Ticks infesting humans in Central America: A review of their relevance in public health.

Ticks are blood-sucking arthropods that parasitize most groups of terrestrial or semiaquatic vertebrates. Humans are accidental hosts to the ticks; however, in humans the ticks can cause damages varying from simple irritation to severe allergies, toxicosis, paralysis, and the transmission of pathogens, some of which can be fatal. Central America represents a narrow isthmus between North and South America and is considered a biodiversity hotspot. The importance of tick-borne diseases in this region is manifested by fatal outbreaks caused by Rickettsia rickettsii, severe and mild cases of other rickettsioses, ehrlichiosis, and tick-borne relapsing fevers, in addition to cases paralysis and strong allergic reactions. Even so, this information is scarce in most countries of this region, and there are no epidemiological data. In this article we present a review of the ticks that parasitize humans in Central America, covering data from the 19th Century to the present day. Of nearly 80 tick species reported in Central America, 28 species are reported on humans. This list includes species that thrive within homes, grazing areas and, to a lesser extent, in wild environments, both in lowland and high mountain forests. The most important genus in this region is Amblyomma, followed by Rhipicephalus and Ornithodoros, and to a lesser extent Haemaphysalis, Ixodes and Dermacentor. These data provide information on the tick species most commonly associated with humans in Central America, and highlight the potential for tick-borne diseases in wild, rural and urban regions.

Direct PCR of lesions suggestive of sporotrichosis in felines / [PCR direta de lesões sugestivas de esporotricose em gatos]

A esporotricose é uma doença emergente e a incidência de esporotricose zoonótica tem aumentado, principalmente no Brasil; a maioria dos casos está relacionada à transmissão de gatos infectados. O diagnóstico definitivo da esporotricose felina é feito por cultura fúngica; no entanto, aguardar o longo período de cultura pode atrasar o início do tratamento. O objetivo deste estudo foi detectar e determinar as espécies de Sporothrix por PCR realizado diretamente das lesões de gatos, provenientes de área endêmica, nos quais a esporotricose fazia parte do diagnóstico diferencial. Um total de 87,1% dos casos foi positivo por PCR ou cultura fúngica para Sporothrix; 81,4% foram confirmados como S. brasiliensis por PCR, 71,4% por isolamento e 65,7% pelos dois métodos. Em conclusão, a análise direta por PCR de lesões sugestivas de esporotricose em gatos é um bom método para confirmar a infecção e determinar as espécies de Sporothrix, garantindo um diagnóstico rápido; esse método tem uma boa concordância com o isolamento fúngico.(AU)

Single nucleotide polymorphisms in the growth hormone and IGF type-1 (IGF1) genes associated with carcass traits in Santa Ines sheep.

Polymorphisms in the growth hormone (GH) and IGF type-1 (IGF1) genes have been associated with the economic traits in farm animals, including BW of some sheep breeds. However, it remains unknown if these polymorphisms also affect carcass traits in sheep. Thus, we aimed to identify polymorphisms in the GH and IGF1 genes in Santa Ines sheep in order to describe their allelic and genotypic frequencies as well as to test the hypotheses that they are associated with the carcass traits. Fragments of 4550 bp (IGF1) and 1194 bp (GH) were sequenced in up to 191 lambs. In all, 18 polymorphisms were identified in the IGF1 and 21 in the GH gene. The IGF1 polymorphisms rs430457475, rs412470350, rs409110739 and rs400113576 showed an additive effect on the internal carcass length (-0.9265±0.4223), rump girth (-2.9285±1.1473), rib yield (-1.0003±0.4588) and neck weight (-0.0567±0.0278), respectively. In addition, the polymorphisms rs58957314 in the GH affected the rib weight (-0.4380±0.1272) and rib yield (-2.2680±0.6970), loin weight (-0.1893±0.0516) and loin yield (-0.9423±0.3259), palette weight (-0.2265±0.0779) and palette yield (-0.9424±0.4184), leg weight (-0.3960±0.1375), neck weight (-0.0851±0.0394) and carcass finishing score (-0.1700±0.0839). These results allow us to conclude that there are polymorphisms in the IGF1 and GH genes associated with carcass traits in Santa Ines sheep, which can provide important information for marker-assisted selection.

