Association between genetic variations at 8q24 and prostate cancer risk in Mexican Men.

BACKGROUND: Variants of 8q24 locus have been associated with prostate cancer (PCa) susceptibility. This study aims to analyze the genetic basis of PCa susceptibility in Mexican men by analyzing SNPs in the 8q24 locus for the first time. METHODS: A case-control study was performed in 875 men recruited from the Mexican Social Security Institute, 326 patients with PCa, and 549 non-PCa patients (88 with benign prostatic hyperplasia BPH and 461 healthy controls). The 8q24 locus SNPs: rs16901979, rs16983267, rs1447295, and rs7837328 were genotyped by allelic discrimination assays using TaqMan probes. Statistical analysis was performed using Epi Info statistical 7.0 and SNPstats softwares. RESULTS: All genotype frequencies were in Hardy-Weinberg Equilibrium. No differences were observed in genotype distribution between PCa and non-PCa patients for rs6983267. Under different inheritance models, the rs16901979, rs1447295, and rs7837328 SNPs were associated with PCa (OR = 2.8, 1.8, and 1.72, respectively; Pc < 0.001) when comparing PCa patients against controls. This association remains between PCa and BPH patients under different models (OR = 8.5, 2.2, and 1.9, respectively; Pc < 0.001). There were no significant differences in allele and genotype distribution among BPH patients and controls. The combined effect of the alleles CGAA for the SNPs rs16901979, rs6983267, rs1447295, and rs7837328 showed significant differences between PCa patients and controls (OR = 2.9, 95% CI = 1.48-5.83, Pc = 0.008). Four 8q24 variants were not associated with D'Amico score, age at diagnosis, and bone metastases. CONCLUSIONS: Our study provides the first confirmation that variants rs16901979, rs1447295, and 7837328 at 8q24 locus are associated with PCa susceptibility in Mexican men.

Tendencia de la mortalidad por fibrosis pulmonar idiopática en Chile / Trend in idiopathic pulmonary fibrosis in Chile

INTRODUCCIÓN: La Fibrosis Pulmonar Idiopática (FPI) es una de las enfermedades respiratorias crónicas del adulto de mayor impacto y letalidad, diversos estudios epidemiológicos muestran tendencias progresivas al aumento de las tasas de mortalidad por FPI. En Chile no existen reportes sobre las tendencias de las tasas de mortalidad por FPI. El objetivo del presente estudio es determinar las tendencias de la mortalidad por FPI en Chile entre los años 2002 y 2015. MÉTODO: Estudio descriptivo de diseño ecológico, a partir de la información de bases de datos secundarias de libre disposición de las estadísticas vitales del Departamento de Estadísticas e Información de Salud (DEIS) y del Instituto Nacional de Estadísticas (INE) de Ministerio de Salud de Chile entre los años 2002 y 2015 se obtuvieron las tasas crudas de mortalidad por fibrosis pulmonar idiopática en población de 45 años y más en ambos sexos y las tasas ajustadas por sexo y edad por regiones, se calculó también la frecuencia mensual de las muertes por FPI y se compararon las tasas medias de mortalidad por regiones. RESULTADOS: Se observó un incremento progresivo de la tasa nacional cruda de mortalidad por FPI entre los años 2002 a 2015, la que fue de 18,5 fallecidos por 100.000 habitantes en el año 2002 hasta 24,6 fallecidos por 100.000 habitantes en el año 2015 con una pendiente de ascenso por año de +0,27 por 100.000 habitantes (p = 0,013). En las mujeres las tasas fueron más altas que en los hombres, pero las pendientes de ascenso no presentaron diferencias entre sexos. En la gran mayoría de las regiones las tasas ajustadas presentaron tendencias significativas al ascenso y las tasas medias más altas se presentaron en las regiones del norte de Chile. Se observó un comportamiento estacional de las muertes siendo las frecuencias más altas en los meses de invierno. CONCLUSIONES: Las tasas de mortalidad por FPI en Chile presentan una tendencia progresiva al aumento, con marcadas diferencias regionales lo que lleva a considerar, entre otros factores, influencia ambiental y contaminación del aire y de suelos que se debieran investigar para poder realizar intervenciones de salud pública que permitan reducir la mortalidad de esta enfermedad en nuestro país.

