First report of group A rotavirus and bovine coronavirus associated with neonatal calf diarrhea in the northwest of Argentina.

Group A rotavirus (RVA) and bovine coronavirus (BCoV) are the two main viral enteropathogens associated with neonatal calf diarrhea. The aim of the present survey was to investigate the epidemiology and the role of RVA and BCoV in the presentation of dairy and beef calf diarrhea in Lerma Valley of Salta province, within the Northwest region of Argentina. Stool samples of calves with or without diarrhea younger than 2 months of age were collected from 19 dairy farms and 20 beef farms between the years 2014 and 2016. Stool samples were screened for RVA and BCoV detection by ELISA. Heminested multiplex RT-PCR was used for RVA typing and RT-PCR to confirm BCoV. Positive samples were submitted to sequencing analysis. Bovine RVA and BCoV were circulating in 63% (12/19) and 10.52% (2/19) of the dairy farms, respectively, where 9.5% (46/484) of the calves were positives to RVA and 0.4% (2/484) to BCoV. In beef herds, RVA was detected in 40% (8/20) of the farms and in 6.75% (21/311) of the calves, without positives cases of BCoV. Molecular analysis showed that in dairy farms, G6P[11] and G10P[11] were the prevalent RVA strains, while in beef farms, G10P[11] was the prevalent. The main finding was the detection for the first time of a G15P[11] causing diarrhea in beef calves of Argentina that represents a new alert to be consider for future vaccine updates. Analysis of detected BCoV showed that it is related to the other circulating strains of Argentina.

Detection and characterization of Deformed Wing Virus (DWV) in apiaries with stationary and migratory management in the province of Entre Ríos, Argentina.

In Argentina, migratory activity in search of floral diversity has become a common approach to maximizing honey production. The Entre Ríos province possesses a floral diversity that allows beekeepers to perform migratory or stationary management. Beyond the impact caused by transhumance, migratory colonies in this province start and end the season in monoculture areas. To study the effect of these practices on viral infection, we assayed for the presence, abundance and genetic characterization of the Deformed Wing Virus (DWV) in honey bees from apiaries with both types of management. In migratory apiaries, DWV was detectable in 86.2% of the colonies at the beginning of the season (September 2018), and 66% at the end of the season (March 2019). On the other hand, DWV was detected in 44.11% and 53.12% of stationary samples, at the beginning and the end of the season, respectively. Sequence analysis from migratory and stationary colonies revealed that all samples belonged to DWV-A type. The highest viral loads were detected in migratory samples collected in September. Higher DWV presence and abundance were associated with migratory management and the sampling time. Based on our findings we propose that the benefit of migration to wild flowering areas can be dissipated when the bee colonies end the season with monoculture.

[Pediatric intensive care in Latin America]. / Los cuidados intensivos pediátricos en Latinoamérica.

OBJECTIVE: To describe the practice of pediatric intensive care in Latin America and compare it with two European countries. DESIGN: Analysis of data presented by member countries of the Sociedad Latinoamericana de Cuidado Intensivo Pediátrico (SLACIP), Spain and Portugal, in the context of a Symposium of Spanish and Portuguese - speaking pediatric intensivists during the Fifth World Congress on Pediatric Intensive Care. SETTING: Pediatric intensive care units (PICUs). PARTICIPANTS: Pediatric intensivists in representation of each member country of the SLACIP, Spain and Portugal. INTERVENTIONS: None. VARIABLES OF INTEREST: Each country presented its data on child health, medical facilities for children, pediatric intensive care units, pediatric intensivists, certification procedures, equipment, morbidity, mortality, and issues requiring intervention in each participating country. RESULTS: Data from 11 countries was analyzed. Nine countries were from Latin America (Argentina, Colombia, Cuba, Chile, Ecuador, Honduras, México, Dominican Republic and Uruguay), and two from Europe (Spain and Portugal). Data from Bolivia and Guatemala were partially considered. Populational, institutional, and operative differences were identified. Mean PICU mortality was 13.29% in Latin America and 5% in the European countries (P=0.005). There was an inverse relationship between mortality and availability of pediatric intensive care units, pediatric intensivists, number of beds, and number of pediatric specialty centers. Financial and logistic limitations, as well as deficiencies in support disciplines, severity of diseases, malnutrition, late admissions, and inadequate initial treatments could be important contributors to mortality at least in some of these countries. CONCLUSION: There are important differences in population, morbidity and mortality in critically ill children among the participating countries. Mortality shows an inverse correlation to the availability of pediatric intensive care units, intensive care beds, pediatric intensivists, and pediatric subspecialty centers.

