general linear model-repeated measures were estimated. No patient presented systolic/diastolic dysfunction on the basal echocardiogram. One minute after vascular unclamping, the incidence of RV dilation was 4.5 times greater in patients with PRS (Cramer´s V > 0.6), and the incidence of RV systolic dysfunction was 62.5% in patients with PRS compared to 15.40% in patients without PRS (Cramer´s V = 0.45). The incidence of LV systolic dysfunction was 25% in patients with PRS compared to 0% in those without (Cramer´s V = 0.45), and left ventricular diastolic dysfunction was 4.8 times greater in patients with PRS (Cramer´s V = 0.45). No patient presented diastolic dysfunction type III. There were significant differences between groups in the evolutionary pattern at 1 and 30 min after unclamping for RV dilation (p = 0.008) and for TAPSE (p = 0.014). Liver graft reperfusion may alter cardiac function. Cardiac dysfunction was more frequent in patients with PRS. These patients exhibited temporary dysfunction of the RV associated with a varying degree of LV diastolic-systolic dysfunction. Trial registration: clinicaltrials.gov (NCT05175534). January 03, 2022; "retrospectively registered".

Lung Ultrasound Abnormalities in Patients Without Pulmonary Pathology Prior to Surgery.

Background: The occurrence of lung ultrasound abnormalities in patients without lung disease remains uncertain, while patients with respiratory disease often exhibit such abnormalities. Objectives: The primary aim was to identify pathological ultrasonographic pulmonary findings and their correlation with baseline diseases and static lung compliance in patients without any pre-existing respiratory conditions. Methods: This prospective observational study enrolled a series of surgical patients with no history of pulmonary pathology (n = 104). Baseline diseases and patients' physical status classification, based on the American Society of Anesthesiologists (ASA), were documented by reviewing medical records. Prior to surgery, a lung ultrasound was performed to assess pulmonary changes. During surgery with general anesthesia, static lung compliance was measured. The Spearman correlation coefficient was employed to determine the correlation between the two variables. Results: Twenty-four patients (23.07%) exhibited 1 - 2 B-lines in certain lung fields. Seven patients (6.7%) had an ultrasound B-line score > 0 (indicating ≥ 3 B-lines). Among these patients, the average number of lung fields with ≥ 3 B-lines was 3.71 ± 2.43. Patients with systemic diseases (ASA ≥ 2) displayed a higher number of B-lines compared to ASA I patients (P-value = 0.039). Pleural irregularities were found in 10 patients (9.6%), while atelectasis and pleural effusion were observed in five (4.8%) and four (3.8%) patients, respectively. The mean lung compliance value was 56.78 ± 15.33. No correlation was observed between the total score of the B-lines and lung compliance (Spearman's correlation: rho = -0.028, P-value = 0.812). Conclusions: Patients without pulmonary pathology may exhibit ultrasound pulmonary abnormalities, which tend to increase with higher ASA scores and do not appear to have a correlation with static lung compliance.

Vasoplegic Syndrome During Cardiopulmonary Bypass in a Twin Pregnancy.

Introduction: The most severe form of hemodynamic instability is vasoplegic syndrome. Case Presentation: This case report presents a case of vasoplegic syndrome in a patient with a twin pregnancy during cardiopulmonary bypass. Conclusions: In this case, we managed vasoplegia by maintaining high flows of the cardiopulmonary bypass, reducing the use of volatile anesthetics, administering vasoactive drugs, and optimizing hemoglobin levels above normal thresholds.

Caracterización in situ de poblaciones de Aloysia gratissima var. gratissima recolectadas del noreste de la provincia de San Luis, Argentina / In situ characterization of populations of Aloysia gratissima var. gratissima collected from the northeast of the province of San Luis, Argentina

Abstract: The aerial part of Aloysia gratissima (Gil lies & Hook. ex Hook.) Tronc., "Usillo", is used as aromatic and medicinal. It is a shrub of up to 3 meters, distributed in North America, from the south of the USA to the north of Mexico, and in South America up to the 37th parallel. As in other native sp ecies, the demand is covered by harvesting in wild populations, which brings about the deterioration of the resource and lack of homogeneity of the harvested product. The variability was characterized in nine populations of A. gratissima var. gratissima fr om the northeast of San Luis, Argentina, based on morphological and phytochemical characters. It was found that the species in the region presents considerable heterogeneity. Diversity was detected in the chemical characteristics of the essential oils anal yzed and the prevalence of mono and sesquiterpenes was related to the olfactory identities identified. The main components were the sesquiterpene spatulenol and the monoterpene 1,8 cineole

