Testing albendazole resistance in Fasciola hepatica: validation of an egg hatch test with isolates from South America and the United Kingdom.

The main goal of the current work was to develop and validate an in vitro fluke egg hatch test, as a method for the detection of albendazole (ABZ) resistance in the liver fluke, Fasciola hepatica. Fluke eggs (200/ml, n= 5) from six different isolates were used in the current experimental work. They were obtained from different geographical locations and named Cullompton (UK), CEDIVE (Chascomus, Argentina), INTA-Bariloche (Bariloche, Argentina), Rubino (Uruguay), Cajamarca (Perú) and Río Chico (Catamarca, Argentina). The fluke eggs were incubated (25 °C) for a 12-h period in the presence of either ABZ or its sulphoxide metabolite (ABZ.SO) (5, 0.5 or 0.05 nmol/ml). Untreated eggs were incubated as a control. Incubated eggs (with or without drug present) were kept in darkness at 25 °C for 15 days. Afterwards, the trematode eggs were exposed to daylight over a 2-h period. Hatched and unhatched eggs were evaluated using an optical microscope, and the ovicidal activity was assessed for each fluke isolate. A very low ovicidal activity ( ≤ 13.4%) was observed in the ABZ-resistant CEDIVE isolate for both ABZ and ABZ.SO. Conversely, in the INTA-Bariloche and Río Chico isolates, which are suspected to be susceptible to ABZ, ovicidal activities ≥ 70.3% were observed after incubation with ABZ at the lowest concentration tested (0.05 nmol/ml). This finding correlates with that previously described for the ABZ-susceptible Cullompton. Finally, the Cajamarca and Rubino isolates behaved as ABZ resistant, since no ovicidal activity was observed after eggs were incubated with ABZ at 0.5 nmol/ml. Considering the specific results obtained for each isolate under assessment, the egg hatch test described here may be a suitable method for detection of ABZ resistance in F. hepatica.

Comparative strategies and success of sympatric and allopatric Fasciola hepatica infecting Galba truncatula of different susceptibilities.

Allopatric infections of French Galba truncatula with an Argentinean isolate of Fasciola hepatica were carried out to determine the infectivity of foreign miracidia in three snail populations differing by their susceptibility to French miracidia (two highly and one poorly susceptible populations). Sympatric infections of G. truncatula with French miracidia were used as controls. Compared to sympatric infections of G. truncatula, snail survival at day 30 post-infection in allopatric groups was significantly lower in a highly susceptible population and significantly greater in the other two. Prevalence in snails infected with the allopatric isolate was significantly lower (16.4-34.5 % instead of 58.6-72.1 %), whereas their patent period was significantly longer (a mean of 69.9-85.9 days instead of 6.4-20.7 days). The mean number of metacercariae was also higher in allopatric groups (236.5-897.3 per cercariae-shedding snail instead of 70.7-222.1). Owing to longer patent periods, the Argentinean isolate of F. hepatica was less pathogenic for these snails. The lower prevalence of infection, the longer patent period and the higher number of metacercariae noted in allopatric groups might be the consequence of an adaptive mechanism used by this digenean introduced to the New World to infect new populations of unusual intermediate hosts.

Lymnaea neotropica and Lymnaea viatrix, potential intermediate hosts for Fascioloides magna.

Experimental infections of two South American lymnaeid populations with Fascioloides magna were carried out to determine whether these snails may sustain larval development of this digenean and, if so, to quantify their potential for cercarial production. The reference group was a French population of Galba truncatula infected and raised according to the same protocol. According to the internal transcribed sequence (ITS)-1 segment of their genomic rDNA, these South American populations were identified as Lymnaea neotropica (origin, Argentina) and Lymnaea viatrix var. ventricosa (origin, Uruguay). In the snail groups followed for cercarial shedding, longer prepatent periods and lower numbers of shed cercariae were noted in South American lymnaeids. In other snails dissected at day 65 post-exposure, the redial and cercarial burdens of F. magna found in the bodies of L. neotropica and L. v. ventricosa were significantly lower than those noted in G. truncatula. Compared to the total cercarial production noted in the dissected snails, the percentage of cercariae that exited from snails was 51.3% for G. truncatula, 32.2% for L. neotropica and 46.8% for L. v. ventricosa. The two South American species of snails can thus be considered as potential intermediate hosts of F. magna.

