Stranding and mass mortality in humboldt penguins (Spheniscus humboldti), associated to HPAIV H5N1 outbreak in Chile.

The highly pathogenic Avian Influenza virus (HPAIV) H5N1 has caused a global outbreak affecting both wild and domestic animals, predominantly avian species. To date, cases of the HPAIV H5 Clade 2.3.4.4b in penguins have exclusively been reported in African Penguins. In Chile, the virus was confirmed in pelicans in December 2022 and subsequently spread across the country, affecting several species, including Humboldt penguins. This study aims to provide an overview of the incidents involving stranded and deceased Humboldt penguins and establish a connection between these events and HPAIV H5N1. Historical data about strandings between 2009 and 2023 was collected, and samples from suspected cases in 2023 were obtained to confirm the presence of HPAIV H5N1. Between January and August 2023, 2,788 cases of stranded and deceased penguins were recorded. Out of these, a total of 2,712 penguins deceased, evidencing a significative increase in mortality starting in early 2023 coinciding with the introduction and spreading of HPAIV H5N1 in the country. Thirty-seven events were categorized as mass mortality events, with the number of deceased penguins varying from 11 to 98. Most cases (97 %) were observed in the North of Chile. One hundred and eighty-one specimens were subjected to HPAIV diagnosis, four of which tested positive for HPAIV H5N1. Spatial analysis validates the correlation between mass mortality events and outbreaks of HPAIV in Chile. However, the limited rate of HPAIV H5N1 detection, which can be attributed to the type and quality of the samples, requiring further exploration.

Mass mortality event in South American sea lions (Otaria flavescens) correlated to highly pathogenic avian influenza (HPAI) H5N1 outbreak in Chile.

In Chile, since January 2023, a sudden and pronounced increase in strandings and mortality has been observed among South American (SA) sea lions (Otaria flavescens), prompting significant concern. Simultaneously, an outbreak of highly pathogenic avian influenza H5N1 (HPAIV H5N1) in avian species has emerged since December 2022. To investigate the cause of this unexpected mortality, we conducted a comprehensive epidemiological and pathologic study. One hundred sixty-nine SA sea lions were sampled to ascertain their HPAIV H5N1 status, and long-term stranding trends from 2009 to 2023 were analyzed. In addition, two animals were necropsied. Remarkably, a significant surge in SA sea lion strandings was observed initiating in January 2023 and peaking in June 2023, with a count of 4,545 stranded and deceased animals. Notably, this surge in mortality correlates geographically with HPAIV outbreaks affecting wild birds. Among 168 sampled SA sea lions, 34 (20%) tested positive for Influenza A virus, and 21 confirmed for HPAIV H5N1 2.3.4.4b clade in tracheal/rectal swab pools. Clinical and pathological evaluations of the two necropsied stranded sea lions revealed prevalent neurological and respiratory signs, including disorientation, tremors, ataxia, and paralysis, as well as acute dyspnea, tachypnea, profuse nasal secretion, and abdominal breathing. The lesions identified in necropsied animals aligned with observed clinical signs. Detection of the virus via immunohistochemistry (IHC) and real-time PCR in the brain and lungs affirmed the findings. The findings provide evidence between the mass mortality occurrences in SA sea lions and HPAIV, strongly indicating a causal relationship. Further studies are needed to better understand the pathogenesis and transmission.

Avian orthoavulavirus 1 (Newcastle Disease virus) antibodies in five penguin species, Antarctic peninsula and Southern Patagonia.

Avian orthoavulavirus 1 (AOaV-1) causes Newcastle disease, one of the most important and contagious infections in poultry, where migratory birds can play a key role as a reservoir. Seven hundred and seven serum samples were collected from five penguin species (King, Magellanic, Gentoo, Chinstrap and Adelie penguins) in the Antarctic and Sub-Antarctic zones. Using a competitive ELISA to detect antibodies against AOaV-1, we identified positive individuals in all penguin species. The Magellanic penguin showed the highest seropositivity rate (30.3%), suggesting it could be a natural reservoir of this virus. At the Antarctic zones, Chinstrap penguin showed the highest occurrence (7.5%). Interesting, positive sera was only obtained in Sub-Antarctic and Northern zones at the Antarctic peninsula, no seroreactivity was observed in Southern locations. Further studies are needed to establish the role of these penguin species in the epidemiology of the AOaV-1 and determine the effects of this virus in these populations.