GII.4 human norovirus and G8P[1] bovine-like rotavirus in oysters (Crassostrea gigas) from Argentina.

Bivalve mollusks have been widely recognized as an important source of foodborne virus. The aim of this work was to determine the presence of norovirus (NoV) and rotavirus (RVA) in Pacific cupped oyster (Crassostrea gigas) from Buenos Aires, Argentina. A total of 88 oyster were processed. 7% of pooled samples resulted positive for NoV GII by RT-qPCR. The nucleotide analysis showed that it was closely related to GII.4/Sydney. Regarding RVA, 21% were positive by RT-qPCR targeting the NSP3 gene. RVA from one pool was isolated in cell culture and infective viral particles were evidenced by immunofluorescence. The genotype constellation of RVA/Oyster-wt/Crassostrea gigas_BA/2015/G8P[1] isolated strain was G8-P[1]-I2-R2-C2-M2-A3-N2-T6-E2-H3, which has a bovine-like genome backbone. Notably, RVA possesses an E2 genotype which is different from the characteristic E12 genotype of RVA circulating in animal species from South America. Our findings evidence not only the presence of enteric viruses in oysters from Argentina, but most important the viability of RVA. This result pose the need to implement surveillance programs to prevent potential foodborne viral outbreaks due to the consumption of contaminated shellfish.

[The Latin-American survey on nutrition in Pediatric Intensive Care (ELAN-CIP)]. / Encuesta LatinoAmericana de nutrición en Cuidados Intensivos Pediátricos (ELAN-CIP).

INTRODUCTION: Artificial Nutrition Support (ANS) is an important therapeutic technique in the care of the critically ill child that is not always implemented appropriately and correctly. There are also different ways of applying it which varies between the different centres and, even among the different health professionals. MATERIAL METHODS: A cross-sectional multicentre survey. RESULTS: A total of 24 PICUs took part in 14 countries, the majority multidisciplinary and belonging to public and university hospitals. The preferred ANS was enteral, administrated by the gastric route and started within the first 72h after admission. The administration techniques and monitoring of the ANS, enteral and parenteral, were variable but generally consistent with the world-wide accept recommendations. CONCLUSIONS: Latin-American PICUs prefer enteral ANS administered by gastric feed soon after admission.

Experimental reactivation of equine herpesvirus-3 following corticosteroid treatment.

State of latency, well known for several herpesviruses, has been proposed for equine herpesvirus-3 (EHV-3) and supported by epidemiological observations. No detailed assessment about reactivation, patterns of excretion and reexcretion has been formally reported. An experimental reactivation study by corticosteroid treatment in previously naturally infected horses was therefore carried out. Two polo mares with clinical and virologically confirmed history of equine coital exanthema were injected with dexamethasone and prednisolone on 3 successive days. Clinical signs, body temperature and clinical samples for virological and serological studies were obtained daily. Mares did not show any systemic clinical signs or hyperthermia. EHV-3 shedding, seroconversion and the presence of a small lesion were observed in one of the mares under study 2 weeks after corticosteroid treatment. The results demonstrate that this virus exhibits a latency-reactivation behaviour similar to that of other alpha herpesviruses. Reactivation of latency may have an important bearing on the appearance of clinical signs in mares and/or stallions during the breeding season without the actual evidence of transfer from mare to stallion or vice versa.

Comparison of two commercial kits and an in-house ELISA for the detection of equine rotavirus in foal feces.

