Azithromycin and moxifloxacin resistance determinants in Mycoplasma genitalium in Lleida, Spain.

OBJECTIVE: Mycoplasma genitalium (MG) is a microorganism related to sexually transmitted infections. Antibiotic resistance of MG leads to an increase in treatment failure rates and the persistence of the infection. The aim of this study was to describe the most frequent mutations associated with azithromycin and moxifloxacin resistance in our geographical area. METHODS: A prospective study from May 2019 to May 2023 was performed. MG-positive samples were collected. Real-time PCRs (AllplexTM MG-AziR Assay and AllplexTM MG-MoxiR Assay, Seegene) were performed in MG positive samples to detect mutations in 23S rRNA V domain and parC gene. RESULTS: A 37.1% of samples presented resistance determinants to azithromycin and the most common mutation detected was A2059G (57.9%). Resistance to moxifloxacin was studied in 72 azithromycin-resistant samples and 36.1% showed mutations, being G248T the most prevalent (73.1%). CONCLUSIONS: The resistance to different lines of treat ment suggests the need for a targeted therapy and the performing of a test of cure afterwards.

A comprehensive approach using multiple biomarkers to detect damage induced by pesticides in broad-snouted caiman (Caiman latirostris) under ex-situ conditions.

Caiman latirostris is one of the two species of the order Crocodylia that inhabit Argentina and is considered a species of vital ecological and economic importance in the north-east of Argentina. In this region, pesticides are the most common contaminants in natural environments and wild caiman populations are subject to this contamination constantly. The aim of this study was to evaluate the effects the main pesticides used in the region: glyphosate (GLY), cypermethrin (CYP) and chlorpyrifos (CPF) -based formulations, as well as the mixture of them, on C. latirostris juveniles under semi-controlled condition of exposure (ex-situ) during 75 days. One hundred yearling caimans (10-month-old) were equally distributed into five experimental groups (20 animals per group): a negative control (NC -tap water), GLY 2% (Roundup® Full II formulation -RU), CYP 0.12% (Atanor® formulation), CPF 0.8% (Lorsban® formulation), and a mixture of the three pesticides (Mx3: GLY 2% + CYP 0.12% + CPF 0.8%). We applied early warning biomarkers to detect damage induced by these chemicals in peripheral blood: activity of the antioxidant enzymes catalase (CAT) and superoxide dismutase (SOD), analysis of lipid peroxidation (LPO) by the thiobarbituric acid reactive substances (TBARS), DNA damage and specific base oxidation through the standard and modified comet assay (CA), chromosome damage by micronucleus (MN) test and other nuclear abnormalities (NAs), hematological and growth parameters. Results showed a statistically significant increase in MN and NAs frequency, DNA damage, with an important contribution of base oxidation for all exposed groups compared to the NC. Total white blood cells count (TWBCC), and growth parameters showed effects mainly at the Mx3. The principal component analysis (PCA) demonstrated more sensitivity for biomarkers associated to genetic damage, including base oxidation to DNA than LPO, antioxidant enzyme modulation, immunotoxicity or growth parameters, to detect pesticides effects, applied under conditions similar to that found in natural environments.

Macrosomía fetal: factores de riesgo y resultados perinatales / Foetal macrosomia: risk factors and perinatal outcomes

