Histopathological changes in the liver and stomach of Didelphis virginiana (Didelphimorphia: Didelphidae) during natural infection with Gnathostoma turgidum (Nematoda: Gnathostomidae).

Gnathostoma turgidum is a nematode parasite that exploits the stomach of Virginian opossums, Didelphis virginiana, in Latin America. The opossum is the definitive host of G. turgidum in the wild. Intrahepatic growth and maturation of the parasite, subsequent migration to the stomach and spontaneous expulsion are common. However, the histopathological lesions caused by G. turgidum are poorly described. A better understanding of the life cycle of this parasite and the pathological changes in natural host-parasite interactions could help to clarify the progression of human infections caused by Gnathostoma binucleatum. The aim of this work was to study morphological changes in the liver and stomach of D. virginiana during natural infection and adult worm expulsion. Three opossums naturally infected with G. turgidum were captured from an endemic area of gnathostomosis. Three uninfected opossums captured from a non-endemic area were used as controls. The opossums were sacrificed at different stages of infection (March, May and December), and a histopathological study of their livers and stomachs was conducted. Injuries in livers were observed by histopathology - areas of necrosis and collagen septa were identified. Parasites caused nodules with necrosis on the periphery of lesions, and collagen fibres were also observed in stomachs. Collagen septa may be caused by antigenic remains of the parasite. Further immunological studies are necessary to verify that stimulation is caused by these factors.

Influence of Quaternary Benzophenantridine and Protopine Alkaloids on Growth Performance, Dietary Energy, Carcass Traits, Visceral Mass, and Rumen Health in Finishing Ewes under Conditions of Severe Temperature-humidity Index.

Twenty Pelibuey×Katahdin ewes (35±2.3 kg) were used to determine the effects of the consumption of standardized plant extract containing a mixture of quaternary benzophenanthridine alkaloids and protopine alkaloids (QBA+PA) on growth performance, dietary energetics, visceral mass, and ruminal epithelial health in heat-stressed ewes fed with a high-energy corn-based diet. The basal diet (13.9% crude protein and 2.09 Mcal of net energy [NE] of maintenance/kg of dry matter) contained 49.7% starch and 15.3% neutral detergent fiber. Source of QBA+PA was Sangrovit RS (SANG) which contains 3 g of quaternary benzophenathridine and protopine alkaloids per kg of product. Treatments consisted of a daily consumption of 0 or 0.5 g SANG/ewe. Ewes were grouped by weight and assigned to 10 pens (5 pens/treatment), with two ewes per pen. The experimental period lasted 70 days. The mean temperature humidity index during the course of this experiment was 81.7±1.0 (severe heat stress). There were no treatment effects on water intake. Dry matter intake was not affected (p = 0.70) by treatments, but the group fed SANG had a numerically (11.2%) higher gain in comparison to the control group, SANG improved gain efficiency (8.3%, p = 0.04), dietary NE (5.2%, p<0.01) and the observed-to-expected NE (5.9%, p<0.01). Supplemental SANG did not affect (p≥0.12) carcass characteristics, chemical composition of shoulder, and organ weights (g/kg empty body weight) of stomach complex, intestines, and heart/lung. Supplemental SANG decreased liver weight (10.3%, p = 0.02) and increased visceral fat (16.9%, p = 0.02). Rumen epithelium of ewes fed SANG had lower scores for cellular dropsical degeneration (2.08 vs 2.34, p = 0.02), parakeratosis (1.30 vs 1.82, p = 0.03) and neutrophil infiltration (2.08 vs 2.86, p = 0.05) than controls. It is concluded that SANG supplementation helped ameliorate the negative effects of severe heat on growth performance of feedlot ewes fed high-energy corn-based diets. Improvement in energetic efficiency may have been mediated, in part, by anti-inflammatory effects of supplemental SANG and corresponding enhancement of nutrient uptake.

The nutrition transition in the Venezuelan Amazonia: increased overweight and obesity with transculturation.