Group A rotaviruses (RVA) are important infectious agents associated with diarrhea in the young of several animal species including foals. Currently, a variety of diagnosis methods are commercially available, like ELISA, latex agglutination and immunochromatographic assays. These commercial tests are mainly designed for the detection of human RVA; its applicability in veterinary diagnosis has been poorly studied. The aim of this study was to compare the sensitivity and specificity of two commercial diagnostic kits, Pathfinder™ Rotavirus and FASTest Rota® strip, with an in-house KERI ELISA, for the detection of equine RVA. A total of 172 stool samples from Thoroughbred foals with diarrhea were analyzed. The presence of equine RVA in samples in which only one of the three methods showed positive results was confirmed by RT-PCR. A sample was considered "true positive" when RVA was detected by at least two of the methods, and "true negative" when it tested negative by the three assays. Following these criteria, 50 samples were found positive and 122 were found negative, and were handled as reference population for the assay validation. Pathfinder™ Rotavirus assay showed 32% sensitivity and 97% specificity, FASTest Rota® strip, 92% sensitivity and 97% specificity, and KERI ELISA, 76% sensitivity and 93% specificity. Pathfinder™ Rotavirus showed 77%, FASTest Rota® strip 95%, and KERI ELISA 88% accuracy to correctly classify the samples as equine RVA positive or negative. Pathfinder failed specifically to detect equine RVA G3P12I6 genotype; such performance might be related to the specificity of the monoclonal antibody included in this kit. According to our results, differences among VP6 genotypes could influence the sensitivity to detect equine RVA in foal feces, and thus assay validation of diagnostic kits for each species is necessary. In conclusion, FASTest Rota® strip is more suitable than ELISA Pathfinder™ Rotavirus for the screening of rotavirus infection in foals. The KERI ELISA showed an acceptable performance, and could be considered a proper economic alternative for equine RVA diagnosis.

Molecular and antigenic characterization of bovine Coronavirus circulating in Argentinean cattle during 1994-2010.

Bovine coronavirus (BCoV) is an important viral pathogen associated with neonatal calf diarrhea. Our aim was to investigate the incidence of BCoV in diarrhea outbreaks in beef and dairy herds from Argentina during 1994-2010. A total of 5.365 fecal samples from diarrheic calves were screened for BCoV diagnosis by ELISA. The virus was detected in 1.71% (92/5365) of the samples corresponding to 5.95% (63/1058) of the diarrhea cases in 239 beef and 324 dairy farms. The detection rate of BCoV was significantly higher in dairy than in beef herds: 12.13% (29/239) vs. 4.32% (14/324) respectively. Phylogenetic analysis of the hypervariable S1 region of seven representative samples (from different husbandry systems, farm locations and years of sampling) indicated that BCoV strains circulating in Argentinean beef and dairy herds formed a cluster distinct from other geographical regions. Interestingly, Argentinean strains are distantly related (at both the nucleotide and amino acid levels) with the Mebus historic reference BCoV strain included in the vaccines currently available in Argentina. However, Mebus-induced antibodies were capable of neutralizing the BCoV Arg95, a field strain adapted to grow in vitro, and vice versa, indicating that both strains belong to the same CoV serotype reported in cattle. This work represents the first large survey describing BCoV circulation in Argentinean cattle.

Antagonistic activities of N-3389, a newly synthesized diazabicyclo derivative, at 5-HT3 and 5-HT4 receptors.

The antagonistic activities of compound N-3389 (endo-3,9-dimethyl-3,9- diazabicyclo[3,3,1]non-7-yl 1H-indazole-3-carboxamide dihydrochloride) at 5-HT3 and 5-HT4 receptors were examined using in vitro and in vivo assays. N-3389 showed potent 5-HT3 receptor antagonistic activities in a radioligand binding assay (pKi = 8.77), against 2-methyl-5-HT (2-Me-5-HT)-induced bradycardia in rats (ED50 = 0.73 micrograms/kg i.v., 38 micrograms/kg p.o.) and against 2-Me-5-HT-induced contraction in longitudinal muscle myenteric plexus preparations of guinea-pig ileum (IC50 = 3.2 x 10(-8) M). As a preliminary to investigating the effect of N-3389 on 5-HT4 receptors, we examined the contraction induced by 5-HT in guinea-pig ileum preparations. We confirmed that 5-HT (10(-8)-10(-5) M) induced biphasic contractions in the preparations. Furthermore, 5-HT3 receptor antagonism inhibited the late phase of the contraction induced by high concentrations of 5-HT (3 x 10(-6)-10(-5) M), whereas 5-HT4 receptor antagonism inhibited the early phase of the contraction induced by low concentrations of 5-HT (10(-8)-10(-6) M). N-3389 (10(-7)-10(-5) M) inhibited both phases of contraction induced by 5-HT. In addition, N-3389 (3 x 10(-7)-3 x 10(-6) M) was found to inhibit the increase of electrically stimulated twitch responses induced by 5-HT (10(-8) M) longitudinal muscle myenteric plexus preparation of the guinea-pig ileum. These results suggest that N-3389 acts as a 5-HT3 and 5-HT4 receptor antagonist.

