Efficacy of First-Line Treatment With Pertuzumab and Trastuzumab in Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in Routine Clinical Practice.

Background: The first-line treatment for human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (MBC) involves a combination of trastuzumab, pertuzumab, and a taxane (TPH). This study assessed the efficacy of trastuzumab and pertuzumab (PH) in routine practice, following the treatment protocols of Uruguay's National Resources Fund (FNR), akin to clinical trials. Methods: Patients with advanced MBC treated with PH between 2008 and 2022 per FNR protocols were evaluated. The Kaplan-Meyer method and log-rank test were utilized for analyzing overall survival (OS). Demographic and clinical variables, including age, menopausal status, and hormone receptors (HR), were analyzed. Results: The study included 318 PH-treated patients. The median age was 56 years, with 63.2% being postmenopausal and 60.4% HR and HER-2 positive. With a median follow-up of 17.2 months, the median OS was 29 months. OS varied based on HR status and the presence of metastases at different sites, significantly lower in patients with brain, cutaneous/subcutaneous, and pulmonary metastases. Additionally, OS was higher in patients treated at private institutions compared to public ones. Conclusions: This study demonstrates the disparity in oncological treatment efficacy between clinical trials and clinical reality in Uruguay, emphasizing the importance of authentic environment research for more representative and effective medicine in Latin America.

Photo-induced protein modifications: a range of biological consequences and applications.

Proteins are the most abundant biomolecules in living organisms and tissues and are also present in many natural and processed foods and beverages, as well as in pharmaceuticals and therapeutics. When exposed to UV-visible light, proteins containing endogenous or exogenous chromophores can undergo direct and indirect photochemical processes, resulting in protein modifications including oxidation of residues, cross-linking, proteolysis, covalent binding to molecules and interfaces, and conformational changes. When these modifications occur in an uncontrolled manner in a physiological context, they can lead to biological dysfunctions that ultimately result in cell death. However, rational design strategies involving light-activated protein modification have proven to be a valuable tool for the modulation of protein function or even for the construction of new biomaterials. This mini-review describes the fundamentals of photochemical processes in proteins and explores some of their emerging biomedical and nanobiotechnological applications, such as photodynamic therapy (PDT), photobonding for wound healing, photobioprinting, photoimmobilization of biosensors and enzymes for sensing, and biocatalysis, among others.

Detection of Leishmania spp. in Cats: Analysis of Nasal, Oral and Conjunctival Swabs by PCR and HRM.

BACKGROUND AND OBJECTIVES: Feline leishmaniasis (FeL) is caused by several species of parasites of the genus Leishmania. The disease can occur with the presence or absence of clinical signs, similar to those observed in other common infectious diseases. In endemic regions for FeL, the infection has been associated with dermatological lesions. Therefore, considering the search for less invasive and more effective diagnostic techniques, we aimed to investigate the presence of Leishmania spp. in domestic cats through Polymerase Chain Reaction (PCR) and high-resolution melting (HRM) analyses of conjunctival, oral, and nasal epithelial cells, and we detected the presence of anti-Leishmania IgG antibodies from serological techniques of the Immunofluorescent Antibody Test (IFAT) and ELISA. METHODS: The PCR and HRM for detection of Leishmania spp. were performed on 36 samples of epithelial cells from the conjunctiva of male and female cats, collected using sterile swabs. The serological tests IFAT and ELISA were also performed. RESULTS: The prevalence of Leishmania donovani infection was 11.1% (4/36) by PCR assay, and those results were confirmed for Leishmania species using the HRM technique. Twenty-four cats (24/36 = 66.7%) were reactive to the IFAT and twenty-two cats were reactive by the ELISA technique (22/36 = 61.1%). INTERPRETATION AND CONCLUSIONS: The use of conjunctival swabs was shown to be a non-invasive, practical, and easy-to-perform technique, and in addition to the genetic sequencing and HRM, it was able to identify the parasitic DNA of L. donovani in cats. This technique can be used for screening diagnosis in future epidemiological surveys of FeL and can be used as a complement to clinical and/or serological tests, as well as associating the clinical history of the animal, for the diagnostic conclusion.

First Ecuadorian statement consensus for the evaluation and treatment of osteoporosis.

