200 years of taxonomic confusion: Sporendonema and allies.

The genus Sporendonema (Gymnoascaceae, Onygenales) was introduced in 1827 with the type species S. casei for a red mould on cheese. Cheese is a consistent niche for this species. Sphaerosporium equinum is another species classified in Gymnoascaceae and has also been reported from cheese. Recently, other habitats have been reported for both Sporendonema casei and Sphaerosporium equinum. The present study aimed to investigate the taxonomy of Sporendonema and Sphaerosporium, as well as a close neighbour, Arachniotus. Two strains of Hormiscium aurantiacum, another related cheese-associated species were also included in the analyses. Strains were evaluated in terms of macro- and micromorphology, physiology including salt tolerance, growth rate at different temperatures, casein degradation, cellulase activity, lipolytic activity, and multi-locus phylogeny with sequences of the nuclear ribosomal internal transcribed spacer region, the D1-D2 region of the large subunit and partial ß-tubulin locus sequences. The results showed that the analysed species were congeneric, and the generic names Arachniotus and Sphaerosporium should be reduced to the synonymy of Sporendonema. Therefore, four new combinations as well as one lectotype and one epitype were designated in Sporendonema. Two strains attributed to Sphaerosporium equinum from substrates other than cheese were found to be phylogenetically and morphologically deviant and were introduced as a new species named Sporendonema isthmoides.

New insights into the systematics of Bactrodesmium and its allies and introducing new genera, species and morphological patterns in the Pleurotheciales and Savoryellales (Sordariomycetes).

The newly discovered systematic placement of Bactrodesmium abruptum, the lectotype species of the genus, prompted a re-evaluation of the traditionally broadly conceived genus Bactrodesmium. Fresh material, axenic cultures and new DNA sequence data of five gene regions of six species, i.e. B. abruptum, B. diversum, B. leptopus, B. obovatum, B. pallidum and B. spilomeum, were studied. Bactrodesmium is a strongly resolved lineage in the Savoryellales (Sordariomycetes), supported by Bayesian and Maximum Likelihood methods. The genus Bactrodesmium is emended and delimited to hyphomycetes characterised by sporodochial conidiomata, mononematous often fasciculate conidiophores, holoblastic conidiogenesis and acrogenous, solitary, dry, pigmented, transversely or rarely longitudinally septate conidia. The conidia are seceding rhexolytically, exhibiting multiple secession patterns. An identification key to 35 species accepted in Bactrodesmium is given, providing the most important diagnostic characters. Novel DNA sequence data of B. longisporum and B. stilboideum confirmed their placement in the Sclerococcales (Eurotiomycetes). For other Bactrodesmium, molecular data are available for B. cubense and B. gabretae, which position them in the Dothideomycetes and Leotiomycetes, respectively. All four species are excluded from Bactrodesmium and segregated into new genera, Aphanodesmium, Gamsomyces and Kaseifertia. Classification of 20 other species and varieties not recognised in the genus is discussed. Based on new collections of Dematiosporium aquaticum, the type species of Dematiosporium, the genus is emended to accommodate monodictys-like freshwater lignicolous fungi of the Savoryellales characterised by effuse colonies, holoblastic conidiogenous cells and dictyosporous, pigmented conidia with a pore in each cell. Study of additional new collections, cultures and DNA sequence data revealed several unknown species, which are proposed as taxonomic novelties in the Savoryellales and closely related Pleurotheciales. Ascotaiwania latericolla, Helicoascotaiwania lacustris and Pleurotheciella erumpens are described from terrestrial, lentic and lotic habitats from New Zealand and France, respectively. New combinations are proposed for Helicoascotaiwania farinosa and Neoascotaiwania fusiformis. Relationships and systematics of the Savoryellales are discussed in the light of recent phylogenies and morphological patterns newly linked with the order through cultural studies.

Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection.

BACKGROUND: Cutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species-groups or sections. METHODS: We present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1). RESULTS: Mycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi. CONCLUSIONS: The ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.

New species of Cordana and epitypification of the genus.

Two interesting fungi belonging to the genus Cordana have been isolated recently in Spain from plant debris. Both are proposed here as new species, described and illustrated. Cordana mercadiana sp. nov. produces 0-1-septate conidia, with a prominent basal scar. Cordana verruculosa sp. nov. differs from the other species of the genus by its unique combination of aseptate, verruculose and small conidia. Both species are compared morphologically with other species of Cordana and their identities supported by the analysis of rDNA sequences. LSU sequence analysis revealed the congeneric relationship of Cordana and Pseudobotrytis; the members of both genera are in a well supported monophyletic lineage that appears to be related to the Coniochaetales but remains incertae sedis within the Sordariomycetes. To establish nomenclatural stability of the genus Cordana, an isolate of C. pauciseptata is designed here as epitype and the two species of Pseudobotrytis are transferred to Cordana. A dichotomous key is provided to identify the currently accepted species of Cordana.

New Bactrodesmiastrum and Bactrodesmium from decaying wood in Spain.

