Factores asociados al desenlace en niños con mal rotación intestinal manejados en el Hospital Infantil de San Vicente Fundación, Medellín, Colombia / Factors associated with outcome in children with intestinal malrotation managed at the Hospital Infantil of San Vicente Fundación, Medellín, Colombia

Introducción. El intestino primitivo rota durante la vida embrionaria. Cuando ocurre de forma inadecuada aparece la malrotación intestinal que puede llevar a la obstrucción o al vólvulo del intestino medio. La incidencia disminuye con el aumento de la edad. La malrotación intestinal es una de las principales causas de complicaciones del tracto gastrointestinal en la edad pediátrica. Métodos. Estudio retrospectivo, observacional, transversal y analítico, de la experiencia durante 10 años en pacientes menores de 15 años con diagnóstico de malrotación intestinal, tratados en el Hospital Infantil de San Vicente Fundación, en Medellín, Colombia. Se buscó la asociación entre variables demográficas, clínicas e imagenológicas con los desenlaces. Resultados. Se obtuvieron 58 pacientes con malrotación intestinal, 65 % menores de 1 año. En 29,3 % de los pacientes se hizo el diagnóstico con la presentación clínica; los síntomas predominantes fueron distensión abdominal y emesis. En el 24,1 % se confirmó el diagnóstico con imágenes. Las variables con una diferencia estadísticamente significativa a favor de encontrar una malrotación complicada fueron choque séptico (OR=11,7), síndrome de respuesta inflamatoria sistémica (OR=8,4) y deshidratación (OR=5,18). Conclusiones. La malrotación intestinal tiene complicaciones como perforación, peritonitis, vólvulo e intestino corto. El vólvulo se acompaña de shock y sepsis, con mortalidad hasta del 50 %. Las imágenes diagnósticas son una ayuda, pero no se puede basar la conducta médica en estas porque ninguna imagen garantiza el diagnóstico definitivo. Los signos de alarma son poco específicos. En menores de un año con emesis, distensión y dolor abdominal se debe sospechar malrotación intestinal.

Introduction. The primitive intestine rotates during embryonic life. When it occurs inappropriately, intestinal malrotation appears, which can lead to obstruction or midgut volvulus. The incidence decreases when age increases. Intestinal malrotation is one of the main causes of complications of the gastrointestinal tract in pediatric age. Method. Retrospective, observational, cross-sectional and analytical study of the experience over 10 years in patients under 15 years of age with a diagnosis of intestinal malrotation, treated at Hospital Infantil of San Vicente Fundación, in Medellín, Colombia. The association between demographic, clinical and imaging variables with the outcomes was sought. Results. There were 58 patients with intestinal malrotation, 65% under one year of age. In 29.3% of patients, intestinal malrotation was diagnosed clinically. The predominant symptoms were abdominal distension and emesis. In 24.1% the diagnosis was confirmed with imaging. The variables with a statistically significant difference in favor of finding a complicated malrotation were septic shock (OR=11.7), systemic inflammatory response syndrome (OR-8.4), and dehydration (OR=5.18). Conclusions. Malrotation has complications such as perforation, peritonitis, volvulus, and short bowel. Volvulus is accompanied by shock and sepsis, with mortality of up to 50%. Diagnostic images are helpful, but medical conduct cannot be based on them because no image guarantees a definitive diagnosis. The warning signs are not very specific. In children under one year of age with emesis, distension and abdominal pain, intestinal malrotation should be suspected.

Evaluation of ELISA in raw milk for detection of antibodies to Mycobacterium avium subsp. paratuberculosis in dairy herd.

Paratuberculosis (PTBC) is a chronic intestinal disease of animals caused by Mycobacterium avium paratuberculosis (MAP). MAP infection is diagnosed through indirect tests based on the immune response. The aims of this study were to compare the performance of two milk ELISA for the diagnosis of PTBC and to assess the bulk tank milk (BTM) MAP exposure in dairy cattle in Argentina. A total of 357 fecal, serum, and milk samples were collected. The fecal samples were processed by culture for MAP isolation, while both, serum and milk samples were used for the detection of antibodies by two different ELISA tests, "in-house" and commercial kit. MAP was isolated in 3.9% of fecal samples. For milk ELISA, poor concordances were obtained. Optimized cut-off points were calculated. The highest sensitivity and specificity values (64% and 80% respectively) were obtained with the combination of MAP isolation and commercial milk ELISA. The results indicate that the combination of different techniques to identify of dairy cattle infected with MAP increases the efficiency of diagnosis. In addition, BTM  samples (n=98) were evaluated to determine herd status using the commercial kit during two seasons, identifying 33.3% of positive samples in autumn and 35.4% in spring.

Overlap Syndrome of Diffuse Systemic Sclerosis, Sjögren Syndrome, and ANCA-Associated Renal-Limited Vasculitis: Three Entities in One Patient - Case Report.