Evaluación de umbrales mínimos de celularidad en unidades de sangre de cordon umbilical en el Instituto Nacional Materno Perinatal del Perú / Evaluation of minimum thresholds of cellularity in units of umbilical cord blood at Instituto Nacional Materno Perinatal in Peru

RESUMEN Con el objetivo de evaluar criterios mínimos de celularidad de las unidades de sangre de cordón umbilical (USCU) según los estándares NETCORD en el Instituto Nacional Materno Perinatal de Lima, Perú, se realizó un estudio transversal que incluyó 100 USCU; se determinó el volumen, el recuento de células nucleadas totales (CNT) por hematología y el número de células CD34+ totales, así como también la viabilidad celular, por citometría de flujo. Se encontró que el 56% de las USCU no cumplen los umbrales mínimos de celularidad para ser criopreservadas en un banco de sangre de cordón umbilical. Se encontró, además, que las USCU de recién nacidos de mayor peso y de sexo femenino presentan mayor volumen y recuentos de células. En conclusión, es necesario considerar estas variables para optimizar la colecta de las USCU y obtener mayores recuentos de células que permita almacenar unidades de alta calidad en un futuro banco de sangre de cordón umbilical en Perú.

ABSTRACT A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.

[Evaluation of minimum thresholds of cellularity in units of umbilical cord blood at Instituto Nacional Materno Perinatal in Peru]. / Evaluación de umbrales mínimos de celularidad en unidades de sangre de cordon umbilical en el Instituto Nacional Materno Perinatal del Perú.

A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.

Reparación del cistocele por vía vaginal con malla subvesical sin tensión: técnica y resultados / Tension-free vaginal mesh repair for anterior vaginal wall prolapse: technique and outcomes

Objetivos: Determinar la eficacia y tolerancia de la interposición de una malla de polipropileno monofilamento colocada sin tensión por vía vaginal bajo la vejiga para la corrección quirúrgica del cistocele, evaluando sus resultados anatómicos postoperatorios, la mejoría en la calidad de vida y sus complicaciones a mediano plazo. Pacientes y Método: El ensayo incluyó a 28 mujeres consecutivas (edad promedio 64 años), portadoras de cistocele grado II o III según la clasificación POP-Q, quienes fueron intervenidas entre septiembre de 2004 y octubre de 2006. Después de una completa disección de la vejiga y plicatura de la fascia perivesical, se labraron 2 túneles laterales hasta perforar la fascia endopélvica a cada lado; luego se configuró la malla de polipropileno monofilamento (Ginemesh®), dimensionada con un cuerpo central y dos ramas laterales, posicionándola sin tensión ni fijación bajo la vejiga, introduciendo y abandonando sus extensiones laterales hacia el espacio paravesical. Del total de la serie, 8 pacientes tenían cistocele G II (29 por ciento) y 20 tenían prolapso G III (71 por ciento); 11 mujeres presentaban además IOE (39 por ciento). El promedio de duración de la cirugía fue de 30 minutos. Como evaluación del resultado anatómico se utilizó la clasificación POP-Q. Para evaluar la satisfacción personal objetiva se usó el cuestionario validado de calidad de vida (I-QOL) al 3º, 6º y 12º mes post cirugía. El promedio de seguimiento fue de 18 meses (10-36).Resultados: La cirugía fue realizada sin problemas en todas las pacientes. La tasa de complicaciones tempranas fue de 7 por ciento (una erosión vaginal y 1 hematoma severo). No se reportó infección de la malla. La tasa de éxito fue de un 93 por ciento. Al sexto mes, el índice de satisfacción en la calidad de vida fue de 89 por ciento, al 12º mes fue de 86 por ciento...

