Prioritizing Colombian plant genetic resources for investment in research using indicators about the geographic origin, vulnerability status, economic benefits, and food security importance.

Germplasm banks are the most significant repository for plant genetic resources for food and agriculture (PGRFA) worldwide. Despite their strategic importance, national germplasm banks of tropical megadiverse developing countries such as Colombia have extremely limited funds. Therefore, making strategic decisions about research investment is essential. Here, we designed a data-driven approach to build an index that sorts Colombian PGRFA into three groups: high, medium, or low priority, based on four pillars of information from open-access databases and aligned with the sustainable goals of no poverty and zero hunger: Geographic origin, vulnerability status, economic benefits, and food security importance. We analyzed 345 PGRFA using the index, separating them into two groups, 275 already conserved in the Colombian germplasm bank (BGVCOL group) and 70 not currently conserved in the BGVCOL (NCB group). We used fuzzy logic to classify each PGRFA by each pillar and integrate it to obtain a priority index. Missing data for native crops were frequent in the BGVCOL group. Therefore we adopted an imputation strategy to fill the gaps and calculated the uncertainty. After applying the index, PGRFA with higher priority were 24 (8.72%) from the BGVCOL (i.e., 15 potatoes, three tomatoes, two tree tomatoes, pineapple, cocoa, papaya, and yacon) and one from NCB (i.e., coffee). We concluded that this methodology successfully prioritized PGRFA in Colombia and shows the big holes of knowledge for future research and alternatives to improve this index. The versatility of this methodology could be helpful in other genebanks with budget limitations for research investment. Supplementary Information: The online version contains supplementary material available at 10.1007/s10531-023-02599-7.

Microorganisms causing of clinical pathologies in canines and domestic felines in Valledupar, Colombia / Microorganismos causantes de patologías clínicas en caninos y felinos domésticos en Valledupar, Colombia

ABSTRACT The pathologies caused by microbial groups generate health risks in domestic dogs and cats; showing a zoonotic potential and producing affections in humans. According to that background, the purpose of this study was to establish the main microorganisms causing clinical pathologies in domestic dogs and cats by reviewing medical records in a veterinary clinic in Valledupar, Colombia. In order to do that, a retrospective study was conducted with clinical histories of dogs and cats admitted during 2017 and 2018 to the veterinary clinic "Mis Mejores Amigos", located in the city of Valledupar, Colombia. Based on the information, a descriptive, explanatory and statistical analysis was applied, the latter by means of a Sperman correlation to evaluate the relationship between race, sex, age, microbial group and pathology-pathogen. From a total of 462 reports of canines and felines admitted to the clinic, a total of 273 diagnoses were obtained. 4% of the felines and 24% of the canines were affected by some microbial group. The most prevalent microorganisms in canines were Ancylostoma spp. (9 %) Entamoeba histolytica (5%) Ehrlichia spp. (5%), and Isospora sp. (5%) while in felines were Haemobartonella felis (20%) and Haemobartonella spp. (17%). It was determined that there is only correlation between the age of felines and the microbial group that affects them, in addition to the pathology presented with the pathogen. It was observed a high percentage of Ancylostoma sp. (9%) in canines of mongrel and French Poodle breeds whilst in felines was found the bacterium Haemobartonella felis in 20% of the mongrel breeds.

RESUMEN Las patologías causadas por grupos microbianos generan riesgos en la salud de perros y gatos domésticos, lo que tiene un potencial zoonótico y produce afecciones en seres humanos. De acuerdo con lo anterior, el objetivo de este estudio fue establecer los principales microorganismos causantes de patologías clínicas en perros y gatos domésticos mediante la revisión de historias clínicas en una clínica veterinaria de Valledupar, Colombia. Se realizó un estudio retrospectivo con historias clínicas de perros y gatos ingresados durante 2017 y 2018 a la clínica veterinaria "Mis mejores amigos", ubicada en la ciudad de Valledupar, Colombia. Con base en la información se aplicó un análisis descriptivo, explicativo y estadístico, este último mediante una correlación de Sperman para evaluar relación entre raza, sexo, edad, grupo microbiano y patología-patógeno. De un total 462 reportes de caninos y felinos ingresados a la clínica, se obtuvieron 273 diagnósticos. El 4% de los felinos y el 24 % de los caninos presentaban afecciones por algún grupo microbiano. Los microorganismos más prevalentes en caninos fueron Ancylostoma spp. (9%) Entamoeba histolytica (5%) Ehrlichia spp. (5%) e Isospora sp. (5%), mientras que en felinos fueron Haemobartonella felis (20%) y Haemobartonella spp. (17%). Se determinó que solo existe correlación entre la edad de felinos y el grupo microbiano que los afecta, además de la patología presentada con el patógeno. Se observó un alto porcentaje de Ancylostoma sp. (9%) en caninos de las razas mestiza y French Poodle, y, por otro lado, en felinos se identificó la bacteria Haemobartonella felis en 20% de los sujetos de raza mestiza.