Osteoporosis management has become more relevant as the life expectancy increases. In Ecuador, approximately 19% of adults over 65 years of age have been diagnosed with osteoporosis. There is no national consensus for the management and prevention of the disease being this proposal the first Ecuadorian consensus. INTRODUCTION: In Ecuador, it is estimated that around 19% of adults over 65 years of age have osteoporosis. Due to the increase in life expectancy in the world population, the evaluation and management of osteoporosis has become more relevant. Currently, there is no national consensus for the management and prevention of the disease. The Ecuadorian Society of Rheumatology presented the project for the elaboration of the first Ecuadorian consensus for the management and prevention of osteoporosis. METHODS: A panel of experts in multiple areas and extensive experience was invited to participate. The consensus was carried out using the Delphi method. Six working dimensions were created: definition and epidemiology of osteoporosis, fracture risk prediction tools, non-pharmacological treatment, pharmacological treatment, calcium and vitamin D, and glucocorticoid-induced osteoporosis. RESULTS: The first round was held in December 2021, followed by the second round in February 2022 and the third round in March 2022. The data was shared with the specialists at the end of each round. After three rounds of work, a consensus was reached for the management and prevention of osteoporosis. CONCLUSION: This is the first Ecuadorian consensus for the management and treatment of postmenopausal osteoporosis.

Haematological values in cattle reared in humid and subhumid tropics of Mexico.

The objective of this study was to determine some factors that influence the haematological values of cattle reared in the humid and subhumid tropics of Mexico. Whole blood samples were taken from 1355 crossbred cattle in the years 2017 to 2019. Haematocrit (HTC, %), total plasma protein (TPP, g/dL) and peripheral eosinophils count (PEOS, × 103/µL) were determined manually, and the main haematological variables were recorded with an automatic analyser. The statistical analysis considered as classification variables age, sex, season (cold, dry and rainy), year (2017, 2018 and 2019) and origin of the cattle. The mean of the haematological parameters was determined along with the confidence limits (CL) of the different categories of animals according to age. Calves younger than 1-year-old presented higher levels of HTC, red blood cell count (RBC), haemoglobin (HGB), red blood cell distribution width (RDW), platelet number (PLT), white blood cell count (WBC) and lymphocyte count (LYMF) than animals older than 2 years of age. However, they showed the lowest mean cell volume (MCV) and TPP values. In cows, the highest levels of PEOS, granulocytes (GRAN), MCV and medium cells (MID) were observed and the lowest HTC, RBC, RDW and WBC levels. Intervals were determined with the 1st quartile (Q1) or lower confidence interval (90% CI) as the minimum values and the 3rd quartile (Q3) or upper confidence interval (90% CI) as the maximum values. The haematological parameters of cattle reared in the Southeast of Mexico are significantly affected by age, sex and environmental conditions.

EVALUATION OF PELIBUEY LAMBS BORN TO MOTHERS PHENOTYPICALLY SEGREGATED ACCORDING TO RESISTANCE TO GASTROINTESTINAL NEMATODES IN THE HUMID TROPICS OF MEXICO.

The objective was to evaluate the effect of the resistance of ewes to gastrointestinal nematodes (GIN) on the parasitologic and productive performance of their lambs during preweaning and postweaning periods. Offspring from 44 Pelibuey ewes classified as resistant or susceptible to GIN were evaluated. During the preweaning period, birth weight (BW), live weight (LW) at 35 and 70 days of age, and live weight changes (LWC) were determined in 73 lambs. During the postweaning period, 20 lambs to susceptible or resistant ewes were evaluated. The lambs were challenged under natural GIN infections and artificial infection with L3 of Haemonchus contortus. The fecal egg count (FEC), hematocrit (HT), peripheral eosinophil count, plasma protein, LW, and LWC were determined. There were no differences among parameters evaluated during preweaning (P > 0.05). The type of lambing (single or multiple) affected the BW, LW, and LWC (P < 0.01). The sex (male) of the lamb had a positive effect on BW at 35 and 70 days of age (P < 0.05). After weaning, lambs of susceptible ewes showed higher FEC than resistant ewes (P < 0.05). The HT of lambs to resistant ewes was higher than those the susceptible group (P < 0.01). In conclusion, offspring of resistant ewes show low FEC compared with those susceptible during the postweaning stage.

