Efectividad de la intervención motora temprana en el desarrollo motor de los niños con parálisis cerebral entre 3 y 5 años de edad. Revisión sistemática / Effectiveness of early motor interventions in children with cerebral palsy between 3 to 5 years of age: Systematic review

La intervención motora temprana es esencial en niños con parálisis cerebral; sin embargo, se desconoce su efectividad entre los 3 y los 5años. El objetivo fue determinar la efectividad de la intervención motora temprana en el desarrollo motor de dicha población. Se realizó una revisión sistemática de literatura acerca de intervenciones motoras tempranas realizada en diferentes bases de datos como Pubmed/Medline, PEDro, OTSeeker, Embase y LILACS. Finalmente se seleccionaron 18 artículos, de los cuales 4 presentaron cambios a favor del grupo experimental en los desenlaces desarrollo motor global y función motora manual, con la terapia de integración sensorial y la terapia de movimiento inducido por restricción, respectivamente; no obstante, los resultados no fueron estadísticamente significativos y el nivel de evidencia fue bajo. La intervención motora temprana podría incluirse con precaución para la mejoría del desarrollo motor global y la función manual. Es necesario realizar estudios de mayor calidad metodológica. (AU)

Early motor intervention is essential in children with cerebral palsy; however, it is unknown its effectiveness between 3 to 5years. The objective was to determinate the effectiveness of early motor intervention in the motor development of this population. A systematic literature search was performed in Pubmed/Medline, PEDro, OTSeeker, Embase, and LILACS. Finally, 18 articles were selected, of which 4 showed favorable changes in the experimental group in the outcomes of overall motor development and manual motor function, with sensory integration therapy and movement-induced restriction therapy, respectively; however, the results were not statistically significant, and the level of evidence was low. Early motor intervention could be cautiously considered for improving overall motor development and manual function. Higher-quality methodological studies are necessary. (AU)

[Effectiveness of early motor interventions in children with cerebral palsy between 3 to 5years of age: Systematic review]. / Efectividad de la intervención motora temprana en el desarrollo motor de los niños con parálisis cerebral entre 3 y 5años de edad. Revisión sistemática.

Early motor intervention is essential in children with cerebral palsy; however, it is unknown its effectiveness between 3 to 5years. The objective was to determinate the effectiveness of early motor intervention in the motor development of this population. A systematic literature search was performed in Pubmed/Medline, PEDro, OTSeeker, Embase, and LILACS. Finally, 18 articles were selected, of which 4 showed favorable changes in the experimental group in the outcomes of overall motor development and manual motor function, with sensory integration therapy and movement-induced restriction therapy, respectively; however, the results were not statistically significant, and the level of evidence was low. Early motor intervention could be cautiously considered for improving overall motor development and manual function. Higher-quality methodological studies are necessary.

Drug-induced liver injury: Relation between the R ratio and histopathology.

INTRODUCTION AND AIM: Drug-induced liver injury (DILI) is a diagnosis based on the ruling out of potential liver diseases and consolidated by establishing causality through the temporal relation between a potentially hepatotoxic substance and altered liver biochemistry. Incidence fluctuates greatly worldwide, with very few reports of causal agents of DILI in Colombia. A retrospective study on patients treated at the Centro de Estudios en Salud (CES), within the time frame of January 2015 and June 2020, was conducted to document the causal substances of DILI in patients with liver biopsy and to correlate the types of histologic patterns with the biochemical pattern of liver injury (R ratio). RESULTS: Of the 254 adult patients with liver biopsy and no tumor etiology, 20 patients were identified as cases of DILI (7.87%). The two most frequently found causal substances were efavirenz, in three HIV-positive patients, and Moringa oleifera (moringa), in two patients. There was a statistically significant association between cholestatic patterns (p = 0.037) and mixed patterns (p = 0.031), in the comparison of the histopathologic categories and the R ratio. CONCLUSION: To the best of our knowledge, there are no reports on DILI secondary to Moringa oleifera (moringa). The R ratio could be a useful tool, in relation to the histologic pattern of injury, in cases of mixed and cholestatic patterns.