Introducción: La macrosomía fetal es definida como un peso al nacer igual o mayor de 4.000 g, con una incidencia aproximadamente del 10%. Se ha asociado con múltiples factores de riesgo como la masa corporal previa, diabetes, multiparidad, sexo fetal varón, etcétera. Es una causa importante de morbimortalidad neonatal y materna, y supone un aumento en la tasa de cesáreas. Objetivo: Identificar la prevalencia de macrosomía fetal en nuestra área, detectar sus principales factores de riesgo y resultados perinatales. Métodos: Se incluyeron 6.221 recién nacidos a término, nacidos en el Hospital Juan Ramón Jiménez, en el curso de los años 2018 y 2019. Se realizó un estudio observacional retrospectivo, tipo caso control. Resultados: La incidencia de macrosomía fue de 5,9%. Los principales factores de riesgo asociados con la macrosomía fueron la edad gestacional, el sexo masculino, la multiparidad y la diabetes pregestacional, con resultados estadísticamente significativos. En cuanto a los resultados perinatales; encontramos asociación entre la macrosomía y la vía del parto, el riesgo de cesárea en los macrosomas es mayor (OR 1,62, IC 95% 1,3-2.1; p < 0,0001). Si el inicio del parto es inducido, el riesgo de cesárea se duplica (RR 2,32; IC 95% 1,56-3,38; p < 0,0001). Como complicaciones neonatales se registró un aumento del riesgo de distocia de hombros (OR 11,45; IC 95% 7,1-18,5; p < 0,0001), fractura de clavícula (OR 6,87, IC 95% 1,3-37,4; p = 0,0258), y parálisis braquial (OR 13,74; IC 95% 2,8-67,87; p = 0,0013). Conclusiones: Es importante conocer los factores de riesgo de macrosomía para poder identificar a estas gestantes y prevenir las complicaciones asociadas. Actualmente no hay consenso sobre cómo y cuándo finalizar la gestación, la inducción del parto o realizar una cesárea son estrategias parciales, que producen un aumento de cesáreas sin disminución de las complicaciones.

Introduction: Macrosomia is defined as a birth weight of 4 000 g or more, and has an incidence of approximately 10%. It has been associated with multiple risk factors such as, previous body mass, diabetes, multiparity, male gender, etc. Macrosomia is an important cause of neonatal and maternal morbidity and mortality, and leads to an increase in the rate of caesarean sections. Objective: Identify the prevalence of foetal macrosomia in our area, and to detect its main risk factors and perinatal outcomes. Methods: The study included a total of 6 221 term infants born in Juan Ramón Jiménez Hospital during the years 2018 and 2019. A retrospective observational case control type study was carried out. Results: The incidence of macrosomia was 5.9%. The main risk factors associated with foetal macrosomia were: gestational age, male gender, multiparity, and pre-gestational diabetes, with statistically significant results. Regarding perinatal outcomes, an association was found between macrosomia and delivery. The risk of caesarean section in macrosomia is higher (OR 1.62, 95% CI; 1.3-2.1, p < 0.0001). Induction of labour doubles the risk of caesarean section (RR 2.32, 95% CI; 1.56-3.38, p < 0.0001). As neonatal complications, was associated with higher risk of shoulder dystocia (OR 11.45, 95% CI 7.1-18.5, p < 0.0001), clavicle fracture (OR 6.87, 95% CI; 1.3-37.4, p < 0.0258), and brachial plexus palsy (OR 13.74, 95% CI; 2.8-67.87, p < 0.0013). Conclusions: It is important to determine the macrosomia risk factors in order to be able to identify these pregnant women, and prevent the associated complications. Currently, there is no consensus on how and when to end the pregnancy. Induction of labour or performing a caesarean section are partial strategies, which lead to an increase in caesarean sections without reducing complications.(AU)

Morbimortalidad asociada al parto prematuro y su relación con el uso de corticoides y sulfato de magnesio / Morbidity and mortality associated with preterm birth and its relationship with the use of corticosteroids and magnesium sulphate

Introducción: El parto prematuro está asociado a múltiples complicaciones, con un aumento de la morbimortalidad perinatal. Sin embargo, muchos estudios apoyan el uso de corticoides y sulfato de magnesio para mejorar los resultados en estos recién nacidos prematuros. El objetivo de nuestro estudio es describir la incidencia de morbimortalidad en recién nacidos prematuros de nuestro entorno y cómo el uso tanto de corticoides como de sulfato de magnesio ha mejorado el pronóstico a corto plazo de estos recién nacidos. Material y métodos: Estudio retrospectivo observacional de 564 recién nacidos prematuros nacidos entre 2018-2019 en el área hospitalaria del Hospital Juan Ramón Jiménez. El tratamiento con corticoides y sulfato de magnesio se realizó según los protocolos actuales de la Sociedad Española de Ginecología y Obstetricia. Resultados: La incidencia de prematuridad fue del 7,9% en nuestro entorno. La gestación gemelar junto con la enfermedad hipertensiva del embarazo fueron las afecciones obstétricas más frecuentes. La cesárea fue la vía de finalización más común en todos los grupos de prematuridad, excepto en la tardía. El síndrome de distrés respiratorio fue la enfermedad más frecuente (más del 33%) en todos los grupos. La tasa de mortalidad neonatal total fue del 1,8%. En cuanto a los corticoides, el principal resultado de nuestra muestra fue una disminución en la morbimortalidad neonatal, estadísticamente significativa en el síndrome de distrés respiratorio y la retinopatía del prematuro. En cuanto al sulfato de magnesio, el principal resultado fue la disminución de la hemorragia intraventricular, la leucomalacia periventricular y la displasia broncopulmonar. Respecto a la mortalidad neonatal, no hubo diferencias significativas. Conclusiones: La morbimortalidad registrada en nuestra muestra fue similar a la descrita en la bibliografía. El tratamiento con corticoides para la maduración pulmonar redujo la morbimortalidad neonatal en general...(AU)

