The c.415C>T polymorphism in NUDT15 is more frequent than the polymorphisms in TPMT in Chilean patients who use thiopurine drugs.

Azathioprine (AZA) and 6-mercaptopurine (6-MP) are drugs widely used in the treatment of autoimmune diseases. Among the enzymes involved in the metabolism of AZA and 6-MP are thiopurine methyltransferase (TPMT) and nudix hydrolase 15 (NUDT15). The existence of single nucleotide polymorphisms in the genes that code for these enzymes could decreased enzymatic activity AND lead to severe myelosuppression. The most relevant polymorphism is NUDT15*3 (rs116855232), where the replacement of cytosine for thymine at position 415, which in turn leads to a loss of enzymatic activity. In a previous study, it was identified that together the polymorphisms in the TPMT gene reach an allelic frequency of 3.81%. There is no information regarding the rs116855232 polymorphism in the NUDT15 gene, so this corresponds to the objective of this report. Blood samples from Chilean adult patients with indications for the use of AZA or 6-MP for different pathologies and who had undergone a TPMT gene polymorphism study were retrospectively analyzed. A total of 253 blood samples were analyzed. Of the 253 patients, 47 presented the c.415C>T polymorphism in the NUDT15 gene, 3 being homozygous and 44 heterozygous. Four of the heterozygous patients for NUDT15 also had the *3A variant in the TPMT gene, also heterozygous. The allelic frequency of the minor T allele found (9.88%) was very similar to that found in patients of Asian origin, and much higher than that reported for the European Caucasian or Latin American population.

Detección de anticuerpos anti virus hepatitis E IgG e IgM utilizando un método automatizado: experiencia de un hospital universitario / Detection of anti-virus hepatitis e IgG and IgM antibodies using an automated method: experience of a university hospital

Resumen La determinación de anticuerpos anti virus hepatitis E (anti-VHE) tiene gran variabilidad dependiendo del ensayo utilizado. En 2015, con un método ELISA manual, publicamos una seroprevalencia de anti-VHE IgG de 32,6% en pacientes con estudio de hepatitis. Existen escasas publicaciones de anti-VHE IgM. Recientemente, se desarrolló el primer método automatizado y en el presente estudio comunicamos la experiencia obtenida. Se analizaron los resultados de 272 pacientes con estudio de anti-VHE IgG y/o IgM mediante técnica automatizada ELFA (VIDAS®), entre mayo de 2018 y agosto de 2020. Se encontró 25,8% (68/264) de positividad para anti-VHE IgG y 3,5% (9/259) para anti-VHE IgM. Cuatro muestras tuvieron ambos anticuerpos positivos. La seropositividad de anti-VHE IgG aumentó con la edad. En conclusión, la seroprevalencia de anti-VHE IgG obtenida fue similar a la publicada previamente. Considerando las ventajas de los ensayos IgM e IgG anti-VHE en el sistema VIDAS®, parecen ser nuevas herramientas valiosas en el estudio serológico de VHE.

Abstract The determination of anti-hepatitis E virus antibodies (anti-HEV) has a high variability depending on the assay used. In 2015, with a manual ELISA method, we reported anti-HEV IgG seroprevalence of 32.6% in patients under hepatitis study. There are few reports of anti-HEV IgM. Recently, it was developed the first automated method and in the present study, we report the experience using this new method. Between May 2018 and August 2020, the results of 272 patients with an anti-HEV IgG and/or IgM study were analyzed using the automated ELFA technique (VIDAS®). Seroprevalence was 25.8% (68/264) for anti-HEV IgG and 3.5% (9/259) for anti-HEV IgM. Four samples were positive for both antibodies. Anti-HEV IgG seropositivity increased with age. In conclusion, the seroprevalence of anti-HEV IgG obtained was similar to previously reported. Taking into account the advantages of these assays, anti-HEV IgM and IgG assays on VIDAS® system, seem to be valuable new tools in serological study of HEV.

[Detection of anti-virus hepatitis e IgG and IgM antibodies using an automated method: experience of a university hospital]. / Detección de anticuerpos anti virus hepatitis E IgG e IgM utilizando un método automatizado: experiencia de un hospital universitario.