First Case Described in the Medical Literature: Male Urethral Sarcoidosis. Description of a Case and Review of the Literature

Objective: Although the sarcoidosis is a multisystemic disease that theoretically can affect almost any organ, the presence of sarcoidosis in the male urethra has not been described in the medical literature. We present the first male case of urethral sarcoidosis. Method: A 46 years old male undergoing follow up due to lower urinary tract symptoms was diagnosed of endobronchial sarcoidosis during the preoperative study for internal urethrotomy. After surgery, he presented clinical improvement for one year. Given the worsening, a new internal urethrotomy was tried. As it was impossible due to complexity they took a biopsy of the urethra. The pathology report described non-caseating granulomas compatible with sarcoidosis. After that, medical and endoscopic management of the urethral sarcoidosis was attempted. As it didn't achieve an adequate control, the patient was derivate to the "complex urethral unit" of the Cruces University Hospital. Once it was valuated, it was decided to start immunotherapy and subsequently an urethroplasty with a double oral mucosa graft was performed. Outcomes: During the postoperative period, a urethral catheter was maintained for two weeks. It was removed after no urinary leakage was observed in de cystourethrography. After that the patient remains with good evolution until today. Conclusions: Urethral affectation by sarcoidosis is a therapeutic challenge itself. For a better symptom control and to reduce the recurrences, a dual approach using systemic treatment in combination with local surgical treatment seems necessary (AU)

Objetivo: Pese a que la sarcoidosis es una enfermedad multisistémica que teóricamente puede afectar a casicualquier órgano, no ha sido descrita en la literatura médicala presencia de sarcoidosis en uretra masculina. Presentamos el diagnóstico y tratamiento del primer caso masculinode sarcoidosis uretral.Método: Varón de 46 años en seguimiento por clínicamiccional de vaciado al que se le diagnosticó de sarcoidosis endobronquial durante el estudio preoperatorio para larealización de una uretrotomía interna. Tras la intervenciónpresentó mejoría clínica durante un año. Ante el empeoramiento, se intentó repetir una nueva uretrotomía internasiendo esta imposible y decidiéndose realizar una biopsia.El informe anatomopatológico describió granulomas no caseificantes compatibles con sarcoidosis. Posteriormente seintentó un manejo médico y endoscópico de la sarcoidosis uretral que no logró un adecuado control por lo que sederivó a la unidad de uretra compleja del Hospital Universitario Cruces. Ante los hallazgos se decidió comenzar coninmunoterapia y posteriormente se realizó una uretroplastiacon doble injerto de mucosa oral.Resultado: Durante el postoperatorio se mantuvo unasonda uretral durante dos semanas. Posteriormente se retirótras la realización de una cistouretrografía miccional seriada donde no se apreciaba fuga urinaria permaneciendo elpaciente con buena evolución hasta hoy en día.Conclusiones: La afectación uretral por sarcoidosissupone actuar ante una patología que de por sí es un retoterapéutico. Para un mejor control sintomatológico y reducir las recidivas parece necesario un abordaje doble mediante un tratamiento sistémico farmacológico en combinación con tratamiento quirúrgico local (AU)

Periodicity characterization of the nonlinear magnetization dynamics.

In this work, we study numerically the periodicity of regular regions embedded in chaotic states for the case of an anisotropic magnetic particle. The particle is in the monodomain regime and subject to an applied magnetic field that depends on time. The dissipative Landau-Lifshitz-Gilbert equation models the particle. To perform the characterization, we compute several two-dimensional phase diagrams in the parameter space for the Lyapunov exponents and the isospikes. We observe multiple transitions among periodic states, revealing complex topological structures in the parameter space typical of dynamic systems. To show the finer details of the regular structures, iterative zooms are performed. In particular, we find islands of synchronization for the magnetization and the driven field and several shrimp structures with different periods.