Introduction: Preterm labour is associated with multiple complications, with an increased risk of perinatal morbidity and mortality. Nevertheless, many studies support the use of corticosteroids and magnesium sulphate to improve outcomes in preterm birth. The objective of this study is to describe the morbidity and mortality incidence in preterm birth in a Spanish hospital and how the use of corticosteroids and magnesium sulphate has improved the short-term prognosis in these newborns. Material and methods: Observational retrospective study of 564 preterm births between the years 2018 to 2019, in the hospital area Juan Ramón Jiménez (Huelva). The treatment with corticosteroids and magnesium sulphate was performed based on current protocols of the Spanish Society of Gynaecology and Obstetrics. Results: The incidence of prematurity in this study was 7.9%. Twin pregnancies and hypertensive pregnancy disease were the most common obstetric disorders. The most common type of delivery was caesarean section in all prematurity groups, except late prematurity. Respiratory distress syndrome was the most frequent pathology (more than 33%) in all groups. Overall neonatal mortality was 1.8‰. As regards the use of corticosteroids, the main outcome was a decrease in neonatal morbidity and mortality, which was statistically significant in respiratory distress syndrome and preterm retinopathy. The use of magnesium sulphate caused a decrease in the incidence of intraventricular haemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia. There were no significant differences in neonatal mortality. Conclusions: Morbidity and mortality registered in this study were similar to that described in the literature. Although the use of corticosteroids reduced neonatal morbidity and mortality in this study...(AU)

Genotoxicity and oxidative stress in Caiman latirostris hatchlings exposed to pesticide formulations and their mixtures during incubation period.

Agricultural expansion and the consequent use of pesticides lead to the loss and fragmentation of natural habitats of several wild species. Then, many species are inevitably exposed to a wide amount of pesticide formulations. Glyphosate (GLY)-based formulations are the most used herbicide, whereas two of the most employed insecticides are chlorpyrifos (CPF) and cypermethrin (CYP). The aim of this study was to evaluate genotoxicity, oxidative damage, and the modulation of antioxidants defenses in peripheral blood of Caiman latirostris after embryonic exposure to pesticide formulations and their mixtures. Pesticides concentrations employed were equivalent to those recommended in agricultural practices for application in soybean crops and a half of them: GLY: 2% and 1%; CYP: 0.12% and 0.06%; CPF: 0.8% and 0.4%. Two similar experiments (E1 and E2) were carried out in consecutive years, where C. latirostris eggs were exposed to pesticide formulations separately and in different mixtures through application on the incubation material. After hatching, blood samples were taken and genotoxicity and oxidative stress was evaluated through the micronucleus (MN) test, the modified comet assay, the lipid peroxidation (LPO) levels and the activities of catalase (CAT) and superoxide dismutase (SOD) antioxidant enzymes. The results indicated the presence of DNA damage, oxidation of purines and pyrimidines, and increased frequency of micronucleus (FMN) in the case of GLY, CYP, and CPF formulations exposure, as well as in all the mixtures tested, with respect to the control groups. Specifically, the results observed for the mixtures would indicate independent action or antagonism of the components for DNA damage and base oxidation (purines and pyrimidines) and a possible potentiation interaction for the FMN in two binary mixtures. However, there were not differences regarding lipid peroxidation, the activity of antioxidant enzymes and growth parameters. This study proved that the use of pesticide formulations at concentrations used in the field generate deleterious genetic effects on this species, then, exposure to them could threaten its survival and health status.

