8-year multicenter retrospective study on partial laminate veneers.

Purpose This retrospective study aimed to evaluate the survival and success rates of ceramic partial laminate veneers. Scanning electron microscopy was used to evaluate fractures and marginal defects.Methods In total, 31 patients received 79 partial laminate veneers on the maxillary anterior teeth. After adhesive luting, restorations were evaluated by calibrated clinicians for up to eight years using modified United States Public Health Service (USPHS) criteria. In addition, epoxy resin replicas were fabricated from silicone impressions and analyzed using scanning electron microscopy. Survival analyses were performed using the Kaplan-Meier and log-rank tests (α = 0.05). Success was analyzed in percentages by comparing the baseline and last follow-up.Results The cumulative survival rates were 100% after 1 year; 95.9% (SE 2.8%) after 5 years; and 61.4% (SE 25.3%) after 8 years. No significant differences (P > 0.05) were observed between functional and non-functional restorations. Changes in the USPHS criteria evaluation were only observed for adaptation: 12.5% (SE 4.7%), marginal discoloration: 4.2% (SE 3.0%), color match: 4.2% (SE 3.0%), and fractures: 16.7% (SE 5.3%). Scanning electron microscopy evaluations revealed undetected initial cracks and deficiencies in the restorations.Conclusions Partial laminate veneers displayed good survival rates during the long-term follow-up. The main problems observed were related to the quality of the margins, color mismatch, and restoration integrity. However, in most cases, restoration replacement was not required.

Factores de riesgo asociados a evolución desfavorable en el tratamiento de las infecciones de partes blandas

Introducción: Las infecciones de piel y partes blandas (IPPB) son una consulta frecuente y los casos graves conllevan morbimortalidad, por lo que su identificación y manejo precoz es fundamental para mejorar el pronóstico. Objetivo: Identificar los factores de riesgo asociados a una evolución desfavorable y mortalidad en pacientes tratados por IPPB en nuestro centro. Materiales y Método: Se realizó un estudio de casos y controles de una serie consecutiva de 172 pacientes con diagnóstico de IPPB entre enero de 2018 y enero de 2019, se recolectaron variables clínicas, de laboratorio e imagenológicas. Se definió como casos aquellos que requirieron cirugía, ingresaron a una unidad de paciente crítico o fallecieron, y como controles a los pacientes con buena respuesta al tratamiento médico. Resultados: Al realizar el análisis estadístico: la leucocitosis > 12.000 cel/mm3 (OR 6,56; IC 95%; 3,21-13,42), y la PCR > 150 mg/dl (OR 7,79; IC 95%; 3,59-16,91), resultaron ser factores de riesgo para evolución desfavorable. El puntaje LRINEC elevado (25,5% vs. 15,1%, p = 0,1034) y la cirugía tardía al ingreso (31,3% vs. 16,2%, p = 0.2632) fueron más frecuente en los casos de evolución desfavorable, pero sin diferencia significativa. Discusión: El uso de parámetros clínicos, de laboratorio e imágenes es fundamental para un diagnóstico precoz y tratamiento oportuno. Conclusiones: La leucocitosis, la elevación de la PCR y la cirugía tardía son factores de mal pronóstico en IPPB. El puntaje LRINEC aún es controversial por su baja sensibilidad.

Introduction: Skin and soft tissue infections (SSTI) are a frequent consultation and severe cases carry morbidity and mortality, so their early identification and management is essential to improve prognosis. Aim: To identify the risk factors associated with an unfavorable evolution and mortality in patients treated for SSTI in our center. Materials and Method: A case-control study of a consecutive series of 172 patients diagnosed with SSTI between January 2018 and January 2019 was carried out, clinical, laboratory and imaging variables were collected. Cases were defined as those that required surgery, were admitted to a critical patient unit or died, and as controls were patients with a good response to medical treatment. Results: When performing the statistical analysis: leukocytosis > 12,000 cel/mm3 (OR 6.56; 95% CI; 3.21-13.42), and CRP > 150 mg/dl (OR 7.79; 95% CI; 3.59-16.91), turned out to be risk factors for unfavorable evolution. The high LRINEC score (25.5% vs. 15.1%, p = 0.1034) and late surgery on admission (31.3% vs. 16.2%, p = 0.2632) were more frequent in cases of evolution unfavorable but without significant difference. Discussion: The use of clinical, laboratory and imaging parameters is essential for an early diagnosis and timely treatment. Conclusions: Leukocytosis, elevated CRP, and late surgery are poor prognostic factors in SSTI. The LRINEC score is still controversial due to its low sensitivity.

Portograma aéreo y neumatosis intestinal como hallazgos incidentales en postoperatorio de cirugía abdominal / Hepatic portal venous gas and pneumatosis intestinalis as incidental findings in post-surgical abdominal surgery

Portograma aéreo o portograma de aire (PA), se define como la presencia de aire en el sistema venoso portomesentérico. Neumatosis intestinal (NI) se define como la presencia de aire en la pared intestinal, independiente de su causa o localización. La principal etiología de estas alteraciones es la isquemia intestinal aguda y en general, se consideran predictores de perforación intestinal y de mal pronóstico. Un pequeño grupo de pacientes con PA y/o NI pueden evolucionar sin complicaciones e incluso cursan sin manifestaciones clínicas. Presentamos el caso de una paciente con antecedente quirúrgico inmediato de gastrectomía total y reconstrucción en Y de Roux, que evidenció en tomografía computarizada (TC) de abdomen de control PA y NI, sin alteraciones clínicas significativas asociadas.