The sensory innervation of the human nipple.

Nipples represent a highly specialized skin with capital importance in mammals for breastfeeding and additionally in humans due to sexuality. The histological studies regarding this region are scarce, so 42 human nipples were studied to describe the morphology of the nipple innervation. Our results exclude the presence of a rich innervation on nipple's skin or superficial dermis, thus definitely excluding nipple skin from the concept glabrous skin. The presence of mechanoreceptors is limited to scarce Merkel cells on the epidermis and some corpuscular capsulated and non-capsulated structures in the dermis; Merkel cells progressively decrease with ageing. No Meissner corpuscles were found and the rare Pacinian corpuscles identified were close to vascular structures and embroidered in the mammary fatty tissue. The great sensitivity observed functionally on the breast and especially in the nipple can be morphologically explained by two elements; on the one hand there is a rich smooth muscle innervation present in the deep dermis; on the other hand the mammary gland demonstrate Piezo2 expression in many glandular cells, with two differentiated patterns in the ductal and in the acinar tissue of the breast. The role of Piezo2 in the normal mammary gland is discussed.

Class I and Class II small leucine-rich proteoglycans in human cutaneous pacinian corpuscles.

Pacinian corpuscles are onion bulb-like multilayered mechanoreceptors that consist of a complicated structure of axon terminals, Schwann related cells (inner core), endoneural related cells (intermediate layer) and perineurial related cells (outer core-capsule). The cells forming those compartments are continuous and share the properties of that covering the nerve fibers. Small leucine-rich proteoglycans are major proteoglycans of the extracellular matrix and regulate collagen fibrillogenesis, cell signalling pathways and extracellular matrix assembly. Here we used immunohistochemistry to investigate the distribution of class I (biglycan, decorin, asporin, ECM2 and ECMX) and class II (fibromodulin, lumican, prolargin, keratocan and osteoadherin) small leucine-rich proteoglycans in human cutaneous Pacinian corpuscles. The distribution of these compounds was: the inner core express decorin, biglycan, lumican, fibromodulin, osteoadherin; the intermediate layer display immunoreactivity for osteoadherin; the outer core biglycan, decorin, lumican, fibromodulin and osteoadherin; and the capsule contains biglycan, decorin, fibromodulin, and lumican. Asporin, prolargin and keratocan were undetectable. These results complement our knowledge about the distribution of small leucine-rich proteoglycans in human Pacinian corpuscles, and help to understand the composition of the extracellular matrix in these sensory formations.

Assessment of Multivariate Neural Time Series by Phase Synchrony Clustering in a Time-Frequency-Topography Representation.

Most EEG phase synchrony measures are of bivariate nature. Those that are multivariate focus on producing global indices of the synchronization state of the system. Thus, better descriptions of spatial and temporal local interactions are still in demand. A framework for characterization of phase synchrony relationships between multivariate neural time series is presented, applied either in a single epoch or over an intertrial assessment, relying on a proposed clustering algorithm, termed Multivariate Time Series Clustering by Phase Synchrony, which generates fuzzy clusters for each multivalued time sample and thereupon obtains hard clusters according to a circular variance threshold; such cluster modes are then depicted in Time-Frequency-Topography representations of synchrony state beyond mere global indices. EEG signals from P300 Speller sessions of four subjects were analyzed, obtaining useful insights of synchrony patterns related to the ERP and even revealing steady-state artifacts at 7.6 Hz. Further, contrast maps of Levenshtein Distance highlight synchrony differences between ERP and no-ERP epochs, mainly at delta and theta bands. The framework, which is not limited to one synchrony measure, allows observing dynamics of phase changes and interactions among channels and can be applied to analyze other cognitive states rather than ERP versus no ERP.

The development of human digital Meissner's and Pacinian corpuscles.

