Deep neural network-based segmentation of normal and abnormal pancreas on abdominal CT: evaluation of global and local accuracies.

PURPOSE: Delay in diagnosis can contribute to poor outcomes in pancreatic ductal adenocarcinoma (PDAC), and new tools for early detection are required. Recent application of artificial intelligence to cancer imaging has demonstrated great potential in detecting subtle early lesions. The aim of the study was to evaluate global and local accuracies of deep neural network (DNN) segmentation of normal and abnormal pancreas with pancreatic mass. METHODS: Our previously developed and reported residual deep supervision network for segmentation of PDAC was applied to segment pancreas using CT images of potential renal donors (normal pancreas) and patients with suspected PDAC (abnormal pancreas). Accuracy of DNN pancreas segmentation was assessed using DICE simulation coefficient (DSC), average symmetric surface distance (ASSD), and Hausdorff distance 95% percentile (HD95) as compared to manual segmentation. Furthermore, two radiologists semi-quantitatively assessed local accuracies and estimated volume of correctly segmented pancreas. RESULTS: Forty-two normal and 49 abnormal CTs were assessed. Average DSC was 87.4 ± 3.1% and 85.5 ± 3.2%, ASSD 0.97 ± 0.30 and 1.34 ± 0.65, HD95 4.28 ± 2.36 and 6.31 ± 6.31 for normal and abnormal pancreas, respectively. Semi-quantitatively, ≥95% of pancreas volume was correctly segmented in 95.2% and 53.1% of normal and abnormal pancreas by both radiologists, and 97.6% and 75.5% by at least one radiologist. Most common segmentation errors were made on pancreatic and duodenal borders in both groups, and related to pancreatic tumor including duct dilatation, atrophy, tumor infiltration and collateral vessels. CONCLUSION: Pancreas DNN segmentation is accurate in a majority of cases, however, minor manual editing may be necessary; particularly in abnormal pancreas.

Mamas tuberosas: reconstrucción mediante tejido autólogo, sin prótesis / Tuberous breast: autologous tissue reconstruction, without implants

Introducción y objetivo: La mama tuberosa es una entidad malformativa muy frecuente en mujeres jóvenes y un reto por su frecuencia y complejidad quirúrgica. Exponemos la transición que hemos llevado a cabo en el manejo de las mamas tuberosas en el servicio público de Cirugía Plástica del Hospital General Universitario Dr. Balmis de Alicante (España), sustituyendo la técnica con prótesis por técnica que emplea en exclusiva tejido autólogo. Material y método: Estudio descriptivo, retrospectivo, revisando los últimos 101 casos realizados en nuestro servicio entre noviembre de 2010 y junio 2022. Recogemos datos acerca de las técnicas quirúrgicas, número de intervenciones necesarias, así como la tasa de complicaciones a corto y largo plazo entre la técnica con material protésico que realizamos de forma habitual hasta 2013 y la técnica con tejido autólogo que utilizamos posteriormente. Describimos la técnica utilizada para corregir la alteración de la forma y la asimetría de volumen de las mamas tuberosas mediante el uso de colgajos glandulares, lipoinjertos y pexias mamarias. Resultados: En el periodo descrito empleamos tejido autólogo de forma exclusiva en el 87% de los casos, el 81% correspondientes a grados II y III de Grolleau, con una media de 2.1 tiempos quirúrgicos. La técnica más utilizada fue la remodelación glandular asociada a lipoinjerto. El índice de complicaciones a medio y largo plazo fue menor en comparación con la reconstrucción habitual con prótesis. Conclusiones: Según nuestra experiencia, la cirugía de la mama tuberosa mediante el uso exclusivo de tejido autólogo en pacientes seleccionadas, permite corregir esta malformación sin recurrir al uso de material protésico, con resultados reproducibles y con menos complicaciones a medio y largo plazo en comparación con la reconstrucción habitual con prótesis.(AU)