Intermediate snail hosts of French Fasciola hepatica: Lymnaea neotropica and Lymnaea viatrix are better hosts than local Galba truncatula.

Allopatric and sympatric infections of Lymnaea neotropica and Lymnaea viatrix var. ventricosa with Argentinean and French isolates of Fasciola hepatica were carried out to determine the capacity of these snails to produce metacercariae and to verify if this capacity changed with snail generation. The same process was also made with a French population of Galba truncatula known to be highly susceptible to French isolates of the parasite. In each lymnaeid species separately considered, the survival rate at day 30 post-exposure and prevalence of F. hepatica infection in the group infected with Argentinean miracidia were significantly greater than those recorded in the corresponding French one. Compared to infected G. truncatula, both South American lymnaeids had longer patent periods and produced a higher number of metacercariae. The highest infections were noted with L. v. ventricosa. In the three snail species, metacercarial production was more important with the Argentinean isolate of miracidia than with the French one. If three successive generations of L. v. ventricosa are exposed to the same French isolate of miracidia, cercarial production significantly increased from parents to the F2 generation, while the other characteristics of infection only showed insignificant variations. L. neotropica and L. v. ventricosa are better intermediate hosts for French F. hepatica than local G. truncatula. The numerical increase of shed cercariae in the F1 and F2 generations of L. v. ventricosa demonstrates a rapid adaptation of this species to the French isolate of the parasite.

Paramphistomum daubneyi: characteristics of infection in three lymnaeid species.

Experimental infections of two South American lymnaeids (Lymnaea neotropica and L. viatrix var. ventricosa) with Paramphistomum daubneyi were carried out to determine if these snail species could sustain larval development of this digenean and, if so, to specify their potential for cercarial production. A French population of Galba truncatula infected and raised according to the same protocol served as controls. In both experiments, prevalence of P. daubneyi infections in snails did not significantly differ from each other. In snail groups evaluated for cercarial shedding (first experiment), a significantly lower number of shed cercariae was noted for L. neotropica, while those from G. truncatula and L. v. ventricosa did not differ significantly from each other. Dissection of infected snails at day 65 post-exposure at 20°C (second experiment) found significantly lower burdens of P. daubneyi rediae and cercariae in the bodies of L. neotropica than in those of G. truncatula and L. v. ventricosa. Compared to total cercarial production observed in dissected snails, the percentage of cercariae which exited from snails was 75.6% for G. truncatula, 21.6% for L. neotropica, and 91.4% for L. v. ventricosa. This last species seems to be a good candidate for metacercarial production of P. daubneyi.

Disfunción endotelial en pacientes diabéticos con o sin úlceras del pie / Endothelial Dysfunction In Diabetic Patients With Or Without Foot Ulcers

Introducción. La disfunción endotelial juega un papel preponderante en la génesis de las complicaciones vasculares de la diabetes y precede a las evidencias anatómicas más tempranas de ateroesclerosis El Eco-Doppler vascular, mediante la determinación de laDilatación arterial flujo-dependiente en la arteria braquial ha demostrado una buena correlación con las pruebas invasivas parael diagnóstico de la Disfunción Endotelial. Objetivo: Determinar la presencia de Disfunción endotelial en pacientes diabéticos con o sin úlceras del pie. Método. Se diseñó un estudio observacional, prospectivo de corte transversal, tipo caso-control en pacientes diabéticos con y sin úlceras del pie, con un muestreo simple no probabilístico, con una población de estudio constituida por 100 pacientes diabéticos subdivididos en Grupo A (de estudio) 50 y Grupo B (control) 50. Resultados. La vasoactividad mediada por el flujo (VMF), en el grupo de estudio fue de 3,1% y en el grupo de control 4,3%, resultados ambos que traducen la presencia de disfunción endotelial, pero más intensa en los pacientes con úlceras del pie diabético. Conclusiones. La disminución de la vasoactividad mediada por el flujo constituye una manifestación temprana de la enfermedad arteriosclerótica, detectable inclusive antes de la aparición de eventos clínicos vasculares periféricos en pacientes diabéticos con o sin úlceras del pie. (AU)