Caso de pseudo-Meigs, signo guía de afección ginecológica subyacente / Case of Pseudo-Meigs, Guide Sign of Underlying Gynecological Condition

Introducción: El síndrome de Meigs consiste en la asociación de tumor benigno de ovario tipo fibroma con ascitis e hidrotórax, que se resuelven tras la extirpación del tumor. El síndrome de pseudo-Meigs secundario al leiomioma uterino es una entidad rara. Presentación de caso: Mujer de 68 años que presentó una historia de un mes con sensación de opresión torácica y disnea. La radiografía de tórax reveló derrame pleural derecho. En la tomografía axial computarizada de abdomen y región pelviana se aprecia ascitis y un gran mioma uterino subseroso. Se sometió a una histerectomía abdominal total con salpingo-ooforectomía bilateral. Conclusiones: La ascitis y el derrame pleural desaparecieron rápidamente en el postoperatorio. Tras 20 meses de seguimiento, no hay recidiva de la enfermedad(AU)

Introduction: Meigs syndrome consists of the association of a benign tumor of the ovary "fibroma type" with ascites and hydrothorax, which resolve after the tumor is removed. The pseudo-Meigs syndrome secondary to uterine leiomyoma is a rare entity. Case report: A 68-year-old woman refered having a month with a sensation of chest tightness and dyspnea. Chest X-ray revealed right pleural effusion. Computed axial tomography of the abdomen and pelvic region shows ascites and a large subserous uterine myoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Conclusions: Ascites and pleural effusion disappeared rapidly in the postoperative period. After 20 months of follow-up, there is no recurrence(AU)

Exfoliated graphite with graphene flakes as potential candidates for TL dosimeters at high gamma doses.

Graphite powder (GP) subjected to microwave radiation (MWG) results in exfoliation of graphite particles into few-layered graphene flakes (GF) intermixed with partially exfoliated graphite particles (PEG). Characterization of MWG by Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM) and Raman spectroscopy reveal few-layer GF with sizes ranging from 0.2 to 5 µm. Raman D, G, and 2D (G') bands characteristic of graphitic structures include evidence of the presence of bilayered graphene. The thermoluminescent (TL) dosimetric properties of MWG are evaluated and can be characterized as a gamma-ray sensitive and dose-resistant material with kinetic parameters (activation energy for the main peak located at 400 and 408 K is 0.69 and 0.72 eV) and threshold dose (~1 kGy and 5 kGy respectively). MWG is a low-Z material (Zeff = 6) with a wide linear range of TL dose-response (0.170-2.5 kGy) tested at doses in the 1-20 kGy range with promising results for applications in gamma-ray dosimetry. Results obtained in gamma irradiated MWG are compared with those obtained in graphite powder samples (GP) without microwave treatment.

Micronuclei and other nuclear abnormalities on Caiman latirostris (Broad-snouted caiman) hatchlings after embryonic exposure to different pesticide formulations.

This study aimed to evaluate the embryotoxicity and genotoxicity of pesticide commercial formulations widely used in soybean crops through the Micronucleus (MN) test and other Nuclear Abnormalities (NAs) in erythrocytes of broad-snouted caiman (Caiman latirostris), exposed by topical application through the eggshell. Embryos were exposed (during all incubation: 70 days approximately) to sub-lethal concentrations of two glyphosate formulations PanzerGold® (PANZ) and Roundup® Full II (RU) (500, 750, 1000µg/egg); to the endosulfan (END) formulation Galgofan® and the cypermethrin (CYP) formulation Atanor® (1, 10, 100, and 1000µg/ egg). Blood samples were taken at the moment of hatching from the spinal vein for the application of the MN test and analysis of other NAs in erythrocytes, as markers of genotoxicity. Results indicated a significant increase in the frequency of MN for PANZ1000, END 10, CYP 1 and CYP 100 (p<0.05), and in the frequency of other NAs including Buds: END 100, 1000 and CYP 10 (p<0.05), eccentric nuclei: END 1, 10, 1000, CYP 10, 100, 1000 (p<0.01) and END 100 (p<0.05), notched nuclei: END 1, 10 (p<0.01) and END 1000, CYP 10, 100,1000 (p<0.05), and total nuclear abnormalities: END 1, 10, 100, 1000, CYP 10, 100 and 1000 (p<0.01), and the positive control (PC) (p<0.05), compared with the negative control. It was demonstrated a concentration dependent-effect in MN frequency only for PANZ (R2=0.98; p<0.01). Our study demonstrated that commercial formulations of pesticides induced genotoxic effects on C. latirostris, and NAs are a good indicator of genotoxicity in this specie.