Parásitos gastrointestinales en mamíferos silvestres cautivos en el Centro de Fauna de San Emigdio, Palmira (Colombia) / Gastrointestinal parasites in captive wild mammals at the fauna center from San Emigdio, Palmira (Colombia)

RESUMEN La parasitosis intestinal en mamíferos silvestres es una de las principales complicaciones debido a las condiciones exógenas del cautiverio; predisponen al animal a complicaciones fisiológicas o infecciones secundarias que impiden su rehabilitación y reintroducción. El objetivo de esta investigación fue determinar la presencia de parásitos gastrointestinales en mamíferos silvestres del Centro de Atención y Valoración de Fauna silvestre del Centro de Educación Ambiental San Emigdio, San Emigdio, Palmira (Colombia). Se tomaron muestras fecales de 25 animales cautivos en el Centro de Atención y Valoración y fueron analizadas mediante dos técnicas: a) montaje con solución salina al 0,85 % y solución de lugol al 1% y b) técnica de flotación por solución saturada (Sheather) con densidad de 1.28g/ml, encontrando un 36% de positividad. Se encontró Enterobius vermicularis, Fasciola sp., Entamoeba sp. y Ancylostoma sp. El grupo de primates no humanos presentó cargas parasitarias más altas con respecto a felinos, caninos y demás mamíferos del estudio. Los microorganismos identificados son reconocidos como parásitos causantes de complicaciones en animales cautivos y en libertad; al igual, son catalogados como posibles riesgos zoonóticos.

ABSTRACT Intestinal parasitosis in wild mammals is one of the main complications due to the exogenous conditions of captivity. They predispose the animal to physiological complications or secondary infections that prevent its rehabilitation and reintroduction. The objective is to determine the presence of gastrointestinal parasites in wild mammals from the Wildlife Care and Valuation Center of the San Emigdio Environmental Education Center, San Emigdio, Palmira (Colombia). Fecal samples were taken from 25 captive animals in Care and Valuation Center being analyzed using two techniques: a) assembly with 0.85% saline solution and 1% lugol solution and b) saturated solution flotation technique (Sheather) with a density of 1.28g/ml, with a 36% of positivity. Enterobius vermicularis, Fasciola sp., Entamoeba sp. and Ancylostoma sp. were found. The group of non-human primates had higher parasitic intensity compared to felines, canines and other mammals in the study. The identified microorganisms are recognized as parasites causing complications in captive animals and in free life; likewise, they are classified as possible zoonotic risks.

The immune response of the scallop Argopecten purpuratus is associated with changes in the host microbiota structure and diversity.

All organisms live in close association with a variety of microorganisms called microbiota. Furthermore, several studies support a fundamental role of the microbiota on the host health and homeostasis. In this context, the aim of this work was to determine the structure and diversity of the microbiota associated with the scallop Argopecten purpuratus, and to assess changes in community composition and diversity during the host immune response. To do this, adult scallops were immune challenged and sampled after 24 and 48 h. Activation of the immune response was established by transcript overexpression of several scallop immune response genes in hemocytes and gills, and confirmed by protein detection of the antimicrobial peptide big defensin in gills of Vibrio-injected scallops at 24 h post-challenge. Then, the major bacterial community profile present in individual scallops was assessed by denaturing gradient gel electrophoresis (DGGE) of 16S rDNA genes and dendrogram analyses, which indicated a clear clade differentiation of the bacterial communities noticeable at 48 h post-challenge. Finally, the microbiota structure and diversity from pools of scallops were characterized using 16S deep amplicon sequencing. The results revealed an overall modulation of the microbiota abundance and diversity according to scallop immune status, allowing for prediction of some changes in the functional potential of the microbial community. Overall, the present study showed that changes in the structure and diversity of bacterial communities associated with the scallop A. purpuratus are detected after the activation of the host immune response. Now, the relevance of microbial balance disruption in the immune capacity of the scallop remains to be elucidated.

Identification and characterization of two variants of the Hfq-sRNA-chaperone in the fish pathogen Piscirickettsia salmonis.