Resumen: La parte aérea de Aloysia gratissima (Gillies & Hook. ex Hook.) Tronc., "usillo", es utilizada como aromática y medicinal. Es un arbusto de hasta 3 metros, distribuido en Norteamerica, desde e l sur de EEUU hasta el norte de México, y en Sudamerica hasta el paralelo 37°. Al igual que en otras especies nativas, la demanda es cubierta por recolección en poblaciones silvestres, lo cual trae aparejado el deterioro del recurso y falta de homogeneidad del producto cosechado. Se caracterizó la variabilidad en nueve poblaciones de A. gratissima var. gratissima del noreste de San Luis, Argentina, en base a caracteres morfológicos y fitoquímicos. Se encontró que la especie en la región presenta una conside rable heterogeneidad. Se detectó diversidad en las características químicas de los aceites esenciales analizados y se relacionó la prevalencia de mono y sesquiterpenos con las identidades olfativas identificadas. Los componentes mayoritarios fueron el sesq uiterpeno espatulenol y el monoterpeno 1,8 cineol.

A Novel GMP Protocol to Produce High-Quality Treg Cells From the Pediatric Thymic Tissue to Be Employed as Cellular Therapy.

Due to their suppressive capacity, the adoptive transfer of regulatory T cells (Treg) has acquired a growing interest in controlling exacerbated inflammatory responses. Limited Treg recovery and reduced quality remain the main obstacles in most current protocols where differentiated Treg are obtained from adult peripheral blood. An alternate Treg source is umbilical cord blood, a promising source of Treg cells due to the higher frequency of naïve Treg and lower frequency of memory T cells present in the fetus' blood. However, the Treg number isolated from cord blood remains limiting. Human thymuses routinely discarded during pediatric cardiac surgeries to access the retrosternal operative field has been recently proposed as a novel source of Treg for cellular therapy. This strategy overcomes the main limitations of current Treg sources, allowing the obtention of very high numbers of undifferentiated Treg. We have developed a novel good manufacturing practice (GMP) protocol to obtain large Treg amounts, with very high purity and suppressive capacity, from the pediatric thymus (named hereafter thyTreg). The total amount of thyTreg obtained at the end of the procedure, after a short-term culture of 7 days, reach an average of 1,757 x106 (range 50 x 106 - 13,649 x 106) cells from a single thymus. The thyTreg product obtained with our protocol shows very high viability (mean 93.25%; range 83.35% - 97.97%), very high purity (mean 92.89%; range 70.10% - 98.41% of CD25+FOXP3+ cells), stability under proinflammatory conditions and a very high suppressive capacity (inhibiting in more than 75% the proliferation of activated CD4+ and CD8+ T cells in vitro at a thyTreg:responder cells ratio of 1:1). Our thyTreg product has been approved by the Spanish Drug Agency (AEMPS) to be administered as cell therapy. We are recruiting patients in the first-in-human phase I/II clinical trial worldwide that evaluates the safety, feasibility, and efficacy of autologous thyTreg administration in children undergoing heart transplantation (NCT04924491). The high quality and amount of thyTreg and the differential features of the final product obtained with our protocol allow preparing hundreds of doses from a single thymus with improved therapeutic properties, which can be cryopreserved and could open the possibility of an "off-the-shelf" allogeneic use in another individual.

Detection of residual pulmonary alterations with lung ultrasound and effects on postoperative pulmonary complications for patients with asymptomatic SARS-CoV-2 infection undergoing surgeries.