Objectives: To determine the efficacy and tolerance of the introduction of a vaginal tension-free monofilament polypropylene mesh placed under the bladder for the surgical correction of cystocele. Patients and Methods: The trial included 28 consecutive women mean age 64 years), with diagnosis of grade II - III cystocele based on POP-Q classification, who were operated between September2004 and October 2006. Surgical technique include a complete dissection of the bladder and fixation of perivesical fascia. Two laterals tunnels were developed to pierce the lateral side of the endopelvic fascia at either side. Then a designed monofilament polypropylene mesh (Ginemesh ®), was placed without any tension free the bladder, positioning their lateral extensions into paravesical space. We evaluated the postoperative anatomical results, improvement in the quality of life and mid-terms complications. Results: Of the total series, 8 patients had G II cystocele (29 percent) and 20 had G III prolapse (71 percent ), 11women had also SUI (39 percent). Mean operative time for surgery was 30 minutes. Anatomical results were objectively measured with POP-Q classification. Evaluate of personal satisfaction was done by application of a validated questionnaire of quality of life (I-QOL) that was full filled at 3, 6 and 12months post surgery. Mean follow-up of the series was 18 months (10-36). No operative complication occurred. Early complication rate was 7 percent (a vaginal erosion and severe bruising ). No infection was reported in the mesh. The success rate for the series was 93 percent. At the sixth month, the rate of satisfaction in the quality of life was has been 89 percent and 86 percent at 12 months...

Evaluación crítica, interpretación, utilidad y resultados del perfil biofísico ecográfico. Hospital Guillermo Almenara, Lima-Perú / Critical evaluation of the ultrasonographic biophysical, profile score, their interpretation and value. Hospital Guillermo Almenara, Lima Perú

Evaluar en forma crítica la utilidad del perfil biofisico cográfico(PBE) en la evaluación del bienestar fetal, definir con presición sus variables, interpretarlo y proponer un flujograma de manejo de valoración del bienestar fetal, definir con precisión sus variables, interpretarlo y proponer un flujograma de manejo de valoración del bienestar fetal de acuerdo al puntaje obtenido en la prueba. Materiales y Métodos: Estudio observacional, prospectivo y ciego en el Servicio de Obstetricia de Alto riesgo del Hospital Guillermo Almenara-EsSalud en Lima, desde octubre de 1997 a setiembre de 1998. Se incluyo a 120 pacientes con edad gestacional > 28 semanas, cuyo estado requeria valoración del bienestar fetal y decisión de culminar el embarazo en forma oportuna. Durante la prueba se evaluó la dificultad y beneficios de medir ultrasonograficamente la frecuencia cardíaca fetal basal y la reactividad cardíaca; la utilidad de establecer un puntaje crítico de la prueba que defina una población en riesgo. Resultados: la aplicación de esta estrategia reveló una alta sensibilidad 87.5 por ciento de l aprueba, un buen valor predictivo positivo 63.6 por ciento y disminución importante del índice de falsos positivos y negativos 36.3 y 2.0 por ciento respectivamente. Conclusiones: Al establecer un flujograma de evaluación del bienestar fetal según los resultados de la prueba y al individualizar clínicamente cada caso para interpretar sus resultados se hace uso eficiente y eficas del PBE.

Prolapso uterino y embarazo / Uterine prolapse and pregnancy

Objetivo: Presentar un caso de prolapso uterino y gestación ocurrido en el Hospital "Guillermo Almenara Irigoyen" y determinar los factores de riesgo para su presentación. Diseño: Descriptivo de caso clínico. Resultados: Se identifica los factores de riesgo para prolapso genital en nuestra población. Conclusiones: el prolapso uterino durante el embarazo es infrecuente. El adecuado conocimiento de las causas, complicaciones y manejo postparto nos llevará a tomar medidas de prevención adecuadas. Palabras clave: Prolapso uterino, embarazo.