Background and objective: Tuberous breast is a very common malformative entity in young women and a challenge due to its frequency and surgical complexity. We present our transition in the management of tuberous breasts of our public Plastic Surgery Service at the Dr. Balmis General University Hospital in Alicante (Spain), replacing technique with prosthetic material for exclusive technique with autologous tissue. Methods: Descriptive, retrospective study, reviewing the last 101 cases performed in our service between November 2010 and June 2022. Data have been collected about the surgical techniques, number of necessary interventions, as well as the rate of shortand long-term complications between the technique with prosthetic material that we routinely performed until 2013 and the technique with autologous tissue that we used subsequently. The technique used to correct the alteration in shape and volume asymmetry of the tuberous breast is described, through using glandular flaps, lipografts and mastopexy techniques. Results: In the period described, the use of autologous tissue exclusively has been carried out in 87% of the cases, 81% corresponding to Grolleau grades II and III, with an average of 2.1 surgical times. The most used technique was glandular remodeling associated with lipograft. The rate of complications in the medium and long term is lower compared to the usual technique with prostheses that we previously performed. Conclusions: According to our experience, treatment of the tuberous breast through the exclusive use of autologous tissue in selected patients, allows this malforation to be fixed without using prosthetic material, with a lower number of complications compared to reconstruction with prosthetic material.(AU)

Radiologists' Expectations of Artificial Intelligence in Pancreatic Cancer Imaging: How Good Is Good Enough?

BACKGROUND: Existing (artificial intelligence [AI]) tools in radiology are modeled without necessarily considering the expectations and experience of the end user-the radiologist. The literature is scarce on the tangible parameters that AI capabilities need to meet for radiologists to consider them useful tools. OBJECTIVE: The purpose of this study is to explore radiologists' attitudes toward AI tools in pancreatic cancer imaging and to quantitatively assess their expectations of these tools. METHODS: A link to the survey was posted on the www.ctisus.com website, advertised in the www.ctisus.com email newsletter, and publicized on LinkedIn, Facebook, and Twitter accounts. This survey asked participants about their demographics, practice, and current attitudes toward AI. They were also asked about their expectations of what constitutes a clinically useful AI tool. The survey consisted of 17 questions, which included 9 multiple choice questions, 2 Likert scale questions, 4 binary (yes/no) questions, 1 rank order question, and 1 free text question. RESULTS: A total of 161 respondents completed the survey, yielding a response rate of 46.3% of the total 348 clicks on the survey link. The minimum acceptable sensitivity of an AI program for the detection of pancreatic cancer chosen by most respondents was either 90% or 95% at a specificity of 95%. The minimum size of pancreatic cancer that most respondents would find an AI useful at detecting was 5 mm. Respondents preferred AI tools that demonstrated greater sensitivity over those with greater specificity. Over half of respondents anticipated incorporating AI tools into their clinical practice within the next 5 years. CONCLUSION: Radiologists are open to the idea of integrating AI-based tools and have high expectations regarding the performance of these tools. Consideration of radiologists' input is important to contextualize expectations and optimize clinical adoption of existing and future AI tools.

THC exposure during adolescence increases impulsivity-like behavior in adulthood in a WIN 55,212-2 self-administration mouse model.

Background: Cannabis addiction is a chronically relapsing disorder lacking effective treatment. Regular cannabis consumption typically begins during adolescence, and this early cannabinoid exposure may increase the risk for drug addiction in adulthood. Objective: This study investigates the development of cannabis addiction-like behavior in adult mice after adolescent exposure to the main psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC). Methods: Adolescent male mice were exposed to 5 mg/kg of THC from postnatal days 37 to 57. Operant self-administration sessions of WIN 55,212-2 (12.5 µg/kg/infusion) were conducted for 10 days. Mice were tested for three addiction-like criteria (persistence of response, motivation, and compulsivity), two parameters related to craving (resistance to extinction and drug-seeking behavior), and two phenotypic vulnerability traits related to substance use disorders (impulsivity and reward sensitivity). Additionally, qPCR assays were performed to detect differentially expressed genes in medial prefrontal cortex (mPFC), nucleus accumbens (NAc), dorsal striatum, and hippocampus (HPC) of "addicted" and "non-addicted" mice. Results: Adolescent THC exposure did not modify WIN 55,212-2 reinforcement nor the development of cannabis addiction-like behavior. Inversely, THC pre-exposed mice displayed impulsive-like behavior in adulthood, which was more pronounced in mice that developed the addiction-like criteria. Moreover, downregulated drd2 and adora2a gene expression in NAc and HPC was revealed in THC pre-exposed mice, as well as a downregulation of drd2 expression in mPFC of vehicle pre-treated mice that developed addiction-like behaviors. Discussion: These findings suggest that adolescent THC exposure may promote impulsivity-like behavior in adulthood, associated with downregulated drd2 and adora2a expression in NAc and HPC.