Several new species belonging to the anamorph genera Bactrodesmiastrum and Bactrodesmium, collected from plant debris in Spain, are described and illustrated. Bactrodesmiastrum pyriforme, sp. nov. is characterized by large, pyriform conidia. Bactrodesmiastrum obovatum comb. nov. is proposed to accommodate janetia obovata, and the Spanish specimen of B. obscurum. the type species of the genus, represents the second known collection of the species worldwide. Analyses of rDNA sequences confirm the distinction between B. obovatum and B. pyriforme, and reveal their relationships with the Savoryellales (Sordariomycetes). Bactrodesmium diver-sum sp. nov. is distinguished from the other species of the genus by its large, pale brown conidia with a conspicuous pore at each septum.

Reflections on Menisporopsis, Multiguttulispora and Tainosphaeria Using Molecular and Morphological Data.

The genera Menisporopsis, Multiguttulispora and Tainosphaeria (Chaetosphaeriaceae) are saprobes inhabiting decaying plant material. This study is based on an integrated morpho-molecular characterisation to assess their generic concepts and explore phylogenetic relationships. Menisporopsis is revealed as polyphyletic, and species with 1-septate conidia and synnemata growing unilaterally along the seta are placed in the new segregate genus Arcuatospora. Codinaea dimorpha and C. triseptata are shown to be congeneric with Multiguttulispora sympodialis, the type species. Two new combinations are proposed: M. sympodialis is found conspecific with M. dimorpha. The Tainosphaeria complex is resolved into three genera. We found that the morphological separation of three groups within the genus is consistent with phylogenetic relationships. Tainosphaeria s. str. is accepted with five species. Tainosphaeria aseptata and T. lunata are transferred to the newly erected Phialoturbella, whereas T. obclavata is revealed as conspecific with Phialogeniculata guadalcanalensis, reducing it to a synonym. A new genus Flectospora is erected for a chloridium-like fungus nested in the Tainosphaeria clade. Based on molecular evidence, we show that asymmetrical, scolecosporous ascospores are a unique teleomorphic characteristic among family members. Therefore, we propose new combinations for Chaetosphaeria hispida in Paragaeumannomyces and Ch. spinosa in the new genus Ericiosphaeria, both exhibiting this rare morphotype.

Delimitation and phylogeny of Dictyochaeta, and introduction of Achrochaeta and Tubulicolla, genera nova.

Dictyochaeta (Chaetosphaeriaceae) is a phialidic dematiaceous hyphomycete with teleomorphs classified in Chaetosphaeria. It is associated with significant variability of asexual morphological traits, which led to its broad delimitation. In the present study, six loci: nuc rDNA internal transcribed spacer region ITS1-5.8S-ITS2 (ITS barcode), nuc 18S rDNA (18S), nuc 28S rDNA (28S), DNA-directed RNA polymerase II second largest subunit gene (RPB2), translation elongation factor 1-α (TEF1-α), and ß-tubulin (TUB2), along with comparative morphological and cultivation studies, are used to reevaluate the concept of Dictyochaeta and establish species boundaries. Based on revised species, morphological characteristics of conidia (shape, septation, absence or presence of setulae), collarettes (shape), and setae (presence or absence) and an extension of the conidiogenous cell proved to be important at the generic level. The dual DNA barcoding using ITS and TEF1-α, together with TUB2, facilitated accurate identification of Dictyochaeta species. Thirteen species are accepted, of which seven are characterized in this study; an identification key is provided. It was revealed that D. fuegiana, the type species, is a complex of three distinct species including D. querna and the newly described D. stratosa. Besides, a new species, D. detriticola, and two new combinations, D. callimorpha and D. montana, are proposed. An epitype of D. montana is selected. Dictyochaeta includes saprobes on decaying wood, bark, woody fruits, and fallen leaves. Dictyochaeta is shown to be distantly related to the morphologically similar Codinaea, which is resolved as paraphyletic. Chaetosphaeria talbotii with a Dictyochaeta anamorph represents a novel lineage in the Chaetosphaeriaceae; it is segregated from Dictyochaeta, and a new genus Achrochaeta is proposed. Multigene phylogenetic analysis revealed that D. cylindrospora belongs to the Vermiculariopsiellales, and a new genus Tubulicolla is introduced.

Phylogeny, Global Biogeography and Pleomorphism of Zanclospora.