Exposure of the intracavernous carotid artery in aneurysm surgery.

The pterional intradural approach was used in five cases of large and giant carotid-ophthalmic aneurysms and in two cases of intracavernous aneurysms that arose from the anterior siphon knee in the cavernous sinus (CS) and extended into the carotid cistern. In four cases of large carotid-ophthalmic aneurysms removal of the anterior clinoid process and the roof of the optic canal gave easy access to the pericarotid ring. The anteromedial part of the pericarotid ring was dissected to expose the extradural portion of the internal carotid artery (ICA) proximal to the neck and to make enough room between the wall of the CS and the extradural portion of the ICA, thus allowing easy clipping of the neck. In one case of a giant carotid-ophthalmic aneurysm extending into the CS with an extradural origin of the ophthalmic artery and in two cases of an intracavernous aneurysm arising from the siphon knee, neck clipping was performed by opening the lateral wall and roof of the CS after removal of the optic strut. The opening of the lateral wall anterior to the 3rd nerve facilitated wide exposure of the anterior siphon knee. The horizontal portion of the intracavernous ICA as well as the whole aspect of the aneurysm could be exposed as a result of the extended opening of the cavernous roof anterior to the posterior clinoid process. Successful operative results were obtained in all seven patients. A visual field detect as an operative complication was noted in one patient. No disturbance of ocular movements was noted.

Monitoring of cortical blood flow during temporary arterial occlusion in aneurysm surgery by the thermal diffusion method.

During aneurysm surgery, regional cortical blood flow (CoBF) was continuously monitored in 12 patients with a thermal diffusion flow probe in an attempt to assess the effects of temporary major arterial occlusion on blood flow and outcome. When the CoBF was above 30 ml/100 g/min, the safe period for temporary clipping applied distal to the perforators was 15 minutes. The occlusion time should be shortened when the CoBF is below 30 ml/100 g/min. Two patients suffered basal infarction, which was not detected by CoBF monitoring. Attention should be paid to the blood flow in the deep structures when a temporary clip is applied at a site proximal to the perforating branches. Direct measurement of CoBF may be of value in estimating the time that temporary occlusion of a major vessel can be tolerated.

Therapeutic potentials of centrally acting dopamine and alpha 2-adrenoreceptor agonists.

The antiparkinsonian activity of several dopamine agonists was investigated in an animal model and clinically in parkinsonian patients. The semisynthetic ergoline, pergolide, the partial ergoline, LY 141865 and the 8-alpha-aminoergoline, CU 32-085 were found to be effective antitremor agents in monkeys with ventromedial tegmental lesions. The administration of pergolide or LY 141865 results in a relief of tremor with a concomitant occurrence of severe abnormal involuntary movements, while the administration of CU 32-085 results in a relief of tremor with the occurrence of only minor abnormal involuntary movements. Clinical studies have revealed that pergolide is an effective drug in patients with advanced Parkinson's disease, and it reduces the "on-off" phenomena. The possible regulation of dopamine neurotransmission by the norepinephrine neuronal systems was reviewed. Preliminary data suggest that clonidine may interact with presynaptic dopamine receptors.

Metastatic choriocarcinoma with neoplastic aneurysms cured by aneurysm resection and chemotherapy. Case report.

A case of choriocarcinoma with brain and lung metastasis is reported. The patient was admitted for treatment of a cerebral hemorrhage from neoplastic aneurysms and, following removal of the hematoma and resection of the aneurysms, her carcinoma was successfully managed with chemotherapy. She has survived for 6 years after onset without neuroimaging evidence of recurrence. Surgical treatment of metastatic lesions followed by prolonged intensive chemotherapy are indicated for the improved prognosis of choriocarcinoma.

Monitoring of cortical blood flow during excision of arteriovenous malformation by thermal diffusion method.