Introduction. Endothelial dysfunction plays a preponderant role in the genesis of vascular complications of diabetes and precedes the earliest anatomical evidence of atherosclerosis. Vascular Echo-Doppler, by determining the flow-dependent arterial dilation inthe brachial artery, has demonstrated a good correlation with invasive tests for the diagnosis of Endothelial Dysfunction. Objective: To determine the presence of endothelial dysfunction in diabetic patients with or without foot ulcers. Method. An observational,prospective, cross-sectional, case-control study was designed in diabetic patients with and without foot ulcers, with a simple non-probabilistic sampling, with a study population consisting of 100 diabetic patients subdivided into Group A (of study) 50 and Group B (control) 50. Results. The flow-mediated vasoactivity (VMF) in the study group was 3.1% and 4.3% in the control group, both results that reflect the presence of endothelial dysfunction, but more intense in patients with diabetic foot ulcers. Conclusions: The decrease in flow-mediated vasoactivity constitutes an early manifestation of arteriosclerotic disease, detectable even before the appearance of peripheral vascular clinical events in diabetic patients with or without foot ulcers. (AU)

Efficacy and productive performance of moxidectin in feedlot calves infected with nematodes resistant to ivermectin.

Anthelmintic resistance (AR) of gastrointestinal nematodes to macrocyclic lactones is an increasingly common worldwide phenomenon limiting cattle production. This has motivated the search for alternatives, such as new active compounds, added drug synergisms, different doses, and alternate administration routes. The aim of this study was the assessment of moxidectin (MXD) performance in feedlot calves with a history of AR to ivermectin (IVM). Crossbred female calves aged 6-7 months and weighing 163kg (SD=34kg) were divided into 3 groups of 35 animals each. They were assigned to the following antiparasitic treatment groups: IVM group (0.2mg/kg IVM); MXD group (0.2mg/kg MXD), and ricobendazole+levamisole (RBZ+LEV) group (7.5mg/kg RBZ+8mg/kg LEV). On days 0, 26, and 47, fecal samples were taken and the weight of each animal was registered. Anthelmintic efficacy (by fecal egg count reduction), total weight gain (TWG) and average daily weight gain (AWG) were compared between the groups. A mixed SAS procedure was used for statistical analysis. Fecal egg count reduction 26 days post-treatment (PT) was calculated at 28% for the IVM group, 85% for the MXD group, and 99% for the RBZ+LEV group. AWGs (Standard Error) of 1.095g (56), 1.264g (49), and 1.340g (52) were registered for the IVM, MXD, and RBZ+LEV groups, respectively (p<0.05). Coprocultures revealed that MXD more effectively reduced Haemonchus spp. and Cooperia spp. egg counts than IVM. This resulted in higher AWGs and TWGs for this group; similar results were seen for the RBZ+LEV group as well. In this study, animals treated with MXD gained about 160 more g/day than animals treated with IVM. This represents a gain of 16 USD per animal over the 47 day trial.

Comparative study of the efficacy of different treatment options in patients with chronic blepharitis.

OBJECTIVE: To compare the efficacy of 3 treatment options in patients with chronic blepharitis. METHODOLOGY: An experimental, randomized, controlled study was conducted on 45 patients (female 67%; Mean age: 40.5 years) diagnosed with chronic blepharitis, in order to compare the effectiveness of three treatment options. Group 1: eyelid hygiene with neutral shampoo three times/day; group 2: neutral shampoo eyelid hygiene plus topical metronidazole gel 0.75% twice/day; group 3: neutral eyelid hygiene with shampoo plus neomycin 3.5% and polymyxin 10% antibiotic ointment with 0.5% dexamethasone 3 times/day. The symptoms and signs were assessed by assigning scores from 0: no symptoms and/or signs; 1: mild symptoms and/or signs, 2: moderate symptoms and/or signs; and 3: severe symptoms and/or signs. RESULTS: A significant improvement was observed in the signs and symptoms in all 3 treatment groups. While groups 1 and 2 had more improvement in all variables studied (P<.05), Group 3 showed no clinical improvement for itching (P=.16), dry eye (P=.29), eyelashes falling (P=.16), and erythema at the eyelid margin (P=.29). CONCLUSIONS: Shampoo eyelid hygiene neutral and neutral shampoo combined with the use of metronidazole gel reported better hygiene results than neutral shampoo lid with antibiotic ointment and neomycin and polymyxin dexamethasone.

The effect of bisbenzylisoquinoline alkaloids on Trypanosoma cruzi infections in mice.