CT of retroperitoneal solitary fibrous tumor.

Solitary fibrous tumors are rare tumors of pluripotent fibroblastic or myofibroblastic origin that generally arise among older individuals, with a mean age of onset ranging from 55 to 65 years. Though typically associated with pleural involvement, solitary fibrous tumors can emerge in virtually every anatomic location within the body. Although most solitary fibrous tumors are benign, approximately 20% may exhibit malignant features such as local invasion, recurrence, and metastases. In this article, we report the case of a 58-year-old male with a diagnosis of a retroperitoneal solitary fibrous tumor. We analyze computed tomography imaging findings and additionally correlate imaging features with the patient's unique pathological and genotypic findings to optimize diagnosis.

Population trends of seabirds in Mexican Islands at the California Current System.

The Baja California Pacific Islands (BCPI) is a seabird hotspot in the southern California Current System supporting 129 seabird breeding populations of 23 species and over one million birds annually. These islands had a history of environmental degradation because of invasive alien species, human disturbance, and contaminants that caused the extirpation of 27 seabird populations. Most of the invasive mammals have been eradicated and colonies have been restored with social attraction techniques. We have recorded the number of breeding pairs annually for most of the colonies since 2008. To assess population trends, we analyzed these data and show results for 19 seabird species on ten island groups. The maximum number of breeding pairs for each nesting season was used to estimate the population growth rate (λ) for each species at every island colony. We performed a moving block bootstrap analysis to assess whether seabird breeding populations are increasing or decreasing. San Benito, Natividad, and San Jerónimo are the top three islands in terms of abundance of breeding pairs. The most widespread species is Cassin's Auklet (Ptychoramphus aleuticus) with 14 colonies. Thirty-one populations of 14 species are significantly increasing while eleven populations of seven species are decreasing. We did not find statistical significance for 19 populations, however, 15 have λ>1 which suggest they are growing. Twelve of the 18 species for which we estimated a regional population trend are significantly increasing, including seven surface-nesting species: Brandt's Cormorant (Phalacrocorax penicillatus), Brown Pelican (Pelecanus occidentalis), Caspian Tern (Hydroprogne caspia), Double-crested Cormorant (P. auritus), Elegant Tern (Thalasseus elegans), Laysan Albatross (Phoebastria immutabilis) and Western Gull (Larus occidentalis), and five burrow-nesting species: Ainley's (Hydrobates cheimomnestes), Ashy (H. homochroa) and Townsend's (H. socorroensis) Storm-Petrels, and Craveri's (Synthliboramphus craveri) and Guadalupe (S. hypoleucus) Murrelets. The BCPI support between 400,000 and 1.4 million breeding individuals annually. Our results suggest that these islands support healthy and growing populations of seabirds that have shown to be resilient to extreme environmental conditions such as the "Blob", and that such resilience has been strengthen from conservation and restoration actions such as the eradication of invasive mammals, social attraction techniques and island biosecurity.

Bodyweight and human capital development: Assessing the impact of obesity on socioemotional skills during childhood in Chile.

