Clinical and Epidemiological Characteristics of Patients Being Treated for Scabies in Spain: Opportunities for Improvement - A Multicenter Cross-Sectional CLINI-AEDV Study. / Características clínicas y epidemiológicas de pacientes diagnosticados de escabiosis en España: oportunidades de mejora. Estudio transversal multicéntrico CLINI-AEDV.

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had typical scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of the cases of scabies studied, the patient had already received treatment. In those cases, we observed several remediable shortcomings that could explain why some of these treatments had failed. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.

[Translated article] Clinical and Epidemiological Characteristics of Patients Being Treated for Scabies in Spain: Opportunities for Improvement - A Multicenter Cross-Sectional CLINI-AEDV Study.

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had clinical features of classic scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of scabies cases, the patient has already received treatment. In those cases, we observe several remediable shortcomings that could explain why some of these treatments fail. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.

Comparación de la Concentración de Hipoclorito de Sodio en la Atención Dental entre Dentistas Generales y Especialistas en Endodoncia / Comparison of the concentration of sodium hypochlorite used in dental care of general dentists and specialists in endodontics

La vida útil de hipoclorito de sodio (NaOCl) es limitada, varios estudios señalan la posibilidad de discrepancias entre la concentración esperada y la concentración real en soluciones de NaOCl usadas como irrigantes endodónticos. El presente estudio investigó si existe alguna diferencia en la concentración usada por endodoncistas y dentistas generales. La solución de NaOCl es hasta la fecha, la solución de irrigación del canal radicular más utilizado, pero no existe un acuerdo general en cuanto a su concentración óptima, que varía desde 0,5 % a 5,25 %. Este estudio fue analítico experimental. El tamaño muestral fue por conveniencia. Los sujetos estudiados fueron especialistas en endodoncia y dentistas generales que se desempeñan tanto en la atención pública como privada, en la ciudad de Santiago de Chile. Participaron del estudio de manera voluntaria, para lo cual llenaron un consentimiento informado y completaron una encuesta previamente validada. Cada sujeto aportó una muestra de la solución de hipoclorito de sodio que utilizaba en su práctica clínica. Las muestras fueron recolectadas en recipientes plásticos oscuros y fueron almacenadas sin estar expuestas a la luz y refrigeradas hasta su análisis. Para el análisis de laboratorio se usó espectrofotometría, el análisis estadístico se emplearon los Test de Student y Fischer para medir si existían diferencias entre las concentraciones de hipoclorito de sodio utilizadas por endodoncistas y dentistas generales. (AU)

The shelf life of sodium hypochlorite (NaOCl) is limited, several studies point out the possibility of discrepancies between the expected concentration and the actual concentration in NaOCl solutions used as endodontic irrigants. The present study investigated whether there is any difference in the concentration used by endodontists and general dentists. NaOCl solution is to date the most widely used root canal irrigation solution, but there is no general agreement as to its optimal concentration, which varies from 0.5% to 5.25%. This study was analytical experimental. The sample size was for convenience. The subjects studied were specialists in endodontics and general dentists who work in both public and private care, in the city of Santiago de Chile. They participated in the study voluntarily, for which they filled out an informed consent and completed a previously validated survey. Each subject provided a sample of the sodium hypochlorite solution used in their clinical practice. The samples were collected in dark plastic containers and were stored without being exposed to light and refrigerated until analysis. For the laboratory analysis, spectrophotometry was used, for statistical analysis the Student and Fischer tests were used to measure whether there were differences between the concentrations of sodium hypochlorite used by endodontists and general dentists. (AU)

Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation / Adaptación cultural y validación de la versión española del Teenagers’ Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel

Background Teenagers’ Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. Methods A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019–May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. Results Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test–retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. Conclusion Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases (AU)