Small RNA and chaperone proteins form synergistic duos that play pivotal roles in controlling gene expression in bacteria. This is the case for Hfq, a highly pleiotropic pretranslational modulator of general protein expression, which responds to harsh environmental conditions and influences fitness and virulence in a wide range of pathogenic Enterobacteria. Given this relevancy, we evaluated the presence and potential role of Hfq in the fish pathogen Piscirickettsia salmonis, a Gram-negative bacterium that threatens the sustainability of Chilean salmon production. Using bioinformatics tools were identified and characterized two variants of Hfq, which share the consensus RNA-binding domains and the active sites described functional Hfq other bacteria. Additionally, we demonstrated that hfq-1 and hfq-2 were transcriptionally active when growing in cell-free media and in infected susceptible fish cell line. Expression of both genes differed under different growth conditions and under stress, suggesting that their roles might be independent and different, depending on the bacterial physiological status. In conclusion, we demonstrate the existence of two different and functional ORF coding for the hfq marker in marine bacteria and a preliminary analysis indicating that these two novel proteins might have relevant roles in the biology and pathogenic potential of P. salmonis.

Are there intracellular Ca2+ oscillations correlated with flagellar beating in human sperm? A three vs. two-dimensional analysis.

STUDY QUESTION: Are there intracellular Ca2+ ([Ca2+]i) oscillations correlated with flagellar beating in human sperm? SUMMARY ANSWER: The results reveal statistically significant [Ca2+]i oscillations that are correlated with the human sperm flagellar beating frequency, when measured in three-dimensions (3D). WHAT IS KNOWN ALREADY: Fast [Ca2+]i oscillations that are correlated to the beating flagellar frequency of cells swimming in a restricted volume have been detected in hamster sperm. To date, such findings have not been confirmed in any other mammalian sperm species. An important question that has remained regarding these observations is whether the fast [Ca2+]i oscillations are real or might they be due to remaining defocusing effects of the Z component arising from the 3D beating of the flagella. STUDY DESIGN, SIZE, DURATION: Healthy donors whose semen samples fulfill the WHO criteria between the age of 18-28 were selected. Cells from at least six different donors were utilized for analysis. Approximately the same number of experimental and control cells were analyzed. PARTICIPANTS/MATERIALS, SETTING, METHODS: Motile cells were obtained by the swim-up technique and were loaded with Fluo-4 (Ca2+ sensitive dye) or with Calcein (Ca2+ insensitive dye). Ni2+ was used as a non-specific plasma membrane Ca2+ channel blocker. Fluorescence data and flagella position were acquired in 3D. Each cell was recorded for up to 5.6 s within a depth of 16 microns with a high speed camera (coupled to an image intensifier) acquiring at a rate of 3000 frames per second, while an oscillating objective vibrated at 90 Hz via a piezoelectric device. From these samples, eight experimental and nine control sperm cells were analyzed in both 2D and 3D. MAIN RESULTS AND THE ROLE OF CHANCE: We have implemented a new system that allows [Ca2+]i measurements of the human sperm flagellum beating in 3D. These measurements reveal statistically significant [Ca2+]i oscillations that correlate with the flagellar beating frequency. These oscillations may arise from intracellular sources and/or Ca2+ transporters, as they were insensitive to external Ni2+, a non-specific plasma membrane Ca2+ channel blocker. LARGE SCALE DATA: N/A. LIMITATIONS REASONS FOR CAUTION: Analysis in 3D needs a very fast image acquisition rate to correctly sample a volume containing swimming sperm. This condition requires a very short exposure time per image making it necessary to use an image intensifier which also increases noise. The lengthy analysis time required to obtain reliable results limited the number of cells that could be analyzed. WIDER IMPLICATIONS OF THE FINDINGS: The possibility of recording flagellar [Ca2+]i oscillations described here may open a new avenue to better understand ciliary and flagellar beating that are fundamental for mucociliary clearance, oocyte transport, fertilization, cerebrospinal fluid pressure regulation and developmental left-right symmetry breaking in the embryonic node. STUDY FUNDING AND COMPETING INTEREST(S): This work was supported by Consejo Nacional de Ciencia y Tecnología (CONACyT) (grants 253952 to G.C.; 156667 to F.M.M. and Fronteras 71 39908-Q to A.D. and Post-doctoral scholarships 366844 to P.H.-H. and 291028 to F.M.) and the Dirección General de Asuntos del Personal Académico of the Universidad Nacional Autónoma de México (DGAPA-UNAM) (grants CJIC/CTIC/4898/2016 to F.M. and IN205516 to A.D.). There are no conflicts of interest to declare.

Molecular characterization of an inhibitor of NF-κB in the scallop Argopecten purpuratus: First insights into its role on antimicrobial peptide regulation in a mollusk.