Frontal Sinus Cholesteatoma Presenting with Intracranial and Orbital Complications: Diagnosis and Treatment.

Frontal sinus keratoma or cholesteatoma is a rare disease of paranasal sinuses and presents as a slow-growing mass that becomes symptomatic as it grows to the surrounding structures. Intracranial complications are not a common presentation and are potentially life-threatening. Frequently the final diagnosis is only made intraoperatively because several other frontal sinus tumors behave likewise. Definitive treatment requires complete removal of the keratoma, and a combined endoscopic and external frontal sinus approach is a good treatment option. In this report, we presented a 68-year-old female with frontal sinus cholesteatoma with diagnostic and therapeutic features of this pathology with the review of the literature.

Do Live Weight, Body Condition Score, Back Muscle or Back-Fat Reserves Create the Suspicion of Goats Infected with Eimeria or Trichostrongylids?

Thirty goats of the breeds Czech Brown Shorthaired and Czech White Shorthaired and their crosses were randomly selected from a flock at a farm in the Czech Republic. All animals were monitored for one year at monthly intervals for their nutritional status (live weight, LW; body-condition score, BCS; depth of musculus longissimus thoracis et lumborum, MLTL; back-fat thickness, BT) and infection intensity with Eimeria sp. (EIM) and strongylid nematodes (STR). Regression-correlation analysis showed a possible interrelation of BCS with EIM infection. Analysis of muscle and fat reserves indicated that BT was better than MLTL in identifying EIM infection. Goat nutritional status was not significantly correlated with STR infection. A linear tendency (p = 0.092), however, was detected for the response of MLTL to STR infection. Results of this study indicated theoretical use of BCS for Eimeria identification and suggested some perspective of BCS for targeting animals infected by strongylid nematode. Validity of our results, however, was limited by number of observed animals managed under specific breeding conditions.

Prevalence and Factors Associated with Ectoparasite Infestations in Dogs from the State of Tabasco, Mexico.

This study was carried out to identify the ectoparasites that infest owned dogs in the state of Tabasco, Mexico. In total, 1,302 dogs were sampled in the 5 ecological regions of Tabasco. The dog owners were surveyed to identify the factors associated with infestations. Ectoparasites were identified using taxonomic keys. Eleven species of ectoparasites were observed. General prevalence was 26.65%. Rhipicephalus sanguineus and Ctenocephalides felis were the most prevalent and abundant ectoparasites. The most important factors associated with ectoparasite infestations in the studied dogs were living outdoors, being a non-purebred, having short hair, being dark-haired, and having a body condition <3. Ectoparasite studies such as the one presented herein generate important information to create control programs focused on decreasing infestations in companion animals and thus the likelihood of zoonotic transmission of pathogens.

Seroprevalence of zika virus in a cattle flock

The present research evaluated the seroprevalence of anti-zika virus (anti-ZIKV) antibodies by virus neutralization test (VNT) in 529 bovines from Andradina city, São Paulo state, Brazil. The reading was performed in an inverted optical microscope, considering reagents when the antibodies were capable to neutralize the ZIKV. Of the 529 samples, 53 (10.01%) were reagents. The animals were healthy at the time of collection. The samples were collected in February 2018, a favorable period for the multiplication of the vector and the highest risk of disease transmission. None of the animals showed anti-bovine viral diarrhea virus (anti-BVDV) antibodies, ruling out a possible cross-reaction, reinforcing the possible contact of the bovine with the ZIKV. In the herd, 88 pregnant females were evaluated; of these, 12 cows were reactive, with no history of reproductive problems or fetal malformations. This is the first research on the seroprevalence of ZIKV in cattle in Brazil, and studies should continue to evaluate cattle as a possible host of this arbovirus and its possible consequences for unique health and agribusiness.

Dirofilaria immitis proteins recognized by antibodies from individuals living with microfilaremic dogs.