OBJECTIVES: Amerindians have a particularly high propensity to overweight and obesity as they change lifestyle and experience a nutrition transition. The aim of this study was to evaluate the effects of transculturation on nutritional status in three Amazonian Amerindian villages. METHODS: Nutritional status was assessed in 232 volunteers: 65 Yanomami from an isolated village and 167 Guahibo subjects from villages with intermediate and high levels of transculturation. RESULTS: There was a significant pattern of decreasing stunting and increasing overweight and obesity across the gradient of transculturation. From the jungle Yanomami to the intermediate and transculturated Guahibo, stunting was respectively 72, 55, and 39%, and children /adult overweight was 0, 3/44, and 15/89%. These anthropometric-based patterns were confirmed by bioimpedance vector analysis. CONCLUSIONS: Transculturation in these Amerindian populations is associated with an increase in overweight and obesity coexisting with undernourished children.

Granular cell tumor of soft tissues: MR findings.

Granular cell tumors (GrCT) are histologically unique neoplasms that often manifest as painless solitary nodules located in the dermis or submucosal tissue. In this article we analyze the radiologic features of this type of tumor in five patients by magnetic resonance imaging (MRI), analyzing morphologic and signal characteristics. MR imaging findings were similar to other publications and we demonstrate low ADC values in our series.

Pioglitazone Enhances the Beneficial Effects of Glucocorticoids in Experimental Nephrotic Syndrome.

Glucocorticoids are the primary therapy for nephrotic syndrome (NS), but have serious side effects and are ineffective in ~20-50% of patients. Thiazolidinediones have recently been suggested to be renoprotective, and to modulate podocyte glucocorticoid-mediated nuclear receptor signaling. We hypothesized that thiazolidinediones could enhance glucocorticoid efficacy in NS. We found that puromycin aminonucleoside-induced proteinuria in rats was significantly reduced by both high-dose glucocorticoids (79%) and pioglitazone (61%), but not low-dose glucocorticoids (25%). Remarkably, pioglitazone + low-dose glucocorticoids also reduced proteinuria (63%) comparably to high-dose glucocorticoids, whereas pioglitazone + high-dose glucocorticoids reduced proteinuria to almost control levels (97%). Molecular analysis revealed that both glucocorticoids and pioglitazone enhanced glomerular synaptopodin and nephrin expression, and reduced COX-2 expression, after injury. Furthermore, the glomerular phosphorylation of glucocorticoid receptor and Akt, but not PPARγ, correlated with treatment-induced reductions in proteinuria. Notably, clinical translation of these findings to a child with refractory NS by the addition of pioglitazone to the treatment correlated with marked reductions in both proteinuria (80%) and overall immunosuppression (64%). These findings together suggest that repurposing pioglitazone could potentially enhance the proteinuria-reducing effects of glucocorticoids during NS treatment.

Outcome of twin pregnancy in a renal transplant recipient treated with tacrolimus.

Our report describes the outcome of a twin pregnancy in a woman who was maintained on tacrolimus after a living related renal transplant. Both babies born at 32 weeks of gestation developed severe respiratory distress requiring ventilator assistance and went on to develop congestive heart failure. Echocardiograms on both babies showed dilated heart chambers. Twin A succumbed to complications, but twin B, who was treated more aggressively with vasopressors, recovered. Autopsy findings on twin A revealed a thrombotic cardiomyopathy with degeneration of cardiac muscle. We believe that the unusual outcome in this set of twins may have been a result of cardiomyopathy secondary to tacrolimus used by the mother during her pregnancy.

Effects of sevoflurane general anesthesia: immunological studies in mice.

Based on the immunomodulatory effects of anesthesia and surgery, a study was undertaken to assess the effect of sevoflurane anesthesia on the immune system in a murine model without surgery. Adult male mice were anesthetized with 3% sevoflurane (1.2 minimal alveolar concentration, MAC) in oxygen for 40 min, whereas nontreated animals served as controls. After sevoflurane anesthesia, peripheral blood leukocyte counts, the splenic composition and in vitro macrophage phagocytic activity and lymphoproliferative response were assessed. The in vivo specific immune response to sheep red blood cells (SRBC), a conventional T-dependent antigen was determined. In addition, liver, spleen, thymus and kidney histopathology and also hepatic and renal functions after anesthesia were studied. Sevoflurane diminished the number of peripheral blood lymphocytes and splenic B-cell counts, enhancing CD4+ lymphocytes in spleen. The in vitro functionality of macrophages and the mitogen-induced lymphoproliferative response were preserved, while the in vivo immune response to SRBC was enhanced in treated animals. Microscopic studies revealed conserved architecture of the spleen, thymus, lymph node, liver and kidney, and there were no differences in serum parameters of hepatic and renal functions between treated and control groups. Our results suggest that 3 days after the anesthetic exposure, animals treated with sevoflurane modulated their peripheral blood leukocyte counts, splenic lymphoid composition and the characteristics of the specific response to SRBC, while there was no evidence of hepatic or renal toxicity.