Zanclospora (Chaetosphaeriaceae) is a neglected, phialidic dematiaceous hyphomycete with striking phenotypic heterogeneity among its species. Little is known about its global biogeography due to its extreme scarcity and lack of records verified by molecular data. Phylogenetic analyses of six nuclear loci, supported by phenotypic data, revealed Zanclospora as highly polyphyletic, with species distributed among three distantly related lineages in Sordariomycetes. Zanclospora is a pleomorphic genus with multiple anamorphic stages, of which phaeostalagmus-like and stanjehughesia-like are newly discovered. The associated teleomorphs were previously classified in Chaetosphaeria. The generic concept is emended, and 17 species are accepted, 12 of which have been verified with DNA sequence data. Zanclospora thrives on decaying plant matter, but it also occurs in soil or as root endophytes. Its global diversity is inferred from metabarcoding data and published records based on field observations. Phylogenies of the environmental ITS1 and ITS2 sequences derived from soil, dead wood and root samples revealed seven and 15 phylotypes. The field records verified by DNA data indicate two main diversity centres in Australasia and Caribbean/Central America. In addition, environmental ITS data have shown that Southeast Asia represents a third hotspot of Zanclospora diversity. Our data confirm that Zanclospora is a rare genus.

Phylogenetic Reassessment, Taxonomy, and Biogeography of Codinaea and Similar Fungi.

The genus Codinaea is a phialidic, dematiaceous hyphomycete known for its intriguing morphology and turbulent taxonomic history. This polyphasic study represents a new, comprehensive view on the taxonomy, systematics, and biogeography of Codinaea and its relatives. Phylogenetic analyses of three nuclear loci confirmed that Codinaea is polyphyletic. The generic concept was emended; it includes four morphotypes that contribute to its morphological complexity. Ancestral inference showed that the evolution of some traits is correlated and that these traits previously used to delimit taxa at the generic level occur in species that were shown to be congeneric. Five lineages of Codinaea-like fungi were recognized and introduced as new genera: Codinaeella, Nimesporella, Stilbochaeta, Tainosphaeriella, and Xyladelphia. Dual DNA barcoding facilitated identification at the species level. Codinaea and its segregates thrive on decaying plants, rarely occurring as endophytes or plant pathogens. Environmental ITS sequences indicate that they are common in bulk soil. The geographic distribution found using GlobalFungi database was consistent with known data. Most species are distributed in either the Holarctic realm or tropical geographic regions. The ancestral climatic zone was temperate, followed by transitions to the tropics; these fungi evolved primarily in Eurasia and Americas, with subsequent transitions to Africa and Australasia.

Evidence for a role of the NOS1AP (CAPON) gene in schizophrenia and its clinical dimensions: an association study in a South American population isolate.

BACKGROUND/AIMS: Recent studies have implicated a region on chromosome 1q21-23, including the NOS1AP gene, in susceptibility to schizophrenia. However, replication studies have been inconsistent, a fact that could partly relate to the marked psychopathological heterogeneity of schizophrenia. The aim of this study is to evaluate association of polymorphisms in the NOS1AP gene region to schizophrenia, in patients from a South American population isolate, and to assess if these variants are associated with specific clinical dimensions of the disorder. METHODS: We genotyped 24 densely spaced SNPs in the NOS1AP gene region in a schizophrenia trio sample. The transmission disequilibrium test (TDT) was applied to single marker and haplotype data. Association to clinical dimensions (identified by factor analysis) was evaluated using a quantitative transmission disequilibrium test (QTDT). RESULTS: We found significant association between eight SNPs in the NOS1AP gene region to schizophrenia (minimum p value = 0.004). The QTDT analysis of clinical dimensions revealed an association to a dimension consisting mainly of negative symptoms (minimum p value 0.001). CONCLUSIONS: Our findings are consistent with a role for NOS1AP in susceptibility to schizophrenia, especially for the 'negative syndrome' of the disorder.

Citizen science project reveals high diversity in Didymellaceae (Pleosporales, Dothideomycetes).

Fungal communities play a crucial role in maintaining the health of managed and natural soil environments, which directly or indirectly affect the properties of plants and other soil inhabitants. As part of a Citizen Science Project initiated by the Westerdijk Fungal Biodiversity Institute and the Utrecht University Museum, which aimed to describe novel fungal species from Dutch garden soil, the diversity of Didymellaceae, which is one of the largest families in the Dothideomycetes was investigated. A preliminary analysis of the ITS and LSU sequences from the obtained isolates allowed the identification of 148 strains belonging to the family. Based on a multi-locus phylogeny of a combined ITS, LSU, rpb2 and tub2 alignment, and morphological characteristics, 20 different species were identified in nine genera, namely Ascochyta, Calophoma, Didymella, Juxtiphoma, Nothophoma, Paraboeremia, Phomatodes, Stagonosporopsis, and Xenodidymella. Several isolates confirmed to be ubiquitous plant pathogens or endophytes were for the first time identified from soil, such as Ascochyta syringae, Calophoma clematidis-rectae, and Paraboeremia litseae. Furthermore, one new genus and 12 novel species were described from soil: Ascochyta benningiorum sp. nov., Didymella degraaffiae sp. nov., D. kooimaniorum sp. nov., Juxtiphoma kolkmaniorum sp. nov., Nothophoma brennandiae sp. nov., Paraboeremia rekkeri sp. nov., P. truiniorum sp. nov., Stagonosporopsis stuijvenbergii sp. nov., S. weymaniae sp. nov., Vandijckomycella joseae gen. nov. et sp. nov., V. snoekiae sp. nov., and Xenodidymella weymaniae sp. nov. From the results of this study, soil was revealed to be a rich substrate for members of Didymellaceae, several of which were previously known only from diseased or apparently healthy plant hosts.