Introduction: The presence of three different entities in a single patient is usually of clinical interest and mostly anecdotal. The overlap of systemic sclerosis (SSc), Sjögren syndrome (SS), and ANCA-associated renal-limited vasculitis has been reported only once previously. Case Presentation: A 61-year-old female was evaluated at consultation with 2 years of symptomatology, presenting cardboard-like skin, sclerodactyly, limited oral opening, and dry skin and eyes. She was admitted for progressive renal failure (serum creatinine, 5.5 mg/dL). Her serology work-up showed positive anti-SCL-70, anti-Ro, anti-La, anti-MPO, and antinuclear antibodies. Renal biopsy was performed and confirmed histological findings for SSc, SS, and ANCA-associated vasculitis with active extracapillary glomerulonephritis with fibrous predominance (EUVAS-Berden sclerotic class), active tubulointerstitial nephritis, focal tubular injury, and moderate chronic arteriolopathy. Treatment with 6 monthly doses of methylprednisolone and cyclophosphamide was established. At the last follow-up, the patient maintained a stable serum creatinine level of 2.6 mg/dL and had decreased proteinuria, no erythrocyturia, and no requirement for renal replacement therapy. Conclusion: Systemic sclerosis is a rare autoimmune disease; nevertheless, overlap with Sjögren syndrome is relatively common, although its association with ANCA vasculitis is anecdotal. Diagnostic integration presents a challenge for nephrologists to define the prognosis and a specific treatment.

Seroprevalencia del SARS-CoV-2 en los pacientes con enfermedades inmunomediadas en tratamiento con terapias biológicas y sintéticos dirigidos / Seroprevalence of SARS-CoV-2 antibodies in patients with immune-mediated inflammatory diseases treated with biological and synthetic targeted therapies

INTRODUCCIÓN: La seroprevalencia del SARS-CoV-2 en las enfermedades inflamatorias inmunomediadas (IMID) sigue siendo fuente de controversia. OBJETIVO: Comparar la seroprevalencia de anticuerpos (Ac) anti SARS-CoV-2 en pacientes con IMID en tratamientos con fármacos antirreumáticos modificadores de la enfermedad biológicos (FAMEb) o sintéticos dirigidos (FAMEsd) frente a un grupo de personas sin IMID. MÉTODOS: Estudio de pacientes con IMID y tratamientos con FAMEb y FAMEsd y de individuos sin IMID. Mediante la técnica de inmunoensayo por quimioluminiscencia indirecta, se determinaron las serologías IgG frente al SARS-CoV-2 entre octubre/2020 y mayo/2021. RESULTADOS: Se estudiaron 1.100 sujetos, 550 pacientes con IMID y 550 personas sin IMID. Se observó una seroprevalencia de 16% (88/550) en los pacientes frente a 19,3% (106/550) en el grupo de personas sin IMID, sin significación estadística (OR 0,790 [IC 95% 0,558-1,118]). Comparando los tratamientos con FAMEb o FAMEsd, se observó una tendencia a una menor seroprevalencia con rituximab, en relación con los individuos sin IMID (OR 0,296 [IC 95% 0,0871,007]). Asimismo, se encontró menor seroprevalencia en los pacientes que además de su FAMEb recibían tratamiento con metotrexato, en comparación con el grupo de personas sin IMID (OR 0,432 [IC 95% 0,223-0,835]). CONCLUSIONES: Las IMID en tratamiento con FAMEb o FAMEsd no influyen en la seroprevalencia frente al SARS-CoV-2 de los pacientes. El tratamiento concomitante con metotrexato disminuye de forma significativa la seroprevalencia en estos pacientes.

BACKGROUND: The seroprevalence of SARS-CoV-2 in immunemediated inflammatory diseases (IMID) remains controversial. AIM: To compare the seroprevalence of antibodies (Ab) to SARS-CoV-2 in patients with IMID receiving treatment with biological diseasemodifying antirheumatic drugs (bDMARD) or targeted synthetic (tsDMARD) versus a group of people without IMID. METHODS: Study of patients with IMID and treatments with bDMARD and tsDMARD and individuals without IMID. IgG serology against SARS-CoV-2 was measured using the two-step sandwich immunoassay technique by indirect chemiluminescence between October 2020 and May 2021. RESULTS: A total of 1100 subjects were studied, 550 patients with IMID and 550 persons without IMID. A seroprevalence of 16% (88/550) was observed in patients versus 19.3% (106/550) in the group of people without IMID, without statistical significance (OR 0.790 [95% CI 0.558-1.118]). Comparing the treatments with bD- MARD or tsDMARD, there was a tendency to lower seroprevalence with rituximab, in relation to individuals without IMID (OR 0.296 [95% CI 0.087-1.007]). In addition, lower seroprevalence was found in patients who received methotrexate treatment in addition to their bDMARD, compared to the group of individuals without IMID (OR 0.432 [95% CI 0.223-0.835]). CONCLUSIONS: IMIDs in treatment with bDMARDs or tsDMARDs do not influence the seroprevalence against SARS-CoV-2 in patients. Concomitant treatment with methotrexate significantly decreased seroprevalence in these patients.

Phylogenetic and Multiple-Locus Variable number tandem repeat analysis of Mycobacterium avium subsp. paratuberculosis isolates from Argentina.

Paratuberculosis is a worldwide chronic enteric disease of ruminants, caused by Mycobacterium avium subsp. paratuberculosis (MAP). While MAP has been widely investigated all around the world, little is known about the different strains that circulate in each country. This study describes the genetic diversity of MAP isolates from different bovine and deer herds from Argentina, analyzed by Multiple-Locus Variable number tandem repeat Analysis (MLVA), as well as the phylogenetic relatedness between geographically distant isolates through Whole Genome Sequencing (WGS) and core-genome analysis. A total of 90 MAP isolates were analyzed. The results showed seven different MLVA genotypes, with almost 75% of them belonging to pattern INMV 1, described in all the herds studied. WGS results suggested the presence of a common INMV 1 strain circulating throughout the country. Our results allow confirming the coexistence of different strains in time and space and the mixed infections identified in some animals. These observations suggest the absence of animal monitoring prior to introduction to the herds and the need for a control program in the country. This study represents the first to report WGS of MAP strains in Argentina.