The determination of anti-hepatitis E virus antibodies (anti-HEV) has a high variability depending on the assay used. In 2015, with a manual ELISA method, we reported anti-HEV IgG seroprevalence of 32.6% in patients under hepatitis study. There are few reports of anti-HEV IgM. Recently, it was developed the first automated method and in the present study, we report the experience using this new method. Between May 2018 and August 2020, the results of 272 patients with an anti-HEV IgG and/or IgM study were analyzed using the automated ELFA technique (VIDAS®). Seroprevalence was 25.8% (68/264) for anti-HEV IgG and 3.5% (9/259) for anti-HEV IgM. Four samples were positive for both antibodies. Anti-HEV IgG seropositivity increased with age. In conclusion, the seroprevalence of anti-HEV IgG obtained was similar to previously reported. Taking into account the advantages of these assays, anti-HEV IgM and IgG assays on VIDAS® system, seem to be valuable new tools in serological study of HEV.

Seroprevalencia de Toxoplasma gondii en un hospital universitario en Chile / Toxoplasma gondii seroprevalence in a university hospital in Chile

Resumen La toxoplasmosis es una enfermedad zoonótica causada por Toxoplasma gondii. Se estima que afecta a un tercio de la población mundial. En Chile, en 1996, se reportó que la seroprevalencia de anticuerpos del tipo IgG contra T. gondii fue 36,9%, la cual aumentaba progresivamente de norte a sur del país. Hasta el momento, no existe información actualizada sobre la seroprevalencia de T. gondii en la Región Metropolitana. En el presente estudio, se determinó la seroprevalencia de IgG anti T. gondii en el periodo 2013-2018 en un centro universitario de Santiago. De un total de 1.666 resultados, 386 (23,2%) fueron positivos. No se encontraron diferencias según sexo y hubo un incremento significativo según el rango etario. No se observó una disminución de la seroprevalencia en los últimos seis años; sin embargo, los resultados señalan una reducción significativa con respecto a investigaciones previas realizadas en la Región Metropolitana.

Abstract Toxoplasmosis is a zoonotic disease caused by Toxoplasma gondii. It is estimated to affect a third of the world's population. In Chile, in 1996, a seroprevalence of IgG antibodies against T. gondii of 36.9% was reported, which progressively increased from north to south of the country. There are no updated reports of the seroprevalence of T. gondii in the Metropolitan Region. In the present study, we determined the seroprevalence of anti T. gondii IgG in the 2013-2018 period at the Clinical Hospital University of Chile. Of a total of 1,666 results, 386 (23.2%) were positive, without gender differences, but with a significant increase with age. A decrease in seroprevalence was not observed in the last six years, however the results obtained show a significant reduction compared to previous research carried out in the Metropolitan Region.

[Toxoplasma gondii seroprevalence in a university hospital in Chile]. / Seroprevalencia de Toxoplasma gondii en un hospital universitario en Chile.

Toxoplasmosis is a zoonotic disease caused by Toxoplasma gondii. It is estimated to affect a third of the world's population. In Chile, in 1996, a seroprevalence of IgG antibodies against T. gondii of 36.9% was reported, which progressively increased from north to south of the country. There are no updated reports of the seroprevalence of T. gondii in the Metropolitan Region. In the present study, we determined the seroprevalence of anti T. gondii IgG in the 2013-2018 period at the Clinical Hospital University of Chile. Of a total of 1,666 results, 386 (23.2%) were positive, without gender differences, but with a significant increase with age. A decrease in seroprevalence was not observed in the last six years, however the results obtained show a significant reduction compared to previous research carried out in the Metropolitan Region.

[Hepatitis E virus seroprevalence in blood donors in a university hospital in Chile]. / Seroprevalencia de virus hepatitis E en donantes de sangre en un hospital universitario en Chile.

In Chile, there are few studies about seroprevalence of IgG antibodies against hepatitis E virus (HEV) in blood banks, between 4 and 8%. The development of new techniques with greater sensitivity and specificity, account for an increase in the seroprevalence of HEV in various countries, the current status in Chile being unknown. In the present study, we determined the seroprevalence of anti-HEV IgG in blood donors of the Clinical Hospital University of Chile, with last generation ELISA techniques. Out of a total of 186 samples, collected in 2014, 56 (30.1%) were positive, without gender differences, but with a significant increase with age (p < 0.001). These results show an increase in the seroprevalence of HEV in blood donors performed with immunoassays of greater sensitivity.