Meissner's and Pacinian corpuscles are cutaneous mechanoreceptors responsible for different modalities of touch. The development of these sensory formations in humans is poorly known, especially regarding the acquisition of the typical immunohistochemical profile related to their full functional maturity. Here we used a panel of antibodies (to specifically label the main corpuscular components: axon, Schwann-related cells and endoneurial-perineurial-related cells) to investigate the development of digital Meissner's and Pacinian corpuscles in a representative sample covering from 11 weeks of estimated gestational age (wega) to adulthood. Development of Pacinian corpuscles starts at 13 wega, and it is completed at 4 months of life, although their basic structure and immunohistochemical characteristics are reached at 36 wega. During development, around the axon, a complex network of S100 positive Schwann-related processes is progressively compacted to form the inner core, while the surrounding mesenchyme is organized and forms the outer core and the capsule. Meissner's corpuscles start to develop at 22 wega and complete their typical morphology and immunohistochemical profile at 8 months of life. In developing Meissner's corpuscles, the axons establish complex relationships with the epidermis and are progressively covered by Schwann-like cells until they complete the mature arrangement late in postnatal life. The present results demonstrate an asynchronous development of the Meissner's and Pacini's corpuscles and show that there is not a total correlation between morphological and immunohistochemical maturation. The correlation of the present results with touch-induced cortical activity in developing humans is discussed.

Periostin, dentin matrix protein 1 and P2rx7 ion channel in human teeth and periodontal ligament.

The periostin is a matricellular protein present in the human periodontal ligament and human dental pulp-derived cells lines, that up-regulates the in vitro expression of some genes involved in the dentin mineralization, such as dentin matrix protein 1 and P2x7-ion channel receptor. Here we investigated the distribution of periostin in human teeth and periodontal ligaments, mapping in parallel the localization of dentin matrix protein 1 and P2x7-ion channel receptor to establish whether or not they are expressed in the same places as periostin. The periodontal ligament and the subodontoblastic layer of the dental pulp displayed strong periostin immunoreactivity, whereas dentin matrix protein 1 was detected in the periodontal ligament co-localized with periostin in the vicinity of the cement. The P2x7 ion channel receptor was regularly absent in both the periodontal ligament and dental tissues, but in some cases, it was observed in the odontoblasts. Present results demonstrate the occurrence of periostin in the healthy adult human tooth without co-localization with proteins involved in tooth mineralization, the expression of which it regulates. These results might serve as a baseline for future studies on pathological conditions.

Analysis of lead pollution levels within an urban ecosystem using the cestode Hymenolepis diminuta and its rat hosts as bioindicators.

The overall goal of this study was to use the Rattus spp./Hymenolepis diminuta model to assess environmental lead pollution in different landscape units of an urban ecosystem. Rats of the genus Rattus were collected from three shanty towns and three residential neighbourhoods of the city of Buenos Aires. Concentrations of lead in the livers of wild rats and in their parasite H. diminuta were measured using inductively coupled plasma mass spectrometry (ICP-MS). The landscape unit and tissue type had a significant effect on lead concentration, being higher in residential neighbourhoods as well as in H. diminuta tissue. Nevertheless, no significant differences were found for the mean lead concentration in livers between uninfected and infected rats. Since the available information describing heavy-metal pollution within the city of Buenos Aires is scarce, the results of this study allow us to update data about the extent of biologically available lead contamination. Considering that rats and H. diminuta are distributed worldwide, this monitoring system for lead pollution might be applied successfully in other urban ecosystems.

Merkel cells and Meissner's corpuscles in human digital skin display Piezo2 immunoreactivity.