This article analyzes the effect of bodyweight on socioemotional skills for children aged two to 12 years in Chile. Using an instrumental variable approach and a representative survey, we show that both BMI and obesity are causality related to children's socioemotional development, even after assuming that our instrument is imperfect. Although we did not find significant differences between boys and girls, we do identify heterogeneous effects by age: the weight penalty for girls starts earlier than for boys. Our findings suggest that early interventions for childhood obesity not only might generate positive impacts on children's health, but also a greater accumulation of non-cognitive human capital in the future.

miRNA signatures associated with vulnerability to food addiction in mice and humans.

Food addiction is characterized by a loss of behavioral control over food intake and is associated with obesity and other eating disorders. The mechanisms underlying this behavioral disorder are largely unknown. We aimed to investigate the changes in miRNA expression promoted by food addiction in animals and humans and their involvement in the mechanisms underlying the behavioral hallmarks of this disorder. We found sharp similitudes between miRNA signatures in the medial prefrontal cortex (mPFC) of our animal cohort and circulating miRNA levels in our human cohort, which allowed us to identify several miRNAs of potential interest in the development of this disorder. Tough decoy (TuD) inhibition of miRNA-29c-3p in the mouse mPFC promoted persistence of the response and enhanced vulnerability to developing food addiction, whereas miRNA-665-3p inhibition promoted compulsion-like behavior and also enhanced food addiction vulnerability. In contrast, we found that miRNA-137-3p inhibition in the mPFC did not lead to the development of food addiction. Therefore, miRNA-29c-3p and miRNA-665-3p could be acting as protective factors with regard to food addiction. We believe the elucidation of these epigenetic mechanisms will lead to advances toward identifying innovative biomarkers and possible future interventions for food addiction and related disorders based on the strategies now available to modify miRNA activity and expression.

Genomics and epigenomics of addiction.

Recent progress in the genomics and epigenomics of addiction has contributed to improving our understanding of this complex mental disorder's etiology, filling the gap between genes, environment, and behavior. We review the behavioral genetic studies reporting gene and environment interactions that explain the polygenetic contribution to the resilience and vulnerability to develop addiction. We discuss the evidence of polymorphic candidate genes that confer susceptibility to develop addiction as well as the studies of specific epigenetic marks that contribute to vulnerability and resilience to addictive-like behavior. A particular emphasis has been devoted to the miRNA changes that are considered potential biomarkers. The increasing knowledge about the technology required to alter miRNA expression may provide promising novel therapeutic tools. Finally, we give future directions for the field's progress in disentangling the connection between genes, environment, and behavior.

Hepatic angiosarcoma in an adult who had Wilms tumor treated in childhood: A case report.

Hepatic angiosarcoma is a rare, highly aggressive mesenchymal liver malignancy with poor prognosis that stems from the endothelial cells that line the walls of blood or lymphatic vessels. It is the third most common primary liver malignancy and is most prevalent among older males. It is difficult to diagnose due to various clinical presentations from asymptomatic to abdominal pain, pleural effusion, and liver failure. The diagnosis of liver angiosarcoma is suspected on imaging features and confirmed by histopathological assessment. Primary management is determined based on the stage of tumor from surgery to palliative care such as chemotherapy or tumor transarterial embolization. We report a 51-year-old female who presented with stage 4 liver angiosarcoma and a history of childhood Wilms tumor. We focus on tumor management using radiological modalities and pathological analysis and discuss secondary liver tumors in survivors of childhood Wilms tumor.

Intra-abdominal lymphangioma: A case report.

Lymphangioma is a rare, benign congenital malformation of the lymphatic system that usually affects the neck and head in children. Intra-abdominal lymphangioma accounts for less than 5 percent of all cases of lymphangioma. The clinical presentation of intra-abdominal lymphangioma can vary from asymptomatic to nausea, vomiting, and abdominal pain. The diagnosis of intra-abdominal lymphangioma is based on imaging modalities and histopathological examination. The definitive treatment is surgical resection. Here we describe the interesting and rare case of a 29-year-old woman with lymphangioma of the retroperitoneum extending to the root of the mesentery. We focus on the diagnosis and management of this rare tumor by the application of radiological modalities and pathological analysis.