Seroprevalencia de virus hepatitis E en donantes de sangre en un hospital universitario en Chile / Hepatitis E virus seroprevalence in blood donors in a university hospital in Chile

Resumen En Chile, existen escasos estudios de seroprevalencia de anticuerpos IgG anti virus hepatitis E (VHE) en bancos de sangre, entre 4 y 8%. El desarrollo de nuevas técnicas con mayor sensibilidad y especificidad, dan cuenta de un aumento de la seroprevalencia de VHE en diversos países, siendo desconocido el estado actual en Chile. En el presente estudio, determinamos la seroprevalencia de IgG anti VHE en donantes de sangre del Hospital Clínico Universidad de Chile, con técnicas de ELISA de última generación. De un total de 186 muestras, recolectadas el año 2014, 56 (30,1%) resultaron positivas, sin diferencias de género, pero con un incremento significativo con la edad (p < 0,001). Estos resultados muestran un aumento en la seroprevalencia de VHE en donantes de sangre realizados con inmunoensayos de mayor sensibilidad.

In Chile, there are few studies about seroprevalence of IgG antibodies against hepatitis E virus (HEV) in blood banks, between 4 and 8%. The development of new techniques with greater sensitivity and specificity, account for an increase in the seroprevalence of HEV in various countries, the current status in Chile being unknown. In the present study, we determined the seroprevalence of anti-HEV IgG in blood donors of the Clinical Hospital University of Chile, with last generation ELISA techniques. Out of a total of 186 samples, collected in 2014, 56 (30.1%) were positive, without gender differences, but with a significant increase with age (p < 0.001). These results show an increase in the seroprevalence of HEV in blood donors performed with immunoassays of greater sensitivity.

Impact of Dietary Lipids on Colonic Function and Microbiota: An Experimental Approach Involving Orlistat-Induced Fat Malabsorption in Human Volunteers.

OBJECTIVES: High-fat diets alter gut microbiota and barrier function, inducing metabolic endotoxemia and low-grade inflammation. Whether these effects are due to the high dietary lipid content or to the concomitant decrease of carbohydrate intake is unclear. The aim of this study was to determine whether higher amounts of dietary fat reaching the colon (through orlistat administration) affect the colonic ecosystem in healthy volunteers and the effect of the prebiotic oligofructose (OF) in this model. METHODS: Forty-one healthy young subjects were distributed among four groups: Control (C), Prebiotic (P), Orlistat (O), and Orlistat/Prebiotic (OP). They consumed a fat-standardized diet (60 g/day) during Week-1 (baseline) and after 1 week of washout, Week-3. During Week-3, they also received their respective treatment (Orlistat: 2 × 120 mg/day, OF: 16 g/day, and maltodextrin as placebo). A 72-h stool collection was carried out at the end of Week-1 (T0) and Week-3 (T1). Fecal fat, calprotectin, and short-chain fatty acids (SCFAs) as well as the antioxidant activity of fecal waters (ferric-reducing antioxidant power), fecal microbiota composition (by deep sequencing), and gut permeability (Sucralose/Lactulose/Mannitol test) were determined at these times. RESULTS: Fecal fat excretion was higher in the O (P=0.0050) and OP (P=0.0069) groups. This event was accompanied, in the O group, by an increased calprotectin content (P=0.047) and a decreased fecal antioxidant activity (P=0.047). However, these alterations did not alter gut barrier function and the changes observed in the composition of the fecal microbiota only affected bacterial populations with low relative abundance (<0.01%); in consequences, fecal SCFA remained mainly unchanged. Part of the colonic alterations induced by orlistat were prevented by OF administration. CONCLUSIONS: In the context of an equilibrated diet, the acute exposition of the colonic ecosystem to high amounts of dietary lipids is associated with an incremented excretion of fecal calprotectin and pro-oxidant activity of the colonic content, in the absence of significant changes in the microbiota.

[Hepatitis E virus seroprevalence: a reappraisal]. / Re-evaluación de seroprevalencia de virus hepatitis E.

Reported seroprevalence of hepatitis E virus (HEV) in developed countries is between 0.3-53%. Published data relies on the assays used and its technical performance. Sensitivity on new available tests has improved, which has changed HEV seroprevalence around the world. We re-evaluated retrospectively, 178 serum samples of patients with previous anti HEV IgG determination between 2009 and 2012. Initial analysis was performed with ELISA kit Genelabs (Singapore), with 7.3% positivity. The reevaluation was done with ELISA kit AccuDiag TM HEV-IgG (Diagnostic Automation, United States), with reported sensitivity and specificity over 99.8%. With the new assay, 32.6% positive samples were found, significantly greater to the previous result (p<0.001) (4.5 times more). There were no differences in gender but a significant association between age and HEV IgG seropositivity was found (p<0.001). This suggests that previous testing might have underestimated HEV seroprevalence in Chile, which should be reevaluated using the new available test.

The relationship between Taekwondo training habits and injury: a survey of a collegiate Taekwondo population.

