Urocortinergic system in the epididymis of the normal and cryptorchid dogs.

Cryptorchidism is associated with changes in the gonads and the spermatic duct system, which may cause infertility problems. Urocortin (UCN) is a corticotrophin-releasing hormone (CRH)-related peptide, which affects several functions of male genital organs. The aim of the present study was to investigate the expression of UCN and its receptors CRHR1 and CRHR2 using immunohistochemistry, western blotting and real-time reverse transcription polymerase chain reaction in tissues collected from the epididymis of normal and cryptorchid dogs. The lumen of the cryptic epididymal duct was found to be relatively smaller than that of the normal one, and interstitial tissue was abundant in the cryptic epididymis. In addition, only a few spermatids were observed in the lumen of the epididymal duct. Results showed that UCN, CRHR2 and CRHR1 were expressed in tissues collected from normal and cryptic epididymal ducts. Urocortin- and CRHR2-immunoreactivities (IRs) were detected in the principal cells of the caput, corpus and cauda of the normal and cryptic epididymides. CRHR1-IR was detected in vascular smooth muscles and fibromuscular cells surrounding epididymal tubules of the normal and cryptorchid dogs. Expression levels of UCN and CRHR2 mRNA were higher in cryptic epididymal ducts than that in normal epididymal ducts. These results suggest that UCN and its receptors might play a role in regulating the maturation and storage of spermatozoa. These findings indicated that the expression of these proteins could be modulated by the cryptorchidism condition.

Comparative assessment of the quality of commercial black and green tea using microbiology analyses.

BACKGROUND: Drinking tea constitutes a tradition which is deeply rooted in the culture of several countries. Moreover, in recent years, tea consumption is growing all over the world. Improper herbal tea storage (long periods, humid environments) represents a relevant health hazard for consumers because of the growth of bacteria and molds. RESULTS: This study analyzed 32 samples of commercially available black and green teas - purchased from southern Italy markets and online-shops - and the monitoring of microbiological quality of the tea bag content was performed. Evaluations were conducted with the aim of characterizing pathogens indicated by the European and American guidelines (total bacterial count, fungi and Escherichia coli) and on the research of Pseudomonas spp. and Clostridium perfringens. The presence of ochratoxin A in tea matrix-leaves and infusions was further assessed, using a validated and accredited HPLC-FLD method. Microbial loads, for over 80% samples, ranged from 1.0 × 102 to 2.8 × 105 CFU/g tea: most of identified microorganisms were classified as Bacillaceae. The utilization of rapid detection and identification methods (PCR and sequencing), allowed the characterization of strains of Pseudomonas psychrotolerans, Staphylococcus warneri, Pantoea gaviniae and the isolation of one strain of Clostridium perfringens, whose ability to produce toxins can result in harmful outcomes for consumers. Fungi were isolated from 70% samples: the most prevalent molds were Aspergillus niger strains, followed by Aspergillus tubingensis. Ochratoxin A was detected in 22 of 32 tea solid samples investigated: concentrations resulted over the indicated limits for food products for 50% samples. CONCLUSIONS: Results obtained demonstrated the need to develop targeted regulations for the safety of herbal teas.

Expression of urocortin and corticotropin-releasing hormone receptors in the horse thyroid gland.

Urocortin (UCN) is a 40-amino-acid peptide and a member of the corticotropin-releasing hormone (CRH) family, which includes CRH, urotensin I, sauvagine, UCN2 and UCN3. The biological actions of CRH family peptides are mediated via two types of G-protein-coupled receptors, namely CRH type 1 receptor (CRHR1) and CRH type 2 receptor (CRHR2). The biological effects of these peptides are mediated and modulated not only by CRH receptors but also via a highly conserved CRH-binding protein (CRHBP). Our aim was to investigate the expression of UCN, CRHR1, CRHR2 and CRHBP by immunohistochemistry, Western blot and reverse transcription with the polymerase chain reaction (RT-PCR) in the horse thyroid gland. The results showed that UCN, CRHR1 and CRHR2 were expressed in the thyroid gland, whereas CRHBP was not expressed. Specifically, UCN immunoreactivity (-IR) was found in the thyroid follicular cells, CRHR2-IR in the C-cells and CRHR1-IR in blood vessels. Western blot analysis and RT-PCR experiments confirmed the immunohistochemical data. These results suggest that a regulatory system exists in the mammalian thyroid gland based on UCN, CRHR1 and CRHR2 and that UCN plays a role in the regulation of thyroid physiological functions through a paracrine mechanism.