Antecedentes Teenagers’ Quality of Life (T-QoL) es un cuestionario de calidad de vida específico para adolescentes con enfermedades cutáneas. Hasta el momento, no existe ningún método validado para este fin en español, por lo que presentamos la traducción, adaptación cultural y validación del T-QoL al español. Método Se diseñó un estudio prospectivo con 133 pacientes (entre 12-19 años), atendidos en el Servicio de Dermatología del Hospital Universitario de Toledo, España (septiembre 2019-mayo 2020). Para la traducción y adaptación cultural se utilizaron las guías de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR). Se evaluó la validez convergente con el Índice de Calidad de Vida en Dermatología (DLQI), el Índice de Calidad de Vida en Dermatología Infantil (CDLQI) y con una Pregunta Global (GQ) sobre la gravedad de la enfermedad autoevaluada. También se analizó la consistencia interna y la fiabilidad de la herramienta T-QoL, y se confirmó su estructura con un análisis factorial. Resultados Las puntuaciones globales de T-QoL se correlacionaron significativamente con el DLQI y el CDLQI (r=0,75) y con la GQ (r=0,63). El análisis factorial mostró un ajuste óptimo para el modelo bifactorial y un ajuste adecuado para el modelo de 3 factores correlacionado. Los indicadores de fiabilidad fueron altos (α de Cronbach=0,89; índice Lambda 6 de Guttman=0,91; Omega ω=0,91) y el test-retest mostró una alta estabilidad (ICC=0,85). Los resultados fueron consistentes con los encontrados por los autores de la prueba original. Conclusiones La versión española del T-QoL es un cuestionario válido y fiable para evaluar la calidad de vida de adolescentes hispanohablantes con enfermedades cutáneas (AU)

[Artículo Traducido] Traducción, adaptación cultural y validación de la versión española del Teenagers’ Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel / Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation

Antecedentes Teenagers’ Quality of Life (T-QoL) es un cuestionario de calidad de vida específico para adolescentes con enfermedades cutáneas. Hasta el momento, no existe ningún método validado para este fin en español, por lo que presentamos la traducción, adaptación cultural y validación del T-QoL al español. Método Se diseñó un estudio prospectivo con 133 pacientes (entre 12-19 años), atendidos en el Servicio de Dermatología del Hospital Universitario de Toledo, España (septiembre 2019-mayo 2020). Para la traducción y adaptación cultural se utilizaron las guías de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR). Se evaluó la validez convergente con el Índice de Calidad de Vida en Dermatología (DLQI), el Índice de Calidad de Vida en Dermatología Infantil (CDLQI) y con una Pregunta Global (GQ) sobre la gravedad de la enfermedad autoevaluada. También se analizó la consistencia interna y la fiabilidad de la herramienta T-QoL, y se confirmó su estructura con un análisis factorial. Resultados Las puntuaciones globales de T-QoL se correlacionaron significativamente con el DLQI y el CDLQI (r=0,75) y con la GQ (r=0,63). El análisis factorial mostró un ajuste óptimo para el modelo bifactorial y un ajuste adecuado para el modelo de 3 factores correlacionado. Los indicadores de fiabilidad fueron altos (α de Cronbach=0,89; índice Lambda 6 de Guttman=0,91; Omega ω=0,91) y el test-retest mostró una alta estabilidad (ICC=0,85). Los resultados fueron consistentes con los encontrados por los autores de la prueba original. Conclusiones La versión española del T-QoL es un cuestionario válido y fiable para evaluar la calidad de vida de adolescentes hispanohablantes con enfermedades cutáneas (AU)

Background Teenagers’ Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. Methods A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019–May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. Results Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test–retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. Conclusion Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases (AU)

Spanish Version of Teenagers' Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation. / [Artículo Traducido] Traducción, adaptación cultural y validación de la versión española del Teenagers' Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel.

BACKGROUND: Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS: A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS: Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r = 0.75) and with the GQ (r = 0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α = 0.89; Guttman's Lambda 6 index = 0.91; Omega ω = 0.91) and test-retest showed a high stability (ICC = 0.85). The results were consistent with those found by the authors of the original test. CONCLUSION: Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.