Hepatic portal venous gas (HPVG) is defined as the presence of air in the portal venous system. Pneumatosis intestinalis (PI) is defined as the presence of air within the bowel wall, regardless of its cause or location. Its main etiology is the intestinal ischemia and are generally considered predictors of intestinal perforation and wrong prognosis. A small group of patients with HPVG and PI may have a different clinical course, without complications and clinical manifestations. We report the case of a patient with immediate surgical history of total gastrectomy and Roux-en-Y reconstruction, which showed in computed tomography (CT) of the abdomen HPVG and PI, without associated clinically significant changes.

Traducción transcultural al español de la clasificación neuromuscular NM-Score sobre funcionalidad motora gruesa, en pacientes con patología neuromuscular / Spanish crosscultural translation of the neuromuscularclassification NM-Score of gross motor function in patientswith neuromuscular diseases

Introduction: Cultural adaptation is a process that is applied in early phases of validation. The “Neuromuscular Score” is an instrument that classifies the gross motor function in people with neuromuscular diseases. It was created in France and has not yet been validated in Chile. Objectives: To carry out the cross cultural adaptation of the “NM Score” from the original version in French to Spanish according to the International standard of translation methodology. Patients and Method: The cross cultural adaptation is a descriptive and transversal study. This study is based on the FACIT methodologic process proposed by Eremenco. Seven health professionals, who achieved inclusion requirements, participated in the translation process. The reliability of the transcultural adaptation was determined with the final version. 30 patients from 6 to 26 years old, with neuromuscular pathology, were interviewed the Teletón Santiago Institute. Results: The methodologic process of translation and adaptation suggests that the translated version does not present great semantic differences. This process has a high global reliability measurements with Cronbach alpha coefficient = 0.93. Conclusion: The translation and adaptation process for NM Score obtained a reliable score and equivalence during its application, giving a representation of the functional compromise.

Introducción: La traducción y adaptación cultural de instrumentos de medición es un proceso que se aplica en las fases iniciales dentro de las etapas de validación de ellos. La Clasificación Puntaje Neuromuscular (NM-Score), es un instrumento que clasifica la severidad de la función motora gruesa en personas con patologías neuromusculares, creada en Francia y no validada en Chile. Objetivos: Realizar la adaptación transcultural de la clasificación NM-Score, desde la versión original en francés al español, según estándares internacionales de metodología de traducción y determinar su confiabilidad. Pacientes y Método: Estudio descriptivo, transversal, basado en metodología de traducción FACIT y medición de confiabilidad propuesto por Eremenco. Siete profesionales de la salud que cumplieron requisitos de inclusión participaron del proceso de traducción. La confiabilidad de la adaptación transcultural se determinó con la versión final de la Clasificación NM Score, que puede ser aplicada a pacientes y padres. Se entrevistaron a 30 usuarios, de 6 a 26 años, con diagnóstico de patología neuromuscular del Instituto Teletón Santiago. Resultados: El proceso metodológico de traducción y adaptación sugiere que la versión traducida no presenta grandes diferencias semánticas y tiene una alta confiabilidad global medido con α de Cronbach = 0,93. Conclusión: El proceso de traducción y adaptación de la Clasificación NM Score obtuvo una versión fiable y de equivalencia al momento de aplicarla a usuarios y padres, dando una representación del compromiso funcional.

ETP-46321, a dual p110α/δ class IA phosphoinositide 3-kinase inhibitor modulates T lymphocyte activation and collagen-induced arthritis.

Class IA phosphoinositide 3-kinases (PI3Ks) are essential to function of normal and tumor cells, and to modulate immune responses. T lymphocytes express high levels of p110α and p110δ class IA PI3K. Whereas the functioning of PI3K p110δ in immune and autoimmune reactions is well established, the role of p110α is less well understood. Here, a novel dual p110α/δ inhibitor (ETP-46321) and highly specific p110α (A66) or p110δ (IC87114) inhibitors have been compared concerning T cell activation in vitro, as well as the effect on responses to protein antigen and collagen-induced arthritis in vivo. In vitro activation of naive CD4(+) T lymphocytes by anti-CD3 and anti-CD28 was inhibited more effectively by the p110δ inhibitor than by the p110α inhibitor as measured by cytokine secretion (IL-2, IL-10, and IFN-γ), T-bet expression and NFAT activation. In activated CD4(+) T cells re-stimulated through CD3 and ICOS, IC87114 inhibited Akt and Erk activation, and the secretion of IL-2, IL-4, IL-17A, and IFN-γ better than A66. The p110α/δ inhibitor ETP-46321, or p110α plus p110δ inhibitors also inhibited IL-21 secretion by differentiated CD4(+) T follicular (Tfh) or IL-17-producing (Th17) helper cells. In vivo, therapeutic administration of ETP-46321 significantly inhibited responses to protein antigen as well as collagen-induced arthritis, as measured by antigen-specific antibody responses, secretion of IL-10, IL-17A or IFN-γ, or clinical symptoms. Hence, p110α as well as p110δ Class IA PI3Ks are important to immune regulation; inhibition of both subunits may be an effective therapeutic approach in inflammatory autoimmune diseases like rheumatoid arthritis.