Expression of urocortin and corticotropin-releasing hormone receptors in the bovine adrenal gland.

Urocortin (UCN), a 40 amino acid peptide, is a corticotrophin-releasing hormone (CRH)-related peptide. The biological actions of CRH family peptides are mediated via two types of G protein-coupled receptors, CRH type 1 receptor (CRHR1) and CRH type 2 receptor (CRHR2). The aim of the present study was to investigate the expression of UCN, CRHR1 and CRHR2 by immunohistochemistry, western blot and real-time RT-PCR in the bovine adrenal gland to clarify the mechanisms of the intra-adrenal CRH-based regulatory system. The results showed that UCN, CRHR1 and CRHR2 were expressed in both the cortex and medulla. Specifically, UCN-immunoreactivity (IR) was distributed in the outer part of the zona fasciculata and in the zona reticularis of the cortex and in the medulla. UCN and CRHR2 mRNA expression levels were higher in the cortex than in the medulla, while CRHR1 mRNA levels were undetectable in the cortex. These results suggest that UCN, CRHR1 and CRHR2 are expressed in the bovine adrenal gland and that UCN might play a role in the intra-adrenal CRH-based regulatory system through an autocrine mechanism.

Exosomes in Dogs and Cats: An Innovative Approach to Neoplastic and Non-Neoplastic Diseases.

Exosomes are extracellular vesicles with a diameter between 40 and 120 nm, which are derived from all types of cells and released into all biological fluids, such as blood plasma, serum, urine, breast milk, colostrum, and more. They contain proteins, nucleic acids (mRNA, miRNA, other non-coding RNA, and DNA), and lipids. Exosomes represent a potentially accurate footprint of the miRNA profile of the parental cell and can therefore be proposed as potential and sensitive biomarkers, both in diagnosing and monitoring a variety of diseases in humans and animals. Liquid biopsy offers itself as a non-invasive or minimally invasive, pain-free, time-saving alternative to conventional tissue biopsy. Exosomes in both human and veterinary medicine find their major application in neoplastic diseases, but applications in the field of veterinary cardiology, nephrology, reproduction, parasitology, and regenerative medicine are currently being explored. Exosomes can therefore be used as diagnostic, prognostic, and, in some cases, therapeutic tools for several conditions. The aim of this review was to assess the current applications of exosomes in veterinary medicine, particularly in dog and cat patients.

[Development of AIDS-related malignancies and infections after starting HAART]. / Desarrollo de neoplasias e infecciones definitorias de sida después de iniciar la terapia antirretroviral de alta eficacia.

In order to evaluate the incidence rate and possible risk factors associated with AIDS-related malignancies and infections (ARMI) we performed data analysis of clinical charts of HIV patients in two hospital cohorts, that started high activity antiretroviral therapy (HAART) between July 2003 and October 2007. Trimethoprim-sulfamethoxazole and Azithromycin prophylaxis was provided according to current guidelines. We evaluated development of ARMI six months after-starting HAART and its association with clinical and epidemiological variables. Of 235 patients analyzed -118 women (50.2%) and 117 men (49.8%)- 11 presented ARMI: 3 pulmonary TB and 3 lymph nodes TB cases, 3 cases with meningeal Cryptococcus, one Chagas's disease presenting brain mass and one with non-Hodgkin lymphoma. ARMI incidence: 4.7%. A CD4 cell count < 100/150 was associated with risk of developing ARMI. The mean CD4 cell count was 73 in patients who developed ARMI and 143 in those who did not. No association was found with the other analyzed variables. In the CD4 cell count < 150 group one out of 4 patients with reactive serology presented Chagas's disease causing brain mass; none of the 46 patients with reactive serology presented toxoplasmosis encephalitis. The incidence rate of ARMI was 4.7%. TB in first place and cryptococcosis in second were the AIDS events more frequently observed. A low CD4 cell count was the only observed risk factor statistically associated with development of ARMI. The role of prophylaxis in this population should be re-evaluated.