INTRODUCTION: Dirofilaria immitis is a nematode that affects human health in several countries of the world. This study was conducted to examine whether serum samples from the owners of microfilaremic dogs present immunoreactivity to parasite proteins. METHODOLOGY: Eight serum samples from the owners of microfilaremic dogs were examined. Total proteins were extracted from adult worms and 12% SDS-PAGE was performed. The gel was electroblotted to a nitrocellulose membrane, and a Western blot (WB) was performed. Reactive bands of 22, 33, 39, 49, and 63 kDa in WB were excised from the gel and analyzed by mass spectrometry (MS). RESULTS: The MS results showed the presence of 10 different proteins of D. immitis recognized by the human serum samples. CONCLUSIONS: These results indicate that in endemic areas of D. immitis, owners of infected dogs recognize specific proteins of the parasite, suggesting a possible infection.

Factores de riesgo para la malignidad de los pólipos vesiculares en dos hospitales públicos de Perú / Risk factors for gallbladder polyp malignancy in two public hospitals of Peru

Resumen Introducción: los pólipos de vesícula biliar, benignos y malignos, en la mayoría de pacientes tienen un diagnóstico generalmente incidental; a través de estudios de imágenes, que no se pueden distinguir con precisión según su grado de malignidad. Objetivo: determinar los factores de riesgo para la malignidad de los pólipos vesiculares en dos hospitales públicos peruanos. Metodología: estudio de cohorte retrospectiva, de datos secundarios, en colecistectomizados del 2004 al 2012 en un hospital de Lima y otro de Callao. Se definió como pólipo maligno según el tipo histopatológico de adenocarcinoma. Se obtuvieron los riesgos relativos y sus intervalos de confianza del 95 % (IC 95 %). Además, mediante curvas ROC (característica operativa del receptor), se obtuvieron la sensibilidad y especificidad según el tamaño de pólipo. Resultados: de las 368 biopsias, 26 (7 %) fueron adenocarcinomas. La mediana del tamaño de los pólipos fue de 4 mm (rango: 1-65 mm), 176 (51 %) tuvieron múltiples pólipos y 85 (23 %) tuvieron litiasis biliar asociada. En el análisis multivariado, se incrementó el riesgo de malignidad por cada milímetro del tamaño del pólipo en 26 % (IC 95 %:14 %-40 %, valor p < 0,001) y del tamaño de la pared vesicular en 182 % (IC 95 %:46 %-445 %, valor p: 0,002), ajustados por la edad del paciente, la litiasis y el tamaño vesicular. Para un tamaño de 6 mm se tuvo una sensibilidad de 81 % y especificidad del 85 %. Conclusión: se concluye que el tamaño del pólipo y el grosor de la pared vesicular estuvieron asociados con la malignidad de pólipos vesiculares.

Abstract Introduction: In most patients, gallbladder polyps, both benign and malignant, are usually an incidental finding. However, imaging studies cannot accurately establish their degree of malignancy. Objective: To determine the risk factors for gallbladder polyp malignancy in two Peruvian public hospitals. Methodology: Retrospective cohort study conducted on secondary data from patients who underwent cholecystectomy between 2004 and 2012 in Lima and another in Callao, Peru. The malignancy of the polyp was established according to the histopathological type of adenocarcinoma. Relative risks and their 95% confidence intervals (95%CI) were obtained. Moreover, ROC curves were used to determine sensitivity and specificity according to the size of the polyp. Results: Of 368 biopsies, 26 (7%) were adenocarcinomas. The median size of the polyps was 4mm (range: 1-65mm). 176 patients (51%) had multiple polyps, and 85 (23%) had associated gallstones. Multivariate analysis showed that the risk of malignancy increased by 26% (95%CI:14-40%, p-value:<0.001) per millimeter of polyp size and by 182% (95%CI:46-445%, p-value=0.002) based on vesicular wall size, adjusted for patient age, lithiasis and vesicular size. For a size of 6mm, sensitivity was 81%, and specificity was 85%. Conclusion: The size of the polyp and the thickness of the vesicular wall are associated with the malignancy of vesicular polyps.

Rickettsia parkeri (Rickettsiales: Rickettsiaceae) detected in Amblyomma maculatum ticks collected on dogs in Tabasco, Mexico.