Five bisbenzylisoquinoline (BBI) alkaloids, curine, cycleanine, isotet:andrine, limacine and pheanthine were tested for trypanocidal activity in C 3H He mice infected with Y or CL strain of Trypanosoma cruzi. The activity was compared with the baseline drug, benznidazole. Oral treatment was more effective with curine at 10 mg/kg or with cycleanine at 2 mg/kg daily for 10 days in mice infected with Y or CL strain. In these groups, the parasitemias were negative after 5-7 weeks after inoculation and mortality time 50 (MT(50)) was significantly higher than untreated mice. Benznidazole was effective in mice infected with CL strain but not in mice infected with Y strain. The other BBI showed a relative efficacy against both strains. The effect of BBI alkaloids could be due to a blocking of the Ca2+ channel for the regulation of T. cruzi infectivity to invade host cells or their selective immunosuppressive properties.

[Clinical risk factors for postoperative proliferative vitreoretinopathy (PVR). A prospective study]. / Factores clínicos de riesgo para el desarrollo de la vitreorretinopatía proliferante (VRP) postquirúrgica. Estudio prospectivo.

PURPOSE: To identify clinical risk factors for development of postoperative PVR, to determine the incidence of this complication and its time of onset by a prospective multicentric study. METHODS: A multicentric and prospective study of 223 patients with rhegmatogenous retinal detachment (RD) was conducted. Logistic regression analysis was used to identify risk factors for PVR among 83 variables related to preoperative, intraoperative and postoperative characteristics. RESULTS: 22 out of 223 RD developed PVR (incidence 9.9%, confidence interval 95%: 5.9-13.9). After logistic regression analysis, four variables showed an odds ratio higher than 1.0 (RD affecting 4 quadrants, cryopexy, aphakia/pseudophakia and those RD in which an encircling band was implanted). None of these factors showed a <

> value lower than 0.05. Most of postoperative PVR (77.2%) appeared in the first month after surgery. CONCLUSIONS: This study establishes the incidence of PVR, and its time of onset, but it was not effective to identify clinical risk factors with a high level of confidence.

[Methods of assessing postoperative pain in children]. / Métodos de valoración del dolor postoperatorio en el niño.

A study of the evaluation of postoperative pain in 210 children using physiological, reference and observation methods. A comparison with other methods leads to the conclusion that observation is the best choice and that some children do not need analgesics during the postoperative period.

[Consequences of the communication between lower urodigestive organs on gonads and gonad ducts]. / Consecuencias de la comunicación urodigestiva baja sobre gónadas y gonaductos.

Though there are not many cases described in the literature and very few for children, the existence of lower urodigestive communications may give rise to inflammatory processes in gonads and gonaducts in the male. We have carried out an experimental study of this aspect on 248 male Wistar rats according to the following design: A 48 animal control group (C) is divided into four equal subgroups sacrificed at the ages of one, two, three and four months. The problem group (P) of 200 animals are all submitted to vesicosigmoidostomy and then 100 are sacrificed after one and two months, and the other 100 are dis-diverted one and two months after the original diversion and sacrificed one month later. No histological alterations were observed in gonads and gonaducts for the sacrificed control animals (n = 48). The animals sacrificed after diversion (44 per 100) showed the following histological alterations: five cases of testicular tube necrosis, two cases of deferent conduit inflammation, one case of deferent conduit necrosis, 12 cases of epididymis inflammation and 13 cases of epididymis necrosis. The animals that also underwent dis-diversion and that were later sacrificed (20 per 100) showed: five cases of testicular tube necrosis, one case of testicular inflammation, two cases of deferent conduit inflammation, four cases of epididymis inflammation and seven cases of epididymis necrosis. Statistical analysis showed that the differences between the two P groups were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

[Urinary de-diversion after diversion with chronic bladder contamination. An experimental study in male rats]. / Desderivación urinaria tras derivación con contaminación crónica vesical. Estudio experimental en ratas macho.