Respuesta humoral IgM e IgG frente a antigenos de excreción-secreción de Schistosoma mansoni en murinos infectados y su relación con las citoquinas Il-10 y TNF-α / Humoral IgM and IgG against excretory-secretory antigens of infected murine with Schistosoma mansoni and its relationship with the cytokines Il-10 and TNF- α

El diagnóstico de fase en la esquistosomiasis es complejo. Se evaluó la respuesta IgM e IgGmurina contra productos de excreción-secreción de Schistosoma mansoni machos (PESGM), hembras (PESGH) y huevos (PESH), su relación con la histopatología y expresión de IL-10 y TNF-α, mediante ELISA, en suero de ratones Balb/c con 8 y 20 semanas de infección (RI8 y RI20) y Ratones sanos(RS). En RI8, se observaron granulomas constituidos por plasmocitos, macrófagos y neutrófilos, depósitos de colágeno alrededor de los granulomas y en la zona interna del huevo. En R20SI, se observaron fibroblastos alrededor del huevo y acúmulos de macrófagos y plasmocito, aumento de los depósitos de colágeno en áreas del granuloma. IgM sérica RI8, presentó un mayor porcentaje de positividad frente PESGH (35%), mientras que IgG el mayor porcentaje de positividad fue PESGH (60%) y PESH (30%). En R20SI, IgM fue 20% positiva frente PESH e IgG 10% frente PESGM, y 25% positiva con PESGH. No se observaron diferencias en IL-10 entre los RS y RI8. TNF-α en RS vs RI8 y RS vs RI20 fue diferente y estadísticamente significativo. Los PESGH podrían detectar fase aguda y PESH fase crónica. El empleo de varios antígenos sería de utilidad en el diagnóstico de fase.

The diagnosis of schistosomiasis phase is complex. The murine IgM and IgG response against excretory-secretory products of Schistosoma mansoni males (PESGM), females (PESGH) and eggs (PESH), its relation to histopathology and expression of IL-10 and TNF-α was assessed by ELISA in serum of Balb / c mice with 8 and 20 weeks of infection (RI8 and RI20) and healthy mice, RS. In RI8, were observed granulomas consisting of plasma cells, macrophages and neutrophils, deposits of collagen around the granulomas and internal area of the egg. In R20SI, fibroblasts around the egg and accumulation of macrophages and plasmocito, increased collagen deposits in areas of granuloma were observed.RI8 serum IgM had a higher percentage of positivity PESGH (35%), while the highest percentage of IgG positivity was PESGH (60%) and PESH (30%). In R20SI, was 20% IgM positive and IgG against PESH PESGM 10% against and 25% positive with PESGH. No differences in IL-10 between the RS and RI8 were observed. TNF-α in RS vs RI8 and RS vs RI20 was different and statistically significant. The PESGH could detect phase acute while PESH chronic phase. The use of several antigens would be useful in the diagnosis phase.

Neurofibromatosis tipo 1 en el embarazo: reporte de caso y revisión de la literatura / Type 1 neurofibromatosis in pregnancy: case report and literature review

INTRODUCCIÓN: La combinación de embarazo y Neurofibromatosis tipo 1 (NF1) ha sido reportada con frecuencias de 1/2.500 a 1/18.500 partos. Patología con manifestaciones que van desde lesiones cutáneas, tumores o complicaciones ortopédicas. En la mujer esta enfermedad podría empeorar durante la gestación, debido a la cantidad de receptores esteroidales que tendrían los neurofibromas y la posibilidad de malignización de tumores del sistema nervioso central. PRESENTACIÓN DEL CASO: Mujer de 22 años, multípara de 1, con una perdida reproductiva a las 6 semanas de gestación, con antecedentes de NF1, un tumor cerebral tipo glioma temporal medial derecho y otro ubicado en nervio óptico izquierdo diagnosticados a los 17 años de edad, escoliosis lumbar operada a sus 13 años, controles con psiquiatra por discapacidad intelectual; además refiere que su madre y hermano presentan lesiones cutáneas compatibles con NF1, con total abandono de seguimiento hace 6 años. Inició sus controles con alto riesgo obstétrico al cursar la semana 22 de embarazo, se hospitalizó a las 37 semanas de gestación para mejorar la referencia y controles con especialistas. En el examen físico de ingreso destacó: escoliosis, estrabismo convergente de ojo derecho, lesiones hiperpigmentadas café con leche en dorso, extremidades inferiores, sin focalidad neurológica. Llegó a embarazo de término, realizándose parto vaginal a las 39semanas, con producto sexo femenino de 3360 gramos por 50 cm, adecuado para la edad gestacional, APGAR 9-10. DISCUSIÓN: Las pacientes embarazadas con NF1 contituyen un grupo de alto riesgo obstétrico, requieren de un equipo de trabajo multidisciplinario, consejería preconcepcional y de controles post parto