The present study was carried out to identify Rickettsia species with zoonotic potential in ticks collected from dogs in a rural area in Tabasco, Mexico. In total 197 Amblyomma maculatum ticks were collected from 40 domestic dogs. The collected specimens were pooled and subjected to DNA extraction. A fragment (380 bp) of citrate synthase gene (gltA) was amplified by polymerase chain reaction (PCR) using universal primers for Rickettsia. A second PCR was later performed to amplify a fragment (420 bp) of the outer membrane protein B gene (ompB). The PCR products were purified, sequenced and compared using the basic local alignment search tool (BLAST). Twenty out of 40 (50%) tick pools assayed were positive for rickettsial DNA using both primer pairs. The consensus sequence obtained from the ompB gene fragments showed 99.5-100% of identity with strains of Rickettsia parkeri. This study provides the first molecular evidence of the presence of R. parkeri in A. maculatum ticks infesting domestic dogs from southeastern Mexico. Close contact between dogs and humans should lead to consider the infection caused by this species of Rickettsia among the differential diagnoses for people of Tabasco, Mexico, who show acute febrile syndrome associated to inoculation eschar and have a clinical history of tick exposure.

Factores asociados a sobrepeso y obesidad en trabajadores de Piura-Perú / Factors Associated With Overweight And Obesity In Workers Of Piura-Peru

Introducción: La obesidad es un problema de salud pública, la cual afecta también al sector laboral. Objetivo: Determinar los factores asociados a sobrepeso y obesidad en trabajadores de Piura.Métodos: Estudio transversal analítico, usando una base de datos secundarios. Se emplearon losregistros de los exámenes ocupacionales tomados a trabajadores de empresas en Sechura ­ Piura.La variable principal fue la clasificación según IMC (normal/sobrepeso/obesidad). Se presentaron losresultados descriptivos y se encontró la asociación entre el tipo de IMC y las otras variables. Resultados:De los 1 203 trabajadores el 93,2%(1 121) fueron varones, con una mediana de 31 años (rango: 18 a 63años). Se encontró diferencia significativa entre el IMC con respecto a diámetro de cintura, diámetro decadera, hemoglobina, colesterol, triglicéridos, HDL, LDL y glucosa. Además del sexo, la edad y el tipode examen (de entrada/periódico/retiro). El estudio no mostró diferencias significativas con respectoal lugar de nacimiento o residencia. Conclusión: Se encontró diferencias en todos los parámetros fisio-antropométricos evaluados, pero no según el lugar de nacimiento/residencia, lo que nos indica que lavigilancia ocupacional en este grupo no debe basarse en sus características demográficas, debiendogenerarse programas laborales para tratar de mejorar la salud global.

Introduction: Obesity is a public health problem, which also affects the worksector. Objective: Determine the factors associated with overweight and obesity inPiura workers. Methods: A cross-sectional study, using secondary database. Weused the occupational exam records of workers of companies in Sechura ­ Piura.The main variable was the BMI classification (normal/overweight/obese).Descriptive results and the association between the type of BMI and othervariables were presented. Results: Of the 1203 workers who met the selectioncriteria, 93.2% (1121) were male, and had a median age of 31 (range: 18-63).Significant difference between BMI with respect to waist circumference, hipdiameter, hemoglobin, cholesterol, triglycerides, HDL, LDL and glucose was found.In addition to gender, age and type of test (entrance/periodic/retirement). The studyshowed no significant differences from the place of birth or residence. Conclusions: There were differences in all the physio-anthropometric parametersevaluated with respect to BMI, except birthplace/residence, which shows that therisk of the working population should not be assessed by these demographiccharacteristics. Work programs to improve global health should be generated.

Factores asociados a la variación de valores espirométricos en trabajadores a gran altura / Factors associated with variation in spirometric values in workers at high altitude