Inhibitors of nuclear factor kappa B (IκBs) are major control components of the Rel/NF-κB signaling pathway, a key regulator in the modulation of the expression of immune-related genes in vertebrates and invertebrates. The activation of the Rel/NF-κB signaling pathway depends largely in the degradation of IκB proteins and thus, IκBs are a main target for the identification of genes whose expression is controlled by Rel/NF-κB pathway. In order to identify such regulation in bivalve mollusks, the cDNA sequence encoding an IκB protein was characterized in the scallop Argopecten purpuratus, ApIκB. The cDNA sequence of ApIκB is comprised of 1480 nucleotides with a 1086 bp open reading frame encoding for 362 amino acids. Bioinformatics analysis showed that ApIκB displays the conserved features of IκB proteins. The deduced amino acid sequence consists of a 39.7 kDa protein, which has an N-terminal degradation motif, six ankyrin repeats and a C-terminal phosphorylation site motif. Phylogenetic analysis revealed a high degree of identity between ApIκB and other IκBs from mollusks, but also to arthropod cactus proteins and vertebrate IκBs. Tissue expression analysis indicated that ApIκB is expressed in all examined tissues and it is upregulated in circulating hemocytes from scallops challenged with the pathogenic Gram-negative bacterium Vibrio splendidus. After inhibiting ApIκB gene expression using the RNA interference technology, the gene expression of the antimicrobial peptide big defensin was upregulated in hemocytes from non-challenged scallops. Results suggest that ApIκB may control the expression of antimicrobial effectors such as big defensin via a putative Rel/NF-κB signaling pathway. This first evidence will help to deepen the knowledge of the Rel/NF-κB conserved pathway in scallops.

Panniculitis caused by Mycobacterium monacense mimicking erythema induratum: a case in Ecuador.

We report the first case of recently characterized species M. monacense associated with chronic nodular vasculitis, infecting a young woman. This case represents the first isolation of M. monacense from Ecuador. The isolate was identified by conventional and molecular techniques.

Chronic exposure to biomass fuel smoke and markers of endothelial inflammation.

Indoor smoke exposure may affect cardiovascular disease (CVD) risk via lung-mediated inflammation, oxidative stress, and endothelial inflammation. We sought to explore the association between indoor smoke exposure from burning biomass fuels and a selected group of markers for endothelial inflammation. We compared serum concentrations of amyloid A protein, E-selectin, soluble intercellular adhesion molecule 1 (ICAM-1) and VCAM-1, von Willebrand factor (vWF), and high-sensitivity C-reactive protein (hs-CRP) in 228 biomass-exposed vs. 228 non-exposed participants living in Puno, Peru. Average age was 56 years (s.d. = 13), average BMI was 26.5 kg/m(2) (s.d. = 4.4), 48% were male, 59.4% completed high school, and 2% reported a physician diagnosis of CVD. In unadjusted analysis, serum levels of soluble ICAM-1 (330 vs. 302 ng/ml; P < 0.001), soluble VCAM-1 (403 vs. 362 ng/ml; P < 0.001), and E-selectin (54.2 vs. 52.7 ng/ml; P = 0.05) were increased in biomass-exposed vs. non-exposed participants, respectively, whereas serum levels of vWF (1148 vs. 1311 mU/ml; P < 0.001) and hs-CRP (2.56 vs. 3.12 mg/l; P < 0.001) were decreased, respectively. In adjusted analyses, chronic exposure to biomass fuels remained positively associated with serum levels of soluble ICAM-1 (P = 0.03) and VCAM-1 (P = 0.05) and E-selectin (P = 0.05), and remained negatively associated with serum levels of vWF (P = 0.02) and hs-CRP (P < 0.001). Daily exposure to biomass fuel smoke was associated with important differences in specific biomarkers of endothelial inflammation and may help explain accelerated atherosclerosis among those who are chronically exposed.

BackCLIP: a tool to identify common background presence in PAR-CLIP datasets.

MOTIVATION: PAR-CLIP, a CLIP-seq protocol, derives a transcriptome wide set of binding sites for RNA-binding proteins. Even though the protocol uses stringent washing to remove experimental noise, some of it remains. A recent study measured three sets of non-specific RNA backgrounds which are present in several PAR-CLIP datasets. However, a tool to identify the presence of common background in PAR-CLIP datasets is not yet available. RESULTS: We used the measured sets of non-specific RNA backgrounds to build a common background set. Each element from the common background set has a score that reflects its presence in several PAR-CLIP datasets. We present a tool that uses this score to identify the amount of common backgrounds present in a PAR-CLIP dataset, and we provide the user the option to use or remove it. We used the proposed strategy in 30 PAR-CLIP datasets from nine proteins. It is possible to identify the presence of common backgrounds in a dataset and identify differences in datasets for the same protein. This method is the first step in the process of completely removing such backgrounds. AVAILABILITY: The tool was implemented in python. The common background set and the supplementary data are available at https://github.com/phrh/BackCLIP. CONTACT: phreyes@gmail.com SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

[Validation of a brief screening test to assess functional capacity in Chilean older people]. / Validación de un test breve para el diagnóstico de capacidad funcional en adultos mayores en Chile.