BACKGROUND: For patients with a clinical course of active SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, there may be a higher risk of perioperative complications. Our main objective is to detect the residual pulmonary alterations in asymptomatic patients after SARS-CoV-2 infection undergoing surgery and determine their relationship with the clinical course of SARS-CoV-2 infection. The secondary aim is to investigate whether the presence of residual pulmonary alterations have any affects on the severity of postoperative pulmonary complications. METHODS: After approval by the Hospital's Ethical Committee, this prospective observational study included consecutive patients (n=103) undergoing various surgical procedures and anesthetic techniques with a history of past SARS-CoV-2 infection. On the day of surgery these patients remained asymptomatic and the polymerase chain reaction (PCR) test for SARS-CoV-2 was negative. The history, physical findings, and clinical course of SARS-CoV-2 infection were recorded. Lung ultrasound was performed before surgery to evaluate the possible residual pulmonary alterations (≥ 3 B-lines and pleural thickening), along with determitation of pulmonary static compliance values during surgery. Postoperative pulmonary complications were collected during hospital stay. RESULTS: 24.27% (n=25) patients presented ≥ 3 B-lines, and 28% (n=29) patients presented pleural thickening. For 15 patients (21.7%) the pulmonary compliance was < 40 mL/cm H2O. Patients with pleural thickening had a higher incidence of pneumonia, acute respiratory syndrome distress, a need for vasoactive drugs and required more days of hospitalization during SARS-CoV-2 infection (p= 0.004, 0.001, 0.03, 0.00 respectively). Patients with ≥ 3 B-lines needed more days in an intensive care unit and vasoactive drugs during SARS-CoV2 infection (p= 0.04, 0.004 respectively). Postoperative pulmonary complications were observed in 5.8% (n=6) of the patients, and were more frequent in the presence of both, ≥ 3 B-lines and pleural thickening (p= 0.01). CONCLUSIONS: In asymptomatic post-COVID-19 patients, pathological findings detected by lung ultrasound before surgery are associated with the severity of the SARS-CoV2 infection and resulted in more postoperative pulmonary complications. In these patients, the incidence of postoperative pulmonary complications appears similar to that described in the surgical population before the pandemic. TRIAL REGISTRATION: clinicaltrials.gov (NCT04922931). June 21, 2021. "Retrospectively registered".

Fibrosis quística y alto flujo termo humidificado, una nueva estrategia en el tratamiento / High-flow nasal cannula therapy in cystic fibrosis, a New Treatment Strategy

Se presenta el caso de un paciente con fibrosis quística, insuficiencia respiratoria crónica tipo II, en tratamiento con solución hipertónica, DNAsa, salbutamol, VNI nocturna y oxigenoterapia 24 horas, quien consulta por presentar desaturación y cefalea en el contexto de cambio de equipo de VNI. Se inicia tratamiento con HFNC y AVAPS presentando mejoría clínica, disminución de los requerimientos de oxígeno, descenso de la PaCO2 , disminución de los tapones mucosos en la tomografía y fluidificación de las secreciones respiratorias. Se plantea al HFNC como posible estrategia de tratamiento en los pacientes con FQ. Al prevenir el daño de la mucosa, disminuir la inflamación y las infecciones podría enlentecer el deterioro de la función pulmonar.

We present the case of a patient with cystic fibrosis and type II chronic respiratory failure under treatment with hypertonic solution, DNAse, salbutamol, night NIV and 24-hour oxygen therapy. The patient consults for desaturation and cephalea in the context of changing NIV equipment. The patient begins treatment with HHHF and AVAPS and shows clinical improvement, decrease in oxygen requirements, decrease in PaCO2 , less mucous plugging on the tomography and fluidifying of respiratory secretions. The HHHF is proposed as possible treatment strategy for patients with CF. By preventing damage to the mucosa and reducing inflammation and infections it could slow down impairment of the lung function.

Fístula esofagobronquial secundaria a tuberculosis / Bronchoesophageal Fistula Secondary to Tuberculosis

La fístula esofagobronquial es una complicación muy poco frecuente de la tuberculosis. Usualmente se asocia a tuberculosis pulmonar y/o mediastinal siendo más frecuente en inmunocomprometidos y en contexto de adenopatías mediastinales en contacto con las estructuras involucradas en el trayecto fistuloso1. Se presenta un caso de un inmunocomprometido, con tuberculosis pulmonar y fístula esofagobronquial como complicación. Se realiza tratamiento antifímico con buena evolución.