New nematicidal and antimicrobial secondary metabolites from a new species in the new genus, Pseudobambusicola thailandica.

During the course of a study on the functional biodiversity of the mycobiota inhabiting rainforests in Thailand, a fungal strain was isolated from a plant sample and shown to represent an undescribed species, as inferred from a combination of morphological and molecular phylogenetic methods. Molecular phylogenetic analyses, based on four DNA loci, revealed a phylogenetic tree with the newly generated sequences clustering in a separate branch, together with members of the Sulcatisporaceae (Pleosporales, Ascomycota). The Thai specimen morphologically resembled Neobambusicola strelitziae in having pycnidial conidiomata with phialidic conidiogenous cells that produce both fusoid-ellipsoid macroconidia and subcylindrical microconidia. However, the new fungus, for which the name Pseudobambusicola thailandica is proposed, differs from N. strelitziae in having conidiomata with well-defined necks, the presence of globose to subglobose thick-walled cells adjacent to conidiomata and the production of chlamydospores in culture. When cultures of P. thailandica, growing on water agar, were confronted with Caenorhabditis elegans nematodes, worms approaching the fungal mycelia were killed. This observation gave rise to a study of its secondary metabolites and six novel and two known compounds were isolated from submerged cultures of P. thailandica. The structures of metabolites 1-6, for which the trivial names thailanones A-F are proposed, were elucidated using a combination of spectral methods, including extensive 1 and 2D NMR analysis and high resolution mass spectrometry. Compounds 4 and 8 showed strong nematicidal and weak antifungal activity, whereas all other tested compounds showed moderate to weak nematicidal activity but no significant effects in the serial dilution assay against various fungi and bacteria. Compounds 1 and 8 also inhibited growth of the pathogenic basidiomycete Phellinus tremulae in a plate diffusion assay.

The Genera of Fungi - fixing the application of the type species of generic names - G 2: Allantophomopsis, Latorua, Macrodiplodiopsis, Macrohilum, Milospium, Protostegia, Pyricularia, Robillarda, Rotula, Septoriella, Torula, and Wojnowicia.

The present paper represents the second contribution in the Genera of Fungi series, linking type species of fungal genera to their morphology and DNA sequence data, and where possible, ecology. This paper focuses on 12 genera of microfungi, 11 of which the type species are neo- or epitypified here: Allantophomopsis (A. cytisporea, Phacidiaceae, Phacidiales, Leotiomycetes), Latorua gen. nov. (Latorua caligans, Latoruaceae, Pleosporales, Dothideomycetes), Macrodiplodiopsis (M. desmazieri, Macrodiplodiopsidaceae, Pleosporales, Dothideomycetes), Macrohilum (M. eucalypti, Macrohilaceae, Diaporthales, Sordariomycetes), Milospium (M. graphideorum, incertae sedis, Pezizomycotina), Protostegia (P. eucleae, Mycosphaerellaceae, Capnodiales, Dothideomycetes), Pyricularia (P. grisea, Pyriculariaceae, Magnaporthales, Sordariomycetes), Robillarda (R. sessilis, Robillardaceae, Xylariales, Sordariomycetes), Rutola (R. graminis, incertae sedis, Pleosporales, Dothideomycetes), Septoriella (S. phragmitis, Phaeosphaeriaceae, Pleosporales, Dothideomycetes), Torula (T. herbarum, Torulaceae, Pleosporales, Dothideomycetes) and Wojnowicia (syn. of Septoriella, S. hirta, Phaeosphaeriaceae, Pleosporales, Dothideomycetes). Novel species include Latorua grootfonteinensis, Robillarda africana, R. roystoneae, R. terrae, Torula ficus, T. hollandica, and T. masonii spp. nov., and three new families: Macrodiplodiopsisceae, Macrohilaceae, and Robillardaceae. Authors interested in contributing accounts of individual genera to larger multi-authored papers to be published in IMA Fungus, should contact the associate editors listed for the major groups of fungi on the List of Protected Generic Names for Fungi (www.generaoffungi.org).

Recommended names for pleomorphic genera in Dothideomycetes.