Variant discovery in a QTL region on chromosome 3 associated with fatness in chickens.

Abdominal fat content is an economically important trait in commercially bred chickens. Although many quantitative trait loci (QTL) related to fat deposition have been detected, the resolution for these regions is low and functional variants are still unknown. The current study was conducted aiming at increasing resolution for a region previously shown to have a QTL associated with fat deposition, to detect novel variants from this region and to annotate those variants to delineate potentially functional ones as candidates for future studies. To achieve this, 18 chickens from a parental generation used in a reciprocal cross between broiler and layer lines were sequenced using the Illumina next-generation platform with an initial coverage of 18X/chicken. The discovery of genetic variants was performed in a QTL region located on chromosome 3 between microsatellite markers LEI0161 and ADL0371 (33,595,706-42,632,651 bp). A total of 136,054 unique SNPs and 15,496 unique INDELs were detected in this region, and after quality filtering, 123,985 SNPs and 11,298 INDELs were retained. Of these variants, 386 SNPs and 15 INDELs were located in coding regions of genes related to important metabolic pathways. Loss-of-function variants were identified in several genes, and six of those, namely LOC771163, EGLN1, GNPAT, FAM120B, THBS2 and GGPS1, were related to fat deposition. Therefore, these loss-of-function variants are candidate mutations for conducting further studies on this important trait in chickens.

SNP and INDEL detection in a QTL region on chicken chromosome 2 associated with muscle deposition.

Genetic improvement is important for the poultry industry, contributing to increased efficiency of meat production and quality. Because breast muscle is the most valuable part of the chicken carcass, knowledge of polymorphisms influencing this trait can help breeding programs. Therefore, the complete genome of 18 chickens from two different experimental lines (broiler and layer) from EMBRAPA was sequenced, and SNPs and INDELs were detected in a QTL region for breast muscle deposition on chicken chromosome 2 between microsatellite markers MCW0185 and MCW0264 (105,849-112,649 kb). Initially, 94,674 unique SNPs and 10,448 unique INDELs were identified in the target region. After quality filtration, 77% of the SNPs (85,765) and 60% of the INDELs (7828) were retained. The studied region contains 66 genes, and functional annotation of the filtered variants identified 517 SNPs and three INDELs in exonic regions. Of these, 357 SNPs were classified as synonymous, 153 as non-synonymous, three as stopgain, four INDELs as frameshift and three INDELs as non-frameshift. These exonic mutations were identified in 37 of the 66 genes from the target region, three of which are related to muscle development (DTNA, RB1CC1 and MOS). Fifteen non-tolerated SNPs were detected in several genes (MEP1B, PRKDC, NSMAF, TRAPPC8, SDR16C5, CHD7, ST18 and RB1CC1). These loss-of-function and exonic variants present in genes related to muscle development can be considered candidate variants for further studies in chickens. Further association studies should be performed with these candidate mutations as should validation in commercial populations to allow a better explanation of QTL effects.

Evaluación de la eficacia de dos prescripciones de cepillos dentales en la remoción de placa bacteriana en pacientes ortodóncicos / Evaluation of two toothbrushes prescriptions on the removal of plaque in patients with fixed orthodontic appliances

La aparatología empleada en los tratamientos de ortodoncia, favorece la retención de placa bacteriana y dificulta su eliminación por parte del paciente, aumentando el riesgo de desarrollar caries, manchas blancas y enfermedad periodontal. Diferentes cepillos dentales se han desarrollado para facilitar la mantención de una adecuada higiene oral en estos pacientes, sin embargo, se ha observado que los cepillos comunmente indicados (cepillo ortodóncico mas cepillo unipenacho), no siempre son bien manejados y difícilmente se usan ambos. El cepillo Cross Action Pro-Salud®, se ha presentado como una alternativa simple de usar y de transportar, por ser un único cepillo que combina las caracteristicas de los dos cepillos comunmente recomendados. Para evaluar la efectividad de este cepillo, en comparación con la prescripción convencional, se evaluaron 2 grupos, de 23 pacientes cada uno, portadores de aparatología fija. Un grupo utilizó la prescripción habitual y un segundo grupo utilizó cepillo Cross Action Pro-Salud®, por un período de 45 días. Los indices de higiene de O`leary, de placa en brackets y gingival modificado fueron registrados al inicio y 45 días después del uso diario de los cepillos antes mencionados. Se utilizó test-t para comparar los resultados obtenidos y se determinó que se produjo una disminución significativa en los tres indices de higiene, no existiendo diferencias en los resultados obtenidos entre ambas prescripciones. El cepillo Oral-B Cross-Action Pro-Salud® es una alternativa recomendable, ya que permite eliminar efectivamente la placa bacteriana en pacientes ortodónticos, y al ser un único cepillo, facilita y acorta el tiempo de cepillado.