INTRODUCTION: The combination of pregnancy and Type 1 Neurofibromatosis (NF1) has been reported in rates of 1 in 2500 to 1 in 18500 deliveries. It's a disease with multiple manifestations such as skin damage, tumors or orthopedic complications. In women the disease may worsen during pregnancy, due to the amount of the neurofribromas' steroid receptors and the possibility of malignant transformation tumors of the central nervous system. CASE REPORT: 22 year old woman, with one previous satisfactory delivery, and a history of reproductive loss at 6 weeks gestation. She is diagnosed with NF1, showing a brain tumor, located in the right temporal medial side, glioma-type and other located in the left optic nerve diagnosed at 17 years of age, lumbar scoliosis operated at 13 years, psychiatrist controls with intellectual disabilities. Also, she relates that his mother and brother have skin lesions compatible with NF1, not keeping track six years ago. She began with high obstetrical risk unit controls at 22 weeks pregnant, then she was hospitalized at 37 weeks of gestation to improve reference and controls. In the physical first exam highlighted: scoliosis, convergent strabismus of the right eye, coffee with milk hyperpigmented lesions in the back, lower extremities without neurological deficit. She had a successful calving, performing vaginal delivery at 39 weeks, with a female of 3360 grams of weight and 50 cm height, appropriate for gestational age, APGAR 9-10. DISCUSSION: Pregnant patients with NF1 are a group of high-risk obstetrics, they require a multidisciplinary team of work, preconception counseling and birth controls after delivery

Efficacy and safety of once-daily maraviroc plus ritonavir-boosted darunavir in pretreated HIV-infected patients in a real-life setting.

OBJECTIVES: Nucleoside reverse transcriptase inhibitor (NRTI)-sparing regimens may be needed in patients with NRTI toxicity. Maraviroc (MVC) plus ritonavir-boosted darunavir (DRV-r) or atazanavir is associated with slightly lower response rates than triple therapy in drug-naïve patients. No information is available on these combinations in pretreated patients. The aim of this study was to assess the efficacy and safety of MVC plus DRV/r once-daily (qd) in HIV-infected pretreated patients. METHODS: A retrospective cohort study including patients starting MVC 150 mg plus DRV/r 800/100 mg qd, with CCR5 tropism and no resistance mutations for DRV/r, was performed. The primary efficacy endpoint was the achievement of plasma HIV RNA < 50 HIV-1 RNA copies/mL after 48 weeks. The frequency of serious adverse effects was investigated. RESULTS: Sixty patients were recruited to the study, of whom 48 (80%) had HIV RNA < 50 copies/mL at baseline. Reasons for starting MVC plus DRV/r were: adverse effects in 38 individuals (63%), simplification in 15 (25%) and virological failure in seven (12%). The main analysis (intention to treat, noncompleter = failure) showed that 47 patients (78%) achieved HIV RNA < 50 copies/mL at 48 weeks (paired comparison with baseline, P = 1.0). On-treatment analysis showed that 42 (86%) of 49 patients presented HIV RNA < 50 copies/mL at 48 weeks (paired comparison with baseline, P = 1.0). Median (interquartile range) CD4 cell counts increased from 491 (301-729) to 561 (367-793) cells/µL at 48 weeks (P = 0.013). Only one patient discontinued therapy because of adverse effects. CONCLUSIONS: Most individuals starting MVC plus DRV/r qd because of simplification or adverse effects maintained HIV suppression after 48 weeks of follow-up.

Short-term changes of metal availability in soil. Part I: comparing sludge-amended with metal-spiked soils.

Sewage sludge application to soils is regulated by its total metal content. However, the real risk of metals is determined by the fraction that is biologically available. The available fraction is highly related to the strength of metal binding by the matrix, which is a dynamic process. The evaluation of the fate of metals in time can contribute increased accuracy of ecological risk assessment. Aiming to evaluate short-term changes in metal availability when metals were applied to soil directly (metal-spiked) or by way of an organic matrix (sludge-amended), a laboratory experiment was performed using open microcosms filled with agricultural soil. A concentration gradient of industrial sludge (11, 15, 55, and 75 t/ha) that was contaminated predominantly with chromium, copper, nickel, and zinc, or soil freshly spiked with the same concentrations of these metals, were applied on top of the agricultural soil. After 0, 3, 6, and 12 weeks, total (HNO(3) 69 %) and 0.01 M CaCl(2)-extractable metal concentrations in soil and metal content in the percolates were measured. Results demonstrated that comparison between sludge-amended and metal-spiked soils may give important information about the role of sludge matrix on metal mobility and availability in soil. In sludge-amended soils, extractable-metal concentrations were independent of the sludge concentration and did not change over time. In metal-spiked soils, metal extractability decreased with time due to ageing and transport of metals to deeper layers. In general, the sludge matrix increased the adsorption of metals, thus decreasing their mobility in soils.