Estudio de prevalencia de microalbuminuria y macroproteinuria en diabéticos y su relación con otras complicaciones / A collaborative study on the prevalence of microalbuminuriaand macroproteinuria in diabetic patients and their relation to other complications

Se determinó la prevalencia de microalbuminuria(Mi) y macroproteinuria(Ma) y otras complicaciones en diabéticos en un estudio multicéntrico en la Argentina. Se entrevistaron 214 pacientes sin selección previa, se evaluó historia clínica, se dividió por tipo de diabetes. La Mi se realizó por radioinmunoanálisis o inmunoturbidimétrico la Ma por método sulfosalicílico. Se relacionaron con edad, antigüedad y prevalencia de hipertensión,dislipemia y retinopatía. Se aplicó para análisis el método estadístico DBase con programa EPI INFO 50. Se calcularon estadísticas descriptivas, se aplicó prueba de chi cuadrado con unnivel de significación p=0.05. La población insulinodependiente (DID)n73(34,1), la no insulinodependinte (DNID) n101(47,2), la insulinorrequiriente(DIR)n40(18,7), la edad promedio del DID 34,88+ 16,3; el DNID 64,27 + 9,83; DIR 61,85 + 9,37,lo que mostró una diferencia estadísticamente significativa para el DID con respecto al DNID y al DIR. La antigüedad de la diabetes no mostró diferencias significativas, lo mismo sucedió con la hemoglobina glicosilada para los diferentes grupos.La prevalencia de Mi fue 26,22,23.17,30 y la Ma fue 21,13, 10,9,26,66 respectivamente. El 19,20 careció de datos para la proteinuria. La prevalencia de hipertensión arterial fue para el DID 15.06,DNID 54,45,DIR 57.50, la dislipemia 13,69, 39,60,47,50 y retinopatía 35,10,24.757 y 57,50 respectivamente,la hipertensión y dislipemia mostraron diferencias estadísticamente significativas si se comparaba los DNID y DIR con respecto DID

Estudio de prevalencia de microalbuminuria y macroproteinuria en diabéticos y su relación con otras complicaciones / A collaborative study on the prevalence of microalbuminuriaand macroproteinuria in diabetic patients and their relation to other complications

Se determinó la prevalencia de microalbuminuria(Mi) y macroproteinuria(Ma) y otras complicaciones en diabéticos en un estudio multicéntrico en la Argentina. Se entrevistaron 214 pacientes sin selección previa, se evaluó historia clínica, se dividió por tipo de diabetes. La Mi se realizó por radioinmunoanálisis o inmunoturbidimétrico la Ma por método sulfosalicílico. Se relacionaron con edad, antig³edad y prevalencia de hipertensión,dislipemia y retinopatía. Se aplicó para análisis el método estadístico DBase con programa EPI INFO 50. Se calcularon estadísticas descriptivas, se aplicó prueba de chi cuadrado con unnivel de significación p=0.05. La población insulinodependiente (DID)n73(34,1), la no insulinodependinte (DNID) n101(47,2), la insulinorrequiriente(DIR)n40(18,7), la edad promedio del DID 34,88+ 16,3; el DNID 64,27 + 9,83; DIR 61,85 + 9,37,lo que mostró una diferencia estadísticamente significativa para el DID con respecto al DNID y al DIR. La antig³edad de la diabetes no mostró diferencias significativas, lo mismo sucedió con la hemoglobina glicosilada para los diferentes grupos.La prevalencia de Mi fue 26,22,23.17,30 y la Ma fue 21,13, 10,9,26,66 respectivamente. El 19,20 careció de datos para la proteinuria. La prevalencia de hipertensión arterial fue para el DID 15.06,DNID 54,45,DIR 57.50, la dislipemia 13,69, 39,60,47,50 y retinopatía 35,10,24.757 y 57,50 respectivamente,la hipertensión y dislipemia mostraron diferencias estadísticamente significativas si se comparaba los DNID y DIR con respecto DID (AU)

[Bilateral tubal occlusion by postpartum mini-laparotomy under local anesthesia and sedation]. / Oclusión tubaria bilateral por minilaparotomía post parto con sedación y anestesia local.