BACKGROUND: The Pfeffer Functional Activities Questionnaire (PFAQ) is a validated instrument used in Chile to diagnose dependency in older people. AIM: To suggest a shorter and easier version of the PFAQ, with appropriate levels of sensitivity and specificity, which may be applied to the general older population. MATERIAL AND METHODS: Three Chilean surveys applied to older people were used, namely the Survey of Life Events of the Elderly, (n = 1,371) and the 2010 and 2013 National Surveys of Quality of Life of Older People (n = 1,954 and 2,644 respectively). To evaluate the instrument, we performed correlation analysis between items and principal components analysis. We calculated internal consistency using Cronbach alpha, we computed sensitivity and specificity indicators, and analyzed convergent and predictive validity. RESULTS: After constructing different scales, the one that gave more information and had the best balance between sensitivity and specificity was chosen. Items with less weight factor and greater gender bias were eliminated, keeping seven questions from the original PFAQ. Reliability was verified using Cronbach alpha's coefficient and from correlations between the new instrument and key variables. CONCLUSIONS: According to our goals, the proposed scale is solely conformed by items that do not have gender bias. It discriminates in the general population adequately, allowing the design of a shorter test, of easier implementation.

Validación de un test breve para el diagnóstico de capacidad funcional en adultos mayores en Chile / Validation of a brief screening test to assess functional capacity in Chilean older people

Background: The Pfeffer Functional Activities Questionnaire (PFAQ) is a validated instrument used in Chile to diagnose dependency in older people. Aim: To suggest a shorter and easier version of the PFAQ, with appropriate levels of sensitivity and specificity, which may be applied to the general older population. Material and Methods: Three Chilean surveys applied to older people were used, namely the Survey of Life Events of the Elderly, (n = 1,371) and the 2010 and 2013 National Surveys of Quality of Life of Older People (n = 1,954 and 2,644 respectively). To evaluate the instrument, we performed correlation analysis between items and principal components analysis. We calculated internal consistency using Cronbach alpha, we computed sensitivity and specificity indicators, and analyzed convergent and predictive validity. Results: After constructing different scales, the one that gave more information and had the best balance between sensitivity and specificity was chosen. Items with less weight factor and greater gender bias were eliminated, keeping seven questions from the original PFAQ. Reliability was verified using Cronbach alpha s coefficient and from correlations between the new instrument and key variables. Conclusions: According to our goals, the proposed scale is solely conformed by items that do not have gender bias. It discriminates in the general population adequately, allowing the design of a shorter test, of easier implementation.

Reflexiones sobre calidad de vida, dignidad y envejecimiento / Thoughts about qua lity of life, dignity and aging

El problema del envejecimiento ha preocupado al hombre desde el principio de su existencia, y en la actualidad se ha acentuado su interés por las implicancias éticas, los cambios sociales y económicos significativos de la población que contribuyen a la modificación del perfil demográfico de un país. Estas condicionantes demográficas se traducen en nuevos escenarios, en los cuales la inequidad, asimetría y exclusión social son factores que influyen en las condiciones de vida del adulto mayor que envejece a pasos acelerados y que plantea principales desafíos, aspiraciones y oportunidades. En consecuencia, las sociedades que envejecen deberían priorizar su preocupación en la dinámica demográfica en función de la percepción de la satisfacción personal, bienestar, calidad y dignidad de vida de sus mayores. El presente trabajo analiza aspectos cruciales del envejecimiento en un intento de una mejor comprensión del proceso de envejecimiento en sí mismo, las condiciones personales, familiares, sociales y ambientales que promueven una vejez digna y en calidad. Destaca que los cambios en las políticas sociales para mejorar la cantidad, calidad y dignidad de vida no son dictados por el avance de los conocimientos científicos, sino por decisiones políticas que reflejan el pensamiento y las necesidades sentidas por la sociedad donde se produce.

The problem of aging has preoccupied man since the beginning of its existence and now has increased its interest in the ethical implications, the social and economic changes significant population contributing to the change in the demographics of a country. These conditions translate into new demographic scenarios, in which inequality, asymmetry and social exclusion are factors that influence the lives of the elderly to age at an accelerated pace and poses major challenges, aspirations and opportunities. Consequently, aging societies should prioritize its concerns on population dynamics based on the perception of personal satisfaction, well being, quality of life and dignity of their elders. This paper analizes key aspects of aging in an attempt to better understand the aging process itself, the personal conditions familiar, social and environmental factors that promote a dignified old age and quality. Stresses that the changes in social policies to improve the quantity, quality and dignity of life are not dictated by the advance of scientific knowledge, but by political decisions that reflect the thought and the felt needs of the society in which it occurs.