Radial artery pseudoaneurysm after transradial cardiac catheterization: A case presentation.

Cardiac catheterization through the radial artery has reduced the percentage of complications seen previously in the femoral approach. Computed tomographic angiography is a noninvasive technique that can accurately diagnose pseudoaneurysms and other vascular pathologies. A 93-year-old female presented to the emergency department with pain and swelling of her right distal arm and wrist after a transradial cardiac catheterization procedure, as part of a transcatheter aortic valve replacement evaluation for severe aortic stenosis. Angiography is the standard diagnosing technique for aneurysms and pseudoaneurysms, but it is an invasive procedure. We show this case in order to highlight the importance of computed tomographic angiography as a noninvasive approach in diagnosing uncommon complications in the clinical setting.

Idiopathic recurrent acute pancreatitis in the context of pancreas divisum: A case report.

Recurrent acute pancreatitis is characterized by frequent episodes of inflammation in the pancreas. The most common causes are alcohol abuse and gallstones but approximately 30% of cases are defined as idiopathic because initial evaluation fails to detect the etiology. In these patients, extensive laboratory and imaging evaluations usually lead to the uncovering of an occult biliary duct stone or sphincter of Oddi dysfunction as the main reason for frequent pancreatitis. We report a 42-year-old female with a longstanding history of acute recurrent pancreatitis in the setting of pancreas divisum due to its rarity. We focus on appropriate investigations by application of specialized laboratory and radiological modalities because determining the etiology is a crucial step in patient management.

Pancreatic cystic desmoid tumor following metastatic colon cancer surgery: A case report.

Desmoid tumors are rare, benign, and locally aggressive neoplasms that stem from connective tissue that have high rates of recurrence after surgery. Intra-abdominal desmoid-type fibromatosis can arise in 2 forms: sporadic or hereditary (associated with familial adenomatous polyposis and Gardner syndrome). The diagnosis of desmoid-type tumors is based on imaging modalities and histopathological examination. The primary treatment is resection surgery. We report a 64-year-old male with a distal pancreatic desmoid tumor. We focus on tumor management by the application of radiological modalities and pathological analysis.

Emerging imaging techniques for acute pancreatitis.

Acute pancreatitis (AP) is caused by acute inflammation of the pancreas and adjacent tissue and is a common source of abdominal pain. The current CT and MRI evaluation of AP is mostly based on morphologic features. Recent advances in image acquisition and analysis offer the opportunity to go beyond morphologic features. Advanced MR techniques such as diffusion-weighted imaging, as well as T1 and T2 mapping, can potentially quantify signal changes reflective of underlying tissue abnormalities. Advanced analytic techniques such as radiomics and artificial neural networks (ANNs) offer the promise of uncovering imaging biomarkers that can provide additional classification and prognostic information. The purpose of this article is to review recent advances in imaging acquisition and analytic techniques in the evaluation of AP.

Caracterización molecular de cepas invasivas de Streptococcus dysgalactiae subsp. equisimilis: estudio multicéntrico Argentina 2011-2012 / Molecular characterization of invasive Streptococcus dysgalactiae subsp. equisimilis. Multicenter study: Argentina 2011-2012

Streptococcus dysgalactiae subsp. equisimilis (SDSE) has virulence factors similar to those of Streptococcus pyogenes. Therefore, it causes pharyngitis and severe infections indistinguishable from those caused by the classic pathogen. The objectives of this study were: to know the prevalence of SDSE invasive infections in Argentina, to study the genetic diversity, to determine the presence of virulence genes, to study antibiotic susceptibility and to detect antibiotic resistance genes. Conventional methods of identification were used. Antibiotic susceptibility was determined by the disk diffusion and the agar dilution methods and the E-test. Twenty eight centers from 16 Argentinean cities participated in the study. Twenty three isolates (16 group G and 7 group C) were obtained between July 1 2011 and June 30 2012. Two adult patients died (8.7%). Most of the isolates were recovered from blood (60.9%). All isolates carried speJ and ssa genes. stG62647, stG653 and stG840 were the most frequent emm types. Nineteen different PFGE patterns were detected. All isolates were susceptible to penicillin and levofloxacin, 6 (26.1%) showed resistance or reduced susceptibility to erythromycin --#91;1 mef(A), 3 erm(TR), 1 mef(A) + erm(TR) and 1 erm(TR) + erm(B)--#93; and 7 (30.4%) were resistant or exhibited reduced susceptibility to tetracycline --#91;2 tet(M), 5 tet(M) + tet(O)--#93;. The prevalence in Argentina was of at least 23 invasive infections by SDSE. A wide genetic diversity was observed. All isolates carried speJ and ssa genes. Similarly to other studies, macrolide resistance (26.1%) was mainly associated to the MLS B phenotype.

