Role of the 4-phosphopantetheinyl transferase of Trichoderma virens in secondary metabolism and induction of plant defense responses.

Trichoderma virens is a ubiquitous soil fungus successfully used in biological control due to its efficient colonization of plant roots. In fungi, 4-phosphopantetheinyl transferases (PPTases) activate enzymes involved in primary and secondary metabolism. Therefore, we cloned the PPTase gene ppt1 from T. virens and generated PPTase-deficient (?ppt1) and overexpressing strains to investigate the role of this enzyme in biocontrol and induction of plant defense responses. The ?ppt1 mutants were auxotrophic for lysine, produced nonpigmented conidia, and were unable to synthesize nonribosomal peptides. Although spore germination was severely compromised under both low and high iron availability, mycelial growth occurred faster than the wild type, and the mutants were able to efficiently colonize plant roots. The ?ppt1 mutants were unable of inhibiting growth of phytopathogenic fungi in vitro. Arabidopsis thaliana seedlings co-cultivated with wild-type T. virens showed increased expression of pPr1a:uidA and pLox2:uidA markers, which correlated with enhanced accumulation of salicylic acid (SA), jasmonic acid, camalexin, and resistance to Botrytis cinerea. Co-cultivation of A. thaliana seedlings with ?ppt1 mutants compromised the SA and camalexin responses, resulting in decreased protection against the pathogen. Our data reveal an important role of T. virens PPT1 in antibiosis and induction of SA and camalexin-dependent plant defense responses.

HTLV-1 infection is frequent among out-patients with pulmonary tuberculosis in northern Lima, Peru.

SETTING: Tuberculosis (TB) and human T-lymphotropic virus 1 (HTLV-1) are frequent in Peru. The prevalence of HTLV-1 among Peruvian TB patients is unknown. OBJECTIVE: To determine the prevalence of HTLV-1, HTLV-2 and the human immunodeficiency virus (HIV) in out-patients with TB and to compare HTLV-1-infected patients with seronegative patients. DESIGN: Cross-sectional study including subjects aged 18-65 years diagnosed with smear-positive pulmonary TB at health centres in northern Lima from November 2004 to August 2005. HTLV and HIV screening was performed using enzyme-linked immunosorbent assay; HTLV-1 and HTLV-2 were confirmed using line immunoassay. RESULTS: There were 311 participants with a median age of 29 years; 173 (56%) were men. HTLV-1 prevalence was 5.8% (18/311, 95%CI 3.2-8.4) and HIV prevalence was 1.3% (4/304, 95%CI 0.4-3.3). HTLV-2 was not diagnosed. In comparison with HIV- and HTLV-seronegative patients, HTLV-1-infected subjects were older (median age 44 vs. 28, P < 0.001) and were more likely to have been born in the southern Andes (OR 4.4, 95%CI 1.6-11.9). They were also more likely to report a history of TB deaths in the family (OR 5.4, 95%CI 1.7-16.8) and had more sputum smear results graded as 3+ (OR 4.1, 95%CI 1.5-11.2). CONCLUSION: HTLV-1 screening among Peruvian TB patients is important. Because 3+ sputum smears are frequent and mortality is high among relatives, families of HTLV-1/TB-positive cases merit special attention.

Evaluación de delirio agudo en pacientes en ventilación mecánica / Evaluation of acute delirium in patients undergoing mechanical ventilation

Introducción: Dentro de la práctica de enfermería es habitual encontrar a pacientes con alteraciones de tipo cognitivo, especialmente conductuales y de orientación. La evidencia muestra que la prevalencia de delirio en diversos países es cercana al 50 por ciento, y se ha demostrado la utilidad de instrumentos de evaluación realizado por enfermeras/os para diagnosticar delirio. Se desconoce la magnitud de este problema en Chile. Objetivos: Evaluar la aplicación del Instrumento CAM-ICU para el diagnóstico del delirio agudo en pacientes en ventilación mecánica (VM). Evaluar la frecuencia y los potenciales factores asociados.Material y método: Diseño descriptivo prospectivo. Criterios de inclusión: pacientes ingresados a UCI, en VM por más de 24 horas. Criterios de exclusión: Antecedentes de Psicosis o enfermedad neurológica, segundo ingreso a UCI. Fueron capacitadas 2 enfermeras/os para la aplicación de la escala CAM-ICU. La aplicación del instrumento se puede efectuar sólo si el puntaje Escala de Agitación y Sedación de Richmond (RASS) se encuentra entre +4 y -3. Se evaluó diariamente a los pacientes ventilados hasta el momento de desconexión de VM, registrando además: deprivación de sueño, uso de drogas vasoactivas (DVA), benzodiazepinas (BZP) y opioides (OP), temperatura (T°), electrólitos plasmáticos (ELP) y glicemia por hemoglucotest (HGT). Resultados: En dos meses, se evaluaron trece pacientes, edad 67 ± 10, hombres 61,5 por ciento, el 61,6 por ciento de los casos presentaba comorbilidad. En el período evaluado, se encontró uso de DVA en 52,4 porciento, BZP 52,4 por ciento, OP 50,8 por ciento, HGT 140 ± 34 mg/dL. En el período de 63 días de VM, fueron evaluables por CAM-ICU 33 días (52,4 por ciento) y la prevalencia de delirio fue de 48,5 por ciento, mientras que en los 30 días restantes (47,6 por ciento), el índice RASS arrojó sedación profunda y sin respuesta, estados no evaluables.