Orthodontic fixed appliances include elements that allow the accumulation of bacterial plaque, making tooth brushing more difficult and increasing the risk of developing caries, white spot lesions, and periodontal disease. Several toothbrushes designs have been developed to facilitate oral hygiene in orthodontic patients; however, it has been observed that most patients do not take enough time to brush using adequately both commonly prescribed toothbrushes (Oral-B End-Tufted® and Oral-B Orthodontic® brushes). Oral B Cross Action Pro-Health® has been presented as an alternative, easier to use and to transport. To assess the effectiveness of Cross Action Pro-Health® versus commonly prescribed toothbrushes, two randomly assigned groups of 23 orthodontic patients each, were evaluated. One group of patients used commonly prescribed toothbrushes and the second group used Cross Action Pro-Health®. O`Leary, modified gingival and Bracket plaque index were measured before and 45 days after the daily use of the two mentioned toothbrushes prescriptions. T-test was used to detect statistically significant differences among the brushes for each index. The results demonstrated a significant reduction of the three indexes with the daily use of Cross Action Pro-Health® and no differences were found versus commonly used prescription. Orthodontic patients may benefit from the use of a single brush prescription (Cross Action Pro-Health®), because effective plaque removal can be achieved easier and faster.

Genotipificación y resistencia antibacteriana de cepas de Campylobacter spp aisladas en niños y en aves de corral / Genotyping and antibacterial resistance of Campylobacter spp strains isolated in children and in free range poultry

Poultry is a main reservoir and source of human infection in campylobacteriosis. Three hundred and forty one stool samples (291 human, 50 avian) were analyzed. In the human group, 220 samples were collected from children with acute diarrheal disease (183 inpatients, 37 outpatients) and 71 from healthy children. Erythromycin and ciprofloxacin agar dilution MIC tests, Penner serotyping and RAPD-PCR genotyping were performed on 23 strains isolated. C. jejuni was reported only in patients with acute diarrhea (5.4 percent inpatients, 2.2 percent outpatients). Campylobacter prevalence in poultry was 34 percent. Cross-resistance to nalidixic acid and ciprofloxacin was found in 33.3 percent of human samples and 11.8 percent of animal samples. Human samples could not be typed using the Penner method. F serotype was the most expressed in poultry. We obtained a total of 14 genotypes (4 / 5 human and 10/15 avian). In conclusion, the predominant species in poultry and humans was C. jejuni, a significant amount of quinolone-resistant human and avian samples were obtained, and avian genotypes and serotypes were not found in human samples. The latter would mean that another source of infection could exist; therefore other reservoirs must be studied.