Washed-biopsy cytology of abdominal lesions.

The accuracy of an alternative method of preparing cytologic smears from material collected under laparoscopic examination was studied. "Washed-biopsy" cytology was performed by saline solution lavage of the fragments using a cytocentrifuge. Rich and well-preserved cellularity was obtained. Among 51 cases, cytology revealed 12 benign, 3 suspicious and 36 malignant cases, including 9 true negatives, 3 false negatives and 36 true positives. Suspicious cases were excluded from the analysis. The sensitivity, specificity, positive and negative predictive values, and efficiency, when comparing the cytologic to the definitive diagnoses, were, respectively, 92.3%, 100.0%, 100.0%, 75.0% and 93.7%. We recommend the routine use of the washed-biopsy method in laparoscopic examinations to improve the accuracy of cytologic investigations.

[Chronic calculous cholecystitis and fibrotic rudimentary appendix associated with situs inversus totalis]. / Colecistite crôniça calculosa e apêndice rudimentar fibrotico associados a situs inversus totalis.

A case of calculous cholecystitis and rudimentary appendix in a 45 year old female patient with complete situs inversus is reported. After radiologic and sonographic examination, surgical treatment resulted in symptoms relief. A high index of suspection is imperative for the precise diagnostic and therapeutic approach.

[Endoscopic cystolithotomy: hypogastric approach]. / Cistolitotomía endoscópica: acceso hipogástrico.

Vesical lithiasis is a relatively frequent problem, the solution of which has changed over the last few years driven by major technological evolution. Traditional open surgery has been outstaged by the new endoscopic techniques and extracorporeal lithotrity. Here, we present our endoscopic resolution protocol through a hypogastric puncture approach, using a conventional nephroscope, with or without the use of ultrasound. This technique has been applied to 39 patients obtaining a 97.4% success rate with minimal morbidity. This procedure is usually performed under local anaesthesia and ambulatory, using an urethrovesical catheter for 1 to 2 days. This approach offers certain advantages over the one through the urethra due to the difficulties of passage through the latter, and the inconvenience of working within a relatively narrow and rigid duct. It is faster and more efficient than extracorporeal lithotrity especially in the presence of very hard or very numerous calculi and, if necessary, can be complemented immediately with a prostate transurethral resection. In summary, this is a simple, efficient and safe technique, and it has become our choice therapy to resolve a vesical lithiatic condition in males.

[Rescue of infected penile prosthesis: initial experience with prosthesis conservation]. / Rescate de prótesis peneana infectada: experiencia inicial con conservación de la prótesis.

Fitting a penial prosthesis has become an effective procedure to treat sexual impotence. However, its main complication, infection, remains a relatively frequent problem which forces the implant removal with the resulting treatment failure. This paper summarizes our early experience in 4 patients with infected penial prosthesis, who were treated by correcting the patient's general status, adequate antibiotic treatment, and deep and regular curing of the infected area. In these 4 patients, we managed to preserve the implant, achieving an adequate functional and cosmetic result. The paper discusses the pathophysiological mechanisms which would explain these improvements and points to the eventual indications and contraindications of the treatment. Finally, a recommendation is made to use this treatment with caution since our experience was still preliminary.

[Natural course of primary skin amyloidosis]. / Evolución natural de la amiloidosis cutánea primitiva.

We reviewed forty medical histories of patients with primitive cutaneous amyloidosis registered in the Unit of Dermatology, Venereology and Allergy of the Ecuadorian Social Security Institute of Guayaquil, who have abandoned the treatment for four or more years, finding a favorable evolution in the 37.5% of patients.