BACKGROUND: Idiopathic Pulmonary Fibrosis (IPF) is one of the chronic respiratory diseases in adults with the greatest impact and high case fatality rate. Various epidemiological studies show progressive trends towards increasing IPF mortality rates. In Chile there are no national reports on country and regional trends in IPF mortality rates. The objective of this study is to determine trends in mortality due to IPF in Chile from year 2002 to 2015. METHOD: Epidemiological study of ecological design based on information from public databases of vital statistics of the Department of Health Statistics and Information (DEIS) and the National Institute of Statistics (INE) of the Ministry of Health of Chile. Crude mortality rates due to IPF in the population aged 45 years and over in both sexes were obtained from years 2002 to 2015. Besides the adjusted mortality rates for sex and age by region, the monthly frequency of IPF deaths during the same period and the average mortality rates by Chilean regions were calculated. RESULTS: A progressive increasing trend in the crude national IPF mortality rate was observed between years 2002 to 2015, which went from 18.5 deaths per 100,000 inhabitants in 2002 to 24.6 deaths per 100,000 inhabitants in 2015 with a slope of ascent per year of +0.27 per 100,000 inhabitants (p = 0.013); female rates were higher than men rates, but without differences in the slopes between sexes; in the vast majority of the regions the rates showed significant upward trends with the higher ones in the northern regions of Chile. A seasonal behavior of the death's frequency was observed being the highest in the winter term. CONCLUSIONS: Mortality rates due to IPF in Chile show a progressive upward trend, with marked regional differences which leads to consider, among other factors, environmental influence and air and soil contamination that should be investigated to carry out public health interventions that allow reducing the mortality of this disease in our country.

Estimación de la prevalencia de riesgo de síndrome de apneas obstructivas del sueño en funcionarios de una Institución de Salud según el cuestionario STOP-Bang / Estimation of the prevalence of risk of obstructive sleep apnea syndrome in workers of a health institution according to the stop-bang questionnaire

INTRODUCCIÓN: En Chile, se estima que 8,5% de los adultos tiene riesgo elevado de síndrome de apnea e hipopnea obstructiva del sueño (SAHOS). OBJETIVO: Estimar el riesgo de SAHOS en funcionarios de la salud. MATERIAL Y MÉTODO: Se consignaron los datos clínicos, antropométricos, presión arterial, cuestionarios STOP-Bang (CSB), índice de Flemons y escalas de Epworth y de Thornton en trabajadores de Clínica Dávila, Santiago, Chile. RESULTADOS: Se evaluaron 1.332 funcionarios, 77,1% mujeres, circunferencia de cuello: 35,7 ± 3,7 cm (26-54), circunferencia de cintura: 89,3 ± 3,7 cm, e índice de masa corporal: 27,5 ± 4,5 (17,5-49,4) kg/m2; 42% tenía sobrepeso y 26% obesidad. El Cuestionario SB los clasificó en tres categorías: Riesgo alto (RA): 43 funcionarios (3,2%), 50 ± 10,5 años; riesgo moderado: 215 (16,1%), 45,6 ± 11,4 años y riesgo bajo: 1.074 (80,6%), 36,2 ± 10,6 años. En hombres, la edad y los puntajes de los cuestionarios de sueño fueron diferentes en las tres categorías de riesgo (p = 0,003 y 0,001). En mujeres, los puntajes de los cuestionarios fueron distintos en los tres grupos de riesgo, no hubo diferencias en la escala de Epworth (p = 0,274), ni en la edad (p = 0,08). La escala Mallampati no permitió predecir el riesgo de SAHOS en ambos sexos. CONCLUSIONES: El cuestionario SB identificó a 9,8% de los hombres con riesgo alto de SAHOS. En los hombres, la edad, cuestionario SB, Flemons, Epworth y Thornton, fueron diferentes en las tres categorías de riesgo de SAHOS. En las mujeres, la edad y escala de Epworth fueron similares en las tres categorías de riesgo.

INTRODUCTION: In Chile, it is estimated that 8.5% of adults are at high risk of Obstructive Sleep Apnea (OSA). OBJECTIVE: To estimate the risk of OSA in health workers. MATERIAL AND METHOD: clinical and anthropometric data, blood pressure, STOP-Bang (CSB) questionnaires, Flemons index and Epworth and Thornton scales were assessed in workers from Clínica Dávila, Santiago, Chile. RESULTS: 1,332 workers were evaluated, 77.1% women, neck circumference: 35.7 ± 3.7 cm (26-54), waist circumference: 89.3 ± 3.7 cm, and body mass index: 27.5 ± 4.5 (17.5-49.4) kg/m2; 42% were overweight and 26% obese. The SB Questionnaire classified them into three risk categories: High risk (HR): 43 workers (3.2%), 50 ± 10.5 years-old; moderate risk: 215 (16.1%), 45.6 ± 11.4 years-old and low risk: 1,074 (80.6%), 36.2 ± 10.6 years-old. In men, age and sleep questionnaire scores were different in the three risk categories (p = 0.003 and 0.001). In women, the sleep questionnaire scores were different in the three risk groups, there were no differences in the Epworth scale (p = 0.274), nor in age (p = 0.08). The Mallampati scale did not allow predict OSA risk in both sexes. CONCLUSIONS: The SB questionnaire identified 9.8% of the men with high risk of OSA. In men, age, SB questionnaire, Flemons index, Epworth and Thornton scale, were different in the three OSA risk categories. In women, the age and Epworth scale were similar in the different risk categories.