This paper provides recommendations of one name for use among pleomorphic genera in Dothideomycetes by the Working Group on Dothideomycetes established under the auspices of the International Commission on the Taxonomy of Fungi (ICTF). A number of these generic names are proposed for protection because they do not have priority and/or the generic name selected for use is asexually typified. These include: Acrogenospora over Farlowiella; Alternaria over Allewia, Lewia, and Crivellia; Botryosphaeria over Fusicoccum; Camarosporula over Anthracostroma; Capnodium over Polychaeton; Cladosporium over Davidiella; Corynespora over Corynesporasca; Curvularia over Pseudocochliobolus; Elsinoë over Sphaceloma; Excipulariopsis over Kentingia; Exosporiella over Anomalemma; Exserohilum over Setosphaeria; Gemmamyces over Megaloseptoria; Kellermania over Planistromella; Kirschsteiniothelia over Dendryphiopsis; Lecanosticta over Eruptio; Paranectriella over Araneomyces; Phaeosphaeria over Phaeoseptoria; Phyllosticta over Guignardia; Podonectria over Tetracrium; Polythrincium over Cymadothea; Prosthemium over Pleomassaria; Ramularia over Mycosphaerella; Sphaerellopsis over Eudarluca; Sphaeropsis over Phaeobotryosphaeria; Stemphylium over Pleospora; Teratosphaeria over Kirramyces and Colletogloeopsis; Tetraploa over Tetraplosphaeria; Venturia over Fusicladium and Pollaccia; and Zeloasperisporium over Neomicrothyrium. Twenty new combinations are made: Acrogenospora carmichaeliana (Berk.) Rossman & Crous, Alternaria scrophulariae (Desm.) Rossman & Crous, Pyrenophora catenaria (Drechsler) Rossman & K.D. Hyde, P. dematioidea (Bubák & Wróbl.) Rossman & K.D. Hyde, P. fugax (Wallr.) Rossman & K.D. Hyde, P. nobleae (McKenzie & D. Matthews) Rossman & K.D. Hyde, P. triseptata (Drechsler) Rossman & K.D. Hyde, Schizothyrium cryptogamum (Batzer & Crous) Crous & Batzer, S. cylindricum (G.Y. Sun et al.) Crous & Batzer, S. emperorae (G.Y. Sun & L. Gao) Crous & Batzer, S. inaequale (G.Y. Sun & L. Gao) Crous & Batzer, S. musae (G.Y. Sun & L. Gao) Crous & Batzer, S. qianense (G.Y. Sun & Y.Q. Ma) Crous & Batzer, S. tardecrescens (Batzer & Crous) Crous & Batzer, S. wisconsinense (Batzer & Crous) Crous & Batzer, Teratosphaeria epicoccoides (Cooke & Massee) Rossman & W.C. Allen, Venturia catenospora (Butin) Rossman & Crous, V. convolvularum (Ondrej) Rossman & Crous, V. oleaginea (Castagne) Rossman & Crous, and V. phillyreae (Nicolas & Aggéry) Rossman & Crous, combs. nov. Three replacement names are also proposed: Pyrenophora grahamii Rossman & K.D. Hyde, Schizothyrium sunii Crous & Batzer, and Venturia barriae Rossman & Crous noms. nov.

Correlación entre la actividad clínica por DAS-28 y ecografía en pacientes con artritis reumatoide / Correlation between clinical activity measured by DAS-28 and ultrasound in patients with rheumatoid arthritis

INTRODUCCIÓN: La artritis reumatoide es una enfermedad multifactorial, sistémica, crónica, autoinmune e inflamatoria, que afecta fundamentalmente las articulaciones. La ultrasonografía/ecografía ha demostrado utilidad en la detección de sinovitis subclínica; sin embargo, la mayoría de la evidencia disponible es en pacientes en remisión y la evidencia para la correlación con el índice de actividad clínica (DAS-28), en Colombia, es limitada. OBJETIVOS: Establecer la correlación entre la actividad clínica medida por DAS-28 y la ecografía, en pacientes con artritis reumatoide. MATERIALES Y MÉTODOS: Cuarenta pacientes con diagnóstico de artritis reumatoide que iniciaron terapia biológica o leflunomida, fueron incluidos en el estudio descriptivo, longitudinal, prospectivo para evaluar la correlación entre el DAS-28 y la ecografía, en la consulta basal y a los 4 meses.RESULTADOS: Se encontró; correlación entre el índice de actividad clínico de la enfermedad (DAS-28) y el índice de actividad ecográfico (DAS ecográfico), tanto por escala de grises (r=0,943,p<0,01) como por Power Doppler(r =0,946, p <0,01); también se encontró; correlación entre el DAS ecográfico por escala de grises y el DAS ecográfico por Power Doppler (r= 0,953 ,p <0,01). CONCLUSIONES: La ecografía es de utilidad en la detección de inflamación subclínica y los resultados son concluyentes cuando se compara el número de articulaciones inflamadas en la evaluación clínica, con el conteo obtenido en la evaluación ecográfica. La evaluación ecográfica sugiere que las manos son las articulaciones con mejor rendimiento para la medición del grado de sinovitis en la artritis reumatoide