Expression of Serum Exosomal miRNA 122 and Lipoprotein Levels in Dogs Naturally Infected by Leishmania infantum: A Preliminary Study.

Current knowledge on the role of exosomal microRNA (miRNA) in canine leishmaniasis (CL), with particular regards to the interaction between miR-122 and lipid alterations, is limited. The aim of this study was to isolate/characterize exosomes in canine serum and evaluate the expression of miR-122 in ten healthy and ten leishmaniotic dogs. Serum exosomes were isolated using a polymer-based kit, ExoQuick® and characterized by flow cytometry and transmission electron microscopy, whereas miR-122-5p expression was evaluated by quantitative reverse-transcriptase polymerase chain reaction. A significant decreased expression of exosomal miR-122-5p, decreased serum levels of high-density lipoproteins, and increased serum levels of low-density lipoproteins were seen in leishmaniotic dogs when compared with healthy dogs. These results suggest that hepatic dysfunctions induced by the parasite interfere with lipoprotein status. The decreased expression of exosomal miR122 represents an additional effect of Leishmania infection in dogs as in people.

[Characteristics of HIV infection by sex in a suburban district of Buenos Aires for the periods 1998 to 2002 and 2003 to 2005]. / Características de la infección por HIV/sida según sexo en una región del Gran Buenos Aires. Períodos 1998-2002/ 2003-2005.

With the aim of evaluating gender differences in one of the poorest districts of Buenos Aires, we reviewed epidemiological and clinical data of newly-diagnosed HIV patients at the Diego Paroissien Hospital between 1998 and 2005.We analyzed 524 clinical charts, 329 (62.8%) of which were from the 1998 to 2002 period and 195 (37.2%) from 2003 to 2005. Women accounted for 241 (46%) of the patients. The dominant mode of transmission was sexual intercourse in women and intravenous drug-use in men. At the time of diagnosis, women were at a significantly lower clinical stage, were younger, and had higher CD4 counts and lower viral loads. No gender differences were found in the rates of continued clinical care or continued antiretroviral therapy at one year follow-up. Comparing the periods 1998 to 2002 and 2003 to 2005, there was a statistically significant increase in diagnoses made during the pregnancy screening in women, in sexual transmission as the primary route of HIV infection, in the frequency of patients (both men and women) who had continued clinical care at one year follow-up, and a decreasing of intravenous drug-use in both sexes.The observed gender differences in the 2003-2005 period persisted even when those women who were diagnosed during their pregnancy screening were excluded from the analysis.

DNA Barcoding to Confirm the Morphological Identification of the Coral Trees (Erythrina spp., Fabaceae) in the Ancient Gardens of Naples (Campania, Italy).

The coral trees (genus Erythrina) have been fostering great interest among the botanists and gardeners of Naples, since their arrival in Europe in the second half of the 18th century. Numerous species were present in the royal and private botanical gardens of the region, but their number has decreased today. The purpose of this work was to verify which species occur nowadays in the public areas of Naples and associate them with the historical information about their introduction. The identification was carried out also by molecular methods, by means of sequencing nuclear and chloroplast DNA markers. The comparison of the sequences obtained for the specimens present in Naples with those present in the literature, together with a morphological examination, allowed us to identify with accuracy the species anciently introduced or nowadays cultivated in Naples.

[Occupational exposure to hepatitis C virus]. / Exposicion ocupacional al virus de hepatitis C.