Hematoma esofágico espontáneo: a propósito de un caso / Spontaneous esophagic hematoma: about a case

El dolor torácico es un motivo frecuente de consulta en los servicios de urgencias, sin embargo, el hematoma esofágico es una causa muy poco frecuente. Se manifiesta más frecuentemente en mujeres de edad media y avanzada, con una triada de dolor torácico súbito, disfagia u odinofagia y hematemesis. Presentamos un caso de una mujer de 89 años con antecedentes de hipertensión arterial en tratamiento, usuaria de antihipertensivos y aspirina, con una historia de dos días de evolución de dolor retroesternal, sensación febril, disnea y tos productiva secundario a un hematoma esofágico.

Thoracic pain is a frequent reason for consultation in the emergency department, however, esophageal hematoma is a very rare cause. It manifests more commonly in women of middle and advanced age, with a triad of sudden chest pain, dysphagia or odynophagia and hematemesis. We present a case of a 89 years old female patient, with a history of arterial hypertension in treatment, user of antihypertensive drugs and aspirin with a two day history of retrosternal pain, febrile sensation, dyspnea and productive cough due to a esophageal hematoma.

Ensayo pictórico: Imágenes en trasplante de páncreas: ¿qué debemos buscar? / Pictorial essay: Imaging in pancreas transplants: what should we look for?

El trasplante de páncreas es una alternativa terapéutica para pacientes diabéticos con complicaciones metabólicas severas y/o enfermedad renal crónica terminal. En el 80% de los casos, se realiza trasplante simultáneo de páncreas y riñón. El ultrasonido (US) es la técnica de elección para una primera evaluación del injerto, principalmente el modo Doppler espectral. Este último permite la evaluación de la vasculatura y perfusión de injerto. La tomografía computada (TC) y resonancia magnética (RM) se reservan para la evaluación de complicaciones (Tabla 1). Se realizó una revisión retrospectiva de una serie casos de trasplante páncreas-riñón realizada en nuestra institución entre los años 2014 y 2017, con un total de 12 casos.

Pancreas transplantation is a therapeutic alternative for diabetic patients with severe metabolic complications and/or terminal chronic kidney disease. In 80% of cases, a simultaneous transplant of pancreas and kidney is performed. Ultrasound (US) is the technique of choice for a first evaluation of the implant, mainly the spectral Doppler mode, which allows evaluation of the graft vasculature and perfusion. Computed tomography (CT) and magnetic resonance imaging (MRI) are reserved for the evaluation of complications (Table). A retrospective review of a series of cases of pancreas-kidney transplantation performed at our institution between 2014 and 2017 was carried out, with a total of 12 cases.

Manejo de obstrucción de vía lagrimal en niños mediante intubación con sonda Monoka®: experiencia inicial en HCUCh / Management of lacrimal duct obstruction in children by intubation with Monoka®: initial experience at HCUCh

Introducción: La obstrucción congénita del ducto nasolacrimal (DNL) es motivo de consulta frecuente en menores de un año. Se encuentra en 6% de los recién nacidos, la mayoría de las veces secundario a la persistencia de una membrana mucosa en la porción distal del DNL (membrana de Hassner). Generalmente se presenta como epífora patológica, es decir, presente después del 3º mes de vida. Esta obstrucción puede evolucionar con resolución espontánea los primeros 12 meses de vida, requerir terapias complementarias o resolución quirúrgica. Objetivo: Analizar los casos de obstrucción de la vía lagrimal en población pediátrica usando sonda Monoka® en pacientes intervenidos en el Hospital Clínico de la Universidad de Chile, que consultaron por epifora; verificando tasas de éxito, complicaciones del procedimiento y seguimiento. Material y método: Se realizó un estudio descriptivo retrospectivo, incluyendo todos aquellos pacientes con diagnóstico de obstrucción de vía lagrimal, mayores de 24 meses de edad, que consultaron en el HCUCh entre julio 2012 y marzo 2014, que requiriesen resolución quirúrgica de su cuadro. Se realizó instalación de sonda Monoka® con la participación conjunta de oftalmología y otorrinolaringología. Resultados: Se reunieron 7 pacientes, obteniendo éxito de 85,7% (6) y 100% de mejoría respecto a los síntomas iniciales. Un paciente presentó una complicación intraoperatoria, definida como un sondeo frustro. La sonda permaneció instalada un promedio de 7,7 meses y fue retirada sin complicaciones. Conclusión: La instalación de sonda Monoka® como procedimiento quirúrgico destinado a la resolución de la obstrucción de vía lagrimal es una técnica sencilla, de fácil acceso, moderado costo y que constituye una solución exitosa para aquellos pacientes afectados. Presenta excelentes resultados a mediano plazo, sin recidiva de la obstrucción de la vía lagrimal y con baja tasa de complicaciones. Es una técnica exitosa que, luego de esta experiencia, podría ser considerada de primera línea en nuestro hospital para aquellos pacientes con diagnóstico de epífora patológica, mayores de 24 meses.