Abdomen abierto y cierre temprano de la pared abdominal / Open abdomen and early closure of the abdominal wall

El abdomen abierto es una opción terapéutica en pacientes críticamente enfermos. Se utiliza cuando el cierre de la cavidad abdominal no puede o no debe ser realizado. No obstante, su utilidad como parte de una estrategia tradicionalmente aceptada ha disminuido, en la medida en que se han incrementado las secuelas en la pared abdominal, en especial la hernia ventral. Los procedimientos requeridos para la reconstrucción anatómica y funcional de la pared abdominal, como parte del tratamiento de una hernia ventral, revisten una alta complejidad y constituyen un nuevo escenario quirúrgico. Igualmente, conllevan incertidumbre respecto a su naturaleza y posibles complicaciones, además de que condicionan mayores gastos al sistema de salud. Para evitar los problemas del cierre tardío de la pared abdominal, se han desarrollado alternativas para superar el abordaje tradicional de "tratar y esperar", hacia "tratar y reconstruir" tempranamente. El objetivo de la presente revisión es realizar una descripción de los principales avances en el tratamiento del abdomen abierto y el papel del cierre temprano de la pared abdominal, haciendo énfasis en la importancia de un cambio conceptual en el mismo

The open abdomen is a therapeutic option in critically ill patients. It is used when the closure of the abdominal cavity cannot or should not be performed. However, its usefulness as part of a traditionally accepted strategy has diminished, as sequelae in the abdominal wall, especially ventral hernia, have increased. The procedures required for the anatomical and functional reconstruction of the abdominal wall, as part of the treatment of a ventral hernia, are highly complex and constitute a new surgical scenario. Likewise, they lead to uncertainty regarding their nature and possible complications, in addition to conditioning higher expenses for the health system. To avoid the problems of delayed closure of the abdominal wall, alternatives have been developed to overcome the traditional "try and wait" approach to "treat and reconstruct" early. The objective of this review is to describe the main advances in the treatment of the open abdomen and the role of early closure of the abdominal wall, emphasizing the importance of a conceptual change in it

Bestatin and bacitracin inhibit porcine kidney cortex dipeptidyl peptidase IV activity and reduce human melanoma MeWo cell viability.

Bestatin and bacitracin are inhibitors of metallo aminopeptidases and bacterial proteases. However, their effects on other human peptidases, like dipeptidyl peptidase IV (DPP-IV, EC 3.4.14.5) are not established. Inhibitors of DPP-IV activity are used for treating type 2 diabetes mellitus, cancers and immune system diseases. Bacitracin and bestatin inhibited porcine membrane-bound DPP-IV (pDPP-IV) activity. Mechanisms were different, i.e. non-competitive with α > 1 (α = 3.9) and Ki value of 75 µM for bestatin, and competitive with Ki value of 630 µM for bacitracin. The binding mode in the tertiary complex enzyme:substrate:bestatin suggested the structural basis of the inhibitory effect and that bestatin is potentially selective for DPP-IV, ineffective vs. S9 family members dipeptidyl peptidase 8/9 and fibroblast activation protein. In the human melanoma MeWo cell line, bestatin and bacitracin inhibited aminopeptidase N (APN) and DPP-IV activities, reduced cell viability and increased DNA fragmentation, suggesting induction of apoptosis. Since bacitracin and bestatin are already marketed drugs, studying in depth the molecular mechanisms underlying their effects on melanoma cells is warranted. Additionally, bestatin emerges as a new lead compound for the development of DPP-IV inhibitors, and a promising dual APN/DPP-IV inhibitor for the treatment of pathologies in which both enzymes are upregulated.

Biochemical evidences for M1-, M17- and M18-like aminopeptidases in marine invertebrates from Cuban coastline.

Metallo-aminopeptidases (mAPs) control many physiological processes. They are classified in different families according to structural similarities. Neutral mAPs catalyze the cleavage of neutral amino acids from the N-terminus of proteins or peptide substrates; they need one or two metallic cofactors in their active site. Information about marine invertebrate's neutral mAPs properties is scarce; available data are mainly derived from genomics and cDNA studies. The goal of this work was to characterize the biochemical properties of the neutral APs activities in eight Cuban marine invertebrate species from the Phyla Mollusca, Porifera, Echinodermata, and Cnidaria. Determination of substrate specificity, optimal pH and effects of inhibitors (1,10-phenanthroline, amastatin, and bestatin) and cobalt on activity led to the identification of distinct neutral AP-like activities, whose biochemical behaviors were similar to those of the M1 and M17 families of mAPs. Additionally, M18-like glutamyl AP activities were detected. Thus, marine invertebrates express biochemical activities likely belonging to various families of metallo-aminopeptidases.