OBJECTIVE: To correlate training habits of Taekwondo (TKD) athletes to risk for injury. BACKGROUND: TKD is a Korean marital art that has been growing in popularity, with nearly 2 million individuals practicing the sport in the United States. Because of the combative nature of the sport, injuries are an inherent risk. However, data on proper training habits, types of injuries sustained during training, and recommendations for athletes to avoid injury are lacking. Frequently, studies of TKD evaluate athletes' injuries during tournaments, but most do not evaluate athletes in training. HYPOTHESIS: Increased training would potentially create more injuries secondary to increased exposure. METHODS: This is a cross-sectional observational survey of 72 collegiate TKD athletes from the Pacific West Sanctioned Taekwondo Tournaments in the 2008-2009 season. Variables analyzed during training and competitions were training sessions per week, workout habits, belt level, years of experience, and characteristics of injury (location, type, mechanism, situation, treatment, and days missed). RESULTS: TKD training habits of individuals who practiced four or more times per week (odds ratio [OR], 4.5; P=0.005) or sparred for more than 2 hours (OR, 8.7; P=0.003) were associated with significantly increased odds (risk) of sustaining an injury. Those who had more than 3 years of tournament experience were more likely to sustain an injury (OR, 0.198; P=0.020). CONCLUSION: Increased risk for injury with more frequent practice and longer sparring should remind coaches and trainers that monitoring and adjusting the athletes' training schedules and exposure time could decrease the chance of injury. An athlete that has spent more years in tournaments along with high-frequency and long-duration training was associated with greater risk for injuries. Prevention and education about the risk for exposure to injury may may help athletes and trainers promote prevention strategies and adjust an athletes' training and tournament schedules to decrease the risk for injury.

The benefits of rehabilitation for palliative care patients.

Palliative care requires an interdisciplinary team approach to provide the best care for patients with life-threatening illnesses. Like palliative medicine, rehabilitation also uses an interdisciplinary approach to treating patients with chronic illnesses. This review article focuses on rehabilitation interventions that can be beneficial in patients with late stage illnesses. Rehabilitation may be useful in improving the quality of life by palliating function, mobility, activities of daily living, pain relief, endurance, and the psyche of a patient while helping to maintain as much independence as possible, leading to a decrease in burden on caregivers and family. Rehabilitative services are underutilized in the palliative care setting, and more research is needed to address how patients may benefit as they approach the end of their lives.

[Assessment of the fulfillment of paracentesis in cirrotic patients admited in two services of internal medicine in hospitals of median complexity]. / Evaluación de la realización de paracentesis en pacientes cirróticos ingresados a dos servicios de medicina interna de hospitales mediana complejidad.

UNLABELLED: The Spontaneous Bacterial Peritonitis (SBP) is a severe complication of cirrhosis. The prognosis depends on the time of initiation of therapy that is required for early diagnosis. OBJECTIVE: To evaluate the performance of diagnostic paracentesis (DP) in cirrhotic patients with ascites during hospitalization. MATERIALS AND METHODS: An observational, analytical, prospective, study conducted during October 2009 to June 2010. RESULTS: There were 92 income, average age was 60.3 years (SD 11.7), corresponding to 57.6% men, the most common etiology of CH was alcohol (48.9%). There were 40 PD (43.5%), of which 35% positive SBP. Of the DP, 47.5% were performed on admission and / or submission of warning signs. The average period of hospitalization was higher in those who underwent late DP. The MELD score both at admission and discharge was significantlyhigher in patients on admission punctured. CONCLUSION: DP was done in less than half of hospitalized cirrhotic, and its timely completion only 1 in 5 of revenues. The DP perform at the right time reduces hospital days.

Evaluación de la realización de paracentesis en pacientes cirróticos ingresados a dos servicios de medicina interna de hospitales mediana complejidad / Assessment of the fulfillment of paracentesis in cirrotic patients admited in two services of internal medicine in hospitals of median complexity

La peritonitis bacteriana espontánea (PBE) es una complicación severa de la cirrosis hepática (CH). Su pronóstico depende del momento de inicio de la terapia para lo que se requiere un diagnóstico oportuno. Objetivo: Evaluar la realización de paracentesis diagnóstica (PD) en cirróticos con ascitis durante su hospitalización. Materiales y métodos: Estudio observacional, analítico y prospectivo, realizado en un período de 11 meses consecutivos. Resultados: Se registraron 92 ingresos, el promedio de edad fue de 60,3 años (DE 11,7), correspondiendo un 57,6% a hombres, la etiología de CH más frecuente fue alcohólica (48,9%). Se realizaron 40 PD (43,5%), de ellas 35% con PBE positiva. Del total de PD, un 47,5% se efectuaron al ingreso y/o al presentar signos de alarma. El promedio de días de hospitalización fue mayor en aquellos en que se realizó la PD tardíamente. El MELD (Model for the End stage Liver Disease) tanto al ingreso como egreso es significativamente mayor en los pacientes puncionados al ingreso. Conclusión: Se realiza PD en menos de la mitad de los cirróticos hospitalizados, siendo su realización oportuna solo en 1 de cada 5 de los ingresos. El realizar PD en el momento adecuado disminuye los días de hospitalización y morbimortalidad.