Introduction: Congenital nasolacrimal duct obstruction (DNL) is frequent complaint in under a year. It is found in 6% of infants, the most often secondary to the persistence of a mucous membrane in the distal portion of the nasolacrimal duct (Hassner membrane). It usually occurs as pathological epifora present after the 3rd month of life. This obstruction can evolve spontaneously resolved the first 12 months of life, require complementary therapies or surgical treatment. Aim: To analyze where we have used the Monoka® probe in pediatric population operated in the Clinical Hospital of the University of Chile, who consulted for pathological epiphora; verifying success rates, procedure complications and monitoring. Material and method: A retrospective descriptive study, which were included all patients with the diagnosis of pathological epiphora over 12 months old, who consulted in the HCUCH between July 2012 and March 2014, that required surgical resolution of their condition. Monocanalicular installation silicone catheter was used with the joint participation of ophthalmology and otorhinolaryngology. Results: We had a total of 7 patients with a success rate of 85.7% (6) and 100% improvement over the initial symptoms. Only one patient presented an intraoperative complication, defined as failed intubation. The probe remained installed an average of 7.7 months and was removed without complications. Conclusions: The installation of Monoka® probe as surgical intervention to resolve the pathological epiphora is a simple, easily accessible and amoderate cost procedure. It's a successful solution for those patients affected. It has excellent mid-term results, no recurrence of obstruction of DNL and low complication rate. It is a successful technique that would be considered frontline in our hospital for patients diagnosed with pathological epiphora over 12 months old.

Reproducible model to perform kidney transplantation in a low-resource population.

BACKGROUND: In several countries, organ transplantation is limited. We describe the implementation of a model to perform kidney transplantation in a low-resource population through a financial mechanism sharing public, patient, and private foundations funds. METHODS: This was a cohort study of 100 low-resource patients undergoing renal transplantation at the Hospital General of México. The mean age of the transplanted population was 30.07 ± 11.4 years, from which 84% reported an income <400 USD/month. Ninety percent of grafts were obtained from live donors. RESULTS: The survival rate at 1 year after the procedure was 98%. Patient rehabilitation after transplantation included the incorporation of individuals into productive life and work. The economically active population increased from 8% to 40% after the transplant procedure. The model was successfully implemented as the result of (i) adequate incorporation of medical staff with solid experience in organ transplantation; (ii) institutional public policy and collaboration between diverse services to support donors and receptors; and (iii) financial collaboration to attract resources and funds to guarantee access to immunosuppressants. CONCLUSIONS: Our results led toward an operational, reproducible model for transplanting patients in developing and financial crisis countries, reflecting beneficial long-lasting effects on the patient from the therapeutic, clinical, and economic points of view.

Normal "high" thyroid stimulating hormone (TSH) levels and pregnancy rates in patients undergoing IVF with donor eggs.

OBJECTIVE: To determine if a relationship exists between pregnancy rates obtained in patients undergoing in vitro fertilization (lVF) with donor eggs and levels of thyroid stimulating hormone greater than 2.5 mlU/L but still within a range considered normal. STUDY DESIGN: Retrospective comparative cohort study. With prior approval of the Ethics Committee, 233 patients undergoing IVF with donor eggs, in a two-year period, were included. Patients were grouped depending on the thyroid stimulating hormone (TSH) level. Pregnancy rates were compared. Statistical analysis was made with the Chi-square test. RESULTS: Pregnancy rates, depending on the TSH level, were 56.6% in patients with TSH levels below 2.49 mU/L vs. 21.6%, in patients with levels above 2.5 mU/L. This difference was statistically significant (p < 0.001). CONCLUSIONS: Mild abnormalities of thyroid function may adversely affect the pregnancy rates in patients un- dergoing in vitro fertilization with donor eggs. A possible alteration in endometrial function may be associated.