Spanish Version of Teenagers' Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation.

BACKGROUND: Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS: A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS: Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test-retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. CONCLUSION: Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.

Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases.

BACKGROUND: Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are poorly characterized. OBJECTIVE: To describe and classify cutaneous reactions after SARS-CoV-2 vaccination. METHODS: A nationwide Spanish cross-sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face-to-face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. RESULTS: From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer-BioNTech; 40·2%), mRNA-1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site ('COVID arm', 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea-like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA-1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer-BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA-1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. CONCLUSIONS: Cutaneous reactions after SARS-CoV-2 vaccination are heterogeneous. Most are mild-to-moderate and self-limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients.

Modulation of intracellular pH in human ovarian cancer.

To sustain tumor growth, the cancer cells need to adapt to low levels of oxygen (i.e., hypoxia) in the tumor tissue and to the tumor-associated acidic microenvironment. In this phenomenon, the activation of the sodium/proton exchanger 1 (NHE1) at the plasma membrane and the hypoxia-inducible factor (HIF) are critical for the control of the intracellular pH (pHi) and for hypoxia adaptation, respectively. Interestingly, both of these mechanisms end in sustaining cancer cell proliferation. However, regulatory mechanisms of pHi in human ovary tissue and in malignant ascites are unknown. Additionally, a potential role of NHE1 in the modulation of H(+) efflux in human ovarian cancer cells is unknown. In this review, we discussed the characteristics of tumor microenvironment of primary human ovarian tumors and tumor ascites, in terms of pHi regulatory mechanisms and oxygen level. The findings described in the literature suggest that NHE1 may likely play a role in pHi regulation and cell proliferation in human ovarian cancer, potentially involving HIF2α activation. Since ovarian cancer is the fifth cause of prevalence of women cancer in Chile and is usually of late diagnosis, i.e., when the disease jeopardizes peritoneal cavity and other organs, resulting in reduced patient survival, new efforts are required to improve patient-life span and for a better understanding of the pathophysiology of the disease. The potential advantage of the use of amiloride and amiloride-derivatives for cancer treatment in terms of NHE1 expression and activity is also discussed as a therapeutic approach in human ovarian cancer.

Deep sequencing in library selection projects: what insight does it bring?

High throughput sequencing is poised to change all aspects of the way antibodies and other binders are discovered and engineered. Millions of available sequence reads provide an unprecedented sampling depth able to guide the design and construction of effective, high quality naïve libraries containing tens of billions of unique molecules. Furthermore, during selections, high throughput sequencing enables quantitative tracing of enriched clones and position-specific guidance to amino acid variation under positive selection during antibody engineering. Successful application of the technologies relies on specific PCR reagent design, correct sequencing platform selection, and effective use of computational tools and statistical measures to remove error, identify antibodies, estimate diversity, and extract signatures of selection from the clone down to individual structural positions. Here we review these considerations and discuss some of the remaining challenges to the widespread adoption of the technology.

Tungiasis: una rara ectoparasitosis. Caso clínico / Tungiasis: Report of one case

We report a 54-year-old male that, after working in a rural zone of Rio de Janeiro, Brazil, presented with an itching cutaneous lesion in the wrist with a black small central zone. The patient extracted from the lesion a on of 0.5 mm diameter. The pathological study of the insect recognized its body segments. The epidemiological background and the characteristics of the lesion led to the diagnosis of tungiasis.

[Tungiasis. Report of one case]. / Tungiasis: una rara ectoparasitosis. Caso clínico.

We report a 54-year-old male that, after working in a rural zone of Rio de Janeiro, Brazil, presented with an itching cutaneous lesion in the wrist with a black small central zone. The patient extracted from the lesion a on of 0.5 mm diameter. The pathological study of the insect recognized its body segments. The epidemiological background and the characteristics of the lesion led to the diagnosis of tungiasis.