OBJETIVO: Determinar la variación temporal de los valores espirométricos según la altitud geográfica de la sede laboral en un grupo de trabajadores de una minera. MATERIAL Y MÉTODOS: Estudio longitudinal que usó los valores de espirometría tomados en varios años a trabajadores de dos sedes, una a nivel del mar y otra en gran altura de la serranía peruana. Se usó los valores del volumen espiratorio forzado al primer segundo (VEF1), la capacidad vital forzada (CVF) e índice TIffeneau (VEF1/CVF). Se analizó con modelos que permiten ajustar por el tiempo (PA-GEE), con familia Gaussian, función de enlace identity y modelos robustos, la variable tiempo fue el año de la toma de espirometría. Se encontró los valores p y signos de coeficiente en cada caso. RESULTADOS: De 1349 registros el 86% (1162) fueron varones, la mediana de las edades fue 35 años (rango intercuartílico: 22-66 años). En el análisis multivariado se encontró que hubo una variación en los valores del VEF1 y CVF, estos aumentaron en los hombres, entre los que tenían mayor estatura y en los operarios, pero disminuyeron conforme aumentaba la edad del trabajador. El índice TIffeneau únicamente disminuía según la edad del trabajador, ajustado por todas las variables mencionadas. CONCLUSIONES: Según lo analizado, el cambio en los valores espirométricos está influido por las variables socio-antropométricas y el tipo de trabajo que realizan. Esto debe ser aplicado para el seguimiento de trabajadores que estén expuestos a condiciones similares, como parte de programas de vigilancia ocupacional

OBJECTIVE: To determine the temporal variation in spirometric values according to the geographical altitude of labor location on a group of mining workers. MATERIAL AND METHODS: A longitudinal study using spirometry values of workers taken several years at two locations, one at sea level and another at high altitude in the Peruvian highlands. The values of forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and Tiffeneau index (FEV1/FVC) were used. It were analyzed with models that adjust for time (PA-GEE), with Gaussian family, identity link function and robust models, the time variable was the year of spirometry take. P value and coefficients were used in each case. RESULTS: From 1349 records, 86% (1162) were male, the median age was 35 years (interquartile range: 22-66). In multivariate analysis we found that there was a variation in the values of FEV1 and FVC, these increased in men, among those with greater stature and operators, but decreased with increasing age of the worker. The Tiffeneau index decreased only according to age of the worker, adjusted for all variables. CONCLUSIONS: According to these data, the change in spirometric values is influenced by the socio-anthropometric variables and the type of work they do. This must be applied for monitoring of employees who are exposed to similar conditions, as part of occupational surveillance programs

Common errors in dual-energy X-ray absorptiometry scans in imaging centers in Ecuador.

Dual-energy X-ray absorptiometry is recognized for measuring bone mineral density. The lack of knowledge can lead to errors both in the acquisition of information and in its analysis and subsequent interpretation. The main errors in Ecuadorian Centers were positioning of the patient to the equipment and incorrect analyzed area. PURPOSE/INTRODUCTION: Dual-energy X-ray absorptiometry (DXA) is recognized as the gold standard for measuring bone mineral density (BMD) with acceptable errors, good precision, and reproducibility. However, the training of operators in different centers and countries is not standardized, and the lack of knowledge can lead to errors both in the acquisition of information and in its analysis and subsequent interpretation. The purpose was to determine the most common errors in the performance of bone densitometry from different imaging centers in Ecuador. METHODS: Cross-sectional descriptive study. We collected DXA scans from different imaging centers in Ecuador. Data from the DXA scan included city of origin, type of specialist that requested it, and densitometry diagnosis. The DXA images provided were analyzed double blind by experts in the field from Argentina. RESULTS: From a total of 141 patients with a mean age of 61 ± 10 years, 93.6% were women. About 78% of the DXA scans came from private imaging centers and 22% from public centers, 95% of all came from the city of Guayaquil. The machines used were Hologic 50.4% and Lunar 49.6%. The densitometric diagnosis was 16.3% normal, 46.1% osteoporosis, and 37.6% osteopenia. A total of 112 left hip and 49 right hip scans were analyzed from which 31.2% and 22.4% had errors in patient positioning, respectively, mainly internal or external rotation. About 140 lumbar scans were analyzed from which 21.4% had patient positioning errors (not centered or not straight). Also in 38.5% the vertebral area did not correspond to L1-L4. About 3.5% had artifacts such as a metal bar or implant. The region of interest was misplaced in 24.1% of the lumbar scans and 19.9% of the femur. CONCLUSIONS: DXA quality standards exist but are often not implemented in clinical practice. When studies are performed incorrectly, it can lead to important errors in diagnosis and therapy. Physicians interested in the management of osteoporosis, although not directly involved in the performance and interpretation of DXA, should be familiar with the protocols to minimize errors and allow the proper use of bone densitometry.