Development of two multiplex mini-sequencing panels of ancestry informative SNPs for studies in Latin Americans: an application to populations of the State of Minas Gerais (Brazil).

Admixture occurs when individuals from parental populations that have been isolated for hundreds of generations form a new hybrid population. Currently, interest in measuring biogeographic ancestry has spread from anthropology to forensic sciences, direct-to-consumers personal genomics, and civil rights issues of minorities, and it is critical for genetic epidemiology studies of admixed populations. Markers with highly differentiated frequencies among human populations are informative of ancestry and are called ancestry informative markers (AIMs). For tri-hybrid Latin American populations, ancestry information is required for Africans, Europeans and Native Americans. We developed two multiplex panels of AIMs (for 14 SNPs) to be genotyped by two mini-sequencing reactions, suitable for investigators of medium-small laboratories to estimate admixture of Latin American populations. We tested the performance of these AIMs by comparing results obtained with our 14 AIMs with those obtained using 108 AIMs genotyped in the same individuals, for which DNA samples is available for other investigators. We emphasize that this type of comparison should be made when new admixture/population structure panels are developed. At the population level, our 14 AIMs were useful to estimate European admixture, though they overestimated African admixture and underestimated Native American admixture. Combined with more AIMs, our panel could be used to infer individual admixture. We used our panel to infer the pattern of admixture in two urban populations (Montes Claros and Manhuaçu) of the State of Minas Gerais (southeastern Brazil), obtaining a snapshot of their genetic structure in the context of their demographic history.

Everolimus versus azathioprine in a cyclosporine and ketoconazole-based immunosuppressive therapy in kidney transplant: 3-year follow-up of an open-label, prospective, cohort, comparative clinical trial.

In cyclosporine-based protocols, everolimus is more effective than azathioprine to reduce acute rejection. Ketoconazole may reduce cyclosporine and everolimus requirements. We compared kidney transplant patients treated with everolimus or azathioprine in a ketoconazole- and cyclosporine-based immunosuppressive regimen. This open-label, prospective trial of low immunologic risk patients. Included one group (n = 11) who received everolimus (target blood level, 3-8 ng/mL) and the other (n = 11) azathioprine (2.0-2.5 mg/kg/d). Both received steroids, ketoconazole, and cyclosporine with C(0) targets (ng/mL) in the everolimus group of 200-250, 100-125, and 50-65 for months 1 and 2 and thereafter and in the azathioprine group of 250-300 in month 1, 200-250 in month 2, 180-200 until month 6, and 100-125 thereafter. Their baseline characteristics were similar. Two biopsy-proven acute rejections occurred in each group. Three-year graft and patient survival in both groups was 100%. Creatinine clearances at months 6, 12, 24, and 36 were 63.7 +/- 25.4, 58.9 +/- 24.9, 56.0 +/- 22.9, and 57.0 +/- 27.6 in the everolimus group versus 72.6 +/- 20, 68.6 +/- 21.3, 71.4 +/- 23.2, and 68.4 +/- 19.2 in the azathioprine group (NS for every comparison). Major complications were rare and similar in both groups. Five patients in the everolimus group received simvastatin versus 4 in the azathioprine cohort (P = .53). The average cyclosporine doses to achieve targets were 0.8-1.2 mg/kg in the everolimus group and 1.6-2.2 mg/kg in the azathioprine group. The average everolimus dose after month 2 was 0.75-0.9 mg/d. We concluded that with cyclosporine, ketoconazole, and steroids, everolimus was as effective and safe as azathioprine. Cyclosporine reduction with everolimus did not influence graft survival or function at 3 years.

Effectiveness and cost of replacing a calcineurin inhibitor with sirolimus to slow the course of chronic kidney disease in renal allografts.