Calidad de los cuidados del drenaje de tórax y habilidades autopercibidas en la atención de enfermería / Quality of thoracic drain care and self-special skills in nursing care

Objetivo principal: Conocer la percepción de los profesionales sobre la calidad de los cuidados en pacientes con drenaje de tórax respecto a la protocolización, capacitación, conocimientos y habilidades auto-percibidas en la atención de enfermería en servicios de internación. Metodología: Estudio transversal en 424 sujetos de hospitales de 3 regiones de Uruguay. Se analizaron 18 variables agrupadas en categorías referidas al personal, protocolización, capacitación y conocimientos, autopercepción de habilidades. Resultados principales: 41% no había recibido capacitación sobre el tema, 79% conocía el protocolo, 46% había presenciado un evento adverso relacionado a este cuidado. El 7% del personal responde correctamente el 100% de las variables sobre conocimiento, el 47% responde correctamente el 80% de ellas, el 43% dijo sentirse capacitado y con destrezas para orientar a otros, el 28% contaba con habilidades pero no se sentía seguro, el resto no se siente con habilidades suficientes. Conclusión principal: La percepción sobe la calidad de los cuidados difiere según el área estudiada. La capacitación y la implementación de programas de educación continua, que brinden conocimientos y se desarrollen con metodologías innovadoras para mejorar habilidades y seguridad de los cuidados, se muestran necesarios para desarrollar en los servicios

Objective: To know the perception of the professionals about quality of care in patients with chest drainage regarding protocolization, training, knowledge and self-perceived skills in nursing care in inpatient services. Methods: A cross-sectional study of 424 subjects from hospitals in three departments (provinces) of Uruguay. We analyzed 18 variables grouped in categories related to personnel, protocolization, training and knowledge, self-perception of skills. Results: 41% had not received training on the subject, 79% knew the protocol, and 46% said they had witnessed an adverse event related to this care. Only 7% of the staff correctly responds to 100% of the knowledge variables, 47% correctly responds 80% of them. Regarding self-perceived skills, 43% said they felt empowered and with skills to guide others, 28% had skills but did not feel safe to orient, the rest did not feel enough skills. Conclusions: The main aspects related to quality that must be improved are related to the implementation of continuous training programs that provide knowledge to the staff and are developed with innovative methodologies that achieve specific skills to improve their skills and safety of care

Relationship between physico-chemical characteristics and potential toxicity of PM10.

PM10 was sampled at a suburban location affected by traffic and industry in the north of Spain. The samples were analysed to determine the chemical components of PM10 (organic and elemental carbon, soluble chemical species and metals). The aim of this study was to assess the toxicity of PM10 in terms of the bulk analysis and the physico-chemical properties of the particles. Total carbon, sulphates, ammonium, chlorides and nitrates were found to be the major constituents of PM10. The contribution of the last of these was found to increase significantly with PM10 concentration (Pearson coefficient correlation of 0.7, p-value < 0.001). Individual airborne particles were characterised morphologically and chemically via a combination of Scanning Electron Microscopy and Energy-Dispersive X-ray spectroscopy (SEM-EDX). The subsequent image analysis revealed C-rich particles with shapes that pointed to combustion processes. Moreover, carbonaceous particles seemed to act as vehicles for sulphur compounds and metals (S, Na, Fe, Ca, Mg, K, Al, Mn, Zn and Cu). Coarse particles were found to be mainly constituted by crustal material and marine and carbonaceous particles. Although most of the studied individual particles in PM10 samples (86.0%) had a diameter within the 0.1-2.5 µm range, 1.8% of them had sizes lower than 0.1 µm 40.2% of the total studied particles were estimated to be inhaled and deposited in the human respiratory tract; 12.3% of these particles would reach the deepest zones, thereby posing a major risk to human health.

Total Synthesis of (±)-Cis-Trikentrin B via Intermolecular 6,7-Indole Aryne Cycloaddition and Stille Cross-Coupling.

An efficient total synthesis of the annulated indole natural product (±)-cis-trikentrin B was accomplished by means of a regioselectively generated 6,7-indole aryne cycloaddition via selective metal-halogen exchange from a 5,6,7-tribromoindole. The unaffected C-5 bromine was subsequently used for a Stille cross-coupling to install the butenyl side chain and complete the synthesis. This strategy provides rapid access into the trikentrins and the related herbindoles, and represents another application of this methodology to natural products total synthesis. The required 5,6,7-indole aryne precursor was prepared using the Leimgruber-Batcho indole synthesis.

Comparative study of ropivacaine 0.5% and levobupivacaine 0.33% in axillary brachial plexus block.