Irritación gástrica producida por diclofenaco de sodio: estudiocomparativo de tabletas de liberación controlada en conejos / Gastric irritation of sodium diclofenac: comparative study of slow-release formulation in rabbits

El objetivo del presente trabajo fue evaluar el potencial irritante gástrico de una formulación nacional de diclofenaco de sodio de liberación controlada comparativamente con un producto de importación y con una formulación recubierta con Sucralfato, mediante un ensayo agudo y otro a dosis repetidas en conejos Nueva Zelanda tratados con una dosis de 59 mg/kg por vía oral. Las tabletas de diclofenaco formulación nacional produjeron irritación gástricaligera en el ensayo agudo, la cual fue similar a la producida condiclofenco importado y diclofenaco recubierto con sucralfato. La administración de diclofenaco formulación nacional durante 5 días en conejos produjo irritación gástrica, observándose erosión sobre la mucosa gástrica similar a la observada con la administración de diclofenaco importado. Los efectos sobre la mucosa gástrica y duodenal producidos por ambas formulaciones de diclofenaco fueron similares en el ensayo agudo y a dosis repetidas siendo factible el empleo de la formulación nacional en ensayos clínicos (AU)

The aims of the study was to evaluate the gastric irritation potential of a slow-release Cubanformulation of sodium diclofenac comparatively with the import product and with a formulation recovered with sucralfate, by means of an acute test and repeated dose test in New Zealand rabbits triedwith an oral dose of 59 mg/kg. National formulation of diclofenac produced slight gastric irritation in the acute test. This result wassimilar to the observed with the import product and sucralfate recovered diclofenac. The administration of national formulation of diclofenac for 5 days in rabbits produced gastric irritation. We observed gastric mucous erosion similar to the import diclofenac treated group. The effects causes by both formulations on the gastric and duodenal mucous were similar in the acute test and repeated dose test, being feasible the employment of the national slow-release formulation in clinical rehearsals (AU)

Molecular and antigenic characterization of rabbit hemorrhagic disease virus isolated in Cuba indicates a distinct antigenic subtype.

Phylogenetic analyses conducted on isolates of rabbit hemorrhagic disease virus (RHDV) from throughout the world have shown well-defined genogroups comprising representative strains of the virus and antigenic variants. In this work, we have isolated and characterized RHDV from the major epizootic that occurred in Cuba in 2004-2005. Sequence analysis of the capsid protein gene and antigenic characterization of this strain has allowed its inclusion as a member of the distinct RHDVa subtype. We also found that specific antibodies directed against RHDV reference strains bound to the Cuban isolate in a competition ELISA and inhibited virus hemagglutination in vitro. This is the second report on the molecular characterization of RHDVa circulating in the American region.

Defectos de pared anterior del abdomen: diagnóstico prenatal y seguimiento / Anterior abdominal wall defects: prenatal diagnosis and monitoring

Abdominal wall defects are ranking in the 4th place of congenital malformations. The most frequent ones are gastroschisis and omphalocele, which show a high perinatal mortality. Over the last 30 years, world incidence has grown. The national incidence and prevalence of these defects should be determined. Objective: The analysis of trends in clinical characteristics of these defects referred to a national centre and treated in Santiago, Chile, between March 2003 and August 2006. Method: 7 cases of omphalocele and 7 cases of gastroschisis were analysed. We studied associated risk factors, prenatal management and postnatal follow-up. Results: The average maternal age in gastroschisis was 18 and 28.4 in omphalocele. Five patients with gastroschisis were primigravida. None of the patients had a history of drugs, alcohol or tobacco intake. Six of seven of omphalocele cases we associated with other malformations, three of them were multiple malformations Cantrell type. None of the cases of gastroschisis showed any associated malformations. In six cases of omphalocele and in one case of gastroschisis fetal karyotyping was studied. Six cordocentesis and one amniocentesis were performed. Results were one Trisomy 18 (omphalocele) and six normal kariotype. In three cases of omphalocele, the babies were delivered with elective cesarean section. In three cases of omphalocele and all cases of gastroschisis, urgent Cesarean section had to be performed. There was one vaginal delivery with a stillborn (Trisomy 18). Among the gastroschisis cases and three of the omphalocele cases, four children were born prematurely. The average weight of the newborns with gastroschisis was 2.365 gr., and 2.770 gr., in omphalocele cases. The distribution by sex in gastroschisis was 6 females: 1 male, in cases of omphalocele it was 4 females: 3 males. Of all 14 cases, two died during the first hours, and one was a stillborn. In the first...