Occupational exposure to Hepatitis C virus is an area of growing concern due to a lack of prophylaxis and limited knowledge regarding prevalence in hospital environment. Between 1999 and 2003, a total of 128 occupational exposures to this virus were registered in Diego Paroissien Hospital, eight of which led to hepatitis (6.3%) and one case to serum conversion (0.8%). Currently there is no preventive therapy and great interest is focused on acute infection therapy the effectiveness of which is still controversial. This study reinforces the fact that adherence to the Universal Precautions is still the most important preventive measure for health care workers, and the most cost beneficial.

Urocortinergic system in the testes of normal and cryptorchid dogs.

Cryptorchidism is the most common disorder of the sexual development in dogs, occurring in 13% of the males. Unilateral cryptorchidism is more frequent than bilateral and the right testis seems to be more frequently affected. Urocortin (UCN) is a corticotrophin-releasing hormone (CRH)-related peptide which was observed to affect several functions in male genital organs. The aim of the present study was to investigate the expression of UCN, and its receptors CRHR1 and CRHR2 by immunohistochemistry, Western blot and real-time RT-PCR in the normal and cryptic testis of the dog. The results showed that UCN, CRHR2 and CRHR1 were expressed in normal and cryptic testes. UCN-immunoreactivity (IR) was distributed in germ cells of the normal and cryptic testis. In the normal testis, CRHR2-IR was found in germ and interstitial Leydig cells. In the cryptic testis CRHR2-IR was distributed in gonocytes and interstitial Leydig cells. CRHR1-IR was distributed in the vessel smooth musculature and peritubular myoid cells. UCN and CRHR2 mRNA expression levels were lower in the cryptic than in normal testes. These results suggest that UCN and its receptors might play a role in regulating the spermatogenesis and hormonal activity of interstitial Leydig cells of the dog testis.

Expression of agouti-related protein (AgRP) in the hypothalamus and adrenal gland of the duck ( Anas platyrhynchos).

The presence and distribution of agouti-related protein (AgRP) immunoreactivity were investigated in the hypothalamus and adrenal gland of the duck using immunohistochemistry and Western blot analysis. Expression of AgRP mRNA was also studied using reverse transcriptase polymerase chain reaction (RT-PCR). A partial coding sequence (cds) of the duck AgRP gene was identified. Western blot analysis showed the presence of an AgRP-like peptide having a molecular weight consistent with the number of predicted amino acids of the avian AgRP. In the hypothalamus, AgRP immunoreactivity was found in neurons of the nucleus infundibularis and in fibers projecting to the median eminence. In the adrenals, AgRP immunoreactivity was observed in medullary cells. These findings suggest that in the duck, AgRP may play a role in regulating energy homeostasis and adrenal endocrine functions.

Expression of urocortin and its receptors in the rat epididymis.

Urocortin (UCN; 40 aa) is a corticotrophin-releasing hormone (CRH)-related peptide. The biological actions of CRH family peptides are mediated by two types of G-protein-coupled receptors, CRH type 1 receptor (CRHR1) and CRH type 2 receptor (CRHR2). The biological effects of the peptides are mediated and modulated not only by CRH receptors but also by a highly conserved CRH-binding protein (CRHBP). The aim of the present study was to investigate the expression of UCN, CRHR1, CRHR2 and CRHBP by immunohistochemistry, Western blot, RT-PCR and real-time RT-PCR in the rat epididymis. Urocortin, CRHR1 and CRHR2, but not CRHBP, were expressed in all segments of the rat epididymis. Specifically, UCN- and CRHR2-immunoreactivities (IRs) were distributed in epididymal epithelial cells of the caput, corpus and cauda. CRHR1-IR was found in the fibromuscular cells surrounding the epididymal duct and in the smooth musculature of the blood vessels throughout the organ. UCN and CRHR2 mRNA expression levels were higher in the caput and corpus than in the cauda, while CRHR1 mRNA level was higher in the cauda than those in the caput and corpus. In summary, UCN, CRHR1 and CRHR2 are expressed in the rat epididymis. It is suggested that CRH-related peptides might play multiple roles in the maturation and storage of spermatozoa.