Las aves de consumo constituyen uno de los principales reservorios y fuente de infección humana de la campilo-bacteriosis. Se analizaron 341 muestras de deposiciones, 291 humanas y 50 aviares. De las muestras, 220 de niños con síndrome diarreico agudo-SDA (183 hospitalizados y 37 consultantes ambulatorios) y 71 niños sanos. A las 23 cepas obtenidas se les realizó CIM por dilución en agar a eritromicina y ciprofloxacina, serotipificación de Penner y genotipiicación por RAPD-PCR. Se encontró Campylobacterjejuni sólo en pacientes con SDA, de ellos 5,4 por ciento ambulatorios y 2,2 por ciento hospitalizados. En aves, la prevalencia de Campylobacter spp., fue de 34 por ciento. Hubo resistencia cruzada a ácido nalidixico y ciprofloxacina en 33,3 por ciento cepas de origen humano y 11,8 por ciento animal. Las cepas humanas fueron no tipiicables por el método de Penner. Predominó entre las aves el serotipo F. Se obtuvo un total de 14 genotipos (4/5 humanos y 10/15 aviares). En conclusión, la especie predominante en aves de corral y en humanos fue C. jejuni, existiendo una alta prevalencia de cepas de origen humano y aviar resistentes a quinolonas. Los genotipos y serotipos aviares no fueron encontrados en cepas de origen humano, lo que indica que podría existir otra fuente de infección, por lo que se requiere estudiar otros reservorios.

[Genotyping and antibacterial resistance of Campylobacter spp strains isolated in children and in free range poultry]. / Genotipificación y resistencia antibacteriana de cepas de Campylobacter spp aisladas en niños y en aves de corral.

Poultry is a main reservoir and source of human infection in campylobacteriosis. Three hundred and forty one stool samples (291 human, 50 avian) were analyzed. In the human group, 220 samples were collected from children with acute diarrheal disease (183 inpatients, 37 outpatients) and 71 from healthy children. Erythromycin and ciprofloxacin agar dilution MIC tests, Penner serotyping and RAPD-PCR genotyping were performed on 23 strains isolated. C. jejuni was reported only in patients with acute diarrhea (5.4% inpatients, 2.2% outpatients). Campylobacter prevalence in poultry was 34%. Cross-resistance to nalidixic acid and ciprofloxacin was found in 33.3% of human samples and 11.8% of animal samples. Human samples could not be typed using the Penner method. F serotype was the most expressed in poultry. We obtained a total of 14 genotypes (4 / 5 human and 10/15 avian). In conclusion, the predominant species in poultry and humans was C. jejuni, a significant amount of quinolone-resistant human and avian samples were obtained, and avian genotypes and serotypes were not found in human samples. The latter would mean that another source of infection could exist; therefore other reservoirs must be studied.

Factores modificantes del movimiento dentario ortodóncico / Modifiers factors of orthodontic tooth movement

El fenómeno de la remodelación ósea es fundamental tanto para ortodoncia como para la ortopedia dentofacial. Esta revisión clínica es sobre la relación de la actividad ósea desencadenada por las fuerzas ortodóncicas con diversos factores, como factores propios de los pacientes, moléculas producidas por tejidos enfermos, o drogas y nutrientes consumidas regularmente por los pacientes, los que pueden alcanzar los tejidos periodontales mecánicamente estresados por las fuerzas ortodóncicas a través de la circulación sanguínea, interactuando así con células blanco que producen la remodelación ósea necesaria para el movimiento dentario ortodóncico. El efecto combinado de estas fuerzas mecánicas con alguno de estos agentes pueden ser inhibitorio, aditivo o sinérgico. El objetivo de esta revisión es describir los mecanismos de acción y los efectos de algunas de las drogas y otros factores sobre la remodelación del tejido óseo y el movimiento dentario ortodóncico (AU)

Bone remodeling is fundamental to orthodontics and dentofacial orthopedics. This clinically oriented overview relate bone responses to orthodontic forces with many factors. Molecules produced in various diseased tissues, or drugs and nutrients consumed regularly by patients, can reach the mechanically stressed paradental tissues through the circulation, and interact with local target cells. The combined effect of mechanical forces and one or more of these agents may be inhibitory, additive or synergistic. The objective of this review is to outline the mechanisms of action and effects of some commonly used drugs and other factors on tissue remodeling and orthodontic tooth movement (AU)

[Detection and genotyping of human papillomavirus in biopsies of uterine cervical adenocarcinoma]. / Detección y tipificación de virus papiloma humano en adenocarcinoma de cuello uterino mediante reverse line blot, Región de La Araucanía, Chile.

