Temperature induced physiological and biochemical alterations in the paddy field cyanobacterium Anabaena doliolum

Combustion of fossil fuels and resultant emission of carbon dioxide has led to increased global temperature. Since cyanobacteria are an integral component of the paddy field microflora and contribute to nitrogen fixation, increase in temperature may adversely affect the nitrogen dynamics of the soil. Therefore, to understand the physiological and biochemical response of the mesophilic diazotrophic cyanobacterium Anabaena doliolum to elevated temperature, the organism was grown under three temperature regimes 30, 35 and 40°C for 15 days. Exposure of the cyanobacterium to 40°C resulted in severe reduction in growth and cellular constituents as compared to the cells exposed to 35°C. The cyanobacterial cells also showed enhanced production of H2O2 and lipid peroxidation products in response to exposure to elevated temperature. Further, we observed increased activity of superoxide dismutase, catalase and peroxidase in A. doliolum exposed to elevated temperature. Increase in the temperature resulted in enhanced level of non-enzymatic antioxidants such as carotenoid, proline and ascorbate. Although, the number of heterocysts increased in response to temperature, the nitrogenase activity decreased significantly. The results have demonstrated the sensitivity of the cyanobacterium A. doliolum to elevated temperature.

CTX-M type extended-spectrum ?-lactamase in Escherichia coli isolated from extra-intestinal infections in a tertiary care hospital in south India

Background & objectives: Infections caused by extended-spectrum ?-lactamase (ESBL)-producing Escherichia coli carrying blaCTX-M genes have been spreading globally, but there are geographical variations in the type of blaCTX-Mgenes prevalent and there are scanty data from India. This study was conducted to determine the CTX-M type ESBLs in E. coli isolates obtained from clinical specimens from patients with extra-intestinal infections attending a tertiary care hospital in south India. Methods: ESBL-producing E. coli isolated from patients with extra-intestinal infections were subjected to PCR using CTX-M group-specific primers. From a representative isolate, full-length CTX-M-15 gene was amplified and sequenced. An internal fragment of this gene was sequenced in 10 representative isolates. Results: Of the 300 isolates of E. coli tested, 88 per cent carried CTX-M genes and blaCTX-M-15was the most dominant gene present in 90 per cent of the positive isolates. Most (91%) of the isolates positive for blaCTX-M were sensitive to meropenem. Interpretation & conclusions: Our findings showed blaCTX-M-15 to be the dominant gene. Based on the data on antimicrobial susceptibility, cefoperazone-sulbactum could be an antimicrobial of choice.

An unusual case of unresolving tunnel infection in a patient on continuous ambulatory peritoneal dialysis

Atypical mycobacteria remain a rare cause of peritoneal dialysis catheter-related tunnel infection (TI) and poses serious risk because of the resistant nature to most antibiotic therapy. Non-tubercular mycobacterial infections lead to chronicity requiring peritoneal dialysis catheter removal. We report an 82-year-old male, with diabetic nephropathy who had a coinfection with Staphylococcus hominis and Mycobacterium abscessus who presented with pus discharge at exit site and TI. He was treated with relocation of the extraperitoneal part of the catheter with a new exit site without catheter removal and multidrug mycobacterial therapy.

Twenty-one episodes of peritonitis in a continuous ambulatory peritoneal dialysis patient: What is the root cause?

A 51-year-old female, with non-alcoholic liver cirrhosis, portal hypertension, type 2 diabetes mellitus, autosomal dominant polycystic kidney disease with a clipped cerebral aneurysm and chronic kidney disease stage 5 was on continuous ambulatory peritoneal dialysis (CAPD) for 6.5 years elsewhere. She came for opinion on continuation of CAPD as she had 21 episodes of peritonitis in 76 months. Her blood pressure was 80/50 mmHg. She was on haemodialysis with a temporary central access for 2 weeks. She had no abdominal tenderness, and exit site looked normal. Fluid was negative for Mycobacterium tuberculosis. Laparoscopically, we replaced the catheter with a new swan-neck Tenckhoff double-cuff catheter through a different exit site in the same sitting. Catheter-tip biofilm culture isolated Enterococcus casseliflavus. Peritoneal sampling biopsy showed evidence of fibrosis. She has adequate ultrafiltration and is currently on automated peritoneal dialysis for 5 months.