Streptococcus dysgalactiae subsp. equisimilis (SDSE) posee factores de virulencia similares a Streptococcus pyogenes y, en consecuencia, produce faringitis e infecciones graves indistinguibles de las generadas por este patógeno clásico. Los objetivos del estudio fueron conocer la prevalencia de SDSE en infecciones invasivas en Argentina, estudiar su diversidad genética, determinar la presencia de genes de virulencia, ensayar su sensibilidad a los antibióticos y conocer los genes de resistencia. Se emplearon métodos convencionales de identificación. La sensibilidad se determinó por difusión, Etest y dilución en agar. Participaron 28 centros de 16 ciudades argentinas. Se obtuvieron 23 aislamientos (16 del grupo G y 7 del grupo C) desde el 1-7-2011 hasta el 30-6-2012. Se registraron 2 muertes en adultos (8,7%). La mayoría de los aislamientos fueron obtenidos de sangre (60,9%). Todos eran portadores de los genes speJ y ssa. Los genotipos más frecuentes fueron stG62647, stG653 y stG840. Se detectaron 19 pulsotipos distintos. Todos los aislamientos fueron sensibles a penicilina y levofloxacina, 6 (26,1%) presentaron resistencia o sensibilidad disminuida a eritromicina (1 mef--#91;A--#93;, 3 erm--#91;TR--#93;, 1 mef--#91;A--#93; + erm--#91;TR--#93; y 1 erm--#91;TR--#93; + erm--#91;B--#93;) y 7 (30,4%) fueron resistentes o tuvieron sensibilidad disminuida a tetraciclina (2 tet--#91;M--#93;, 5 tet--#91;M--#93; + tet--#91;O--#93;). La prevalencia anual en la Argentina fue de al menos 23 infecciones invasivas por SDSE y se observó una amplia diversidad genética. Todos los aislamientos presentaron los genes ssa y speJ. Como en otros estudios, la resistencia a macrólidos (26,1%) estuvo asociada, principalmente, al fenotipo MLS B.

Concepciones sobre la crianza: el pensamiento de madres y padres de familia / Conceptions regarding upbringing: the thoughts of parents

Al ser la familia una de las principales instituciones de desarrollo del ser humano, se convierte en uno de los pilares responsables sobre los que se sostiene el bienestar personal y social, además de constituirse en el espacio en donde se construye una visión particular del mundo. Esto hace relevante el estudio del pensamiento de madres/padres de familia (expresado a través de creencias), quienes se convierten en los principales actores de la crianza y por ende del bienestar y desarrollo familiar. El presente trabajo tiene como objeto evaluar las concepciones que madres/padres de familia mantienen acerca de la crianza. Participaron 40 familias, quienes respondieron un Cuestionario Atribucional de Modelos Parentales (Martínez, Salazar e Infante, 2013) y una entrevista semiestructurada en la cual se indagó sobre la dinámica familiar y las prácticas de crianza. Los resultados señalan que el modelo parental se traduce en una pauta de crianza negociadora, un vínculo de apego cercano y un patrón de éxito promotor. En el análisis de las entrevistas se encontraron cuatro categorías que muestran los aspectos de la crianza que los participantes perciben como fáciles y difíciles, la propia autopercepción en el rol de madres/padres que desempeña y los retos más comunes a los que se enfrentan las familias de hoy. Se concluye que el pensamiento de madres/padres sobre la crianza se conforma a partir de sus conocimientos, creencias y actitudes claramente influenciados por el contexto social cercano, la cultura dominante y la cultura heredada sobre la familia arraigada en las experiencias previas de crianza...