Introduction: Within the nursery practice setting patients with cognitive disfunctions-specially those related to behavior and confusion-may be found constantly. Evidence shows us that delirium prevalence amounts to 50 percent in various countries and the usefulness of assessment instruments applied by nurses for diagnosing delirium has been proven. In Chile, the magnitude of this problem is not known.Objectives: To evaluate applicability of CAM-ICU Instrument (Confusion Assessment Method for the Intensive Care Unit) for diagnosing acute delirium in mechanically ventilated patients. To assess frequency and potential associated factors. Material and Method: A prospective descriptive method was applied in this study. Inclusion criteria: patients admitted to ICU undergoing mechanical ventilation for longer than 24 hours. Exclusion criteria: patients with psychosis or neurological diseases records; second admittion to UCI. For proper application of CAM-ICU Scale two nurses were trained. This instrument can only be applied if the Richmond Agitation and Sedation Scale (RASS) score is between +4 y -3.Mechanically ventilated patients were assessed on a daily basis until their MV weaning. Sleep deprivation, use of vasoactive drugs (VAD), benzodiazepines (BZP) and opioids (OP), temperature (Tº), plasmatic electrolytes (PEL), and glycemia (hemogluco-test) (HGT) were also recorded. Results: In a two-month period, thirteen (13) patients were evaluated; age 67±10; 61.5 percent male; 61.6 percent of the cases presented comorbility. During assessment period, use of VAD in 52.4 percent; BZP in 52.4 percent; OP in 50.8 percent, and HGT 140±34 mg/dL were reported. During a 63-day period of MV, 33 (52.4 percent) days were assessable through CAM-ICU and delirium prevalence was 48.5 percent, while in the remaining 33 days (47.6 percent), the RASS index revealed deep sedation and no response to voice or physical stimulation, both being non-assessable status.

10 años de cáncer de testículo en la Provincia de Ñuble (1995 - 2004) / 10 years of testicle cancer in the Province of Ñuble (1995 - 2004)

Introducción: El cáncer testicular de células germinales es de alta incidencia en nuestra provincia y se encuentra por sobre el promedio nacional. En reportes preliminares, hemos observado un predominio de los tumores germinales no seminomatosos por sobre el seminoma. Objetivo: Definir las características del cáncer de testículo de células germinales diagnosticados en la provincia de Ñuble, durante el periodo 1995-2004. Sujeto y Método: Estudio descriptivo y prospectivo, de 139 pacientes con diagnóstico de cáncer de testículo, con domicilio en la provincia de Ñuble, para el periodo en estudio. Los pacientes fueron seguidos en el Hospital de Chillán y las consultas privadas de los urólogos tratantes para el periodo en estudio. Resultados: Durante el periodo en estudio, se diagnosticaron 139 pacientes con cáncer de testículo, de los cuales el 5,03 por ciento fueron bilaterales. El 74,5 por ciento se generaron en comunas de predominio urbano. La edad promedio de presentación fue de 31,2 años. La incidencia promedio fue de 6,23 por 100.000 hombres (máximo de 8,22 - mínimo de 4,34). Los tumores germinales no seminomatosos (TGNS) fueron la presentación histológica más frecuente, con 58,9 por ciento. Las etapas I y II de Royal Mardsen fueron las predominantes con 57 por ciento y 28 por ciento, respectivamente. Conclusión: El cáncer de testículo en la provincia de Ñuble es de alta incidencia, con un predominio de los tumores no seminomatosos. La incidencia de tumores bilaterales, se encuentra por sobre los valores reportados en la literatura internacional.

[Microdoses of BCG vaccine for prophylaxis in bladder cancer stage T1]. / Microdosis de vacuna BCG como profilaxis en cáncer vesical etapa T1.

A prophylaxis with a minidose of BCG Vaccine (1 mgr.) is performed in vesical instillation during one year, to 108 patients bearing bladder cancer in the stage T1. In the first month the instillations are once a week, each fifteen days the second and third month and then, once a month for one year. An 19.4% of recurrences is obtained with an general average observation time of 37.3 months as well as an important increase of muster populations of T lymphocytes and a positive test of dinitroclorobenzene. As complications we have obtained an inguinal BCG adenitis and in a few cases disury and frequency for two or three days. We conclude that the doses of the BCG vaccine used during the period of one year, is satisfactory in the reduction of recurrences and without important complications.

The eastern Cree bush-kit program evaluation; its usefulness.

In 1982 the Cree Board of Health and Social Services of James Bay in northern Quebec created the bush-kit program to provide hunters and trappers with the technical skills to handle medical problems in the bush. A formative evaluation of the program revealed a decrease in calls and in medical evacuations from the bush and high levels of satisfaction among the participants, health professionals and community leaders. However, specific service accessibility problems were identified at the time of the evaluation as indicated by participation rates of only 50% of the targeted hunters and trappers. These findings as well as discussions with bush-kit administrators led to subsequent improvements in the program and an increased participation rate the following year.