Prevalencia de norovirus como agente etiológico de gastroenteritis en niños venezolanos / Prevalence of norovirus like gastroenteritis etiologic agent in venezuelan children

Las gastroenteritis representan una causa importante de morbimortalidad en el mundo y en Venezuela. Su etioligía en infantes es principalmente viral, encontrando a los Norovirus como agentes asociados. Considerando la escasa documentación al respecto, se realizó este estudio para evaluar la prevalencia de Norovirus en niños de 0 a 10 años con diarrea aguda que acudieron a la Policlínica Metropolitana en Caracas; verificando su asociación con otros factores etiológicos y demográficos. 102 muestras fecales fueron sometidas al análisis bacteriológico, parasitológico y viral, utilizando para la detección de Norovirus un ensayo ELISA RIDASCREEN Norwalk-like-Virus. Al análisis estadístico incluyó los índices O. R, y Chi Cuadrado para analizar las frecuencias de los agentes etiológicos, permitiendo además verificar si la diarrea por Norovirus era Independiente de otros patogénos, del sexo y grupos etareos. Se utilizó Excel y el paquete estadístico SPSS 1.0. Los resultados sugirieron que el riesgo de diarrea por Norovirus se sextuplicó en los niños de 1-2 años en comparación con los mayores a 5 años (O.R 5,8842 p:0,0070;x210,879 p:0,012). En los casos positivos, la prevalencia de Norovirus fue del 68,9% y 30% de ellos presentó coinfección con otros patógenos, pero la asociación no fue significativa (p>0,05). Considerando los casos de diarrea que quedan sin diagnósticar, sería lógico pensar que Norovirus circularía con una lata frecuencia en Venezuela, ya que la prevalencia fue superior a la resprtada en otras poblaciones (39,2% vs 5-33%). El impacto de las infecciones por Norovirus en Venezuela se desconece completamente y debe ser estudiado con mayor profundidad.

Gastroenteritis is a very important cause of mobility and mortality in Venezuela and the rest of the World. Their etiology on children is mainly caused by viruses, including Norovirus. Considering the lack of related documentarion in Venezuela, we performed a study in order to calculate the prevalence of Norovirus on children betwen 0 to 10 years old, with acute diarrhea treated on the Policlinica Metropolitna, Caracas; also we analyzed his association with other etiological and demographic factors. 102 stool samples were tested for bacteria parasitic and viruses. For Norovirus we used the ELISA RIDASCREEN Norwalk-like-Virus, (r-biopharm, Germany). The statistical calculations included O.R. and Chi Square ratios, in order to analyze the frequency of the different etiological agents and also to verify if the diarrheas for Norovirus were independent from other pathogenic agents, sex or age groups. We used Excel and SPSS 1.0 software for statistical calculations. The results suggested that the risk of getting a diarrhea caused for Norovirus was 6 times higher on children from 1 to 2 years old than those older that five years old. (OR 5,8842 p:0,0070;x210,879p:0,012) The prevalence for Norovirus was 68,9% and 30% of them presented simultaneous infection with other pathogenic agents, but this association wasn't significative (p>0,05). Considering the high number of diarrhea cases that lack of a proper etiological diagnostic, it's possible that the Norovirus are circulating with a high frequency in Venezuela, due the prevalence reported on this study is above the reported in other population studies (39,2% vs 5-33%). The actual impact of Norovirus in Venezuela is still unknown and must be study with more detail.