Los defectos de la pared anterior del abdomen se ubican en 4° lugar de las malformaciones congénitas, siendo los más frecuentes la gastrosquisisy el onfalocele que presentan una alta mortalidad perinatal. En los últimos 30 años se reporta un aumento de la incidencia a nivel mundial. Es importante determinar la incidencia y prevalencia nacional de estos defectos. Objetivos: Analizar tendencias en las características clínicas de los defectos de pared anterior del abdomen, derivados a un centro de referencia nacional (Centro de Referencia Perinatal Oriente, CERPO), y atendidos en su red en Santiago, Chile, entre Marzo 2003 y Agosto 2006. Método: Se analizan todos los casos encontrados en el periodo. Se trata de 7 onfaloceles y 7 gastrosquisis, factores de riesgo asociados, evolución prenatal y seguimiento postnatal. Resultados: Media de edad materna 18 años en gastrosquisis y 28.4 años en onfaloceles. Cinco de 7 pacientes con gastrosquisis eran primigestas. Ninguna paciente tiene antecedentes de consumo de drogas, alcohol ni tabaco. Malformaciones asociadas en 6 de 7onfaloceles, de las cuales 3 de 7 eran malformaciones múltiples tipo Cantrell. Ninguna gastrosquisis presentó malformaciones asociadas. Se realizaron siete cordocentesis y una amniocentesis a 6 onfaloceles y a 1 gastrosquisis resultando 1 trisomia 18 (onfalocele) y 6 cariogramas normales. Nacieron por cesárea programada 3 de 7 onfaloceles y por cesárea de urgencia 3 de 7 onfaloceles y 7 de 7 gastrosquisis. Un parto vaginal por óbito (trisomía 18). Edad gestacional al parto: 4 de 7 gastrosquisis nacieron de pretérmino: y 3 de 6 onfaloceles. Peso promedio de recién nacidos vivos con gastrosquisis:2.365 g, onfaloceles: 2.770 g. Distribución por sexo en gastrosquisis 6 femeninos / 1 masculino, en onfalocele 4 femeninos / 3 masculinos. Tres de 14 fallecieron en las primeras horas de vida o nacieron muertos. En los primeros tres meses de vida fallecieron 3 de 6 onfaloceles y 1 de...

Toxicidad aguda oral y subcrónica en ratas de un extracto acuoso liofilizado de Ocimum tenuiflorum L / Acute and subchronic oral toxicity in rats of a lyophilized aqueous extract of Ocimum tenuiflorum L

El potencial tóxico de un extracto acuoso liofilizado fue evaluado mediante el ensayo de toxicidad aguda oral y subcrónica a 90 días en ratas Wistar de ambos sexos. Los métodos empleados fueron los descritos por las normas OECD. En el ensayo agudo se administró por vía oral la dosis de 2000 mg/kg y en el ensayo subcrónico 250, 500 y 1000 mg/kg/día durante 13 semanas. Se evaluaron los signos tóxicos y peso corporal en ambos ensayos. En el estudio subcrónico además se evaluó el consumo de alimentos, indicadores hematológicos (hemoglobina, hematocrito, recuento diferencial de leucocitos, recuento total de leucocitos y recuento total de eritrocitos) y bioquímica clínica (glucosa, alanino amino transferasa, aspartato amino transferasa, colesterol, urea, bilirrubina y creatinina). También se realizó necropsia y examen histopatológico de órganos y tejidos (corazón, riñón, hígado, bazo, cerebro, pulmón, estómago, intestino, timo, glándulas suprarrenales, tiroides, paratiroides, páncreas, glándulas salivales, ganglio cervical, testículos, vesículas seminales, próstata y ovarios) y se determinó el peso relativo de órganos (corazón, riñón, hígado, bazo, cerebro, pulmón, timo, glándulas suprarrenales, próstata, testículos y ovarios). No se apreciaron signos tóxicos ni mortalidad como consecuencia de la administración del liofilizado de Ocimum tenuiflorum L. en ninguno de los ensayos. Los parámetros analizados de peso corporal, consumo de alimentos, hematología, bioquímica, peso relativo de órganos y análisis histopatológico de órganos y tejidos no evidenciaron toxicidad significativa atribuible a la sustancia de prueba

The toxic potential of a lyophilized aqueous extract was evaluated by oral acute and 90 days subchronic toxicity in Wistar rats of both sexes. The methods used were those described by OECD guidelines. In an oral acute toxicity test, a dose of 2000 mg/kg and for subchronic toxicity test, doses of 250, 500 and 1000 mg/kg/day for 13 weeks were administered. The toxic signs and corporal weight were evaluated for both assays. In addition, in subchronic toxicity test, the food consumption, haematology (haemoglobin, haematocrit, erythrocyte count, total and differential leucocyte count) and clinical biochemistry determination (glucose, alanine aminotransferase, aspartate aminotransferase, cholesterol, urea nitrogen, total bilirubin and creatinine) were evaluated. Gross necropsy and histopathological examination of organs and tissues (heart, kidney, liver, spleen, brain, lung, stomach, intestine, thymus, adrenals, thyroid/parathyroid, pancreas, salivary glands, cervical ganglion, testicles, seminal vesicles, prostate and ovaries) were carried out and relative weight of each organ was determined (heart, kidney, liver, spleen, brain, lung, thymus, adrenals, prostate, testicles and ovaries). Oral acute and subchronic toxicity tests showed no significant toxic effects attributable to the test substance, with absence of toxic symptoms or mortality and normal weight increment, food consumption, haematology, biochemistry, organs relative weight and histopathological examination of organs and tissues