Evidence of in utero infection by Mycobacterium avium subsp. paratuberculosis using Multiple-Locus Variable-number tandem-repeat Analysis:: first report in Argentina / Evidência de infecção intra-uterina por Mycobacterium avium subsp. paratuberculosis usando Multiple-Locus Variable-number tandem-repeat Analysis:: primeiro relato na Argentina

A pregnant heifer with an advanced clinical stage of paratuberculosis was reported in a herd in Argentina. Thus, the animal was euthanized and samples of organs of the cow and its fetus was taken and cultured for bacteriology in specific medium. Tissues were analyzed by histopathology (hematoxylin-eosin and Ziehl-Neelsen staining). Histopathological analysis of the cows samples revealed the presence of lesions consistent with paratuberculosis, and Ziehl-Neelsen staining revealed the presence of acid-fast bacilli, whereas the fetal tissues showed absence of lesions but the presence of acid-fast bacilli by Ziehl-Neelsen staining. After growing in specific medium, colonies in tissues from both cow and fetus were positive for IS900-PCR, confirming the presence of Mycobacterium avium subsp. paratuberculosis (MAP). Finally, the isolates were typed by Multiple-Locus Variable-number tandem-repeat Analysis (MLVA), which confirmedthe epidemiological link between them. This study is the first in Argentina to report the detection of MAP that shares an identical MLVA type in a pregnant cow and its fetus. The results of this study are consistent with previous reports and highlight the intra-uterine transmission of MAP as an important source of infection within herds.

Uma novilha prenha em estado clínico avançado de paratuberculose foi observada em um rebanho bovino na Argentina. O animal foi eutanasiado e foram colhidas amostras dos seus órgãos e dos órgãos feto as quais foram cultivadas para bacteriologia em meio específico. Os tecidos foram examinados por histopatologia (coloração de hematoxilina-eosina e Ziehl-Neelsen). Na histopatologia das amostras colhidas da novilha foram observadas lesões compatíveis com paratuberculose e a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes, nos tecidos fetais não foram observadas lesões, porém a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes. Após o crescimento em meio específico, as colônias foram positivas para o teste IS900-PCR nos tecidos de ambos, vaca e feto, confirmando a presença de Mycobacterium avium subsp. paratuberculosis. Por fim, os isolados foram tipados por Multiple-Locus Variable-number tandem-repeat Analysis, confirmando a relação epidemiológicaentre eles. Este estudo relata a primeira detecção de Mycobacterium avium subsp. paratuberculosis na Argentina em que houve o compartilhamento de um tipo idêntico de MLVA em uma vaca prenhe e no seu feto. Os resultados deste estudo são consistentes com relatos anteriores e destacam a tra

Evidence of in utero infection by Mycobacterium avium subsp. paratuberculosis using Multiple-Locus Variable-number tandem-repeat Analysis:: first report in Argentina / Evidência de infecção intra-uterina por Mycobacterium avium subsp. paratuberculosis usando Multiple-Locus Variable-number tandem-repeat Analysis:: primeiro relato na Argentina

A pregnant heifer with an advanced clinical stage of paratuberculosis was reported in a herd in Argentina. Thus, the animal was euthanized and samples of organs of the cow and its fetus was taken and cultured for bacteriology in specific medium. Tissues were analyzed by histopathology (hematoxylin-eosin and Ziehl-Neelsen staining). Histopathological analysis of the cows samples revealed the presence of lesions consistent with paratuberculosis, and Ziehl-Neelsen staining revealed the presence of acid-fast bacilli, whereas the fetal tissues showed absence of lesions but the presence of acid-fast bacilli by Ziehl-Neelsen staining. After growing in specific medium, colonies in tissues from both cow and fetus were positive for IS900-PCR, confirming the presence of Mycobacterium avium subsp. paratuberculosis (MAP). Finally, the isolates were typed by Multiple-Locus Variable-number tandem-repeat Analysis (MLVA), which confirmedthe epidemiological link between them. This study is the first in Argentina to report the detection of MAP that shares an identical MLVA type in a pregnant cow and its fetus. The results of this study are consistent with previous reports and highlight the intra-uterine transmission of MAP as an important source of infection within herds.

Uma novilha prenha em estado clínico avançado de paratuberculose foi observada em um rebanho bovino na Argentina. O animal foi eutanasiado e foram colhidas amostras dos seus órgãos e dos órgãos feto as quais foram cultivadas para bacteriologia em meio específico. Os tecidos foram examinados por histopatologia (coloração de hematoxilina-eosina e Ziehl-Neelsen). Na histopatologia das amostras colhidas da novilha foram observadas lesões compatíveis com paratuberculose e a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes, nos tecidos fetais não foram observadas lesões, porém a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes. Após o crescimento em meio específico, as colônias foram positivas para o teste IS900-PCR nos tecidos de ambos, vaca e feto, confirmando a presença de Mycobacterium avium subsp. paratuberculosis. Por fim, os isolados foram tipados por Multiple-Locus Variable-number tandem-repeat Analysis, confirmando a relação epidemiológicaentre eles. Este estudo relata a primeira detecção de Mycobacterium avium subsp. paratuberculosis na Argentina em que houve o compartilhamento de um tipo idêntico de MLVA em uma vaca prenhe e no seu feto. Os resultados deste estudo são consistentes com relatos anteriores e destacam a tra

Evidence of in utero infection by Mycobacterium avium subsp. paratuberculosis using Multiple-Locus Variable-number tandem-repeat Analysis: first report in Argentina / Evidência de infecção intra-uterina por Mycobacterium avium subsp. paratuberculosis usando Multiple-Locus Variable-number tandem-repeat Analysis: primeiro relato na Argentina