The transformation of mechanical energy into electrical signals is the first step in mechanotransduction in the peripheral sensory nervous system and relies on the presence of mechanically gated ion channels within specialized sensory organs called mechanoreceptors. Piezo2 is a vertebrate stretch-gated ion channel necessary for mechanosensitive channels in mammalian cells. Functionally, it is related to light touch, which has been detected in murine cutaneous Merkel cell-neurite complexes, Meissner-like corpuscles and lanceolate nerve endings. To the best of our knowledge, the occurrence of Piezo2 in human cutaneous mechanoreceptors has never been investigated. Here, we used simple and double immunohistochemistry to investigate the occurrence of Piezo2 in human digital glabrous skin. Piezo2 immunoreactivity was detected in approximately 80% of morphologically and immunohistochemically characterized (cytokeratin 20+ , chromogranin A+ and synaptophisin+ ) Merkel cells. Most of them were in close contact with Piezo2- nerve fibre profiles. Moreover, the axon, but not the lamellar cells, of Meissner's corpuscles was also Piezo2+ , but other mechanoreceptors, i.e. Pacinian or Ruffini's corpuscles, were devoid of immunoreactivity. Piezo2 was also observed in non-nervous tissue, especially the basal keratinocytes, endothelial cells and sweat glands. The present results demonstrate the occurrence of Piezo2 in cutaneous sensory nerve formations that functionally work as slowly adapting (Merkel cells) and rapidly adapting (Meissner's corpuscles) low-threshold mechanoreceptors and are related to fine and discriminative touch but not to vibration or hard touch. These data offer additional insight into the molecular basis of mechanosensing in humans.

Endoneurial-CD34 positive cells define an intermediate layer in human digital Pacinian corpuscles.

The endoneurial and/or perineurial origin of the outer core; i.e. the concentric and continuous lamellae located outside the complex formed by the axon and the Schwann-related cells, in human Pacinian corpuscles is still debated. Here we used immunohistochemistry coupled with a battery of antibodies to investigate the expression of perineurial (Glucose transporter 1 and epithelial membrane antigen) or endoneurial (CD34 antigen) markers in human digital Pacinian corpuscles. CD34 immunoreactivity was restricted to one layer immediately outside the inner core, whereas the proper outer core displayed antigens typical of the perineurial cells. These results demonstrate an intermediate endoneurial layer that divides the Pacinian corpuscles into two distinct compartments: the avascular inner neural compartment (formed by the axon and the Schwann-related cells that form the inner core), and the outer non-neural compartment (formed by the outer core). The functional relevance of these findings, if any, remains to be clarified.

Coevolución genética Homo sapiens-Helicobacter pylori y sus implicaciones en el desarrollo del cáncer gástrico: una revisión sistemática / A Systematic Review of Genetic Coevolution of Homo Sapiens and Helicobacter Pylori: Implications for Development of Gastric Cancer

Helicobacter pylori (H. pylori), clasificada como carcinógeno tipo I para cáncer gástrico (CG), ha acompañado al hombre al menos desde hace 116 000 años. Los conocimientos de las fuerzas evolutivas que modulan el rol de esta bacteria en el desarrollo del espectro de enfermedades gástricas son aún escasos. Esta revisión sistemática recopila artículos que reportan un proceso de coevolución, relacionan los componentes ancestrales huésped-hospedero y describen mecanismos adaptativos de H. pylori al entorno gástrico humano, con el fin de comprender si el proceso de coevolución modula la patogenicidad de la bacteria y el desarrollo de enfermedades gástricas. Se realizó una búsqueda sistemática en las bases de datos electrónicas: MEDLINE (OvidSP), Scopus (ScienceDirect), Scielo y Tree of Science (ToS); términos de búsqueda: "stomach", "cancer", "neoplasms", "ethinicity", "evolution", "genetics", "ancestry" y "Helicobacter pylori". Idiomas: inglés y español. Los datos fueron filtrados por un revisor utilizando un formulario estándar de extracción y ulteriormente revisados por otro. El riesgo de sesgo y la calidad metodológica de los estudios fueron evaluadas con el programa: Critical Appraisal Skills Programme (CASP). Del total de 1584 estudios, 36 cumplieron los criterios de inclusión. Los factores más relevantes en el desarrollo del espectro de enfermedades asociadas con la infección por H. pylori son: la disrupción en el proceso de coevolución entre la bacteria y su huésped humano -por la transferencia horizontal de segmentos de genes que no han evolucionado con sus anfitriones-; las sustituciones de aminoácidos; la fijación y la selección positiva principalmente en las regiones hipervariables.