DNA extraction from skins of wild (Hydrochoerus hydrochaeris and Pecari tajacu) and domestic (Sus scrofa domestica) species using a novel protocol.

Sometimes, commercial products obtained from wild animals are sold as if they were from domestic animals and vice versa. At this point of the productive chain, legal control of possible wildlife products is difficult. Common in the commerce of northern Argentina, skins of two wild species, the carpincho and the collared peccary, look very similar to each other and to those of the domestic pig; it is extremely difficult to differentiate them after they have been tanned. Because there was no an adequate methodology to discriminate between leather of these three species, we developed a new methodology of DNA extraction from skin and leather. This new method involves digesting a leather sample using proteinase K, followed by precipitation of proteins with 5 M NaCl, cleaning with absolute isopropanol and DNA precipitation with 70% ethanol. DNA is hydrated in Tris-EDTA buffer. This protocol provided good-quality DNA suitable for analysis with molecular markers. This new protocol has potential for use in identifying leather products of these species using molecular markers based on RAPDs.

Lack of short-term increase in serum mediators of fibrogenesis and in non-invasive markers of liver fibrosis in HIV/hepatitis C virus-coinfected patients starting maraviroc-based antiretroviral therapy.

The aim of this study was to analyze serum changes in mediators of fibrogenesis and in non-invasive markers of liver fibrosis among HIV/HCV-coinfected patients starting maraviroc (MVC)-based antiretroviral therapy. Patients included in this prospective pilot study met the following criteria: (1) HIV-infection, (2) detectable serum HCV-RNA, and ((3) started MVC. Transforming growth factor-ß1 (TGF-beta1), matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were measured in serum samples at baseline and 6 months after starting MVC. AST-to-platelet ratio index (APRI) was assessed at the same time points. Twenty-four patients were analyzed. Median (IQR) serum levels at baseline and after 6 months on MVC of TGF-beta1 were 27,295 (20,562-36,844) and 33,753 (18,973-46,130) pg/mL (p=0.116), of MMP-2 were 216 (186-274) and 241 (194-306) ng/mL (p=0.247), and of TIMP-1 were 237 (170-284) and 216 (171-271) ng/mL (p=0.415). APRI levels were 0.99 (0.53-3.46) at baseline and 0.83 (0.48-2.34) at 6 months (p=0.16). Serum mediators of liver fibrogenesis and fibrosis do not change significantly in HIV/HCV-coinfected patients in the short-term after starting MVC. As TGF-beta1 levels have been shown to increase over time in HCV infection and liver fibrosis worsens rapidly in HIV/HCV coinfection, these parameters seem to evolve in a different way in MVC-treated patients.

Toxicity to Eisenia andrei and Folsomia candida of a metal mixture applied to soil directly or via an organic matrix.

Regulatory limits for chemicals and ecological risk assessment are usually based on the effects of single compounds, not taking into account mixture effects. The ecotoxicity of metal-contaminated sludge may, however, not only be due to its metal content. Both the sludge matrix and the presence of other toxicants may mitigate or promote metal toxicity. To test this assumption, the toxicity of soils recently amended with an industrial sludge predominantly contaminated with chromium, copper, nickel, and zinc and soils freshly spiked with the same mixture of metals was evaluated through earthworm (Eisenia andrei) and collembolan (Folsomia candida) reproduction tests. The sludge was less toxic than the spiked metal mixture for E. andrei but more toxic for F. candida. Results obtained for the earthworms suggest a decrease in metal bioavailability promoted by the high organic matter content of the sludge. The higher toxicity of the sludge for F. candida was probably due to the additive toxic effect of other pollutants.

The prevalence of metabolic syndrome in Latin America: a systematic review.

OBJECTIVE: To assess the available data on the prevalence of metabolic syndrome (MS) in Latin-American countries. DESIGN: Systematic review. Searches were carried out in PubMed, ISIWeb, SCielo and Redalyc, using 'metabolic syndrome x' and 'prevalence' as keywords for titles and/or abstracts. Articles selected were cross-sectional studies in Latin-American countries, whose main objective was to study MS and whose study population is described below. MS must be determined using Adult Treatment Panel III criteria. Twelve studies with these criteria were selected, one of which was multi-centric. SETTING: Latin America. SUBJECTS: Apparently healthy subjects aged 18-65 years (including young adult, mature adult and elderly populations) of both genders. RESULTS: The general prevalence (weighted mean) of MS in Latin-American countries was 24·9 (range: 18·8-43·3) %. MS was slightly more frequent in women (25·3 %) than in men (23·2 %), and the age group with the highest prevalence of MS consisted of those over 50 years of age. The most frequent components of MS were low HDL cholesterol levels (62·9 %) and abdominal obesity (45·8 %). Similar outcomes were obtained from the multi-centre study on Latin-American populations analysed. CONCLUSIONS: The present review brings us closer to an understanding of the prevalence of MS in Latin-American countries. However, it is not possible to know the full scope of the problem, partly because data from some countries are not available, and because the methodological differences among the studies published up to the present limit a joint analysis of their results.