A pregnant heifer with an advanced clinical stage of paratuberculosis was reported in a herd in Argentina. Thus, the animal was euthanized and samples of organs of the cow and its fetus was taken and cultured for bacteriology in specific medium. Tissues were analyzed by histopathology (hematoxylin-eosin and Ziehl-Neelsen staining). Histopathological analysis of the cow's samples revealed the presence of lesions consistent with paratuberculosis, and Ziehl-Neelsen staining revealed the presence of acid-fast bacilli, whereas the fetal tissues showed absence of lesions but the presence of acid-fast bacilli by Ziehl-Neelsen staining. After growing in specific medium, colonies in tissues from both cow and fetus were positive for IS900-PCR, confirming the presence of Mycobacterium avium subsp. paratuberculosis (MAP). Finally, the isolates were typed by Multiple-Locus Variable-number tandem-repeat Analysis (MLVA), which confirmed the epidemiological link between them. This study is the first in Argentina to report the detection of MAP that shares an identical MLVA type in a pregnant cow and its fetus. The results of this study are consistent with previous reports and highlight the intra-uterine transmission of MAP as an important source of infection within herds.(AU)

Uma novilha prenha em estado clínico avançado de paratuberculose foi observada em um rebanho bovino na Argentina. O animal foi eutanasiado e foram colhidas amostras dos seus órgãos e dos órgãos feto as quais foram cultivadas para bacteriologia em meio específico. Os tecidos foram examinados por histopatologia (coloração de hematoxilina-eosina e Ziehl-Neelsen). Na histopatologia das amostras colhidas da novilha foram observadas lesões compatíveis com paratuberculose e a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes, nos tecidos fetais não foram observadas lesões, porém a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes. Após o crescimento em meio específico, as colônias foram positivas para o teste IS900-PCR nos tecidos de ambos, vaca e feto, confirmando a presença de Mycobacterium avium subsp. paratuberculosis. Por fim, os isolados foram tipados por Multiple-Locus Variable-number tandem-repeat Analysis, confirmando a relação epidemiológica entre eles. Este estudo relata a primeira detecção de Mycobacterium avium subsp. paratuberculosis na Argentina em que houve o compartilhamento de um tipo idêntico de MLVA em uma vaca prenhe e no seu feto. Os resultados deste estudo são consistentes com relatos anteriores e destacam a transmissão intra-uterina de Mycobacterium avium subsp. paratuberculosis como importante fonte de infecção nos rebanhos de bovinos.(AU)

Evidence of in utero infection by Mycobacterium avium subsp. paratuberculosis using Multiple-Locus Variable-number tandem-repeat Analysis: first report in Argentina / Evidência de infecção intra-uterina por Mycobacterium avium subsp. paratuberculosis usando Multiple-Locus Variable-number tandem-repeat Analysis: primeiro relato na Argentina

A pregnant heifer with an advanced clinical stage of paratuberculosis was reported in a herd in Argentina. Thus, the animal was euthanized and samples of organs of the cow and its fetus was taken and cultured for bacteriology in specific medium. Tissues were analyzed by histopathology (hematoxylin-eosin and Ziehl-Neelsen staining). Histopathological analysis of the cow's samples revealed the presence of lesions consistent with paratuberculosis, and Ziehl-Neelsen staining revealed the presence of acid-fast bacilli, whereas the fetal tissues showed absence of lesions but the presence of acid-fast bacilli by Ziehl-Neelsen staining. After growing in specific medium, colonies in tissues from both cow and fetus were positive for IS900-PCR, confirming the presence of Mycobacterium avium subsp. paratuberculosis (MAP). Finally, the isolates were typed by Multiple-Locus Variable-number tandem-repeat Analysis (MLVA), which confirmed the epidemiological link between them. This study is the first in Argentina to report the detection of MAP that shares an identical MLVA type in a pregnant cow and its fetus. The results of this study are consistent with previous reports and highlight the intra-uterine transmission of MAP as an important source of infection within herds.(AU)

Uma novilha prenha em estado clínico avançado de paratuberculose foi observada em um rebanho bovino na Argentina. O animal foi eutanasiado e foram colhidas amostras dos seus órgãos e dos órgãos feto as quais foram cultivadas para bacteriologia em meio específico. Os tecidos foram examinados por histopatologia (coloração de hematoxilina-eosina e Ziehl-Neelsen). Na histopatologia das amostras colhidas da novilha foram observadas lesões compatíveis com paratuberculose e a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes, nos tecidos fetais não foram observadas lesões, porém a coloração de Ziehl-Neelsen revelou a presença de bacilos álcool-ácido resistentes. Após o crescimento em meio específico, as colônias foram positivas para o teste IS900-PCR nos tecidos de ambos, vaca e feto, confirmando a presença de Mycobacterium avium subsp. paratuberculosis. Por fim, os isolados foram tipados por Multiple-Locus Variable-number tandem-repeat Analysis, confirmando a relação epidemiológica entre eles. Este estudo relata a primeira detecção de Mycobacterium avium subsp. paratuberculosis na Argentina em que houve o compartilhamento de um tipo idêntico de MLVA em uma vaca prenhe e no seu feto. Os resultados deste estudo são consistentes com relatos anteriores e destacam a transmissão intra-uterina de Mycobacterium avium subsp. paratuberculosis como importante fonte de infecção nos rebanhos de bovinos.(AU)

Acompanhamento psicológico e permanência em estudantes universitários / Acompañamiento psicológico y permanencia en estudiantes universitarios / Psychological accompaniment and permanence in university students

El estudio tiene como objetivo establecer la relación entre el acompañamiento psicológico y la permanencia estudiantil, mediante el análisis de las variables individuales, académicas y sociodemográficas. El estudio siguió un diseño Ex post-facto, de tipo descriptivo correlacional con un muestreo censal de 520 estudiantes quienes han asistido a acompañamiento psicológico de manera voluntaria. La información fue obtenida mediante un cuestionario que explora características sociodemográficas, académicas y específicas de seguimiento psicológico. Se realizaron análisis comparativos y correlaciónales encontrando una relación positiva entre la permanencia y el acompañamiento psicológico breve ante crisis situacionales. Adicionalmente, se concluyó que la permanencia estudiantil se relaciona con la edad, el género, el semestre, el promedio, el motivo de consulta y el método terapéutico desarrollado en el proceso de acompañamiento psicológico. Se discutieron los resultados a la luz de antecedentes que han explicado los fenómenos de la permanencia y la deserción en contexto escolares.