Renal grafts suffer a progressive decrease in glomerular filtration rate (GFR) because of several factors including calcineurin inhibitor (CNI) nephrotoxicity. Switching CNIs to sirolimus may improve this adverse prognosis. We performed a prospective, open-label clinical trial among 18 kidney transplant patients with more than 12 months of evolution (range, 385-1826 days), showing progressive GFR decreases and biopsies with interstitial fibrosis and tubular atrophy (IFTA). Immunosuppressive treatment included cyclosporine, ketoconazole, and steroids associated with azathioprine or mycophenolate mofetil. After signing an Institutional Review Board-approved written consent, cyclosporine was switched to sirolimus seeking to achieve a trough blood sirolimus concentration of 6-15 ng/mL. Wilcoxon and Student's t-tests were used to compare the values in the annual periods before and after the switch. GFR was estimated by the Modification of Diet in Renal Disease formula. There were no acute rejection episodes. Estimated GFR on the day of the switch was 38.0 +/- 12.1 mL/min. After CNI switch, the slope of the estimated GFR significantly improved from -6.5 +/- 9.2 to 8.1 +/- 14.0 mL/min/year (P < .01). The estimated GFR 1 year after the switch was 47.2 +/- 16.9 mL/min (P = .003 vs baseline). Total expenditures increased. The ratio of post-switch versus baseline total expenditures was 1.93 (95% confidence interval, 1.54-2.31) and the ratio of sirolimus to CNI cost was 2.16 (95% confidence interval, 1.53-2.78). Switching from CNI to sirolimus for kidney transplants with decreasing GFR and a biopsy with IFTA changes, suggesting progressive graft nephropathy, almost doubled total expenses. It is necessary to conduct trials using clinical end points to definitively validate this therapeutic intervention.

Leishmaniasis cutánea asociada a síndrome antifosfolipídico / Cutaneous leishmaniasis associated to antiphospholipid syndrome

Presentamos el caso de un paciente masculino de 24 años, con diagnóstico de leishmaniasis cutánea, que muestra cuadro clínico caracterizado por lesiones ulcerosas, de bordes definidos, edematoso y eritematoso en brazo derecho y párpado superior de ojo izquierdo, acompañado de dolor intenso en el mismo miembro, documentándose por ecografía y flebografía trombo en el nivel de la vena basílica en el brazo derecho. Se diagnostica trombosis venosa y se solicitan anticuerpos anticardiolipinas, los cuales reportan positivos, llegando a la conclusión de que el paciente es portador de un síndrome antifosfolipídico secundario, siendo esta asociación poco frecuente.

We present a 24 years old male patient, with diagnosis of cutaneous leishmaniasis, characterized by clinical erythematous, edematous and ulcerating lesions of well defined edges, in his right arm and upper left eyelid, accompanied by intense pain at the same extremity; a thrombus was documented by ultrasound and phlebography at the basilica vein in his right arm. It was diagnosed venous thrombosis and the anticardiolipin-antibodies was reported was positive. We made the diagnosis of secondary antiphospholipid syndrome secondary, being this a rare association.

Incremento de IL-6 y plaquetas en la exposición crónica a combustiles de biomasa. ¿Estado procoagulante? / Increased IL-6 and platelets during chronic exposure to biomass fuel. A proclotting state?

Antecedentes: Mßs del 90 por ciento de residentes en zonas rurales en el Perú usan biomasa para preparar sus alimentos. Los infartos agudos de miocardio se relacionan con un incremento de las nanopartículas presentes en el ambiente. Objetivos: Conocer si la exposición crónica acombustibles de biomasa se acompa±a de un estado procoagulante. Población de estudio: 185 personas residentes en Chancay (100 Km. al norte de Lima), de las cuales 95 tenían exposición a combustibles de biomasa y 90 no. Metodología: Estudio descriptivo, transversal. A todos los participantes se les hizo: 1. Cuestionario ATS-78, modificado por Accinelli, ya validado en estudios previos. 2. Examen clínico. 3. Hemograma. 4. Determinación de IL-6. Resultados: Se encontró nivelesde IL-6 en 1,84 pg/ml las personas expuestas y de 0,87 pg/ml en las no expuestas (p menor que 0,005) a combustibles de biomasa. Las plaquetas también fueron mßs en los expuestos (269 vs 245 x 103/mm3, p=0,004). Conclusiones: La exposición a combustibles de biomasa generaría un estado de hipercoagulabilidad caracterizado por un incremento de la IL-6 y las plaquetas.

Summarize Precedents: More than 90 per cent of residents in rural zones in Peru uses biomass to prepare his (her, your) food. The sharp (acute) hearts attacks of myocardium relate to an increase of the present nanopartículas in the environment. Aims (Lenses): To know if the chronic exhibition to fuels of biomass accompanies of a condition(state) procoagulante. Population of study: 185 resident persons in Chancay (100 km to the north of Lima), of which 95 had exhibition to fuels of biomass and 90 not. Methodology: descriptive, transverse Study. There became all the participants: 1. Questionnaire ATS-78, modified by Accinelli, already validatedin previous studies. 2. Clinical examination. 3. Hemograma. 4. Determination of IL-6. Results: one found levels of IL-6 in 1,84 pg/ml the exposed persons and of 0,87 pg/ml in not exposed (p menor que 0,005) to fuels of biomass. The platelets also were more in the exposed ones (269 vs 245 x 103/ mm3, p=0,004). Conclusions: The exhibition to fuels of biomass would generate a condition (state) of hipercoagulabilidad characterized by an increase of the IL-6 and the platelets.