Presencia de Bartonella henselae en gatos: cuantificación del reservorio natural y riesgo de exposición humana de esta zoonosis en Chile / Presence of Bartonella henselae in cats, in Chile

Background: The availability of a serologic test for cat scratch disease in humans has allowed the diagnosis of an increasing number of cases of this disease in Chile. Aim: To perform a serological survey for Bartonella henselae among cats in Chile. Material and methods: Blood samples from 187 cats living in three Chilean cities were obtained. IgG antibodies againts Bartonella henselae were measured using indirect immunofluorescence. Blood cultures were done in 60 samples. The presence of Bartonella henselae in positive cultures was confirmed by restriction fragment length polymorphism polimerase chain reaction (RFLP-PCR). Results: The general prevalence of IgG antibodies against Bartonella henselae was 85.6%. No differences in this prevalence were found among cats younger or older than 1 year, or those infested or not infested with fleas. However domestic cats had a lower prevalence when compared with stray cats (73 and 90% respectively, p <0.01). Bartonella henselae was isolated in 41% of blood cultures. All the isolated were confirmed as Bartonella henselae by RFLP-PCR. Conclusions: This study found an important reservoir of Bartonella henselae in Chilean cats and therefore a high risk of exposure in humans who have contact with them.

Usefulness of myocardial perfusion SPECT in patients with left bundle branch block and previous myocardial infarction.

BACKGROUND: The diagnostic value of myocardial perfusion scintigraphy in patients with left bundle branch block (LBBB) and previous acute myocardial infarction has not been evaluated. OBJECTIVE: To determine the utility of single photon emission computed tomography (SPECT) in patients with LBBB and previous acute myocardial infarction. METHODS: Seventy two consecutive patients with permanent LBBB and previous acute myocardial infarction were studied with stress-rest SPECT using 99mTc compounds. The same stress procedures were followed in all patients: (1) exercise alone when it was sufficient; (2) exercise plus simultaneous administration of dipyridamole if exercise was insufficient. RESULTS: In 26 of 28 patients (93%) who had a Q wave acute myocardial infarct before the development of LBBB, there was concordance between abnormal Q waves and rest SPECT in the localisation of myocardial necrosis (kappa = 0.836; p = 0.0001). In 48 patients who had coronary angiography, the positive predictive value of exercise (+dipyridamole) myocardial SPECT for the diagnosis of left anterior descending coronary artery stenosis was 93%, for left circumflex coronary artery stenosis, 96%, and for right coronary artery stenosis, 89%. Specificity values were 83%, 91%, and 69%, respectively. However, sensitivity (69%, 64%, and 89%) and negative predictive values (48%, 46%, and 82%) were suboptimal. CONCLUSIONS: Rest myocardial perfusion SPECT with technetium compounds is useful for localising healed myocardial infarction in patients with LBBB, and exercise (+dipyridamole) SPECT has a high positive predictive value and specificity for the diagnosis of coronary stenosis in these patients.

Quantitation of red cell-bound IgG, IgA, and IgM in patients with autoimmune hemolytic anemia and blood donors by enzyme-linked immunosorbent assay.

This paper describes an enzyme immunoassay for the quantitative determination of IgG, IgA, and IgM immunoglobulins on RBCs. Ether eluates made from RBCs were followed by an enzyme-linked immunosorbent assay of immunoglobulin concentration. Calibration curves were derived from immunoglobulin standards and the number of molecules of each isotype per RBC was calculated. The assay was carried out in 200 healthy blood donors and 62 patients with warm autoimmune hemolytic anemia (AIHA), two of them with a negative DAT. For healthy blood donors, mean values were 58 IgG, 16 IgA, and 3 IgM molecules per RBC. For patients with a positive DAT, the mean values were 3435 IgG, 157 IgA, and 69 IgM molecules per RBC. An increased level of IgA was found in 12 patients without IgA autoantibodies demonstrable in RBC eluates. Increased IgG levels were also observed in patients with a negative DAT and, in one case, an increased level of IgA was also found. The enzyme-linked immunosorbent assay using ether eluates is a sensitive method for quantitating RBC autoantibodies in patients with AIHA as well as immunoglobulins bound to RBCs in healthy individuals.