O estudo tem como objetivo estabelecer a relação entre o acompanhamento psicológico e a permanência estudantil, mediante a análise das variáveis individuais, acadêmicas e sóciodemográficas. O estudo seguiu um modelo Ex post-facto, de tipo descritivo com uma amostra de censo de 520 estudantes os quais se submeteram a acompanhamento psicológico de maneira voluntária. A informação foi obtida mediante um questionário que explora características sóciodemográficas, acadêmicas e específicas de seguimento psicológico. Realizaram-se análises comparativas e correlacionais encontrando uma relação positiva entre a permanência e o acompanhamento psicológico breve ante crises situacionais. Adicionalmente, concluiu-se que a permanência estudantil se relaciona com a idade, o gênero, o semestre, a média, o motivo de consulta e o método terapêutico desenvolvido no processo de acompanhamento psicológico. Discutiram-se os resultados à luz de antecedentes que explicam os fenômenos da permanência e a deserção em contextos escolares.

The study aims to establish the relationship between psychological support and university permanence, through the analysis of individual, academic and sociodemographic variables. The study followed an ex post-facto, descriptive correlational design with a census sampling of 520 students who have voluntarily attended psychological support. The information was obtained through a questionnaire that explores sociodemographic, academic and specific characteristics of psychological follow-up. Comparative and correlational analyzes were performed finding a positive relationship between permanence and brief psychological accompaniment in the face of situational crises. Additionally, it was concluded that university permanence is related to age, gender, semester, average, the reason for consultation and the therapeutic method developed in the psychological accompaniment process. The results were discussed in the light of background that have explained the phenomena of permanence and dropout in school context.

Necesidades de cuidado en los pacientes con demencia y/o alzheimer: una revisión integrativa / Health care needs in patients with dementia and/or alzheimer's: a comprehensive review / Necessidades de cuidado nos pacientes com demência e/ou Alzheimer: uma revisão integrativa

Resumen Introducción Identificar la evidencia científica relacionada con las necesidades de cuidado en pacientes con demencia y/o Alzheimer en Latinoamérica. Materiales y Métodos Se realizó una revisión integrativa de la evidencia científica bajo la metodología propuesta por Ganong, se realizó una búsqueda en las bases de datos: Embase, Ovid, PubMed, Proquest, SciELO, ISI Web of Science y Scopus, Redalycs en artículos publicados desde el año 2012- 2019. Resultados Se incluyeron 20 artículos producto de investigaciones primarias de tipo cualitativo y cuantitativo. Se presentan y discuten como hallazgos las siguientes categorías: necesidades de cuidado físicas, necesidades de cuidado psicológicas, necesidades de cuidado a nivel social. Discusión y Conclusiones Se evidencia un vacío de conocimiento en el contexto Latinoamericano sobre las investigaciones dirigidas al paciente con demencia y/o Alzheimer. Conocer las necesidades de cuidado de los pacientes con demencia se convierten una prioridad para los profesionales sanitarios, puesto que brindar una adecuada intervención a promueve la calidad de vida tanto del paciente como el cuidador.

Abstract Introduction This study aims to identify scientific evidence related to the health care needs of patients with dementia and/or Alzheimer's disease in Latin America. Materials and Methods A comprehensive review of the scientific evidence was carried out following the Ganong's methodology to search in the Embase, Ovid, PubMed, ProQuest, SciELO, ISI Web of Science and Scopus, REDALyC databases for articles published from 2012 to 2019. Results 20 articles were included as the result of primary qualitative and quantitative research. The following categories are presented and discussed as findings: physical care needs, psychological care needs, and social care needs. Discussion and Conclusions In the Latin American context, there is a knowledge gap on the research oriented to patients with dementia and/or Alzheimer's disease. Recognizing the health care needs of patients with dementia becomes a priority for health professionals since providing an appropriate intervention promotes the quality of life of patients and their caregivers.

Resumo Introdução Identificar a evidência científica relacionada com as necessidades de cuidado em pacientes com demência e/ou Alzheimer na América Latina. Materiais e Métodos Revisão integrativa da evidência científica de acordo com a metodologia proposta por Ganong, uma busca foi realizada nos bancos de dados Embase, Ovid, PubMed, Proquest, SciELO, ISI Web of Science e Scopus, Redalycs, sobre artigos publicados no período 2012-2019. Resultados Foram incluídos 20 artigos fundamentados em pesquisas primárias de tipo qualitativo e quantitativo. As seguintes categorias são apresentadas e discutidas como achados: necessidades de cuidado físicas, necessidades de cuidado psicológicas, necessidades de cuidado na esfera social. Discussão e Conclusões Verificou-se uma lacuna de conhecimento no âmbito Latino-americano sobre as pesquisas voltadas para o paciente com demência e/ou Alzheimer. Conhecer as necessidades de cuidado dos pacientes com demência se torna uma prioridade para os profissionais sanitários, visto que oferecer uma adequada intervenção promove uma melhor qualidade de vida tanto para o paciente quanto para o cuidador.