NTRODUCTION: Rheumatoid arthritis is a multifactorial, systemic, chronic, autoimmune, and inflammatory disease that mainly affects the joints. Ultrasound has shown to be useful in detecting subclinical synovitis; however, most of the available evidence is in patients on remission, and the evidence on a correlation with the clinical activity measured by DAS-28, in our midst, is limited. OBJECTIVE: To establish the correlation between clinical activity measured by DAS-28 and ultrasound in patients with rheumatoid arthritis. MATERIALS AND METHODS: A total of 40 patients diagnosed with rheumatoid arthritis who were started on biological therapy or leflunomide were included in the descriptive, longitudinal, prospective study to evaluate the correlation between DAS-28 and ultrasound at baseline visit and 4 months later. RESULTS: A correlation was found between DAS-28 and ultrasound, both by using the grayscale (r = 0.943, p <.01) and the power Doppler (r = 0.946, p <.01). There was also a correlation between the ultrasound DAS by grayscale and ultrasound DAS by power Doppler (r = 0.953, p<.01). CONCLUSIONS: Ultrasound is a useful tool for detecting sub-clinical inflammation and the results are conclusive when comparing the number of swollen joints in the clinical evaluation with the count obtained in the ultrasound assessment. Ultrasound evaluation suggests that the hands are the joints with better performance for measuring the grade of synovitis in rheumatoid arthritis

APROPIACIÓN SOCIAL E INVESTIGACIÓN PARTICIPATIVA EN INGENIERÍA EN REHABILITACIÓN / SOCIAL APPROPRIATION AND PARTICIPATORY RESEARCH IN REHABILITATION ENGINEERING

La ingeniería en rehabilitación tiene entre sus objetivos principales el desarrollo de soluciones que mejoren la calidad de vida de las personas con discapacidad, las cuales, si son desarrolladas a través de metodologías de investigación y diseño participativo, pueden presentar ventajas significativas como productos que dan mejor respuesta a las necesidades de la comunidad, mayor aceptación de los resultados por parte de la misma y el hallazgo de fuentes y nichos potenciales de innovación. Adicionalmente, dichas metodologías permiten que los beneficios para esta población no se asocien solamente a los resultados o productos generados, sino que complementariamente se logren desde los mismos procesos investigativos a través de la inclusión y participación auténticas, generando un mayor impacto social. Este artículo propone un enfoque metodológico para el desarrollo de productos de habilitación y rehabilitación en el cual convergen las tendencias de investigación participativa, el diseño y la voz de la comunidad que pide ser copartícipe en los proyectos, en unión a las estrategias para la apropiación social del conocimiento. Adicionalmente se exponen ejemplos, barreras y dificultades, retos y recomendaciones para llevar a cabo una investigación según el enfoque participativo. Las reflexiones planteadas pueden además ser aplicadas a otras áreas del saber.

One of the main goals of rehabilitation engineering is improving the quality of life of people with disabilities through developing solutions for their specific needs. When participatory methodologies for research and design are applied, the resulting solutions show advantages such as products that better address the needs of the community, solutions that are better accepted by the community, and the identification of potential sources and niches for innovation. In addition, participatory methodologies provide benefits that are not only associated with the generated results and products but with the processes themselves. When research processes are inclusive and promote authentic participation a higher social impact can be obtained. This paper proposes a methodological approach for the development of habilitation and rehabilitation products that allows the convergence of participatory research tendencies, design tendencies and the voice of the community that claims for co-participation. This approach also incorporates strategies for the social appropriation of knowledge. Examples, barriers, difficulties, challenges and recommendations for conducting research with a focus on participation are also presented. The reflections herein presented may also be applied to other fields.

Comparación de la biodisponibilidad y la farmacocinética entre dos formulaciones de tabletas de metforminade 850 mg en voluntarios colombianos sanos / Bioavalaibility and pharmacokinetic comparison of two formulations of metformin 850 mg tablets in healthy Colombian volunteers

Purpose: The aim of this study was to compare the bioavailability of two formulations of metformin 850 mg tablets: Glucophage® from Merck Santè laboratories (reference product) and Metformin from Winthrop Pharmaceuticals de Colombia SA (test product) in healthy Colombian volunteers.Methods: A random, double blind, two-period, two-week wash out period, crossover study was performed in 24 healthy male and female volunteers for a single 850-mg dose of metformin tablets administrated with 240 ml of water after 12 hours of fasting. Once the drug was administrated, blood samples were collected before and within 24 hour, and plasma metformin concentration was determined by using a validated HPLC method. Pharmacokinetic parameters such as Cmax, AUC0-96h, AUC0-∞, and Tmax were determined. The formulations were considered bioequivalent if the logarithmic mean ratios of ln-transformed Cmax and AUC0-∞ values were within the equivalence range of 80%-125%.Results: ANOVA analysis of the ln-transformed Cmax and AUC0-∞ indicated that none of the effects examined (formulation, period, within and between-subjet variances and carry over) was statistically significant. The mean (±SD) of Cmax 1217.38 (± 251.72) ng/ml vs. 1305.25 (± 301.06) ng/ml, AUC0-96h 1363.49 (± 315.51) ng.h/ml vs. 1584.82 (± 368.75) ng.h/ml, AUC0-∞, 7155.75 (± 1440.74) ng.h/ml vs. 7777.08 (± 1896.49) ng.h/ml, and Tmax 2.57 (± 0.93) h vs. 2.22 (± 0.94) h were obtained with test and reference formulations, respectively. These pharmacokinetic parameters presented differences with the results from other published papers. The 90% confidence interval of the logarithmic ratio of AUC0-∞ and Cmax was within the range of 80-125%.Conclusions: In this study in healthy Colombian volunteers, a single 850-mg dose of metformin tablet test formulation met the criteria for bioequivalence to the reference formulation based on pharmacokinetic parameters AUC0-∞ and Cmax.