Increased leptin mRNA expression in the blood of dogs naturally infected by Leishmania infantum.

Canine leishmaniosis (CL) is a severe and potentially fatal zoonosis caused by the protozoan Leishmania infantum. Severe forms of CL are commonly associated with a non-protective, humoral immune-response and high parasitic loads. Leptin, a 16 kD hormone mainly secreted by adipocytes, regulates both the innate and adaptive immunity. The goal of this study was to evaluate leptin mRNA expression levels in blood samples from privately owned dogs with CL (n = 11) and healthy controls (n = 10) using quantitative, real-time polymerase chain reaction. Blood samples from dogs with CL expressed significantly higher leptin mRNA levels (two-fold) compared to healthy controls (P = 0.018). The results suggest a possible involvement of leptin in the pathophysiology of Leishmania infection in dogs and the possible use of leptin as a biomarker for CL. Future studies investigating the immunological role of leptin in dogs with CL are warranted.

[A study of occupational blood and body fluid exposure among nursing staff at a reference hospital in Buenos Aires, Argentina]. / Estudio sobre la exposición ocupacional a sangre y fluidos corporales en el personal de enfermería de un hospital de referencia de Buenos Aires, Argentina.

OBJECTIVES: To determine the frequency of occupational blood and body fluids exposure (OBBFE) among the nursing staff at the Dr. Diego Paroissien Hospital in Buenos Aires, Argentina; analyze the possible risk factors associated; and assess the level of knowledge regarding universal precautions and control procedures following exposure: METHODS: A cross-sectional descriptive study was performed using a voluntary and anonymous survey administered between April and May 2005. In addition to personal and professional data, information was collected on knowledge and practice of universal precautions and procedures, OBBFE experienced, barriers to following the standards, and whether or not the Hepatitis B vaccine had been received. The dependent variable in the analysis was ever having experienced an OBBFE accident: RESULTS: Of the 186 responses analyzed, 77.7% were female, the mean age was 44.6 +/- 8.9 years, and the institution was 13.3 +/- 6.4 years old. Of those surveyed, 91 (48.9%) indicated that at some time they had an OBBFE, with 33 (17.7%) of these having occurred during the previous year; 73.0% confirmed that the tools necessary for complying with universal precautions were available always or almost always; 76.2% felt they had complete information, although 56.3% said they had not received adequate training; and, 94.1% claimed to have been vaccinated against Hepatitis B. Being overworked (54.5%), insufficient training (21.8%), and a lack of protective tools (18.8%) were the reasons most often identified as impeding compliance with universal precaution guidelines. Not having received training during the preceding year and having recently started work in a clinical or adult intensive-care unit were significantly associated with having experienced an OBBFE: CONCLUSIONS: These results signal a risk alert for OBBFE among health care workers and underscore the need for improving standards and surveillance.

Expression of pituitary adenylate cyclase-activating polypeptide in the primary lymphoid organs of the duck Anas platyrhynchos.

The expression of pituitary adenylate cyclase-activating polypeptide (PACAP) was studied in the thymus and bursa of Fabricius of the duck Anas platyrhynchos, at different ages, using immunohistochemistry, Western blotting, RT-PCR and sequencing. In the thymus, PACAP immunoreactivity (-ir) was found in lymphoid cells. CD68/ and PGP 9.5/PACAP38 double labelling showed that PACAP was not expressed either in macrophages or in epithelial cells, suggesting that the PACAP-positive cells observed were lymphoid cells. Immunoreactive lymphocytes were observed in the interlobular septa. They increased in number with ageing. In the bursa, PACAP-ir was found in nerve fibres and in a few lymphoid cells. RT-PCR revealed PACAP mRNA expression in the thymus but not in the bursa. These results suggest that PACAP plays a role in the functions of the immune system in birds.