We have carried out an experimental model of urinary diversion and dis-diversion on male Wistar rats in order to study the complications that are produced after diversion, as well as to see whether the alterations continue unchanged, or increase, or diminish after dis-diversion. The following experimental design was used: a control group made up of 48 animals an a problem group of 200 animals all submitted to vesicosigmoidostomy of which 100 were designed to be subsequently dis-diverted. The sacrificed animals (n = 112) were studied for somatic, biochemical and histological parameters. Statistical comparison of the problem group with the controls showed significant differences for the somatic and biochemical parameters, especially in the form of weight-size retardation, increase of urea, creatinine, calcium, phosphorus, uric acid, cholesterol, transaminase, alkaline phosphatase, sodium and chlorine and decrease in albumin and total proteins. After dis-diversion there is an improvement of some of these parameters without reaching total normalization. This leads us to think that either the lesions are irreversible, or more time after dis-diversion is needed for there to be reversibility. We also describe the histological lesions found at the level of the vesicointestinal anastomosis, and the mortality of our series which is higher than that presented by females, a fact inducing us to think that factors exist in the male which increase the mortality.

[Efficacy of topical 0.3% ciprofloxacin application in reducing the conjunctival biota of patients undergoing cataract extraction]. / Eficacia de la aplicación tópica de 0,3% ciprofloxacina en la reducción de la biota conjuntival de pacientes operados de cataratas.

OBJECTIVE: To determine the efficacy of topical 0.3% ciprofloxacin in reducing conjunctival biota in patients undergoing cataract surgery. PATIENTS AND METHODS: Experimental, prospective, randomized, controlled and single-blind study. Forty-six eyes of 46 patients were randomized into 2 groups, the study group (n=23) received topical 0.3% ciprofloxacin one day before surgery for six times, and on the day of the surgery one drop every 15minutes starting one hour before surgery until 3 doses were completed. The control group (n=23) did not receive any antibiotics. For both groups for the surgical field 10% povidone-iodine was applied. Samples from the conjunctiva were taken at four different times and then cultured on solid media (chocolate agar, blood agar) and enrichment broth (thioglycolate). The aqueous humor samples were also cultured in thioglycolate. The presence of bacteria was identified quantitatively and qualitatively, and the frequency of contamination was measured by considering the presence of bacteria in liquid and solid culture media. The number of colony forming units (CFU) was counted in the solid culture medium. RESULTS: Positive cultures were obtained in 82.6% and 78.2% of the patients in the study and control groups, respectively, before the administration of 0.3% ciprofloxacin. The administration of 0.3% ciprofloxacin significantly reduced the CFU compared to the control group (P<.05). Immediately after the use of povidone-iodine, the proportion of patients with a positive culture decreased to 21.7% in the study group, and 8.7% in the control group. At the end of the surgery, this percentage was 26% and 30.4%, respectively. The most common isolated pathogen was negative-coagulase Staphylococcus (66.7%). CONCLUSION: The administration of 0.3% ciprofloxacin reduces conjunctival bacterial load in the preoperative period. However, it was unable to eradicate the bacteria completely. The administration of povidone-iodine reduced conjunctival biota in 50%-70% of patients undergoing cataract surgery.

Everolimus monotherapy or combined therapy in liver transplantation: indications and results.

INTRODUCTION: Everolimus is a potent immunosuppressant with several advantages over calcineurin inhibitors, such as good tolerance, preventive effects on cardiovascular morbidity, and mortality and cancer prevention as it inhibits cell proliferation. PATIENTS AND METHODS: Between April 1986 and December 2010, we performed 1500 liver transplants (OLT) in 1341 recipients, including 57 patients who were prescribed everolimus 24 (42.1%) as monotherapy and 33 (57.9%) as treatments combined with other immunosuppressants. We performed a retrospective analysis of our experience with conversion to everolimus in OLT recipients. RESULTS: The 43 men and 14 women had a mean overall age at transplantation of 59.1 ± 10 years. The most frequent indication for OLT was hepatocellular carcinoma (HCC; 53.8%). Everolimus was introduced to prevent HCC recurrence (53%), development of de novo tumors (33%), address renal dysfunction (7%), or overcome side effects of other immunosuppressants (7%). We observed a significant improvement in renal function using the estimated glomerular filtration rate (Crockcroft-Gault formula) from 68.5 mL/min before to 74.5 mL/min after switching to everolimus. The 72% of recipients who developed ≥1 adverse event, most frequently showed hyperlipidemia (34.4%). CONCLUSION: Both monotherapy and combined everolimus regimens were well-tolerated immunosuppressive regimens in liver transplant recipients with recurrent or de novo malignancies. Everolimus improved renal function. The most common side effects were hyperlipidemia, edema, and mouth ulcerations, which were well controlled with anti-lipidemic agents or decreased everolimus dosages.