Objetivo: El objetivo de este estudio es comparar la bioequivalencia de dos formulaciones de tabletas de metformina de 850 mg: Glucophage® del Laboratorio Merck Santè (producto de referencia) y metformina de Laboratorios Winthrop Pharmaceuticals de Colombia SA (producto de prueba), en voluntarios colombianos sanos.Métodos: Se realizó un estudio aleatorizado, doble ciego, cruzado, en dos períodos y con un tiempo de lavado de dos semanas, en 24 voluntarios sanos, hombres y mujeres, que recibieron una dosis única de metformina de 850 mg, con 240 ml de agua, después de 12 horas de ayuno. Luego de la administración del medicamento, se recolectaron muestras de sangre durante 24 horas y las concentraciones plasmáticas de metformina se determinaron con un método de HPLC validado. Se calcularon los parámetros farmacocinéticos: Cmax, AUC0-96h, AUC0-∞, y Tmax. Las formulaciones se consideraron bioequivalentes si la relación de la media transformada a ln de Cmax y AUC0-∞ estaba dentro del rango de bioequivalencia de 80% a 125%.Resultados: El Anova de los datos transformados a ln de Cmax y AUC0-∞ indicaron que ninguno de los efectos analizados (formulación, período, variación intra e intersujetos y arrastre) fueron estadísticamente significativos. La media (±SD) de los parámetros obtenidos para los productos de prueba y de referencia, respectivamente, fueron: Cmax 1217.38 (± 251.72) ng/ml vs. 1305.25 (± 301.06) ng/ml, AUC0-96h 1363.49 (± 315.51) ng.h/ml vs. 1584.82 (± 368.75) ng.h/ml, AUC0-∞, 7155.75 (± 1440.74) ng.h/ml vs. 7777.08 (± 1896.49) ng.h/ml, and Tmax 2.57 (± 0.93) h vs. 2.22 (± 0.94) h. El intervalo de confianza de la relación logarítmica del AUC0∞ y Cmax se encontró dentro del rango de 80% a 125%.

Caer en la trampa: el accidente por mina antipersonal: la experiencia de los sobrevivientes, Antioquia, Colombia, 2007 / Caught in the trap: survivors’ experiences after landmine accidents, Antioquia, Colombia, 2007

Objetivo: este artículo es el resultado parcial de una investigación llevada a cabo en el contexto de la formación en una maestría en el área de la salud colectiva, cuyo propósito fue interpretar el proceso de integración a la vida cotidiana de los sobrevivientes a accidentes por mina antipersonal, a través de sus relatos para la reconstrucción de experiencias. Metodología: el estudio se hizo con un abordaje metodológico cualitativo etnográfico particularista y focalizado; como técnicas para recolectar la información se utilizaron la entrevista semiestructurada a cuatro participantes y la observación durante la misma. Resultados: en esta publicación se muestra la categoría caer en la trampa, en respuesta a la pregunta ¿cuál es la experiencia con el accidente de los sobrevivientes de minas antipersonal?, que describe el momento de la explosión e incluye el lugar donde sucedió, la actividad que realizaban en ese momento, el objeto con el que fueron heridos, los daños y las sensaciones que les produjo tanto a sí mismos como a sus acompañantes. Conclusiones: la educación en el riesgo de minas es una estrategia adecuada para asegurar que las personas y comunidades se sensibilicen sobre los riesgos, reduciéndolos a un nivel en el que puedan recrear un entorno libre de las limitaciones impuestas por su presencia.

Objective: This report is the partial result of a survey carried out with the purpose of interpreting the process of reintegration to daily life of survivors after landmine accidents, through their testimonies when they recall their experiences.Methodology: A qualitative methodological approach and an ethnographic particularistic focus were employed.The techniques for gathering information were semis tructured interviews to four participants, and observations during them.Results: This paper shows the category caught in the trap in response to the question: How is the experience of landmine accidents survivors? It describes the moment and place of the blast, the activity that was being carried out, the object responsible for the injuries, the harm caused, and the sensations of the survivors and their companions.Conclusions: Education on the risk of landmines is an adequate strategy to make communities and persons aware of the dangers posed by those artifacts.Consequently, the possibility arises to reduce such dangers to levels consistent with the recreation of milieus free from the restrictions imposed by the presence of landmines.