BACKGROUND: The aim of this prospective, randomized, double-blind study was to compare the block induced by ropivacaine 0.5% with levobupivacaine 0.33% at the recommended dose range in upper limb surgery. These concentrations have provided equivalent block after epidural analgesia. We hypothesized that the block induced by both local anesthetics at clinical equipotent dose would be similar in axillary block. METHODS: Eighty-six patients received 30 mL of ropivacaine 0.5% (150 mg) or 30 mL of levobupivacaine 0.33% (99 mg) by axillary approach. Sensory and motor blocks were assessed in the 5 main nerve territories of the arm at 2, 5, 10, 15, 20, 25, and 30 mins and every 6 hrs for the first 24 hrs. We used the Student t test and chi test for comparison between groups and an analysis of survival. P < 0.05 was considered statistically significant. RESULTS: Onset of motor block was 9.0 mins (SD, 5.3 mins) for ropivacaine and 12.4 mins (SD, 7.8 mins) for levobupivacaine (P = 0.02). Time to be considered ready for surgery was similar in both groups: ropivacaine, 25.2 mins (SD, 5.1 mins); and levobupivacaine, 25.3 mins (SD, 6.4 mins) (t = -0.09, P = 0.93). Sensory block was 9.2 hrs (SD, 3.1 hrs) for ropivacaine and 11.3 hrs (SD, 4.1 hrs) for levobupivacaine (P = 0.01). CONCLUSIONS: Onset of motor block was significantly faster for ropivacaine than levobupivacaine (P = 0.02), but the time to be ready for surgery was similar with both drugs. Duration of sensory block was prolonged with levobupivacaine (P = 0.01).

Factores de virulencia en cepas de Aeromonas aisladas de pacientes con enfermedad diarreica aguda en Cuba / Virulence factors in Aeromonas strains isolated from patients with acute diarrheas in Cuba

Objetivo: se realizó un estudio en cepas de Aeromonas aisladas de pacientes con enfermedad diarreica aguda en Cuba, para conocer la expresión fenotípica de la citotoxina y la enterotoxina como factores de virulencia. Métodos: se investigaron 46 cepas (A. hydrophila, A. veronii biovar sobria, A. caviae, A. veronii biovar veronii y Aeromonas spp.), aisladas de heces de pacientes con enfermedad diarreica aguda, en el período comprendido entre 2005 y 2006. Todas las cepas tenían identificado su patrón de susceptibilidad antimicrobiana. Se comprobó la expresión fenotípica de la citotoxina y la enterotoxina en la línea celular Vero. Resultados: el estudio demostró que 91,31 por ciento de las cepas mostraron actividad citotóxica y 43,48 por ciento actividad enterotóxica. De las cepas multirresistentes, 93,75 por ciento presentó al menos un factor de virulencia estudiado. Conclusiones: los resultados demostraron que los 2 factores de virulencia investigados estuvieron presentes en las cepas estudiadas, contribuyendo así a los múltiples esfuerzos que se realizan para conocer los mecanismos de enteropatogenicidad de este género bacteriano.

Objective: A study was carried out in Aeromonas strains isolated from patients with acute diarrheas in Cuba to find out the phenotypical expression of the cytotoxin and the enterotoxin as virulence factors. Methods: Forty six strains of the genus Aeromonas (A. hydrophila, A. veronii bv sobria, A. caviae, A. veronii bv veronii and Aeromonas spp.) isolated from stool specimens taken form patients with acute diarrheal disease were studied from 2005 to 2006. All the strains had their pattern of antimicrobial susceptibility pattern identified. The phenotypic expression of the cytotoxin and the enterotoxin in the Vero cell line was checked. Results: It was demonstrated that 91,31 percent of the strains showed cytotoxic activity and 43,48 percent of them enterotoxic activity. Regarding multiresistant strains, 93,75 percent presented with at least one of the studied virulence factors. Conclusions: these results proved that the two researched virulence factors did exist in the studied strains, thus contributing to the many efforts that are being made to learn about the mechanisms of enteropathogenicity of this bacterial genus.