The first 1000 cases of tubal sterilization post-delivery by minilaparotomy with sedation and local anesthetic, were reviewed; these procedures were realized at the Hospital of Zona Francisco del Paso y Troncoso of the IMSS, in México City, during the period comprehended between December 1990 and October 1991. The greatest group of cases by age corresponded to the period between 20 to 29 years in 52.3%. 65% of the women had 3 or 4 children alive. The range of the diastolic blood pressure was between 70-80 mmHg in 66.3%. 19.7% with a value of hemoglobin less than 10 g. 2.3% of the patients with 100-120 kgs. of weight. The contraceptive method used previously with greatest frequency was the DIU in 40.6%. In all of the cases the indication was satisfied parenthood. In 100% of the cases the same drug was used for sedation, diazepam (oral) and chlorhydrate of nalbulfine, with simple lidocaine as a local anesthetic. Likewise in all the cases the Pomeroy technique was performed. The time between the childbirth and the surgery was less than 12 hours in 92.9% of the cases. And the time between the surgery and the recuperation reset was of 12-34 hours in 96%. In 0.8% of the cases the transoperatory complication of the surgery was the bleeding as a result of tearing of the mesosalpinx. The postoperatory complications after one week were the formation of hematoma and/or abscess at the site of the incision representing 0.5% of the cases. All these procedures are realized at a unit that was created especially for this kind of surgery and treatment.

PIP: The first 1000 postpartum tubal occlusions by minilaparotomy under sedation and local anesthesia performed at a Mexican Institute of Social Security hospital in Mexico City were retrospectively reviewed. The operations took place between December 1990 and October 1991. The youngest patient was 17 and five patients were under 20. 52.3% were aged 20-29, 31.9% were aged 30-34, and 13.8% were aged 35-40. 65% of the women had three or four live births and 16.8% had two. The diastolic blood pressure was between 81 and 90 for 12.1%, between 91 and 100 for 8.9%, and between 101 and 120 for 3.7%. 19.7% had hemoglobin levels below 10 g. 37 women with hemoglobin levels between 4 and 8 g were sterilized; all received transfusions before discharge. 66.7% of the women weighed between 50 and 70 kg, but 2.3% weighed 100-120 kg. 40.6% used IUDs, 16.8% oral contraceptives, and 14.2% injectable methods. 24.8% had never used a contraceptive method. The Pomeroy technique was used in all cases. All patients were given Lidocaine. The operation was performed within 12 hours of delivery in 92.8% of cases. 96.3% of the women were discharged within 24 hours. Bleeding, resulting from tearing of the mesosalpinx, occurred in 0.8% of cases. A hematoma or abscess at the site of the incision was observed in 0.5% at one week follow-up. The data indicate that bilateral tubal occlusion by postpartum minilaparotomy under local anesthesia and sedation, rather than general anesthesia, is a rapid and safe procedure, even for obese and hypertensive women.

[Renal oncocytoma. Presentation of a case]. / Oncocitoma renal. Presentación de un caso.

One case of renal oncocytoma whose diagnosis was established after radical nephrectomy is presented here. The histological heterogeneity of this tumour indicates that the safest treatment is still the radical nephrectomy, at which time diagnosis is most often established. Our case has a special interest as it presented two hepatic lesions suggestive of metastasis.

[Wunderlich syndrome: presentation of a case]. / Síndrome de Wunderlich: aportación de un caso.

We present a case of spontaneous renal bleeding due to renal neoplasia. We analyse other causes of Wunderlich's syndrome and, following Kendall, we defend the indication of radical nephrectomy especially of non-filiated etiology in the cases in which other causes have been discounted and the contralateral kidney is sound.