Incremento de los niveles de interleuquina 6 en personas expuestas a le±a cuando chacchan coca / Increased IL-6 levels in persons exposed to firewood while chewing (chacchar) coca leaves

Introducción: 4 000 a±os que el hombre utiliza la hoja de coca. Su principal constituyente activo es la cocaína. No se conoce exactamente cómo ejerce su efecto en el organismo humano. Objetivo: Determinar los niveles sericos de IL-6 en personas con el hßbito de chacchar coca que ademßs estßn expuestas a combustibles de biomasa. Material y métodos: Se estudió en Chancay a 100 personas que utilizaban combustibles de biomasa para cocinar seleccionadas por muestreo no probabilistico. Dentro de este grupo se separó a las que ademßs chacchaban coca, que fueron 6, las que se aparearon con no chacchadores de la misma edad e índice de exposición. Se determinó los niveles séricos de IL-6 en ambos grupos. Resultados: La población de chacchadores estuvo formada por cinco mujeres, que chacchaban coca desde 27,3 (intervalo de 10 ß 50) a±os atrßs, con un promedio de edad de 50,16 (intervalo de 30 ß 75) a±os y con un índice de exposición a combustibles de biomasa de 196 horas-a±o. Fue apareada con 15 personas todas de sexo femenino, con un promedio de edad de 42 (intervalo de 29 ß 73) a±os y con un índice de exposición 161,4 de horas-a±o. Todos los chacchadores refirieron sentirse enfermos, lo que sucedió sólo entre el 15,4 por ciento de los no chacchadores. (p = 0,011) Los niveles séricos de IL-6b fueron mßs elevados en los chacchadores de coca. (2,659 vs. 0,952; p = 0,001). Conclusiones: Los chacchadores de ccoca expuestos ademßs a biomasa tenían casi tres veces mßs elevado los niveles séricos de IL-6 comparados con los no chacchadores, por lo que ambas exposiciones con llevarían a una desfavorable respuesta inmune e inflamatoria y a un mayor riesgo de enfermedades vasculares.

Introduction: 4 OOO-year-old man used the coca leaf. Its main active constituent is cocaine. It is not known exactly how it exerts its effect on the human body. Aim: To determine serum levels of IL-6 in people with the habit of coca chacchar are also exposed to biomass fuels. Materials and methods: Chancay was studied in 100 people using biomass fuels for cooking selected by non-probability sampling. Within this group broke away to further chacchaban coca, which were 6, which mated with chacchadores not of the same age and rate of exposure. It was determined the serum levels of IL-6 in both groups. Results: The population of chacchadores consisted of five women who chacchaban coca from 27.3 (range 10 to 50) years ago, with an average age of 50.16 (range 30 to 75) years and with an index of exposure biomass fuels to 196 hours annually. He was paired with 15 people all female, with an average age of 42 (range 29 to 73) years and with an index of 161.4 hours of exposure-year. All spoke chacchadores feel sick, what happened just 15.4 per cent of non chacchadores. (p = 0011) Serum levelsof IL-6 were higher in the chacchadores coca. (2.659 vs. 0.952, P = 0.001) Conclusions: The chacchadores of ccoca also exposed to biomass were almost three times higher serum levels of IL-6 compared with non chacchadores, so that both exposures lead to an adverse immune and inflammatory response and an increased risk of vascular disease.

[Intraoperative high frequency oscillatory ventilation in 2 children undergoing lung surgery]. / Uso intraoperatorio de ventilación de alta frecuencia oscilatoria en dos casos pediátricos de cirugía pulmonar.

Over the past 10 years, the application of high frequency oscillatory ventilation (HFOV) has been extended beyond the neonatal period. The technique is now used in various respiratory disease settings when conventional mechanical ventilation fails. Even though HFOV has become increasingly routine in some pediatric intensive care units, familiarity with it is still limited among anesthesiologists and surgeons and it is not often applied during surgery. We report our experience using HFOV during thoracic surgery on 2 pediatric patients, one aged 5 years and the other aged 1 month. The respective surgical procedures were to close a bronchopleural fistula and to obtain a lung biopsy in order to provide guidance for limiting therapeutic intervention. In both cases the procedure was performed without adverse effects and allowed medical interventions to be carried out. We conclude that it is possible to perform thoracic surgery in pediatric patients undergoing HFOV. This ventilation mode can be useful during surgery and teams that care for critically ill children should be familiar with the equipment.