BACKGROUND: The genotyping of Human Papillomavirus (HPV) will improve knowledge about the local epidemiological association of this virus with adenocarcinoma. AIM: To determine the frequency of HPV genotypes in biopsies of women with uterine cervical adenocarcinoma in a geographic region of Chile. MATERIALS AND METHODS: Forty-one cervical biopsies with a pathological diagnosis of adenocarcinoma, corresponding to all women diagnosed with this cancer between 2002 and 2004, were analyzed. Viral gene Ll was amplified by PCRfor viral detection. HPV genotyping was carried out by a Reverse Line Blot technique. RESULTS: Seventy one percent of biopsies were positive for HPV. The most common genotypes found were HPV 16 (61%), followed by HPV 18 (19.5%). Eighty seven percent of biopsies had a single HPV infection. Three patients had a multiple HPV infection. All of the latter were infected by HPV 16, associated with other three viral genotypes (45, 52 and 66). No low-risk HPV genotypes were found. CONCLUSIONS: In this sample of biopsies, there was a high prevelence of HPV 16 and a low prevalence of HPV 18, which historically has been related to adenocarcinoma. The genotypes found correspond to those described in South America.

Detección y tipificación de virus papiloma humano en adenocarcinoma de cuello uterino mediante reverse line blot, Región de La Araucanía, Chile / Detection and genotyping of human papillomavirus in biopsies of uterine cervical adenocarcinoma

Background: The genotyping of Human Papillomavirus (HPV) will improve knowledge about the local epidemiological association of this virus with adenocarcinoma. Aim: To determine the frequency of HPV genotypes in biopsies of women with uterine cervical adenocarcinoma in a geographic region of Chile. Materials and Methods: Forty-one cervical biopsies with a pathological diagnosis of adenocarcinoma, corresponding to all women diagnosed with this cancer between 2002 and 2004, were analyzed. Viral gene Ll was amplified by PCRfor viral detection. HPV genotyping was carried out by a Reverse Line Blot technique. Results: Seventy one percent of biopsies were positive for HPV. The most common genotypes found were HPV 16 (61 percent), followed by HPV 18 (19.5 percent). Eighty seven percent of biopsies had a single HPV infection. Three patients had a multiple HPV infection. All of the latter were infected by HPV 16, associated with other three viral genotypes (45, 52 and 66). No low-risk HPV genotypes were found. Conclusions: In this sample of biopsies, there was a high prevelence of HPV 16 and a low prevalence of HPV 18, which historically has been related to adenocarcinoma. The genotypes found correspond to those described in South America.

Genotipificación de aislados clínicos de Helicobacter pylori en base a genes asociados a virulencia cagA, vacA y babA2: Primer aislamiento de una cepa babA2 positiva en pacientes chilenos / Genotypying of clinical isolates of Helicobacter pylori by cagA, vacA and babA2 virulence associated genes: First detection of a babA2 positive strain in Chilean patients

Background: Helicobacter pylori-associated gastroduodenal diseases depends on host characteristics, environmental conditions and bacterial virulence factors, such as cagA, vacA y babA2 gene products. Moreover, peptic ulcer disease has been related with cagA+, vacAs1m1 strains, while metaplasia and gastric cancer has been associated to cagA+, vacAs1 and babA2+ H pylori strains. Gene babA2 has not yet been described in clinical isolates from Chilean patients. Aim: To investigate the presence of cagA, vacA (s and m) and babA2 genes in clinical isolates of H pylori from Chilean patients. Material and Methods: Sixty six isolates from 41 patients were genotyped by PCR, using primers for s1a, s1b, s2, m1, m2, cagA and babA2 genes as previously described. Results: cagA gene was detected in 16 isolates (24.2 percent) while vacAs1a, vacAs1b, vacAs2, vacAm1 and vacAm2 were detected in 28 (42.4 percent), 14 (21.2 percent), 17 (25.8 percent), 21 (31.8 percent) and 29 isolates (43.9 percent), respectively. One isolate (1.5 percent) was babA2 positive, being the first isolate with this genotype described in Chile. Besides the babA2+ genotype this clinical isolate also presented cagA+ and vacAs1a which has been related with metaplasia or gastric cancer. Five isolates showed an ulcerogenic profile cagA+, vacAs1m1. Conclusions: The results presented indicate the prevalence of vacAs1m1 genotype among the clinical isolates analyzed, and a low frequency of babA2 genotype.