Factores sociodemográficos y fisiopatológicos asociados a la tuberculosis del sistema nervioso central en un Hospital Público de Lima-Perú, 2014-2017 / Sociodemographic and physiopathological factors associated with tuberculosis of the central nervous system in a Public Hospital of Lima-Peru, 2014-2017

Objetivo: Determinar los factores sociodemográficos y fisiopatológicos de la neurotuberculosis (NTB) en los pacientes registrados en el Programa de Control de la Tuberculosis (PCT) del Hospital Nacional Dos de Mayo. Materiales y Métodos: Se realizó un estudio transversal analítico, desarrollado entre Julio del 2014 y Julio del 2017. Se diseñó una ficha que incluyó datos sociodemográficos, fisiopatológicos y las características al diagnóstico. Se obtuvieron las razones de prevalencia (RP) crudos y ajustados, con intervalos de confianza al 95%. Resultados: Participaron 1038 pacientes. El 16% de toda la población y de 34% de las tuberculosis extra pulmonares tenia NTB. La forma clínica más frecuente fue la meningoencefalitis tuberculosa (MEC TB) (96%). Dentro de las manifestaciones clínicas destacaron las convulsiones (22%), cefalea (20%), signos meníngeos (18%) y trastorno del sensorio (16%). La presencia de NTB estuvo asociada al diagnóstico de VIH (RPa: 2,06; IC95%: 1,53-2,76; Valor p<0,001), condición de alcoholismo (RPa: 1,53; IC95%: 1,04-2,25; Valor p=0,030) y género femenino (RPa: 1,40; IC95%: 1,06-1,84; Valor p=0,019). Conclusiones: El diagnóstico de VIH, condición de alcoholismo y el género femenino son factores asociados a mayor frecuencia de NTB en el Hospital Dos de Mayo.

Objective: To determine the sociodemographic and physiopathological factors of neurotuberculosis (NTB) in the patients registered in the Tuberculosis Control Program (TCP) of the Hospital Nacional Dos de Mayo. Materials and Methods: Analytical cross- sectional study, developed between July 2014 and 2017 July. We designed a card that included data sociodemographic, pathophysiological and the diagnostic characteristics. Were obtained prevalence ratio (RP) raw and adjusted, with 95% confidence intervals. Results: 1038 patients participated. 16% of the entire population and 34% of the extrapulmonary tuberculosis had NTB. The most common clinical form was tuberculous meningoencephalitis (MEC TB) (96%). Within the clinical manifestations emphasized the seizures (22%), headache (20%), meningeal signs (18%) and sensory disorder (16%). The presence of NTB was associated with the diagnosis of HIV (aPR: 2.06, 95%CI: 1.53-2.76, P value <0.001), alcoholism (aPR: 1.53, 95%CI: 1.04-2.25, p value = 0.030) and female gender (aPR: 1.40, 95%CI: 1.06-1.84, p value = 0.019). Conclusions: The diagnosis of HIV, condition of alcoholism and the female gender are factors associated with increased frequency of NTB in the Hospital Dos de Mayo.

Variation in phenotypic resistance to gastrointestinal nematodes in hair sheep in the humid tropics of Mexico.

The objective of the study was to evaluate phenotypic resistance against gastrointestinal nematodes in Blackbelly, Pelibuey and Katahdin ewes before pregnancy in the humid tropics of Mexico. Individual faecal and blood samples were taken in 59 Pelibuey, 69 Blackbelly and 73 Katahdin ewes. The egg count per gram of faeces (EPG) of gastrointestinal nematodes (GINs) was determined. The percentage of packed cell volume (PCV) and body condition score (BCS) of each animal were also recorded. The ewes were segregated as susceptible, intermediate or resistant based on the EPG using the quartile method. The data were analysed using the general linear method, and the means between breeds were compared by Tukey's test. The relationships between the EPG, PCV and BCS were evaluated by Spearman correlation. The Katahdin ewes showed the highest EPG counts (3613.6 ± 5649) compared to the Blackbelly and Pelibuey ewes (576.1 ± 1009 and 56.8 ± 187, respectively, P < 0.01). The PCV values between breeds were similar (P > 0.05). The susceptible ewes had the highest EPG counts and the lowest PCV percentage (5069 ± 6404 and 22.8% ± 8.1% respectively) compared to the resistant ewes (P < 0.01). A higher percentage of Katahdin ewes were susceptible compared to the other breeds (P < 0.05). The main GIN species were Haemonchus contortus, Trichostrongylus colubriformis and Cooperia curticei. In conclusion, Katahdin ewes showed susceptibility to GIN compared to Blackbelly and Pelibuey ewes before the pregnancy period in the humid tropics of Mexico.