Split liver transplantation: where? when? how?

Donor scarcity is among the greatest concerns in the transplantation community. Dividing a liver graft theoretically offers a double benefit for candidates on the waiting list. Split liver transplantation entails a higher logistic and technical complexity that is extensively compensated, not only with an increase in the accessibility for child and adult candidates on the liver transplant waiting list, but also acceptable survival results.

Liver transplantation from anti-hepatitis C virus-positive donors: our experience.

BACKGROUND: Hepatitis C (HCV) is among the most common causes of end-stage liver disease worldwide. The donor shortage leads us to consider alternative organ sources such as HCV-positive donors. The outcomes of these transplants must be evaluated thoroughly since there is universal recurrence of disease among HCV-positive liver transplant recipients. METHODS: From January 2005 to April 2011, we performed 143 liver transplants (OLT) to treat end-stage liver disease secondary to HCV infection. Thirteen patients (9,1%) received livers from HCV-positive donors. A control group consisted of 130 HCV-positive patients who underwent OLT during the same period with organs from HCV-negative donors. Donor HCV status was assessed by 2 tests: HCV antibodies and viral load. Not only recipient and graft survivals were analyzed, but also frequency, timing and severity of hepatitis recurrence. RESULTS: Among 143 transplants performed in HCV-positive recipients during a 6-year period from January 1, 2005, to April 30, 2011, 9.1% of patients received an organ from an anti-HCV-positive donor, 72.7% of whom showed a negative viral load. The vast majority (80%) of our patients suffered hepatitis during their follow-up, 22.4% of which were severe cases. CONCLUSIONS: No significant difference in patient or graft survival was observed between the 2 groups. A high percentage of grafts with initial positive serology for HCV showed no viral replication. Grafts from HCV-positive donors can be considered to be a safe, effective source for liver donation.

Frecuencia de colonización por Estreptococo grupo B en embarazadas de 35 a 37 semanas en el Hospital Materno-Infantil San Pablo / Frequency of group B Streptococcus colonization in 35 to 37 weeks pregnant women in the San Pablo Maternal-Child Hospital

La colonización del Estreptococo grupo B en la embarazada está relacionada a patologías perinatales, constituyéndose en una causa muy importante de morbi-mortalidad neonatal. De manera a reducir dicha morbi-mortalidad, el Centro de Control y Prevención de Enfermedades Infecciosas de Estados Unidos desarrolló una estrategia que consiste en realizar el cultivo de muestra tanto vaginal como ano-rectal de todas las mujeres entre 35 y 37 semanas de gestación. El objetivo de este trabajo fue determinar la frecuencia de colonización por Estreptococo β hemolítico grupo B en mujeres gestantes entre las 35-37 semanas de embarazo que concurrieron al Hospital Materno-Infantil San Pablo, Centro de Salud Nº 5, desde abril del 2010 a agosto del 2011. Se realizó un estudio con diseño observacional descriptivo de corte transverso. Las muestras fueron tomadas mediante hisopado de introito vaginal y ano-rectal, colocadas en medio de transporte Stuart y remitidas al Instituto de Investigaciones en Ciencias de la Salud para el cultivo en agar sangre, previo enriquecimiento en caldo Todd Hewitt. La identificación bacteriana se realizó mediante pruebas bioquímicas convencionales y la confirmación mediante aglutinación con látex. La frecuencia de colonización obtenida fue relativamente alta, de 23,6%. Los resultados de este estudio permiten dimensionar la problemática en nuestro país y evidenciar la necesidad de la implementación de un programa a nivel nacional para la detección del Estreptococo grupo B de forma rutinaria en las embarazadas. De esta manera, se podrá disminuir la morbi-mortalidad perinatal y materna con la administración oportuna del tratamiento profiláctico.