Factores de virulencia en cepas de Aeromonas aisladas de pacientes con enfermedad diarreica aguda en Cuba / Virulence factors in Aeromonas strains isolated from patients with acute diarrheas in Cuba

Objetivo: se realizó un estudio en cepas de Aeromonas aisladas de pacientes con enfermedad diarreica aguda en Cuba, para conocer la expresión fenotípica de la citotoxina y la enterotoxina como factores de virulencia. Métodos: se investigaron 46 cepas (A. hydrophila, A. veronii biovar sobria, A. caviae, A. veronii biovar veronii y Aeromonas spp.), aisladas de heces de pacientes con enfermedad diarreica aguda, en el período comprendido entre 2005 y 2006. Todas las cepas tenían identificado su patrón de susceptibilidad antimicrobiana. Se comprobó la expresión fenotípica de la citotoxina y la enterotoxina en la línea celular Vero. Resultados: el estudio demostró que 91,31 por ciento de las cepas mostraron actividad citotóxica y 43,48 por ciento actividad enterotóxica. De las cepas multirresistentes, 93,75 por ciento presentó al menos un factor de virulencia estudiado. Conclusiones: los resultados demostraron que los 2 factores de virulencia investigados estuvieron presentes en las cepas estudiadas, contribuyendo así a los múltiples esfuerzos que se realizan para conocer los mecanismos de enteropatogenicidad de este género bacteriano(AU)

Objective: A study was carried out in Aeromonas strains isolated from patients with acute diarrheas in Cuba to find out the phenotypical expression of the cytotoxin and the enterotoxin as virulence factors. Methods: Forty six strains of the genus Aeromonas (A. hydrophila, A. veronii bv sobria, A. caviae, A. veronii bv veronii and Aeromonas spp.) isolated from stool specimens taken form patients with acute diarrheal disease were studied from 2005 to 2006. All the strains had their pattern of antimicrobial susceptibility pattern identified. The phenotypic expression of the cytotoxin and the enterotoxin in the Vero cell line was checked. Results: It was demonstrated that 91,31 percent of the strains showed cytotoxic activity and 43,48 percent of them enterotoxic activity. Regarding multiresistant strains, 93,75 percent presented with at least one of the studied virulence factors. Conclusions: these results proved that the two researched virulence factors did exist in the studied strains, thus contributing to the many efforts that are being made to learn about the mechanisms of enteropathogenicity of this bacterial genus(AU)

Geographical distribution of HCV genotypes in Mexico.

UNLABELLED: Chronic hepatitis C (CHC) is the second cause of endstage liver disease in our country and one of the main indications of liver transplantation. Hepatitis C virus (HCV) genotype is the principal prognostic factor and the determinant of the therapeutic scheme. In our country few data exist regarding the prevalence of HCV infection and genotype distribution in the Mexican Republic has not been determined. The aim of this study was to characterize the prevalence of the different HCV genotypes and to explore their geographical distribution. METHODS: Mexican patients with hepatitis C infection, detected throughout the country between 2003 and 2006, were included. All samples were analyzed by a central laboratory and Hepatitis C genotype was identified by Line Immuno Probe Assay in PCR positive samples (Versant Line Probe Assay Quest Diagnostics Nichols Institute, San Juan Capistrano CA). Data were analyzed according to the four geographical areas in Mexico. RESULTS: One thousand three hundred and ninety CHC patients were included. The most frequent genotype detected was genotype 1 (69%) followed by genotype 2 (21.4%) and genotype 3 (9.2%). Genotype 4 and 5 were infrequent. There was no subject infected with genotype 6. Genotype 1 and 2 exhibit very similar distribution in all geographical areas. Genotype 3 infected patients were more frequent in the North region (52%) compared with other areas:center-western (30%), center (17%), South-South east (1%) (p < 0.001). CONCLUSIONS: The most prevalent HCV genotype in Mexico is genotype 1. Geographical distribution of HCV genotypes in the four geographical areas in Mexico is not homogenous with a greater frequency of genotype3 in the north region. This difference could be related to the global changes of risk factors for HCV infection.

Two specific sites for binding of K88ab Escherichia coli fimbriae to porcine intestinal brush border membranes.