Desarrollo de neoplasias e infecciones definitorias de sida después de iniciar la terapia antirretroviral de alta eficacia / Development of AIDS-related malignancies and infections after starting HAART

Con el objetivo de evaluar la incidencia de neoplasias e infecciones definitorias de Sida (NIDS) y los posibles factores asociados a su desarrollo luego de iniciada la terapia antirretroviral de alta eficacia (HAART) analizamos las historias clínicas de los pacientes que iniciaron tratamiento entre julio 2003 y octubre 2007. Todos recibieron profilaxis con trimetoprima-sulfametoxazol y azitromicina según la recomendación actual. Evaluamos el desarrollo de NIDS en los 6 meses posteriores al inicio de la terapia y su asociación con variables clínicas y epidemiológicas. Analizamos 235 historias clínicas: 118 mujeres (50.2%) y 117 hombres (49.8%). Observamos 11 casos de NIDS: 3 formas pulmonares y 3 ganglionares de tuberculosis, 3 meningitis por Criptococcus neoformans, 1 chagoma cerebral y 1 linfoma no Hodgkin. Presentar recuento de células CD4 menor a 100 o 150 células/ml se asoció con riesgo de desarrollar NIDS. La media de células CD4 fue 73 en los pacientes que desarrollaron NIDS y 143 en los que no la desarrollaron. No hubo asociación con las otras variables analizadas. En pacientes con CD4 menor a 150 células/ml observamos un caso de chagoma cerebral entre 4 con serología reactiva para Chagas, y ninguno de toxoplasmosis cerebral entre 46 con serología reactiva para toxoplasmosis. Concluimos que la tasa de incidencia de NIDS fue del 4.7%, siendo tuberculosis en primer lugar y criptococosis en segundo las enfermedades más frecuentemente observadas. Presentar bajo recuento de células CD4 se asoció de manera significativa al desarrollo de NIDS. Debería reevaluarse el rol de la quimioprofilaxis.

In order to evaluate the incidence rate and possible risk factors associated with AIDS-related malignancies and infections (ARMI) we performed data analysis of clinical charts of HIV patients in two hospital cohorts, that started high activity antiretroviral therapy (HAART) between July 2003 and October 2007. Trimethoprim-sulfamethoxazole and azytromicin prophylaxis was provided according to current guidelines. We evaluated development of ARMI six months after-starting HAART and its association with clinical and epidemiological variables. Of 235 patients analyzed -118 women (50.2%) and 117 men (49.8%)- 11 presented ARMI: 3 pulmonary TB and 3 lymph nodes TB cases, 3 cases with meningeal Cryptococcus, one Chagas' disease presenting brain mass and one with non-Hodgkin lymphoma. ARMI incidence: 4.7%. A CD4 cell count < 100/150 was associated with risk of developing ARMI. The mean CD4 cell count was 73 in patients who developed ARMI and 143 in those who did not. No association was found with the other analyzed variables. In the CD4 cell count < 150 group one out of 4 patients with reactive serology presented Chagas's disease causing brain mass; none of the 46 patients with reactive serology presented toxoplasmosis encephalitis. The incidence rate of ARMI was 4.7%. TB in first place and cryptococcosis in second were the AIDS events more frequently observed. A low CD4 cell count was the only observed risk factor statistically associated with development of ARMI. The role of prophylaxis in this population should be re-evaluated.