SPET miocárdico de perfusión y ventriculografía isotópica en la miocardiopatía hipertrófica obstructiva y no obstructiva / Myocardial perfusion spect and isotopic ventriculography in obstructive and non-obstructive hypertrophic myocardiopathy

Objetivos: Valorar el papel del SPET miocárdico de perfusión y de la ventriculografía isotópica en la miocardiopatía hipertrófica (MH).Material y Métodos: A una serie consecutiva de 101 pacientes (54 ñ 15 años de edad, 50 mujeres, 55 obstructivos), diagnosticados por ecocardiograma-Doppler de MH, se les practicó un SPET miocárdico de perfusión con 99mTctetrofosmina y una ventriculografía isotópica. El seguimiento medio desde el momento del diagnóstico fue de 9,9 ñ 6,7 años (entre 1 y 28 años). Resultados: El 36 por ciento de los pacientes presentaron defectos de perfusión (15 defectos fijos y 21 defectos reversibles). En las MH no obstructivas se observó un mayor número de pacientes con defectos fijos (p = 0,01) y en los pacientes con defectos fijos se observó una mayor incidencia de ondas Q patológicas en el ECG (p = 0,01), mayores volúmenes ventriculares (p < 0,05), menor fracción de eyección (p = 0,001) y un tiempo a la velocidad máxima de llenado ventricular superior (p < 0,05). Cuatro pacientes fallecieron, 15 presentaron síncope, en 18 se indicó la implantación de marcapasos y en 6 miectomía. La fracción de eyección fue más alta en los pacientes que presentaron síncope (p = 0,034) mientras que ninguna variable isotópica fue predictora de mortalidad ni de indicación de marcapasos o miectomía. Conclusiones: Ni la tomogammagrafía miocárdica de perfusión ni la ventriculografía isotópica aportan información pronóstica en la MH, aunque en los pacientes con síncope se observan valores de fracción de eyección más elevados. Los pacientes con defectos fijos presentan mayor proporción de ondas Q patológicas en el ECG, mayores volúmenes ventriculares y fracción de eyección más baja en la ventriculografía isotópica, lo cual indica una evolución hacia la forma dilatada de la MH (AU)

[Myocardial perfusion SPECT and isotopic ventriculography in obstructive and non-obstructive hypertrophic myocardiopathy]. / SPET miocárdico de perfusión y ventriculografía isotópica en la miocardiopatía hipertrófica obstructiva y no obstructiva.

OBJECTIVE: To evaluate the role of myocardial perfusion SPET and radionuclide ventriculography in patients with hypertrophic cardiomyopathy (HC). METHODS: Exercise myocardial perfusion SPET with 99mTc-tetrofosmin and radionuclide ventriculography were performed in a consecutive series of 101 patients (54 15 years, 50 women, 55 with dynamic obstruction) diagnosed of HC by echo. Follow-up from the diagnosis was 9,9 6,7 years (1 to 28 years). RESULTS: Thirty six percent of patients had perfusion defects (non reversible in 15 and reversible in 21). In non obstructive HC higher number of patients with non reversible defects (p = 0.01 was obseved and in patients with no reversible defects higher incidence of pathologic Q waves in ECG (p = 0.01), Higher ventricular volumes (p < 0.05), lower ejection fraction (p = 0,0001) and longer time to peak emptying velocity (p < 0.05). There were 4 cardiac deaths, 15 syncopes, 18 pacemakers and 6 myectomy. Ejection fraction was higher in patients with syncope (p = 0,034) and there was no isotopic variable predictive of mortality, pacemaker or myectomy. CONCLUSIONS: Neither SPET nor radionuclide ventriculography have a prognostic role in patients with HC, but patients with syncope have higher values of ejection fraction. Patients with non reversible defects have higher rate of pathologic Q waves in ECG, higher ventricular volumes and lower ejection fraction. This is indicative of evolution to dilated form of HC.

Standard provocative manoeuvres in patients with and without left bundle branch block studied with myocardial SPECT.

BACKGROUND: The objective of this study was to determine the prevalence of anterior and septal defects in patients with left bundle branch block (LBBB), and to assess the diagnostic accuracy of myocardial single photon emission computed tomography (SPECT) with technetium compounds in patients with and without LBBB using standard provocative manoeuvres. METHODS: Five hundred and nine consecutive patients (456 without LBBB and 53 with LBBB) without previous infarction who had a coronary angiography performed within <3 months of the scintigraphic study were retrospectively evaluated. The same stress procedures were followed in all patients. (1) Only exercise when it was sufficient; and (2) exercise + simultaneous administration of dypiridamole if exercise was insufficient. Only reversible defects were considered positive and > or =50% of coronary stenosis was considered significant. RESULTS: Prevalence of reversible anterior and septal defects was low (33% and 12%, respectively) in patients with LBBB. Although lower values of global sensitivity (81%) and specificity (73%) were obtained in these patients, there were no significant differences with respect to the patients without LBBB (89% and 86%, respectively). Specificity values for the diagnosis of stenosis of left anterior descending (78%), left circumflex (96%) and right coronary artery (74%) in patients with LBBB were lower, but without significant statistical differences with respect patients without LBBB (90%, 96% and 82%, respectively). CONCLUSIONS: Myocardial SPECT with technetium compounds, using standard provocation manoeuvres, can be used in patients with LBBB with only a mild decrease in diagnostic accuracy as compared to patients without LBBB.