Estudio de bioequivalencia de clonazepam, tabletas de 2 mg, en voluntarios sanos colombianos / Bioequivalence study of clonazepam 2 mg tablets in colombian healthy volunteers

Con el fin de determinar la bioequivalencia de dos formulaciones de tabletas de 2 mg de clonazepam: Sedatril®/Clonazepam MK (Tecnoquímicas S. A., Cali, Colombia) como producto de prueba y Rivotril® (Roche Químicos e Farmacéuticas S. A., Río de Janeiro, Brasil), como producto de referencia, se realizó un estudio de bioequivalencia en 26 voluntarios sanos. Los productos de prueba y de referencia se administraron en condiciones de ayuno de acuerdo con un diseño cruzado aleatorio de dosis única, con dos secuencias, dos tratamientos y un período de lavado de 28 días. Las muestras de sangre se obtuvieron desde las 0 hasta las 96 horas después de la administración del medicamento. Los niveles plasmáticos de clonazepam se determinaron con un método validado por cromatografía líquida de alta eficiencia con detección ultravioleta (HPLC/UV, siglas en inglés). Los parámetros farmacocinéticos ABC0-96, ABC0-∞, Cmax, Tmax, t1/2, and ke se determinaron de los perfiles plasmáticos concentración-tiempo por el método no compartimental. El test de bioequivalencia se realizó con los datos transformados a logaritmo natural (ln) de ABC0-∞ and Cmax. Los intervalos de confianza del 90 por ciento para la relación producto de prueba/producto de referencia fueron de 87,9 por ciento a 103,6 por ciento y 84,4 por ciento a 104,0 por ciento, respectivamente. Estos resultados estuvieron dentro de los rangos de aceptación del 80,0 por ciento al 125 por ciento, establecidos por la FDA y se concluyó que ambos productos son bioequivalentes.

In order to determine the bioequivalence of two formulations of clonazepam 2 mg tablets: Sedatril®/ Clonazepam MK (Tecnoquímicas S. A., Cali, Colombia) as a test product and Rivotril® (Roche Químicos e Farmacêuticas S. A., Rio de Janeiro, Brazil) as a reference product, a bioavailability study was performed in 26 healthy volunteers. Test and reference products were administered under fasting conditions following a single dose, two-sequences, two treatments, crossover randomized design with a 28-day-washout period. Blood samples were obtained from 0 to 96 hours after dosing. Plasma clonazepam levels were determined by a validated high performance liquid chromatography with UV detection method (HPLC/UV). ABC0-96, ABC0-∞, Cmax, Tmax, t1/2, and ke, pharmacokinetic parameters were determined from plasma level-time profiles by a noncompartmental method. ln-trasformed ABC0-∞ and Cmax were tested for bioequivalence. 90%-confidence intervals for test/reference ratio of these parameters were 87.9% to 103.6% and 84.4% to 104.0%, respectively. These results were within the FDA acceptance range of 80% to 125% and it was concluded that both products were bioequivalent.

Biodisponibilidad comparativa entre dos formulaciones de gabapentina cápsulas de 300 mg en voluntarios sanos colombianos / Comparative bio-availability between two formularies of Gabapentine capsules of 300 mg in Colombian volunteers

Introducción: Comparar la biodisponibilidad entre dos productos equivalentes farmacéuticos, permite declarar la bioequivalencia o no de dos medicamentos sometidos a estudio bajo condiciones experimentales similares.Objetivo: Se sometieron a estudio in vivo para determinar la equivalencia biológica, los productos farmacéuticos gabapentina cápsulas de 300 mg, Gabantex®/Gabapentina MK, producto de prueba, de Tecnoquímicas S.A. y Neurontin®, producto de referencia, propiedad de Parke-Davis. Método: El estudio se realizó en 14 voluntarios sanos bajo un diseño aleatorio cruzado, con dosis única. Se administraron 600 mg de cada producto y se tomaron muestras de sangre por un período de 36 horas. Para la determinación de la gabapentina en plasma se aplicó la técnica de cromatografía líquida con detector de fluorescencia. La biodisponibilidad fue comparada para los parámetros farmacocinéticos de área bajo la curva concentración plasmática vs. tiempo (ABC0ºº), concentración máxima (Cmax), el tiempo máximo (Tmax) y la exposición temprana (ABC0Tmax). Resultados: Los intervalos de confianza del 90/100 para el producto de prueba fueron en ABC0ºº 87.5/100-114.5/100, Cmax 85.0-109.7/100 y ABC0Tmax 97.9/100-118.8/100, contenidos en el intervalo de confianza de 80/100-125/100 del producto de referencia. Para el Tmax fue 68.4/100- 94.5/100 que no está contenido en el intervalo de confianza de 80/100 a 120/100 del producto de referencia. Discusión: El parámetro farmacocinético de mayor diferencia en este estudio fue el Tmax para alcanzar la Cmax, diferencia que se explica por factores tales como el origen del principio activo, los excipientes y la tecnología farmacéutica empleada. Conclusiones: Las dos formulaciones son bioequivalentes con respecto al ABC0ºº, Cmax y ABC0Tmax y no bioequivalente con respecto al Tmax, lo cual garantiza que al utilizar el producto de prueba se logrará una respuesta terapéutica similar a la del producto de referencia