Estudio sobre la exposición ocupacional a sangre y fluidos corporales en el personal de enfermería de un hospital de referencia de Buenos Aires, Argentina / A study of occupational blood and body fluid exposure among nursing staff at a reference hospital in Buenos Aires, Argentina

OBJETIVOS: Determinar la frecuencia de la exposición ocupacional a sangre y fluidos corporales (EOSFC) en el personal de enfermería del Hospital Dr. Diego Paroissien, de Buenos Aires, Argentina, analizar los posibles factores de riesgo asociados y evaluar el nivel de conocimientos sobre las normas vigentes de prevención y control después de la exposición. MÉTODOS: Estudio descriptivo de corte transversal mediante una encuesta voluntaria y anónima aplicada entre abril y mayo de 2005. Además de los datos personales y profesionales, se recabó información acerca de los conocimientos y la capacitación sobre las medidas de precaución universales y los procedimientos a seguir, los accidentes de EOSFC sufridos, los factores que atentaban contra el cumplimiento de las normas y si estaban vacunados contra la hepatitis B. La variable dependiente para el análisis fue haber sufrido alguna vez una EOSFC. RESULTADOS: Se analizaron 186 encuestas, de ellas 77,7 por ciento correspondían a mujeres; la edad promedio era de 44,6 ± 8,9 años y la antigüedad en la institución de 13,3 ± 6,4 años. De los encuestados, 91 (48,9 por ciento) refirieron haber sufrido alguna vez una EOSFC y 33 (17,7 por ciento) de ellas ocurrieron el año previo; 73,0 por ciento afirmó disponer de los elementos adecuados para cumplir con las normas de precaución universal siempre o casi siempre, 76,2 por ciento consideró tener la información adecuada, aunque 56,3 por ciento afirmó no haber recibido una capacitación adecuada; 94,1 por ciento refirió estar vacunado contra la hepatitis B. La sobrecarga de trabajo (54,5 por ciento), la insuficiente capacitación (21,8 por ciento) y la carencia de los elementos de protección necesarios (18,8 por ciento) fueron las situaciones señaladas con mayor frecuencia que atentaban contra el cumplimiento de las precauciones universales. No haber recibido capacitación el año previo y desempeñarse en una unidad de cuidados clínicos o intensivos de adultos...

OBJECTIVES: To determine the frequency of occupational blood and body fluids exposure (OBBFE) among the nursing staff at the Dr. Diego Paroissien Hospital in Buenos Aires, Argentina; analyze the possible risk factors associated; and assess the level of knowledge regarding universal precautions and control procedures following exposure. METHODS: A cross-sectional descriptive study was performed using a voluntary and anonymous survey administered between April and May 2005. In addition to personal and professional data, information was collected on knowledge and practice of universal precautions and procedures, OBBFE experienced, barriers to following the standards, and whether or not the Hepatitis B vaccine had been received. The dependent variable in the analysis was ever having experienced an OBBFE accident. RESULTS: Of the 186 responses analyzed, 77.7 percent were female, the mean age was 44.6 ± 8.9 years, and the institution was 13.3 ± 6.4 years old. Of those surveyed, 91 (48.9 percent) indicated that at some time they had an OBBFE, with 33 (17.7 percent) of these having occurred during the previous year; 73.0 percent confirmed that the tools necessary for complying with universal precautions were available always or almost always; 76.2 percent felt they had complete information, although 56.3 percent said they had not received adequate training; and, 94.1 percent claimed to have been vaccinated against Hepatitis B. Being overworked (54.5 percent), insufficient training (21.8 percent), and a lack of protective tools (18.8 percent) were the reasons most often identified as impeding compliance with universal precaution guidelines. Not having received training during the preceding year and having recently started work in a clinical or adult intensive-care unit were significantly associated with having experienced an OBBFE. CONCLUSIONS: These results signal a risk alert for OBBFE among health care workers and underscore the need for improving...

Características de la infección por HIV/sida según sexo en una región del Gran Buenos Aires: Períodos 1998-2002/ 2003-2005 / Characteristics of HIV infection by sex in a suburban district of Buenos Aires for the periods 1998 to 2002 and 2003 to 2005