The cortical blood flow adjacent to arteriovenous malformations was monitored in six patients before, during, and after excision of arteriovenous malformations using a thermal diffusion probe. In a large arteriovenous malformation, a progressive increase in cortical blood flow up to two times the preexcision value was noted with occlusion of the feeding arteries. Lowering arterial pressure to keep normal cortical blood flow during and after operation resulted in minimum brain edema and an excellent result. Direct measurement of cortical blood flow is of value in determining the precise level of hypotension to prevent brain edema and ischemia that may occur with excision of a large arteriovenous malformation.

CT angiography with helical CT in the assessment of acute stage of subarachnoid hemorrhage.

PURPOSE: We evaluated the usefulness of helical CT in the preoperative assessment of ruptured cerebral aneurysms during the acute stage of subarachnoid hemorrhage (SAH). METHODS: Nine patients with 13 aneurysms were included in this study. Helical CT scanning was performed before preoperative angiography. The section thickness and the table-movement speed were 1-2 mm/sec. Helical CT scanning was started 20 sec after the start of injection of 100 ml of contrast agent at a rate of 3 ml/sec. RESULTS: The average CT value of SAH was 51.9 Hounsfield units (HU) and that of the aneurysm was 191.7 HU. Nine of 13 aneurysms greater than 3.0 mm in diameter were identified by three-dimensional CT angiography (3DCTA). In seven cases, the information provided by 3DCTA images, maximum intensity projection images, and multiplanar images, was very useful in surgical planning, providing information concerning the configuration of the neck and relationships between the aneurysm and brain parenchyma. Four aneurysms in two cases were not depicted by 3DCTA because they were located outside the imaging volume. This problem was overcome by changing the imaging volume according to the extent of origin of SAH. CONCLUSION: We conclude that helical CT in patients with SAH is useful for surgical planning, providing valuable information that cannot be obtained by conventional angiography.

[Hypothalamic hamartoma with precocious puberty--a case report].

A case of hypothalamic hamartoma with precocious puberty is presented and the literature of reported cases is reviewed. An 8-year-old boy was admitted to our hospital because of precocious puberty and mental retardation. His genital development was Tanner's stage 4 and pubic hair was Tanner's stage 3. Bone age was 11 years. Plain CT showed an isodense mass in the suprasellar cistern which was not enhanced following contrast administration. Metrizamide CT cisternography showed a filling defect in the suprasellar cistern. Endocrinological evaluation revealed high levels of serum luteinizing hormone (LH) and testosterone with a marked response of LH to LH-RH injection. A left frontotemporal craniotomy was performed and the tumor was partially removed. The tumor was gray, firm and well-circumscribed with poor vascularity. Postoperatively, a right oculomotor palsy and transient diabetes insipidus developed. He was discharged ambulatory one month later. Serum LH and testosterone returned to normal and the response of LH to LH-RH injection became normal. Hamartoma was diagnosed on histological examination. Electron micrographic study showed numerous dense granules with approximately 0.1 mu in diameter, in which Judge proved LH-RH by immunofluorescent study in 1977. Our case supports the hypothesis that hypothalamic hamartoma may cause precocious puberty by autonomous secretion of LH-RH and we consider that neurosurgical treatment is recommended.

[Carotid-cavernous fistula successfully treated with embolization and radiation therapy: report of three cases].

Three cases of mixed internal and external carotid-cavernous fistula (CCF) were successfully treated with embolization of feeders from the external carotid artery (ECA) and focal irradiation to the cavernous sinus (CS). Cases 1 and 2 were females, 63 and 69 years old respectively, both with spontaneous left CCF. Case 3 was a 55 year old male with posttraumatic left CCF. Symptoms of case 1 were double vision, left chemosis and exophthalmos; those of case 2 were double vision, left retroobital pain, left forehead dysesthesia and blurred vision; and case 3 complained of double vision, left chemosis, left exophthalmos and pulsatile tinnitus. In all three cases, angiography disclosed left CCF fed by ipsilateral dural branches from the internal maxillary artery (IMA) and the internal carotid artery (ICA). In case 1, small branches from the ascending pharyngeal artery also fed the CS. In cases 2 and 3, feeders from the ECA were arising only from branches of the IMA. In case 3, hypertrophy of the meningohypophyseal trunk was visible. In cases 1 and 2, although the CS was opacified, feeders from the ICA were not clearly visible. Embolizations of branches of the IMA were performed in all cases using Ivalon under selective catheterization. In case 1, symptoms partially improved, but in cases 2 and 3, visual symptoms were transiently aggravated. Focal irradiation to the CS was done with total doses of 30, 30 and 40 Gy each for cases 1, 2, and 3 respectively. In case 1, clinical symptoms gradually improved about one third way through irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Intra-arterial chemotherapy with ACNU in the treatment of malignant gliomas].