Fitness effects of Wolbachia and Spiroplasma in Drosophila melanogaster.

Maternally inherited endosymbionts that manipulate the reproduction of their insect host are very common. Aside from the reproductive manipulation they produce, the fitness of these symbionts depends in part on the direct impact they have on the female host. Although this parameter has commonly been investigated for single infections, it has much more rarely been established in dual infections. We here establish the direct effect of infection with two different symbionts exhibiting different reproductive manipulation phenotypes, both alone and in combination, in the fruit fly Drosophila melanogaster. This species carries a cytoplasmic incompatibility inducing Wolbachia and a male-killing Spiroplasma, occurring as single or double (co-) infections in natural populations. We assessed direct fitness effects of these bacteria on their host, by comparing larval competitiveness and adult fecundity of uninfected, Wolbachia, Spiroplasma and Wolbachia-Spiroplasma co-infected females. We found no effect of infection status on the fitness of females for both estimates, that is, no evidence of any benefits or costs to either single or co-infection. This leads to the conclusion that both bacteria probably have other sources of benefits to persist in D. melanogaster populations, either by means of their reproductive manipulations (fitness compensation from male death in Spiroplasma infection and cytoplasmic incompatibility in Wolbachia infection) or by positive fitness interactions on other fitness components.

Male-killing Spiroplasma naturally infecting Drosophila melanogaster.

Elucidation of the mechanism of action of selfish genetic elements is difficult outside species with well-defined genetics. Male-killing, the phenomenon whereby inherited bacteria kill male hosts during embryogenesis, is thus uncharacterized in mechanistic terms despite being common and important in insects. We characterized the prevalence, identity and source of the male-killing infection recently discovered in Drosophila melanogaster in Brazil. Male-killing was found to be present in 2.3% of flies from Recife, Brazil, and was uniquely associated with the presence of Spiroplasma infection. The identity of sequences across part of the 16S and across the 16S-23S ITS region indicated that the male-killing infection of D. melanogaster was very closely related to S. poulsonii, the source of the male-killing infection in willistoni group flies also found in South America. The sequences of two further protein-coding genes indicated the D. melanogaster infection to be most closely related to that found in D. nebulosa, from the willistoni group. Our data suggest that the establishment of D. melanogaster in South America was associated with the movement of male-killing bacteria between species.

Estudio comparativo de detección del virus papiloma humano (VPH) en muestras citológicas y biopsias de cuello uterino / Detection of human papilloma virus in cytologic samples or biopsies of the cervix

Background: The DNA quality for the detection and typification of Human Papilloma Virus (HPV) varies according to the type of sample in which it is studied. This may affect the sensitivity and specificity of the method employed. Aim: To study the yield and specificity of HPV detection and typification in uterine cervical samples obtained by cervical brushing fresh frozen and formalin fixed tissue. Material and methods: Cytological, fresh frozen and fixed tissue samples from 44 patients (nine with low grade lesions and 35 with high grade lesions) were studied. Nested polymerase chain reaction for genes E6/E7 was used to typify HPV groups as low risk or high risk. Results: Of all the cytological samples obtained by brushing 84% of fixed samples and 43% of fresh frozen samples were positive for HPV. The yields were significantly different when comparing brushing with fixed tissue or fresh frozen tissue and fixed tissue with fresh frozen tissue (p <0.05). The frequency of high risk HPV fluctuated from 41% in fresh frozen tissue to 98% in cytological samples. Low risk HPV was detected in 16% of fresh frozen tissue and 68% of cytological samples. A mixed infection was detected in 66%, 41% and 14% of cytological, fresh frozen and fixed tissue samples respectively. Conclusions: Cytological samples obtained by brushing had the highest yield for the detection of cervical infection with HPV.

Low temperature cure of a male killing agent in Drosophila melanogaster.