Reducción de las amputaciones con Heberprot P en la terapia local del pie diabético / Reduction in the amputation rate with Heberprot P in the local treatment of diabetic foot

INTRODUCCIÓN. El síndrome de Pie diabético, se ha convertido en un problema sanitario mundial, por su alta frecuencia, recidiva y costos, a su vez, la frecuencia de ulceración y amputación aumenta progresivamente. Pretendemos a través de la siguiente investigación demostrar el impacto en la reducción de las tasa de amputaciones por Pie diabético asociada al uso del Heberprot P. MÉTODOS. Diseñamos un estudio analítico retrospectivo con los pacientes ingresados con el diagnóstico de Pie diabético en el Servicio Provincial de Angiología y Cirugía Vascular del Hospital Clínico-Quirúrgico Docente de Matanzas José R López Tabrane, entre enero del 2007 y septiembre del 2010 incluyendo ambos. De ellos seleccionamos nuestra muestra consistente en 2 grupos: Grupo A En los cuáles se empleo la terapia convencional aplicada a esta entidad y Grupo B en los cuales además de la terapia convencional, se utilizó localmente el heberprot P. RESULTADOS. Se aprecia una significativa reducción de la frecuencia de amputaciones en el grupo tratado con heberprot P encomparación con la terapia convencional, demostrando su utilidad en los grados 3,4 y 5 de Wagner y en las lesiones tanto neuropáticas como neuroisquémicas, observándose a su vez una marcada reducción en el tiempo de granulación y epitelización con el empleo del mismo. Hechos todos que avalan la importancia de su empleo local en el pie diabético(AU)

BACKGROUND. The diabetic foot syndrome (DFS), has become in a world sanitary problem, by its high frequency and cost, is important also for the increase in the prevalence of ulceration and amputation. Is objective of this investigation to demonstrate the impact in the reduction of the amputation rate for DFS associated with the use of the heberprot P. METHODS. The design of the investigation is retrospective, analytic with the patients admitted with the diagnosis of DFS in the provincial service of vascular surgery of the University Clinical Surgical Hospital of Matanzas Jose R. Lopez Tabrane, from January 2007 to September of 2010, including both. From this we select our population that consist of 2 groups. Group A that use conventional therapy and Group B in witch associated to the conventional therapy we use local treatment withheberprot P. RESULTS. We obtain a significative reduction in the amputation rate in the group that received local treatment with heberprotP when a comparison is established with a conventional treatment, the effectiveness is observe for the groups 3,4 and 5 of the Wagner classification and in the neuropatic and euroischemics ulcers, with a reduction in the granulation and epithelisation time. Facts that show the importance of this local treatment in the wound healing of the DFS(AU)

Frecuencia de serogrupos de estreptococos beta-hemolíticos enhisopados faríngeos de pacientes con faringitis / Frequency of beta-hemolytic streptococci serogroups in throat swabs of

El Streptococcus pyogenes o estreptococo beta-hemolítico (EBH) grupo A es la causa másfrecuente de faringitis bacteriana; su importancia radica en las secuelas no supurativasque puede desencadenar como la fiebre reumática aguda y la glomerulonefritis agudapost-estreptocócica. Casos de faringitis por grupos de EBH diferentes al grupo A,específicamente los del grupo C y G están documentados, pero su papel no estácompletamente claro. El objetivo de este estudio retrospectivo fue determinar lafrecuencia de serogrupos de EBH aislados de hisopados faríngeos de niños y adultos confaringitis, que acudieron al departamento de Microbiología del Laboratorio San Roque enAsunción-Paraguay, entre junio de 2006 a junio de 2007. Las muestras de hisopadosfaríngeos fueron cultivadas en agar sangre de carnero al 5 por ciento e incubadas por 48h a 35ºCen atmósfera de 5 por ciento de CO2 y las colonias beta-hemolíticas identificadas por métodosmicrobiológicos convencionales. De los 303 cultivos, 42 (13,9 por ciento) resultaron positivos paraEBH, de estos 25 (8,3 por ciento) fueron identificados como EBHA, 4 (1,3 por ciento) EBHC y 13 (4,3 por ciento)EBHG. La frecuencia relativa de los serogrupos fue de 59,5 por ciento del grupo A, 9,5 por ciento del grupoC y 31 por ciento del grupo G. Teniendo en cuenta que el 40,5 por ciento de los aislamientos de EBH eradiferente al grupo A, no debería considerarse al EBHA como único estreptococo patógenode la faringe, por lo tanto se debería identificar e informar todos los serogrupos en formarutinaria para un correcto diagnóstico y tratamiento, como una medida para prevenir laslesiones no supurativas que las infecciones por estos serogrupos pueden desencadenar.