Helicobacter pylori (H. pylori) is classified as carcinogen type I for gastric cancer (GC). Although it has accompanied man for at least 116,000 years, knowledge of the evolutionary forces that modulate the role of this bacterium within the development of the spectrum of gastric diseases is still scarce. This systematic review compiles articles that report a process of coevolution process, relate host-host ancestral components, and describe H. pylori’s mechanisms of adaptation to the human gastric environment in order to understand if coevolution has modulated the pathogenicity of these bacteria and the development of gastric diseases. A systematic search was carried out in MEDLINE (OvidSP), Scopus (ScienceDirect), Scielo and Tree of Science (ToS). The following search terms were used: "Stomach", "Cancer", "Neoplasms", "Ethinicity", "Evolution", "Genetics", "Ancestry" and "Helicobacter pylori", and searches were conducted in both English and Spanish. The data were filtered by one reviewer using a standard extraction form and then reviewed by another. The risk of bias and the methodological quality of the studies were evaluated using the Critical Appraisal Skills Program (CASP). Thirty-six of the total 1,584 studies found met the inclusion criteria. The most relevant factors in the development of the spectrum of diseases associated with H. pylori infection are amino acid substitutions, binding and positive selection mainly in the hypervariable regions, and disruption of the coevolution process between the bacteria and their human hosts as the result of horizontal transfer of gene segments that did not evolve with their host.

Análisis electroencefalográfico de la conectividad funcional en habituación por teoría de gráficas / Electroencephalographic analysis of the functional conectivity in habituation by graphics theory

Resumen Se ha propuesto, en la literatura de neurociencias, la hipótesis de que el cerebro funciona con base en redes glioneuronales, responsables de los procesos sensoriales, motores y cognitivos. La teoría de gráficas ofrece modelos matemáticos para describir estas redes complejas a partir de simples abstracciones: nodos y aristas. En este trabajo se plantea el uso de técnicas de procesamiento de señales para el análisis de la conectividad funcional entre ensambles neuronales a partir de medidas derivadas del EEG a través de la teoría de gráficas. Se describen los procedimientos para el análisis de la conectividad, desde el procesamiento y acondicionamiento de los registros, el cálculo de la densidad espectral en el EEG en banda ancha, la determinación de medidas de conectividad entre electrodos, y la estimación de parámetros de las redes complejas resultantes. Se analizó el EEG de 50 sujetos en intervalos de antes (Pre) y durante la fotoestimulación repetida (Rph). Con base en la significancia estadística de la respuesta durante Rph de desincronización/sincronización (D/S) en la banda alfa, y su extensión en las regiones corticales, los participantes se separaron en tres grupos: G1, G2 y G3. La pendiente de la regresión lineal D/S vs repetición en banda alfa, fue significativa en 16 de 16 regiones en G1, 12 de 16 en G2 y 5 de 16 en G3. La conectividad funcional siguió estos cambios mientras que en las bandas delta, theta y beta no se registraron modificaciones. D se relaciona con activación y la S con inhibición lo que apoya la hipótesis de la participación de alfa en el proceso cognitivo de habituación a la fotoestimulación.