Molecular detection of Dirofilaria immitis in dogs and mosquitoes in Tabasco, Mexico.

BACKGROUND & OBJECTIVES: Dirofilaria immitis is a filarial nematode that causes heartworm disease in domestic as well as wild canines and felines; and cutaneous or pulmonary infections in humans. The purpose of the study was to estimate the prevalence of D. immitis in domestic dogs in Tabasco, Mexico and to assay mosquitoes temporally and spatially associated with dogs for evidence of infection. METHODS: Blood was collected from 1050 dogs in 1039 houses during a random household survey performed in 2016 and 2017. Genomic DNA was extracted and assayed by polymerase chain reaction (PCR) using pan-filarial primers and various species-specific primers. Dog owners were interviewed using a structured questionnaire designed to collect information on factors that may impact the occurrence of filarial infection. The association between canine dirofilariasis prevalence and factors likely to impact infection was determined by univariate logistic regression analysis, followed by multivariate binomial logistic regression analysis. Indoor and outdoor resting mosquitoes were collected from houses by manual aspiration. Mosquitoes were identified according to species, homogenized and tested by PCR for filarial nematodes. RESULTS: A total of 84 (8%) dogs were positive for D. immitis DNA, while 3 (0.3%) dogs contained Acanthocheilonema reconditum DNA. Several factors were significantly associated with D. immitis infection. For example, dogs that lived <100 m from a large source of open standing water were significantly more likely (p = 0.002) to become infected with D. immitis than other dogs. Additionally, dogs with infrequent or no anthelmintic treatment were significantly more likely (p = 0.0) to become infected than dogs that were regularly treated. The entomologic investigation yielded 2618 female mosquitoes from 14 species. Four pools of Culex quinquefasciatus were positive for D. immitis DNA and the minimum infection rate, calculated as the number of positive pools per 1000 mosquitoes tested, was 2.9. INTERPRETATION & CONCLUSION: The study identified several factors positively associated with an increased risk of D. immitis infection in domestic dogs in Tabasco and provides evidence that Cx. quinquefasciatus is potentially an important vector in this region. This information can be used by local veterinarians and dog owners to reduce the burden of D. immitis on canine health.

Lethal and sub-lethal effects of commonly used anti-sea lice formulations on non-target crab Metacarcinus edwardsii larvae.

The pesticides used by the salmon industry to treat sea lice, are applied in situ via a bath solution and are subsequently discharged into the surrounding medium. The effects of cypermethrin, deltamethrin, azamethiphos and hydrogen peroxide were assessed on the performance of Metacarcinus edwardsii larvae, an important crab for Chilean fishery. All larvae were dead or dying after 30 min of exposure to cypermethrin and after 40 min to deltamethrin at concentrations 100 and 20 times lower (0.15 and 0.1 µg L-1, respectively) than the concentrations and exposure times recommended by the manufacturers (CRM) to treat sea lice. Azamethiphos affected all larvae at a concentration 10 times lower than CRM. Hydrogen peroxide had the lowest detrimental effects, but at the CRM, 100% of the larvae were affected. Sub-lethal effects, i.e prolonged developmental time, were observed at concentrations lower than CRM. Repeated exposure to azamethiphos (0.0625-0.5 µg L-1) and hydrogen peroxide (188-1500 mg L-1) had effects on survival. In conclusion, the pesticides used against parasitic copepod tested here, negatively affect non-target crustacean larvae. Due to the product's characteristics, the lethal effects of the pyrethroids probably are restricted to the time and area of application, while the action of azamethiphos may extend to a wider area. Current data are insufficient to accurately dimension the effects of these compounds in the field. More research is required to evaluate the consequences of prolonged developmental times and/or reduction in appendage mobility, so as the effects of these compounds on the pelagic and benthic communities.