PCR detection and microbiological isolation of Salmonella spp. from fresh beef and cantaloupes.

Species belonging to the genus Salmonella are an important cause of enteric fevers, gastroenteritis, and septicemia, and the pathogens are commonly transmitted through contaminated food. In this study, polymerase chain reaction (PCR) amplification of a 287-bp region of the invA gene was compared to a microbiological technique to determine the presence of Salmonella in retail beef and in cantaloupe rinse samples. Both methods showed the same level of sensitivity, detecting 1 CFU/25 g of meat after enrichment for 24 h at 42 degrees C. The presence of Salmonella was determined in 50 commercial top sirloin beef samples that were not artificially inoculated. Three samples were positive by the microbiological method, and these samples and an additional sample were positive by the PCR. Both methods were also used to test surface rinses of cantaloupes collected from 4 farms in Nayarit, Mexico. Salmonella was detected by the microbiological method in 9 of 20 samples (45%), whereas the pathogen was detected by the PCR in 11 samples (55%). This study demonstrates the utility of the PCR targeting the invA gene to determine the presence of Salmonella spp. in beef and cantaloupe samples.

Improved performance of Brucella melitensis native hapten over Brucella abortus OPS tracer on goat antibody detection by the fluorescence polarization assay.

The current method for goat brucellosis diagnosis is based on the World Organization for Animal Health (OIE) using the screening card test (CT), with antigen at 8% (CT8) or 3% (CT3) of cell concentrations, and the confirmatory complement fixation test (CFT). However, these tests do not differentiate antibodies induced by vaccination from those derived from field infections by Brucella species or other bacterial agents; in places like Mexico, where the prevalence of brucellosis and the vaccination rates are high, there is a considerable percentage of false positive reactions that causes significant unnecessary slaughter of animals. Furthermore, results of the fluorescence polarization assay (FPA) using the Brucella abortus O-polysaccharide (OPS) tracer in goats are poorer than those with cattle. The present study was undertaken to investigate a tracer prepared from the native hapten (NH) of the Rev. 1 strain of Brucella melitensis to improve FPA performance on goat brucellosis diagnosis. Evaluation of 48 positive samples and 96 negative samples showed that the NH tracer was more accurate (p<0.01) than the OPS tracer (97.2% vs. 93.8% accuracy, respectively). On the diagnostic performance evaluation, the NH tracer performed better (87.5% accuracy, 79.5% sensitivity, 84.3% specificity, and 163.8 performance index) than the OPS tracer (83.5%, 75.9%, 81.0%, and 156.9, respectively) using 1009 positive and 2039 negative Mexican field goat sera samples selected by test series approved by the OIE (card test 3% and CFT). We demonstrated a new application for the NH lipopolysaccharide on detecting antibodies against Brucella using the FPA, which may yield faster results (minutes vs. 24-72h) than the immunodiagnosis assays frequently used in bovine brucellosis. In addition, NH tracer produces similar or better performance results than the conventional OPS tracer, using the FPA in goat sera samples.

Differences on nitrogen availability in a soil amended with fresh, composted and thermally-dried sewage sludge.

Anaerobically-digested sludge called fresh sludge (F), composted sludge (C) and thermally-drying sludge (T), all from the same batch, were applied to the surface of a calcareous Udic Calciustept with loamy texture. Dosage equivalent was 10 t ha(-1) of dry matter. The concentration of mineral nitrogen (ammonium and nitrate) in the soil was measured in order to estimate the effects of the post-treatments to which the different kinds of sewage sludge are subjected in relation to the availability of N in the surface layer of the soil. The most significant differences in NH(4)-N and NO(3)-N concentrations due to the transformation of the organic matter were observed during the first three weeks following soil amendment. Thermally-dried and composted sludge initially displayed higher concentrations of ammonium and nitrate in soil. Five months after the amendment, soil applied with fresh sludge showed the highest concentrations of NH(4)-N and NO(3)-N (6.1 and 36.6 mg kg(-1), respectively). It is clear that the processes of composting and thermal-drying influence the bioavailability of nitrogen from the different types of sewage sludge.

Fentanyl intratecal reduce los requerimientos de propofol TCI sitio-efecto en la sedación monitorizada por índice biespectral (bis) durante anestesia espinal para cirugía artroscópica / Intrathecal fentanyl reduces the dose of TCI propofol effect required for sedation monitored by bispectral index during spinal anesthesia for arthroscopic surgery