Twelve patients with supratentorial gliomas were treated with intra-arterial ACNU followed by intravenous maintenance chemotherapy. Six of the patients, treated from February 1987 through May 1989, received doses of 120-200 mg/m2 (high dose treatment group); six patients, treated from June 1989 through October 1990, received doses of 80-100 mg/m2 (low dose treatment group). The drug was given via the supraophthalmic portion of the internal carotid artery or vertebral artery at a rate of 10 mg/min. The response rate (CR + PR) on CT scan was 50% (3/6) in the high dose treatment group and 17% (1/6) in the low dose treatment group. Survival periods from first operation, however, did not differ between the high and low dose treatment groups. Bone marrow suppression was dose-related and reversible at these doses. Severe neurotoxicities (hemiparesis and aphasia) developed in the patients who received 200 mg/m2 of ACNU; in one case, this was irreversible. High dose intra-arterial ACNU chemotherapy is effective in reducing tumor size on CT scan but the prognosis is not improved. The dose limiting factor of intra-arterial nitrosourea is neurotoxicity, and doses of more than 200 mg/m2 are considered to be dangerous.

Equine G3P[3] rotavirus strain E3198 related to simian RRV and feline/canine-like rotaviruses based on complete genome analyses.

Equine group A rotavirus (RVA) strains are the most important cause of gastroenteritis in equine neonates and foals worldwide, and G3P[12] and G14P[12] are epidemiologically the most important genotypes. The genotype constellation of an unusual Argentinean G3P[3] RVA strain (RVA/Horse-wt/E3198/2008/G3P[3]) detected in fecal samples of a diarrheic foal in 2008 was shown to be G3-P[3]-I3-R3-C3-M3-A9-N3-T3-E3-H6. Each of these genotypes has been found typically in feline and canine RVA strains, and the genotype constellation is reminiscent to those of Cat97-like RVA strains. However, the phylogenetic analyses revealed only a distant relationship between E3198 and known feline, canine and feline/canine-like human RVA strains. Surprisingly, a rather close relationship was found between E3198 and simian RVA strains RVA/Simian-tc/USA/RRV/1975/G3P[3] for at least 5 gene segments. RRV is believed to be a reassortant between a bovine-like RVA strain and a RVA strains distantly related to feline/canine RVA strains. These analyses indicate that E3198 is unlikely to be of equine origin, and most likely represents a RVA interspecies transmitted virus, possibly in combination with one or more reassortments, from a feline, canine or related host species to a horse. Further studies are in progress to evaluate if this strain was a single interspecies transmission event, or if this strain started to circulate in the equine population.

Experimental infection with equid herpesvirus 3 in seronegative and seropositive mares.

Equine coital exanthema (ECE), caused by equid herpesvirus 3 (EHV-3), has been recognized as an economically significant venereal disease for years. However, no infection models on the natural host have been established. In order to set up an experimental infection protocol, seronegative and seropositive mares were topically inoculated in the perineal region with 4 × 10(6)TCID(50)/ml of EHV-3. Clinical signs were then evaluated by means of a designed scoring system, and body temperature was recorded daily. Virological, and serological studies were also performed. Typical ECE lesions, with clinical scores of 90, 92, 160 and 172, were observed in the four seronegative animals. Only mild ECE lesions were observed in the two seropositive mares, being the clinical scores 53 and 41. Both groups of mares shed the virus, but the duration of virus shedding was shorter and its intensity was lower in seropositive mares than in seronegative ones. Moreover, EHV-3 antibody response was detected in both seronegative and seropositive mares after experimental infection and re-infection, being more moderate in seropositive ones. As a conclusion, EHV-3 infection of mares was experimentally achieved in a reproducible manner. The typical lesions of ECE were observed after topical EHV-3 infection in seronegative mares, in association with virus excretion and neutralizing antibody kinetics.