Being the family one of the main institutions of human development, it becomes one of the responsible pillars upon which the personal and social well-being is sustained, in addition to constituting the space where a particular vision of the world is built. This makes the study of parentÆs thoughts relevant (expressed through beliefs), who become the main actors of upbringing and therefore of the welfare and family development. The present work has as its aim to assess the concepts that parents maintain about parenting. Participants included 40 families who answered a designated questionnaire of parental models (Martinez, Salazar & Infante, 2013), and a semi-structured interview which inquired about the family dynamics and child-rearing practices. The results indicate that the parental model translates into a negotiated upbringing pattern; a link of close attachment and a pattern of success promoter. In the interview analysis they found four categories that show the aspects of upbringing that participants perceive as easy and difficult; the personal perceptions on the role of parents being carried out, and the most common challenges facing families today. It is concluded that parental thoughts regarding upbringing is produced from their knowledge, beliefs and attitudes clearly influenced by the nearby social context, the dominant culture, and the inherited culture on the rooted family in the previous upbringing experiences...

Molecular characterization of invasive Streptococcus dysgalactiae subsp. equisimilis. Multicenter study: Argentina 2011-2012.

Streptococcus dysgalactiae subsp. equisimilis (SDSE) has virulence factors similar to those of Streptococcus pyogenes. Therefore, it causes pharyngitis and severe infections indistinguishable from those caused by the classic pathogen. The objectives of this study were: to know the prevalence of SDSE invasive infections in Argentina, to study the genetic diversity, to determine the presence of virulence genes, to study antibiotic susceptibility and to detect antibiotic resistance genes. Conventional methods of identification were used. Antibiotic susceptibility was determined by the disk diffusion and the agar dilution methods and the E-test. Twenty eight centers from 16 Argentinean cities participated in the study. Twenty three isolates (16 group G and 7 group C) were obtained between July 1 2011 and June 30 2012. Two adult patients died (8.7%). Most of the isolates were recovered from blood (60.9%). All isolates carried speJ and ssa genes. stG62647, stG653 and stG840 were the most frequent emm types. Nineteen different PFGE patterns were detected. All isolates were susceptible to penicillin and levofloxacin, 6 (26.1%) showed resistance or reduced susceptibility to erythromycin [1 mef(A), 3 erm(TR), 1 mef(A)+erm(TR) and 1 erm(TR)+erm(B)] and 7 (30.4%) were resistant or exhibited reduced susceptibility to tetracycline [2 tet(M), 5 tet(M)+tet(O)]. The prevalence in Argentina was of at least 23 invasive infections by SDSE. A wide genetic diversity was observed. All isolates carried speJ and ssa genes. Similarly to other studies, macrolide resistance (26.1%) was mainly associated to the MLSB phenotype.

[Differential diagnosis of imported filariasis by molecular techniques (2006-2009)]. / Diagnóstico diferencial de filariasis importada mediante técnicas moleculares (2006-2009).