Seroprevalencia de anticuerpos anti Helicobacter pylori en personal de la sección gastroenterología del hospital clínico de la Universidad de Chile / Seroprevalence of antibodies against Helicbacter pylori in personnel working in the gastroenterology section of the clinical hospital of the University of Chile

Introduction: Helicobacter Pylori (Hp), a bacterium that colonizes gastric mucosa, is considered an important pathogen in some forms of histological gastritis, gastric and duodenal ulcers and a risk factor for gastric adenocarcinoma and lymphoma. Means of transmission are the oro-oral and feco-oral routers. Infection could be acquired by contamination with products as saliva, vomits, aerosols or feces from people colonized by the bacterium. Aim: was to study the seroprevalence of antibodies against Helicobacter Pylori in personnel working in the gastroenterology section of the clinical hospital of the University of Chile. Material and methods: the study included physicians that perform endoscopic procedures, technical assistants for them and laboratory personnel. Anti-Hp antibodies were determined with an ELFA (fluorescent immunoassay) method. Results: the group was formed by 35 persons, being 19 males and 16 females and 26 (74 percent) were anti-Hp positive, among them 14/19 (78 percent) males and 12/16 (75 percent) females, without difference. No difference was found in endoscopy 18/24 (73 percent) or extraendoscopy 8/11 (75 percent) personnel, or professionals (68 percent) and non professional assistants (90 percent). Conclusion: prevalence of antibodies against Hp is high in our section (74 percent) in accordance with what has been found in other studies in our population.

Antecedentes: el Helicobacter pylori (Hp) es una bacteria que coloniza principalmente la mucosa gástrica y desempeña un rol etiopatogénico importante en algunas formas de gastritis, ulceraciones gastro-duodenales y es además un factor de riesgo de padecer adenocarcinoma y linfoma gástrico. Se ha postulado que la vía de contagio principal seria, oral-oral o fecal-oral. Existiría un riesgo de adquirir la infección al estar en contacto con secreciones orales, aerosoles, vómitos o deposiciones de sujetos colonizados con la bacteria. El propósito de la siguiente investigación fue estudiar la seroprevalencia de anticuerpos anti Helicobacter pylori en la sección de gastroenterología del hospital clínico de la Universidad de Chile. Material y métodos: el grupo de estudio estuvo formado por los médicos que realizan endoscopias, el personal técnico de apoyo a este procedimiento y el personal del laboratorio clínico de la sección gastroenterología. Los anticuerpos anti-Helicobacter pylori se analizaron empleando la técnica ELFA, (inmunoensayo de fluorescencia), Resultados: se estudiaron 35 personas, 19 hombres y 16 mujeres. Veintiséis sujetos (74 por ciento) tuvieron anticuerpos anti Hp positivos. No se encontró diferencia según sexo, siendo positivos 14/19 hombres y 12/16 mujeres, 78 y 75 por ciento, respectivamente. Tampoco se encontró diferencia entre los que trabajan en área de endoscopia o extraendoscopia, 18/24 y 8/11, 73 y 75 por ciento, respectivamente, ni entre los profesionales 68 por ciento y ayudantes 90 por ciento. Conclusión: la presencia de anticuerpos anti Hp fue altamente prevalente en nuestra sección (74 por ciento) aunque concordante con las cifras de infección que se manejan a nivel poblacional.

Lysine is catabolized to 2-aminoadipic acid in Penicillium chrysogenum by an omega-aminotransferase and to saccharopine by a lysine 2-ketoglutarate reductase. Characterization of the omega-aminotransferase.

The biosynthesis and catabolism of lysine in Penicillium chrysogenum is of great interest because these pathways provide 2-aminoadipic acid, a precursor of the tripeptide delta-L-2-aminoadipyl-L-cysteinyl-D-valine that is an intermediate in penicillin biosynthesis. In vivo conversion of labelled L-lysine into two different intermediates was demonstrated by HPLC analysis of the intracellular amino acid pool. L-lysine is catabolized to 2-aminoadipic acid by an omega-aminotransferase and to saccharopine by a lysine-2-ketoglutarate reductase. In lysine-containing medium both activities were expressed at high levels, but the omega-aminotransferase activity, in particular, decreased sharply when ammonium was used as the nitrogen source. The omega-aminotransferase was partially purified, and found to accept L-lysine, L-ornithine and, to a lesser extent, N-acetyl-L-lysine as amino-group donors. 2-Ketoglutarate, 2-ketoadipate and, to a lesser extent, pyruvate served as amino group acceptors. This pattern suggests that this enzyme, previously designated as a lysine-6-aminotransferase, is actually an omega-aminotransferase. When 2-ketoadipate is used as substrate, the reaction product is 2-aminoadipic acid, which contributes to the pool of this intermediate available for penicillin biosynthesis. The N-terminal end of the purified 45-kDa omega-aminotransferase was sequenced and was found to be similar to the corresponding segment of the OAT1 protein of Emericella (Aspergillus) nidulans. This information was used to clone the gene encoding this enzyme.