Con el propósito de evaluar características de la infección por HIV/sida en uno de los distritos más pobres del Gran Buenos Aires, revisamos datos clínicos y epidemiológicos de las historias clínicas de los pacientes con diagnóstico reciente de infección por HIV en el hospital Dr. Diego Paroissien entre 1998 y 2005. Analizamos 524 historias clínicas, 329 (62.8%) correspondientes al período 1998-2002 y 195 (37.2%) al 2003-2005, 241 mujeres (46%) y 283 hombres (54%). El modo dominante de transmisión en las mujeres fue sexual y en los hombres el uso de drogas intravenosas. Las mujeres presentaron al momento del diagnóstico de infección por HIV, de manera estadísticamente significativa, menor estadio clínico, menor edad, mayores valores de recuento de células CD4 y menores de carga viral. No observamos diferencias entre ambos sexos en la frecuencia con que los pacientes continuaron en control clínico al año de seguimiento, iniciaron terapia antirretroviral y continuaron en tratamiento al año de haber iniciado el mismo. Comparando los períodos 1998- 2002 y 2003-2005 se determinó un aumento, estadísticamente significativo, del diagnóstico como parte del control del embarazo en la mujer, del modo primario sexual de adquisición, de la frecuencia de pacientes que continuaron en control clínico al año de seguimiento y de la disminución del uso de drogas inyectables para ambos sexos. Las diferencias de sexo observadas persisten en el período 2003-2005 cuando se excluyeron del análisis las mujeres en las que se realizó el diagnóstico como parte del control del embarazo.

With the aim of evaluating gender differences in one of the poorest districts of Buenos Aires, we reviewed epidemiological and clinical data of newly-diagnosed HIV patients at the Diego Paroissien Hospital between 1998 and 2005.We analyzed 524 clinical charts, 329 (62.8%) of which were from the 1998 to 2002 period and 195 (37.2%) from 2003 to 2005. Women accounted for 241 (46%) of the patients. The dominant mode of transmission was sexual intercourse in women and intravenous drug-use in men. At the time of diagnosis, women were at a significantly lower clinical stage, were younger, and had higher CD4 counts and lower viral loads. No gender differences were found in the rates of continued clinical care or continued antiretroviral therapy at one year follow-up. Comparing the periods 1998 to 2002 and 2003 to 2005, there was a statistically significant increase in diagnoses made during the pregnancy screening in women, in sexual transmission as the primary route of HIV infection, in the frequency of patients (both men and women) who had continued clinical care at one year follow-up, and a decreasing of intravenous drug-use in both sexes.The observed gender differences in the 2003-2005 period persisted even when those women who were diagnosed during their pregnancy screening were excluded from the analysis.

Exposicion ocupacional al virus de hepatitis c / Occupational exposure to hepatitis C virus

La transmisión ocupacional de virus de hepatitis C (VHC) es un área de creciente preocupacióndada la falta de profilaxis y la poca información de su prevalencia en el medio hospitalario. Sobre128 exposiciones ocupacionales ocurridas en el Hospital Diego Paroissien entre1999 y 2003 hubieron 8 casosde exposición a VHC (6.3%) y un caso de seroconversión posterior a la exposición (0.8%). No existiendo en laactualidad terapia preventiva para VHC resulta de gran interés la posibilidad de tratamiento de la infección aguda.La mayor parte de los autores coincide en recomendar el tratamiento del episodio agudo de hepatitis porVHC basado en la evidencia actual, aunque aún no está bien definida la mejor estrategia diagnóstica y terapéutica.El acatamiento de las Normas de Precauciones Universales sigue siendo en la actualidad la más importantemedida preventiva para evitar la infección ocupacional por VHC en el personal de salud y la de mejor equilibriocosto-beneficio.

Occupational exposure to Hepatitis C virus is an areaof growing concern due to a lack of prophylaxis and limited knowledge regarding prevalence in hospitalenvironment. Between 1999 and 2003, a total of 128 occupational exposures to this virus were registeredin Diego Paroissien Hospital, eight of which led to hepatitis (6.3%) and one case to serum conversion (0.8%).Currently there is no preventive therapy and great interest is focused on acute infection therapy the effectivenessof which is still controversial. This study reinforces the fact that adherence to the Universal Precautions is stillthe most important preventive measure for health care workers, and the most cost beneficial.