[Proportional entropy of normal cardiac dynamic and with arrhythmia in the Intensive Care Unit] / Entropía proporcional de dinámicas cardiacas normales y con arritmia en la unidad de cuidados intensivos.

Background: Based on the theory of probability and not equiprobable entropy ratios in the context of dynamical systems theory, a methodology for cardiac dynamic evaluation was developed. Objectives: To confirm the clinical applicability of the diagnostic methodology based on probability and entropy for patients with different types of arrhythmia assessing the degree of intensification in the ICU through its characteristic proportions. Methods: 80 Holter records from ICU diagnosed with arrhythmia and 20 normal were analyzed. Holter clinical findings were masked and were taken from them the maximum and minimum values of heart rate and total number of beats per minute to build the numerical attractor for each dynamics. Probability, entropy, S/k ratio, and proportions of entropy were evaluated, establishing its mathematical diagnosis and quantifying its severity level. Results: It was shown that the methodology difference in all cases normal of abnormal dynamics, obtaining a sensitivity and specificity of 100 % and Kappa coefficient of 1, showing that it is also possible to establish quantitatively the degree of exacerbation. Conclusions: The methodology developed is useful in clinical practice to correlate the severity of arrhythmias with physical and mathematical predictions of exacerbation.

Antecedentes: Con base en la teoría de la probabilidad y las proporciones de la entropía no equiprobable en el contexto de la teoría de los sistemas dinámicos se desarrolló una metodología de evaluación de la dinámica cardiaca. Objetivo: Confirmar la aplicabilidad clínica de la metodología diagnóstica basada en la probabilidad y la entropía para pacientes con diferentes tipos de arritmia evaluando el grado de agudización en la UCI por medio de sus proporciones características. Métodos: Se analizaron 80 registros Holter de la UCI con diagnóstico de arritmia y 20 normales. Se enmascararon las conclusiones clínicas del Holter y se tomaron de este los valores máximo, mínimo de frecuencia cardiaca y número total de latidos por hora para construir el atractor numérico para cada dinámica. Se calculó la probabilidad, la entropía, la relación S/k, y se evaluaron las proporciones de la entropía, estableciendo su diagnóstico matemático y cuantificando su nivel de gravedad.Resultados: Se demostró que la metodología diferencia en todos los casos dinámicas normales de anormales, obteniendo valores de sensibilidad y especificidad de 100% y coeficiente Kappa de 1, evidenciando que es posible además establecer cuantitativamente el grado de agudización.Conclusiones: La metodología desarrollada es útil en la práctica clínica para correlacionar la gravedad de las arritmias con predicciones de agudización físicas y matemáticas. Palabras Clave: diagnóstico, entropía, probabilidad, Arritmias Cardíacas. Resultados: Se demostró que la metodología diferencia en todos los casos dinámicas normales de anormales, obteniendo valores de sensibilidad y especificidad de 100% y coeficiente Kappa de 1, evidenciando que es posible además establecer cuantitativamente el grado de agudización. Conclusiones: La metodología desarrollada es útil en la práctica clínica para correlacionar la gravedad de las arritmias con predicciones de agudización físicas y matemáticas.

Double trisomy (XXX+21 karyotype) in a six-year-old girl with down phenotype.

We describe a case of a six-year-old girl who presents multiple dysmorphic features characteristic of Down's syndrome. She has a significant general developmental delay, with a score that correspond to 32 months of developmental age. This delay is especially in language, with a very scant vocabulary. She communicates with some hand sign words or pointing, although her auditory responses in hearing test were normal. Two previous karyotype studies showed 47, XXX, +21 anomalies. This double trisomy is a rare condition described in isolated cases in the literature and none of these refers to the developmental aspects of these children (Balwan et al. 2008; Li et al. 2004; Park et al. 1995; Day et al. 1963).

Nc886 is epigenetically repressed in prostate cancer and acts as a tumor suppressor through the inhibition of cell growth.

BACKGROUND: Nc886 is a 102 bp non-coding RNA transcript initially classified as a microRNA precursor (Pre-miR-886), later as a divergent homologue of the vault RNAs (vtRNA 2-1) and more recently as a novel type of RNA (nc886). Although nc886/vtRNA2-1/Pre-miR-886 identity is still controversial, it was shown to be epigenetically controlled, presenting both tumor suppressor and oncogenic function in different cancers. Here, we study for the first time the role of nc886 in prostate cancer. METHODS: Nc886 promoter methylation status and its correlation with patient clinical parameters or DNMTs levels were evaluated in TCGA and specific GEO prostate tissue datasets. Nc886 level was measured by RT-qPCR to compare normal/neoplastic prostate cells from radical prostatectomies and cell lines, and to assess nc886 response to demethylating agents. The effect of nc886 recovery in cell proliferation (in vitro and in vivo) and invasion (in vitro) was evaluated using lentiviral transduced DU145 and LNCaP cell lines. The association between the expression of nc886 and selected genes was analyzed in the TCGA-PRAD cohort. RESULTS: Nc886 promoter methylation increases in tumor vs. normal prostate tissue, as well as in metastatic vs. normal prostate tissue. Additionally, nc886 promoter methylation correlates with prostate cancer clinical staging, including biochemical recurrence, Clinical T-value and Gleason score. Nc886 transcript is downregulated in tumor vs. normal tissue -in agreement with its promoter methylation status- and increases upon demethylating treatment. In functional studies, the overexpression of nc886 in the LNCaP and DU145 cell line leads to a decreased in vitro cell proliferation and invasion, as well as a reduced in vivo cell growth in NUDE-mice tumor xenografts. Finally, nc886 expression associates with the prostate cancer cell cycle progression gene signature in TCGA-PRAD. CONCLUSIONS: Our data suggest a tumor suppressor role for nc886 in the prostate, whose expression is epigenetically silenced in cancer leading to an increase in cell proliferation and invasion. Nc886 might hold clinical value in prostate cancer due to its association with clinical parameters and with a clinically validated gene signature.