Introducción: La adición de opioides a los anestésicos locales en anestesia espinal (AE) modula algunos aspectos de la anestesia y la analgesia. Nuestro objetivo fue evaluar dos dosis de fentanilo (F) intradural sobre los requerimientos de propofol (P) en la sedación durante AE. Pacientes y Método: Estudio clínico, prospectivo, controlado de 75 pacientes, ASA I, distribuidos en 3 grupos: Grupo 1 (n=25): Bupivacaína 0,75 por ciento HB (BHB), 12,5 mg; Grupo 2 (n=25): BHB 12,5 mg + 15 µgr F; Grupo 3 (n=25): BHB 12,5 mg + 25 µgr F. Realizada AE, se instaló monitor BIS XP, registrándose valor basal. Luego, se inició sedación con propofol TCI sitio-efecto con dosis de 2,5 µgr/ml, para mantener BIS entre 60 y 75. Se registró BIS, signos vitales, dosis total utilizada (DTP), dosis promedio de infusión (DPI), el costo final del consumo de P y el tiempo de latencia del despertar. Resultados: El DPI fue de 0,084 mg*kg-1*min-1 (G 1), 0,059 mg*kg-1*min-1 (G 2) y 0,061 mg*kg-1*min-1 (G 3) (p < 0,05 G2 y G3 v/s G1). La DTP fue 344 mg*hr-1 (G 1), 227 mg*hr-1 (G 2) y de 241 mg*hr-1 (G 3). Los costos de P fueron menores en 32,8 por ciento en el Grupo 2 y 29,1 por ciento en el G 3, comparados con G 1. Conclusiones: La adición de 15 ó 25 µgr de F a la BHB reduce las dosis promedio de infusión, dosis total utilizada y los costos de P en pacientes bajo AE.

The addition of opioids to local anesthetics used in spinal anesthesia (SA) modulates some aspects of the anesthesia and analgesia. Our purpose was to evaluate two intrathecal fentanyl (F) doses over TCI Propofol requirements for sedation during SA. Methods: Prospective clinical study of 75 patients, ASA I, randomly assigned in 3 groups: Group 1 (n=25): Bupivacaine 0.75% HB (HBB), 12.5 mg; Group 2 (n=25): BHB 12.5 mg + 15 µgr F; Group 3 (n=25): BHB 12.5 mg + 25 µgr F. After SA a BIS XP monitor was installed and basal value registered. Then, sedation with Propofol TCI site-effect was started with a dose of 2.5 µgr/ml, to obtain BIS between 60 and 75. We registered total infusion dose (TID), mean infusion dose (MID), propofol costs and vital signs variations. Results: TID was 0.084 mg*kg-1min-1 (G 1), 0.059 mg*kg-1min-1 in (G 2) and 0.061 mg*kg-1*min-1 (G 3) (p < 0.05 G2 and G3 v/s G1). The MID was 344 mg*hr-1 in Group 1, 227 mg*hr-1 in Group 2 and 241 mg* hr-1 in Group 3 (p < 0.05). Propofol costs were lower in a 32.8% in Group 2 and in 29.1% in Group 3 v/s Group 1 (p < 0.05). Conclusions: The addition of 15 or 25 µgr of F to HBB reduces the total infusion doses and the mean infusion doses as well as propofol costs in patients under spinal anesthesia. Key words: Intrathecal fentanyl, sedation, spinal anesthesia, intrathecal opioids, propofol requirements.

The renaissance of T regulatory cells: looking for markers in a haystack

Un tema básico en la Inmunología es cómo el Sistema Inmunitariopuede proteger al huésped frente a una extraordinaria variedadde organismos patógenos al mismo tiempo que controla esasrespuestas para que su duración o intensidad no sean perjudicialespara el organismo. Desde hace varios años se han acumuladolos datos que subrayan la importancia de linfocitos T diferenciadosen el timo, denominados linfocitos T reguladores (Treg), enla supresión de las respuestas inmunitarias normales y patológicas,contribuyendo a la tolerancia a los elementos propios y a lahomeostasis inmune. Su papel en el control de la respuesta inmunitariafrente a tumores, alergenos, patógenos e injertos alogeneicosha llamado la atención hacia su potencial uso terapéutico. Sinembargo, para que este potencial pueda convertirse en realidad esprecisa una buena caracterización fenotípica y funcional de estasubpoblación, una tarea que se ha comprobado dificultosa. Así,todavía no están claros muchos puntos acerca de los genes diferenciadoresmaestros de este linaje celular, sus marcadores de superficieespecíficos, o sus mecanismos de supresión.En dos trabajos muy recientes se han descrito las nucleotidasasCD39 y CD73 como marcadores de superficie de las célulasTreg, lo que permite unir la actividad supresora de estas célulascon modelos previos de inmunosupresión en los cuales la adenosinay el AMP cíclico tenían un papel funcional primordial

A key issue in Immunology is how the Immune System managesto achieve its major aim of protecting the host against an extraordinaryvariety of pathogens while, at the same time, controllingresponses whose perduration and intensity might be harmful tothe organism. For some years now, evidence has come out ofthe importance of a thymus-derived T cell subpopulation, called“regulatory” (Treg), able of suppressing physiological and pathologicalresponses, contributing to self tolerance and immunehomeostasis. Its role in controlling immune response to tumours,allergens, pathogens and allogeneic grafts has driven the attentiontowards its therapeutic potential. However, to develop thistherapeutic potential to the full a good phenotypical and functionalcharacterization of this subpopulation is necessary, a taskthat has proven difficult. Thus, many factors still remain obscureconcerning the master differentiation genes of these cells, thespecificity of their surface markers, or their suppressor mechanisms.In two recent papers, the nucleotidases CD39 and CD73 havebeen described as T regulatory cell surface markers, linking thesuppressive activity of these cells with previous immunosuppressormodels in which adenosine and cAMP had functionalrelevance for cellular immunoregulation