We have studied the characteristics of the binding of the K88ab Escherichia coli fimbrial antigen to porcine brush border membranes by solid phase binding assay. Binding of biotinylated K88ab to brush border membranes followed a sigmoidal dependence and was saturable, apparent saturation occurring with 0.8 ng of fimbriae (approx. 7 ng of fimbriae per microg of brush border protein) irrespective of incubation temperature in the range of room temperature to 4 degrees C. A Hill plot of log [(fimbriae bound)/(maximal binding-fimbriae bound)] vs. log free fimbriae gave a maximal slope of about 2, indicating the existence of two binding sites. From an analysis of an Scatchard plot, apparent binding constants (1)K(2) and (2)K(2) of 7.1 x 10(8) and 17.1 x 10(8)M(-1) were obtained at room temperature. Nor did temperature have any effect on the rate of binding or on receptor affinity (S(0.5)).

Adhesion of Escherichia coli K88ab fimbriae to porcine enterocytes: effect on enzymatic activities of the brush border, and cyclic AMP and GMP levels.

We have studied the cellular alterations, after in vitro adherence, of purified K88ab fimbriae to membranes of porcine enterocytes. Effects on enzymatic activities as disaccharydases and alkaline phosphatase show low changes. While cAMP levels were decreased (44%), guanylyl cyclase was increased (up to 200%), and levels of cGMP were in consequence significantly affected. This study support the role of cyclic GMP as intracellular mediator for adherence, and suggest their implication in disease, affecting a membrane-mediated mechanisms for guanylate cyclase activation, that is unique in the intestine.

Cómo enseñar a niños con autismo a hacer preguntas funcionalmente relevantes: una réplica sistemática / How to teach children with autism to ask questions functionally relevant: a systematic replication

Este estudio fue una réplica sistemática del estudio de Williams, Pérez-González y Vogt para enseñar a un niño con autismo a hacer preguntas. Presentamos al niño cajas con objetos agradables dentro. Enseñamos al niño a preguntar: «¿Qué hay en la caja?», para saber el nombre del objeto, «¿Me lo enseñas?», para verlo, y «¿Me lo das?», para obtenerlo. El niño aprendió a hacer la primera pregunta. Cuando aprendió a hacer la segunda pregunta dejó de hacer la primera. Entonces, analizamos si aún en esas condiciones el niño aprendería a realizar las tres preguntas independientemente. El niño volvió a aprender a hacer la primera pregunta y también aprendió la tercera. Una prueba final mostró que el niño aprendió a hacer cada pregunta de forma independiente. Además, el niño generalizó las preguntas en su ambiente. Entonces, estos resultados mostraron que el tener dificultades para aprender las dos primeras preguntas no afecta a la adquisición final de estas tres preguntas como tres habilidades funcionalmente independientes, apropiadas a su contexto específico. Este hallazgo tiene relevancia para la habilitación de niños con autismo y de niños con trastornos generalizados de desarrollo

This study was a systematic replication of Williams, Pérez-González, and Vogt’s study aimed to teach a child with autism to ask questions. We presented to the child boxes with pleasant objects inside. We taught him to ask, «What is in the box?» to know the name of the object, «Can I see it?» to see it, and «Can I have it?» to retrieve it. The child learned to ask the first question. When he learned to ask the second question, he stopped asking the first one. Then, we analyzed whether the child would learn, under these circumstances, to ask the three questions independently. The child learned again the first question. He also learned to ask the third one. A final probe showed that the child learned the three questions as three independent repertoires. Moreover, he generalized question asking to his everyday life. Thus, these results showed that having difficulties to ask the first two questions does not affect the final acquisition of the three questions as three functionally independent skills, appropriate to each specific context. These findings are relevant for the habilitation of children with autism and children with pervasive development delays

Complete development of Cryptosporidium parvum in rabbit chondrocytes (VELI cells).

Cryptosporidium parvum is an intracellular protozoan parasite that causes severe infection in humans and animals. The great difficulties in treating people and animals suffering from cryptosporidiosis have prompted the development of in vitro experimental models. The aim of this study was to demonstrate that C. parvum can complete its entire life cycle-from sporozoite to infective oocyst-in VELI cells (a line derived from primary culture of rabbit auricular chondrocytes). Successful infections were produced by inoculating cell cultures. Infection of MDCK, HTC-8 and VELI cells with C. parvum closely paralleled in vivo infections with regard to host cell location and chronology of parasite development. Oocysts which were produced in VELI cells were infective for infant NMRI mice. The growth of C. parvum in VELI cells provides a model, both simple and inexpensive, for testing anticryptosporidial drugs and studying host-parasite interactions.