INTRODUCTION: The last few years has seen an increase in the number of immigrants and travellers from endemic areas where filariasis are mainly caused by Loa loa (L. loa), Mansonella perstans (M. perstans) and Wuchereria bancrofti (W. bancrofti) species. These demographic changes has led to the need for better filariae species-specific molecular diagnostic tests to solve problems, as alternatives to the more time consuming classic parasitology methods. Thus, the objective of the present work was the implementation of optimised molecular protocols (nested-PCR and ITS1-RFLP) developed in our laboratory, for the differential diagnosis of filarial parasites. The results obtained were compared with those obtained using the conventional parasitological methods. MATERIAL AND METHODS: A total of 523 samples (517 peripheral blood, 5 adult worms and one vitreous body) were sent to Parasitology Department of the National Microbiology Centre, Carlos II Research Institute (ISCIII), from 47 Health Centres in the Autonomous Regions of Spain, from 2006 to 2009. The samples were studied by the Knott technique, nested-PCR and ITS1-RFLP. RESULTS: The molecular techniques applied on blood samples showed to be more sensitive that Knott's concentration technique in the diagnosis of both L. loa (n=12 versus n=4) and M. perstans (n=57 versus n=25) infections. CONCLUSIONS: The nested-PCR and ITS1-RFLP are potential diagnostic tools for daily routine laboratory species-specific and sensitive detection of L. loa and M. perstans filarial species in immigrant population and travellers from endemic areas where these filarial species are co-endemic. Knott's concentration technique was less sensitive than molecular methods and should be carried out as a complementary diagnostic assay.

Diagnóstico diferencial de filariasis importada mediante técnicas moleculares (2006-2009) / Differential diagnosis of imported filariasis by molecular techniques (2006-2009)

Introducción: Durante los últimos años se ha registrado un aumento creciente de la población inmigrante y de viajeros procedentes de áreas endémicas de filariasis producidas por Loa loa (L. loa), Mansonella perstans(M. perstans) y Wuchereria bancrofti (W. bancrofti). Esta situación epidemiológica ha hecho necesario el desarrollo de técnicas específicas de diagnóstico molecular, alternativas al método parasitológico clásico.Por lo tanto, el objetivo planteado en este trabajo ha sido la utilización de las técnicas moleculares optimizadas en nuestro laboratorio, nested-PCR e ITS1-RFLP, en el diagnóstico de filariasis importadas, y la comparación de los resultados obtenidos con los derivados del diagnóstico parasitológico. Material y métodos: Se ha estudiado mediante la técnica de concentración de Knott, nested-PCR e ITS1-RFLP un total de 523 muestras (517 sangres, 5 helmintos adultos y un humor vítreo) que fueron remitidas al Servicio de Parasitología del Centro Nacional de Microbiología-Instituto de Salud Carlos III, entre los años 2006 y 2009, por 47 centros sanitarios de las comunidades autónomas. Resultados: Las técnicas moleculares utilizadas demostraron ser más sensibles que el método de concentración de Knott, tanto en el diagnóstico de L. loa (n = 12 frente a n = 4) como en el de M. perstans (n=57frente a n = 25) en el total de muestras de sangre estudiadas. Conclusión: Los métodos de PCR utilizados permiten un diagnóstico específico y más sensible de L. loay M. perstans en muestras clínicas de población inmigrante y viajeros procedentes de áreas endémicas, donde estas especies de filarias son coendémicas. El método de concentración de Knott debe emplearse como técnica complementaria siempre que sea posible (AU)

Introduction: The last few years has seen an increase in the number of immigrants and travellers from endemic areas where filariasis are mainly caused by Loa loa (L. loa), Mansonella perstans (M. perstans) and Wuchereria bancrofti (W. bancrofti) species. These demographic changes has led to the need for better filariae species-specific molecular diagnostic tests to solve problems, as alternatives to the more time consuming classic parasitology methods. Thus, the objective of the present work was the implementation of optimised molecular protocols (nested-PCR and ITS1-RFLP) developed in our laboratory, for the differential diagnosis of filarial parasites. The results obtained were compared with those obtained using the conventional parasitological methods. Material and methods: A total of 523 samples (517 peripheral blood, 5 adult worms and one vitreous body)were sent to Parasitology Department of the National Microbiology Centre, Carlos II Research Institute(ISCIII), from 47 Health Centres in the Autonomous Regions of Spain, from 2006 to 2009. The samples were studied by the Knott technique, nested-PCR and ITS1-RFLP.Results: The molecular techniques applied on blood samples showed to be more sensitive that Knott’s concentration technique in the diagnosis of both L. loa (n=12 versus n=4) and M. perstans (n=57 versusn = 25) infections (AU)