[In vitro emergence of ertapenem resistance in Escherichia coli producing extended-spectrum ß-lactamase]. / Rápida adquisición de resistencia in vitro al ertapenem en Escherichia coli productora de betalactamasa de espectro extendido.

INTRODUCTION: The occurrence of community-associated infections due to extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. These organisms are frequently resistant to many of the antimicrobial agents but remain susceptible to carbapenems. We investigated the in vitro emergence of carbapenem resistance in a collection of clinical isolates of ESBL -producing E. coli. MATERIAL AND METHODS: First and second-step resistant mutants were obtained from E. coli with ESBL. Aliquots of 50 µl containing > 109 CFU were applied to Mueller-Hinton plates containing meropenem, imipenem or ertapenem. MICs for native strains and mutants were determined using the epsilometric test (E-test). RESULTS: Resistant mutants were not selected with imipenem or meropenem. E. coli growth was observed on ertapenem (0.5 mg/L)-containing plates in 13 of 57 clinical isolates (22.8 %).The ertapenem MIC for these first-step mutants were ≥ 1 mg/L, remaining susceptible to imipenem and meropenem. The first-step mutants were used as native strains. Six second-step resistant mutants were selected with ertapenem. All were fully resistant (CMI ≥ 8 mg/L) to ertapenem, three were resistant to meropenem and one to imipenem. Four second-step resistant mutants were selected with meropenem. All were resistant to ertapenem, meropenem, and two of them were resistant to imipenem. CONCLUSIONS: Stable resistant mutants were easy to select with ertapenem among ESBL-producing E. coli. Two steps were necessary to select resistant mutants to meropenem or imipenem. The use of ertapenem in high-inoculum infections or in undrained focus of infection should be monitored to reduce the risk on selection of resistance.

Marcadores de selección en cerdos Pampa Rocha: comparación con razas autóctonas de España y Portugal / Selection markers in Pampa Rocha piqs: a comparison with autochthonous breeds of Spain and Portugal

RESUMEN Objetivo. El análisis de marcadores de selección permite obtener datos de la vida evolutiva de una raza o línea y permite también evaluar la conveniencia o no de su uso en programas de mejora genética. Hemos evaluado SNPs en cuatro genes (IGF2, MC4R, PRKAG3 y PEPCK-C), que tienen importantes efectos fenotípicos, en cerdos de la raza Pampa Rocha, una raza criolla, y hemos comparado sus frecuencias alélicas con cerdos de diversas razas autóctonas y líneas de España y Portugal no sometidas a selección así como con jabalíes y cerdos de la raza Piétrain. Materiales y métodos. Los SNPs fueron analizados mediante diversas técnicas de RT-PCR. Resultados. Los resultados de los análisis muestran una similitud de frecuencias alélicas entre los cerdos de la raza Pampa Rocha y los cerdos autóctonos de la península ibérica sobre todo en el gen IGF2 y, en menor medida en el gen PEPCK-C. Sin embargo difieren considerablemente en el caso del marcador MC4R y, también en menor medida, en PRKAG3. En el trabajo se discute el uso potencial de los resultados obtenidos para orientar la selección genética de cerdos de la raza Pampa Rocha. Conclusiones. Nuestros resultados demuestran la peculiaridad de la raza Pampa Rocha con respecto a los marcadores estudiados.

ABSTRACT Objective. The analysis of selection markers allows to obtain information about the evolutive story of a particular breed or line and allows also to evaluate the usefulness of those markers for breeding programs. We have analyzed SNPs in four genes of the creole pig breed Pampa Rocha and we have compared their allelic frequencies with the allelic frequencies of diverse autochthonous breeds of Spain and Portugal and also with Piétrain pigs and wild boars. Materials and methods. The SNPs were analyzed using diverse RT-PCR methods. Results. The results of the analysis show that Pampa Rocha pigs have similar allelic frequencies with the autochthonous breeds of Spain and Portugal especially in the case of IGF2 and also, but not so coincident, in the case of PEPCK-C. However, they differ considerably for MC4R, and also, but in a lower extent, for PRKAG3. We discuss in this work the usefulness of our results for breeding of Pampa Rocha pigs. Conclusions. Our results demonstrate the peculiarity of the Pampa Rocha breed regarding the markers studied.