Sustitutivos óseos de fosfato tricálcico / Bone substitutes of tricalcium phosphate

Introduction: Tricalcium phosphate ceramics are biocompatible and biodegradable porous materials that can be formulated as bone cements or preformed as blocks, granules or powders. Material and method: The in vivo behaviour in an animal model was studied for a-tricalcium phosphate cement (CFalphaT) and for a-tricalcium phosphate ceramic (CFbetaT), materials which were compared with the fresh cancellous bone graft (AOEF). Eighteen New Zealand rabbits were used, which were implanted in cavitary defects created in the right distal femoral metaphysis, being evaluated microscopically at 12 weeks. Results: The histologic study demonstrated that the 3 implants were osteointegred and replaced by neoformed bone. The histomorphometric study determined that bone neoformation obtained at l2 weeks was equivalent, without significant statistically differences, for the 3 evaluated bone substitutes. The area of no reabsorbed biomaterial was lightly bigger for the CFbetaT, although without significant statistically differences (p < 0.05). Conclusion: Tricalcium phosphate ceramics are useful biomaterials in bone replacement, because they contribute to create an osteoconductive scaffold which is progressively replaced by neoformed bone.

Introducción: Las cerámicas de fosfato tricálcico son materiales porosos biocompatibles y biodegradables que pueden ser formuladas como cementos óseos o preformadas como bloques, gránulos o polvos. Material y Método: Se estudió el comportamiento in vivo, en un modelo animal, de un cemento de fosfato a-tricálcico (CFalfaT) y una cerámica de fosfato beta-tricálcico (CFbetaT), materiales que fueron comparados con el autoinjerto Óseo esponjoso fresco (AOEF). Se emplearon 18 conejos Nueva Zelanda los que fueron implantados en defectos cavitarios creados en la metáfisis femoral distal derecha, siendo evaluados microscópicamente a las 12 semanas. Resultados: El estudio histológico demostró que los 3 implantes se osteointegraron y fueron reemplazados por hueso neoformado. El estudio histomorfométrico determinó que la neoformación ósea obtenida a las 12 semanas fue equivalente, sin diferencias estadísticamente significativas, para los 3 sustitutivos óseos evaluados. El área de biomaterial no reabsorbido fue ligeramente mayor para la CFbetaT, aunque sin diferencias estadísticamente significativas (p < 0,(5). Conclusión: Las cerámicas de fosfino tricálcico son biomateriales útiles para rellenar defectos Óseos, dado que aportan un molde estructural osteoconductivo que en forma progresiva es reemplazado por tejido óseo neoformado.

Nefropatía por reflujo. Estudio de 15 años / Reflux nephropathy. 15 year study

Introducción: La nefropatía por reflujo (NFR), constituye la complicación más importante del reflujo vesicoureteral (RVU). Material y método: Se estudiaron retrospectivamente 200 pacientes con RVU en un período de 15 años, en ellos se determinó el tiempo en que apareció la proteinuria, la hipertensión arterial (HTA), tipo de cicatriz y de reflujo. Resultados: El 9% de la serie estudiada (18 pacientes) evolucionaron a la nefropatía por reflujo, todos estos pacientes tenían RVU de alto grado y cuadros recurrentes de infección del tracto urinario (ITU), el 72,2% evolucionó a la NFR antes de los 5 años de evolución del RVU y de ellos el 76,1% tenían RVU secundario. La proteinuria se observó en el 100% de los casos, asociado, en ocasiones, a la HTA. Conclusiones: La presencia de cicatrices renales bilaterales en pacientes con reflujo vesicoureteral de alto grado, con infecciones urinarias recurrentes, unido a malformaciones del tracto urinario, representan los factores fundamentales que se relacionan con la aparición de la nefropatía de reflujo; constituye la proteinuria un elemento precoz y constante en pacientes que desarrollan una nefropatía por reflujo, la cual, unida a la hipertensión arterial, constituye un riesgo importante en el deterioro de la función renal en estos pacientes

Introduction: Reflux nephropathy (RN) is the main complication of vesicoureteral reflux (VUR). Material and methods: A retrospective study of 200 patients with VUR was made during 15 years. The time when proteinuria appeared, arterial hypertension, kind of scar and of reflux were determined. Result: Nine percent of the patients (18 individuals) developed RN, all of them had high grade VUR and also had frequent episodes of urinary tract infections (UTI). Seventy two percent of patients developed RN during the first five years after the diagnosis of VUR and 76.1% of them had secondary VUR. Proteinuria was observed in 100% of patients and it was accompanied by arterial hypertension in some patients. Conclusions: Bilateral renal scars in patients with high grade VUR, recurrent UTI associated to urinary tract malformations are the main risk factors for the developing of RN. Proteinuria is a constant and early element in patients with RN, and together with arterial hypertension are risk factors for the deterioration of renal function in these patients