Expression of cefD2 and the conversion of isopenicillin N into penicillin N by the two-component epimerase system are rate-limiting steps in cephalosporin biosynthesis.

The conversion of isopenicillin N into penicillin N in Acremonium chrysogenum is catalyzed by an epimerization system that involves an isopenicillin N-CoA synthethase and isopenicillin N-CoA epimerase, encoded by the genes cefD1 and cefD2. Several transformants containing two to seven additional copies of both genes were obtained. Four of these transformants (TMCD26, TMCD53, TMCD242 and TMCD474) showed two-fold higher IPN epimerase activity than the untransformed A. chrysogenum C10, and produced 80 to 100% more cephalosporin C and deacetylcephalosporin C than the parental strain. A second class of transformants, including TMCD2, TMCD32 and TMCD39, in contrast, showed a drastic reduction in cephalosporin biosynthesis relative to the untransformed control. These transformants had no detectable IPN epimerase activity and did not produce cephalosporin C or deacetylcephalosporin C. They also expressed both endogenous and exogenous cefD2 genes only after long periods (72-96 h) of incubation, as shown by Northern analysis, and were impaired in mycelial branching in liquid cultures. The negative effect of amplification of the cefD1 - cefD2 gene cluster in this second class of transformants is not correlated with high gene dosage, but appears to be due to exogenous DNA integration into a specific locus, which results in a pleiotropic effect on growth and cefD2 expression.

Conversion of pipecolic acid into lysine in Penicillium chrysogenum requires pipecolate oxidase and saccharopine reductase: characterization of the lys7 gene encoding saccharopine reductase.

Pipecolic acid is a component of several secondary metabolites in plants and fungi. This compound is useful as a precursor of nonribosomal peptides with novel pharmacological activities. In Penicillium chrysogenum pipecolic acid is converted into lysine and complements the lysine requirement of three different lysine auxotrophs with mutations in the lys1, lys2, or lys3 genes allowing a slow growth of these auxotrophs. We have isolated two P. chrysogenum mutants, named 7.2 and 10.25, that are unable to convert pipecolic acid into lysine. These mutants lacked, respectively, the pipecolate oxidase that converts pipecolic acid into piperideine-6-carboxylic acid and the saccharopine reductase that catalyzes the transformation of piperideine-6-carboxylic acid into saccharopine. The 10.25 mutant was unable to grow in Czapek medium supplemented with alpha-aminoadipic acid. A DNA fragment complementing the 10.25 mutation has been cloned; sequence analysis of the cloned gene (named lys7) revealed that it encoded a protein with high similarity to the saccharopine reductase from Neurospora crassa, Magnaporthe grisea, Saccharomyces cerevisiae, and Schizosaccharomyces pombe. Complementation of the 10.25 mutant with the cloned gene restored saccharopine reductase activity, confirming that lys7 encodes a functional saccharopine reductase. Our data suggest that in P. chrysogenum the conversion of pipecolic acid into lysine proceeds through the transformation of pipecolic acid into piperideine-6-carboxylic acid, saccharopine, and lysine by the consecutive action of pipecolate oxidase, saccharopine reductase, and saccharopine dehydrogenase.