Environmental factors can affect transmission or phenotype expression of selfish cytoplasmic endosymbionts such as embryonic male killers. Temperature is one factor that usually affects the transmission rate of selfish cytoplasmic endosymbionts. Heat cures have been described for several host-parasite systems, cold cures, however, are rare. We report a temperature cure of the Drosophila melanogaster male-killing agent, which occurs when flies are raised at 16.5 degrees C. Flies grown at 20, 24, and 28 degrees C maintained an extremely female biased sexual proportion.

Tipificación del virus papiloma humano (VPH) en lesiones preneoplásicas y carcinoma del cuello uterino en mujeres de la IX Región-Chile / Human papilloma virus (HPV) typing in preneoplastic and neoplastic lesions of the uterine cervix in the IX region-Chile

Background: Uterine cervical cancer (UCC) is an important public health problem in Chile. Although HPV infection has been established as the main cause of UCC, little is known of its frequency and distribution in our population. Aim: To determine the presence and frequency of viral genotypes in uterine cervical specimens with preneoplastic and neoplastic lesions. Material and Methods: Two nested consensus PCRs followed by identification of amplified product by dot-blot hybridization and restriction fragment length polymorphism (RFLP) were used to analyze 175 biopsies. Results: Detection of HPV was 40% in cases without histological lesion, 88% in low grade lesions, 89% in high grade lesions (HGL) and 93.5% in invasive carcinoma. Of all HPV positive cases, 89.5% were classified as high risk and only a 4.9% of HPV cases were of low risk type. Six percent of cases had multiple infections. Distribution of viral genotypes according to RFLP was: HPV33 (25.3%), 16 (18.7%), 52 (13.3%), 31 (12%), 35 (6.6%), 18 (2.7%). Conclusions: Most HPV found in biopsies with HGL and UCC were of high risk genotype. The elevated presence of high risk HPV in patients without cervical lesions may be a factor that explains the high percentage of UCC cases in our region. Most common viral types were: HPV16, 31, 33 and 52. Viral detection and typing may provide valuable information for patient selection and follow up and for allocation of resources (Rev Méd Chile 2003; 131: 1382-90).

Arthroscopic repair of acute traumatic anterior shoulder dislocation in young athletes.

PURPOSE: To compare the results of arthroscopic repair in acute anterior shoulder traumatic dislocation with those of nonoperative treatment. TYPE OF STUDY: A prospective nonrandomized study was performed. METHODS: Between August 1989 and April 1997, 46 patients were seen after a first episode of traumatic anterior shoulder dislocation. The average age was 21 years (range, 17 to 27 years). Most dislocations were in rugby players (36 patients). There were 18 patients treated by nonoperative methods and 28 patients treated by acute arthroscopic repair; 22 patients using transglenoid suture and 6 patients with bone anchor suture fixation. RESULTS: Of the patients treated nonoperatively, 94.5% suffered a redislocation between 4 and 18 months (average, 6 months). In the operative group, 96% of the patients (27) obtained excellent results according to the Rowe scale. Only 1 patient suffered a redislocation 1 year after surgery. Three different types of lesions were found during surgery: group I, capsular tear with no labrum lesion (4%); group II, capsular tear with partial labrum detachment (32%); and group III, capsular tear and full anterior labrum detachment (64%). The average follow-up was 67.4 months (range, 28 to 120). There were no surgical complications. CONCLUSIONS: The operative group obtained 96% excellent results, but the nonoperative group only obtained 5.5% excellent results, according to the Rowe scale. The nonoperative group showed a high incidence of redislocation (94.5%) compared with the operative group (4%). Based on the findings of this study, we recommend using an arthroscopic evaluation and repair after an initial anterior traumatic shoulder dislocation in young athletes.

Tracheobronchomalacia: dynamic airway evaluation with multidetector CT.

OBJECTIVE. The objective of our study was to evaluate the role of dynamic inspiratory-expiratory imaging with multidetector CT in patients with suspected tracheobronchomalacia. CONCLUSION. Multidetector CT with inspiratory-expiratory imaging is a promising method in the evaluation of patients with dynamic airway collapse. In our study, the degree of dynamic collapse correlated well with bronchoscopic results. Dynamic expiratory multidetector CT may offer a feasible alternative to bronchoscopy in patients with suspected tracheobronchomalacia.