Abstract The hypothesis that the brain works using glial-neuronal networks that are responsible for sensory, motor and cognitive processes has been proposed in the neuroscience literature. Graph theory offers mathematical models to describe these complex networks from simple abstractions such as nodes and connecting edges. In this work, usign signal processing techniques to the analysis of functional connectivity between neuronal emsembles derived from EEG measurements through theory graph. Procedures for the analysis of connectivity are described, from multichannel record processing and conditioning, computation of wideband power spectral density, determination of connectivity measures between electrodes, and parameter estimation of the resulting complex networks. EEG recordings from fifty subjects were analyzed in intervals before (pre) and during repeated photostimulation (Rph). Based on the statistical significance of the response during Rph, desynchronization/synchronization (D/S) in alfa band, and its wide distribution in corticals areas, the participants were divided into three groups: G1 , G2 and G3. The slope D/S in alfa band was significant in 16 of 16 regions (G1), 12 of 16 (G2) and 5 of 16 (G3). The functional connectivity depicted the same trend as these changes, whereas in the delta, theta and beta bands occurred no modifications. D is related to activation and S with inhibition, supporting the hypothesis of alfa-band's participation in the cognitive process of habituation to photostimulation.

Acid-sensing ion channels and transient-receptor potential ion channels in zebrafish taste buds.

Sensory information from the environment is required for life and survival, and it is detected by specialized cells which together make up the sensory system. The fish sensory system includes specialized organs that are able to detect mechanical and chemical stimuli. In particular, taste buds are small organs located on the tongue in terrestrial vertebrates that function in the perception of taste. In fish, taste buds occur on the lips, the flanks, and the caudal (tail) fins of some species and on the barbels of others. In fish taste receptor cells, different classes of ion channels have been detected which, like in mammals, presumably participate in the detection and/or transduction of chemical gustatory signals. However, since some of these ion channels are involved in the detection of additional sensory modalities, it can be hypothesized that taste cells sense stimuli other than those specific for taste. This mini-review summarizes current knowledge on the presence of transient-receptor potential (TRP) and acid-sensing (ASIC) ion channels in the taste buds of teleosts, especially adult zebrafish. Up to now ASIC4, TRPC2, TRPA1, TRPV1 and TRPV4 ion channels have been found in the sensory cells, while ASIC2 was detected in the nerves supplying the taste buds.

Infection levels of the cestode Hymenolepis diminuta in rat populations from Buenos Aires, Argentina.

Ecological studies on zoonotic parasites are crucial for the design and implementation of effective measures to prevent parasite transmission. The aim of this study was to evaluate factors such as season, landscape unit, rat sex and rat body length, affecting the abundance of the cestode Hymenolepis diminuta, a parasite of synanthropic rats, within an urban environment. A parasitological survey was undertaken on 169 rats from landscape units such as shantytowns, parklands, industrial-residential areas and scrap-metal yards in Buenos Aires, Argentina. The overall prevalence of H. diminuta was 21.3%, although the occurrence of this species in rats was not homogeneous. The abundance of H. diminuta, using a zero-inflated negative binomial model, was correlated with rat body length. In shantytowns, abundance levels were higher than other landscape units, largely due to differences in individual environmental characteristics and rat assemblages. The populations of arthropod intermediate hosts could be subjected to seasonal fluctuations and the degree of urbanization. Shantytowns are overcrowded urban marginal settlements with most inhabitants living in precarious conditions and supporting large populations of rats, thereby increasing the risk of zoonotic infection.

BK Virus Nephropathy in Kidney Transplantation: An Approach Proposal and Update on Risk Factors, Diagnosis, and Treatment.

BK virus belongs to Polyomaviridae family; it causes 95% of nephropathy cases related to polyomavirus, with the other 5% caused by JC virus. Nephropathy jeopardizes graft function, causing a premature failure of the graft in 1%-10% of patients with kidney transplants. Nowadays, antiviral effective treatment is unknown, which is why blood and urine screening of renal transplantation patients has become the most important recommendation to guide the decrease of immunosuppression, and the only proven method to decrease poor outcomes. Different interventions, such as cidofovir, leflunomide, fluoroquinolones, and intravenous immunoglobulin, have been attempted with no improvement at all. This review aims to summarize the most relevant features of BK virus, historical issues, transmission mechanisms, risk factors, and therapeutic interventions.