Evaluación probabilista de la dinámica cardiaca arrítmica con y sin metoprolol / Probabilistic evaluation of arrhythmic cardiac dynamics with and without metoprolol

Resumen Introducción: A partir de la teoría de los sistemas dinámicos y de la teoría de la probabilidad se han desarrollado metodologías altamente sensibles de aplicación clínica que permiten diferenciar normalidad, enfermedad y evolución hacia la enfermedad cardiaca. Métodos: Se seleccionaron los registros Holter de siete casos normales y 73 con diagnóstico de arritmia con y sin tratamiento terapéutico de metoprolol. Se aplicaron medidas de probabilidad establecidas previamente para evaluar la frecuencia cardiaca máxima, mínima y promedio, así como el número de latidos por hora. Resultados: Casi la mitad de los casos con arritmias y sin tratamiento presentaron medidas matemáticas de enfermedad y de evolución hacia la enfermedad, mientras que en el grupo con tratamiento con metoprolol, tres cuartas partes cumplieron con estas características. Conclusiones: Se lograron distinciones matemáticas más objetivas entre dinámicas cardiacas tratadas con y sin metoprolol, las cuales pueden ser de gran utilidad para realizar seguimiento individual.

Abstract Introduction: Based on the theory of dynamic systems and probability theory, highly sensitive clinical methodologies have been developed to differentiate normality, disease and evolution towards cardiac disease. Methods: Holter recordings, 7 normal and 73 with arrhythmia diagnosis with and without therapeutic treatment of Metoprolol, were selected. Probability measures, established in a previous work, were applied for assessing maximum, minimal and average heart rate and beats per hour. Results: It was found that almost a half of the cases with arrhythmias without beta-blocker therapy exhibited mathematical measures of illness and evolution towards disease, whereas in the treatment group with Metoprolol, three quarters accomplished these features. Conclusions: More objective mathematical distinctions were achieved between cardiac dynamics treated with and without metoprolol, which is very useful for individual follow-up.

Did Mozart suffer from Gilles de la Tourette syndrome? / ¿Mozart padeció síndrome de Gilles de la Tourette?

Abstract The personal and private lives of great men and women in history, like writers, painters and musicians, have been the subject of great interest for many years. A clear example of this is the vast scrutiny is cast over the famous composer, Wolfgang Amadeus Mozart. What may have started as curiosity, rapidly evolved into extensive research, as the answers about the musician's legendary talent may lie in the details of his life (his childhood, his relationships, his quirks and his mannerisms). It is usually up to historians, anthropologists or philosophers to delve into the pages of old books, trying to grasp answers and clues. However, for some time, physicians have sought their own part in solving the puzzle. The long told hypothesis regarding Mozart's diagnosis of Gilles de la Tourette syndrome will be examined. Could all of the peculiarities and oddities of the genius be caused by a neurological disorder? Or was this musical genius just an eccentric brilliant man?

Resumen Por años, la vida privada de los grandes hombres y mujeres de la historia, escritores, pintores y músicos, ha sido objeto de gran interés. Un claro ejemplo de esto es el gran escrutinio que se ha hecho sobre el aclamado compositor Wolfgang Amadeus Mozart. Lo que posiblemente comenzó como simple curiosidad rápidamente se convirtió en una investigación exhaustiva, pues en los detalles de su vida (su infancia, relaciones, mañas y manierimos) podría estar la evidencia de su legendario talento. Usualmente, son los historiadores, antropólogos y filósofos los que se sumergen en las páginas de viejos y ajados libros tratando de encontrar respuestas y pistas; sin embargo, desde algún tiempo, los médicos han reclamado su propio papel en la resolución de estos interrogantes. Este artículo explora la hipótesis sobre el posible diagnóstico de síndrome de Gilles de la Tourette para Mozart. ¿Todas las peculiaridades y rarezas del genio podrían estar causadas por un trastorno neurológico o se trataba solamente de un hombre brillante y excéntrico?

[Did Mozart Suffer from Gilles de la Tourette Syndrome?] / ¿Mozart padeció síndrome de Gilles de la Tourette?

The personal and private lives of great men and women in history, like writers, painters and musicians, have been the subject of great interest for many years. A clear example of this is the vast scrutiny is cast over the famous composer, Wolfgang Amadeus Mozart. What may have started as curiosity, rapidly evolved into extensive research, as the answers about the musician's legendary talent may lie in the details of his life (his childhood, his relationships, his quirks and his mannerisms). It is usually up to historians, anthropologists or philosophers to delve into the pages of old books, trying to grasp answers and clues. However, for some time, Physicians have sought their own part in solving the puzzle. The long told hypothesis regarding Mozart's diagnosis of Gilles de la Tourette syndrome will be examined. Could all of the peculiarities and oddities of the genius be caused by a neurological disorder? Or was this musical genius just an eccentric brilliant man?.