The Spontaneous Bacterial Peritonitis (SBP) is a severe complication of cirrhosis. The prognosis depends on the time of initiation of therapy that is required for early diagnosis. Objective: To evaluate the performance of diagnostic paracentesis (DP) in cirrhotic patients with ascites during hospitalization. Materials and methods: An observational, analytical, prospective, study conducted during October 2009 to June 2010. Results: There were 92 income, average age was 60.3 years (SD 11.7), corresponding to 57.6% men, the most common etiology of CH was alcohol (48.9%). There were 40 PD (43.5%), of which 35% positive SBP. Of the DP, 47.5% were performed on admission and / or submission of warning signs. The average period of hospitalization was higher in those who underwent late DP. The MELD score both at admission and discharge was significantly higher in patients on admission punctured. Conclusion: DP was done in less than half of hospitalized cirrhotic, and its timely completion only 1 in 5 of revenues. The DP perform at the right time reduces hospital days.

Pleomorphic adenoma of the palate: two cases report and literature review / Adenoma pleomorfo palatino: reporte de 2 casos y revisión de la literatura

Pleomorphic adenoma (PA) is the most common neoplasm encountered in major and minor salivary glands. Intraorally, it is most frequently developed in the palatal glands. Histologically, it is characterized by a diverse architecture comprised of epithelial stromal elements mixed with mucoid, myxoid, or chondroid fibrohyaline. A PA does not generally present gender bias and can occur at any age with the same clinical behavior. It is usually a round, slow-growing, painless tumor, which is firm upon palpation. We reported two cases of adult patients who were treated using transoral resection at San Juan de Dios Hospital in La Serena.

El Adenoma Pleomorfo es la neoplasia más común de las glándulas salivales mayores y menores. Intraoralmente las glándulas del paladar son las más afectadas. Histológicamente se caracteriza por una arquitectura variada que comprende elementos epiteliales mezclados con estroma mucoide, mixoide, fibrohialino o condroide, Los AP no suelen presentar predisposición por sexos, pudiendo aparecer a cualquier edad, con el mismo comportamiento clínico. Se presentan habitualmente como una tumoración redondeada de crecimiento lento, indolora y firme a la palpación. Presentamos dos casos de pacientes adultos, quienes fueron tratados mediante resección transoral en el hospital de la Serena.

Prevention of liver ischemia reperfusion injury by a combined thyroid hormone and fish oil protocol.

Several preconditioning strategies are used to prevent ischemia-reperfusion (IR) liver injury, a deleterious condition associated with tissue resection, transplantation or trauma. Although thyroid hormone (T3) administration exerts significant protection against liver IR injury in the rat, its clinical application is controversial due to possible adverse effects. Considering that prevention of liver IR injury has also been achieved by n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation to rats, we studied the effect of n-3 PUFA dietary supplementation plus a lower dose of T3 against IR injury. Male Sprague-Dawley rats receiving fish oil (300 mg/kg) for 3 days followed by a single intraperitoneal dose of 0.05 mg T3/kg were subjected to 1 h of ischemia followed by 20 h of reperfusion. Parameters of liver injury (serum transaminases, histology) and oxidative stress (liver contents of GSH and oxidized proteins) were correlated with fatty acid composition, NF-κB activity, and tumor necrosis factor-α (TNF-α) and haptoglobin expression. IR significantly modified liver histology; enhanced serum transaminases, TNF-α response or liver oxidative stress; and decreased liver NF-κB activity and haptoglobin expression. Although IR injury was not prevented by either n-3 PUFA supplementation or T3 administration, substantial decrease in liver injury and oxidative stress was achieved by the combined protocol, which also led to increased liver n-3 PUFA content and decreased n-6/n-3 PUFA ratios, with recovery of NF-κB activity and TNF-α and haptoglobin expression. Prevention of liver IR injury achieved by a combined protocol of T3 and n-3 PUFA supplementation may represent a novel noninvasive preconditioning strategy with potential clinical application.