Detección de unidades discretas de tipificación de Trypanosoma cruzi en triatominos recolectados en diferentes regiones naturales de Perú / Identifying Trypanosoma cruzi discreet typing units in triatomines collected in different natural regions of Perú

Resumen Introducción. Trypanosoma cruzi se ha dividido en seis unidades taxonómicas discretas (Discreet Typing Units, DTU) denominadas TcI, TcII, TcIII, TcIV, TcV y TcVI. Aún se desconocen los factores determinantes de la dinámica de la transmisión vectorial de los genotipos de T. cruzi en las diferentes regiones geográficas de distribución de la enfermedad de Chagas en Perú. Objetivo. Detectar y tipificar las unidades taxonómicas discretas de T. cruzi en las heces de siete especies de triatominos (Panstrongylus chinai, P. geniculatus, P. herreri, Rhodnius robustus, R. pictipes, Triatoma carrioni y T. infestans), capturados en ocho departamentos de diferentes regiones naturales de Perú. Materiales y métodos. Se examinaron 197 insectos para la detección de tripanosomas. Se extrajo el ADN del contenido intestinal de cada insecto y se amplificó mediante reacción en cadena de la polimerasa (PCR) de los genes kDNA, SL-IR, 24Sa rRNA y 18Sa RNA para detectar las DTU de T. cruzi. Resultados. Se detectaron cinco infecciones con T. rangeli y 113 con T. cruzi. De estas últimas, fue posible identificar 95 de TcI (dos en P. chinai, una en P. geniculatus, 68 en P. herreri, cuatro en R. pictipes, siete en R. robustus, una en T. carrioni, y 12 en T. infestans); cinco de TcII (cuatro en P. herreri, una en T. infestans); cuatro de TcIII (tres en P. herreri, una en R. robustus) y cuatro infecciones de TcIV en P. herreri. Conclusión. Este es el primer trabajo de caracterización a gran escala de T. cruzi en el intestino de vectores de importancia epidemiológica en Perú, orientado a generar información básica que permita entender la dinámica de la transmisión vectorial de T. cruzi en esta región del continente.

Abstract Introduction: Trypanosoma cruzi has been divided by international consensus into six discrete typing units (DTU): TcI, TcII, TcIII, TcIV, TcV y TcVI. The factors determining the dynamics of T. cruzi genotypes vector transmission of Chagas' disease in the different geographical regions of Perú are still unknown. Objective: To detect and type T. cruzi DTUs from the faeces of seven species of triatomines (Panstrongylus chinai, P. geniculatus, P. herreri, Rhodnius robustus, R. pictipes, Triatoma carrioni and T. infestans) captured in eight departments from different natural regions of Perú. Materials and methods: We examined 197 insects for detecting trypanosomes. DNA was extracted from each insect intestinal contents and PCR amplification of kDNA, SL-IR, 24Sa rRNA and 18Sa RNAwas performed for detecting T. cruzi DTUs. Results: Five T. rangeli and 113 T. cruzi infections were detected; 95 of the latter were identified as TcI (two in P. chinai, one in P. geniculatus, 68 in P. herreri, four in R. pictipes, seven in R. robustus, one in T. carrioni, 12 in T. infestans), five as TcII (four in P. herreri, one in T. infestans), four as TcIII (three in P. herreri, one in R. robustus) and four TcIV infections in P. herreri. Conclusions: This is the first study which has attempted a large-scale characterization of T. cruzi found in the intestine of epidemiologically important vectors in Perú, thus providing basic information that will facilitate a better understanding of the dynamics of T. cruzi vector transmission in Perú.

Neurovascular structures at risk during anterolateral and medial arthroscopic approaches of the hip / Estructuras neurovasculares en riesgo durante abordajes artroscopicos anterolaterales y mediales de la cadera

To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and cross-sectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve.

El objetivo fue describir las áreas de seguridad para la colocación de 5 portales estándar (portal anterior, anterolateral, posterolateral, portal anterior proximal medial y portal anterior distal medial) y 3 portales mediales emergentes (antero medial, portal posteromedial y posteromedial distal) para proporcionar una descripción topográfica de la seguridad de cada portal. Se realizó un estudio descriptivo, observacional y transversal, en la que se disecó el triángulo femoral de 12 caderas. Se colocaron los 5 portales laterales y los 3 portales mediales. Se documentó la medición de cada estructura neurovascular de relevancia clínica en relación a cada uno de los portales evaluados. En cuanto al portal de mayor riesgo entre los laterales, se encontró el portal anterior con mayor cercanía al nervio cutáneo femoral lateral (1,42±0,85 cm), ubicado lateral al portal. En los portales mediales el portal anterior medial tiene el margen más estrecho respecto a la arteria femoral (2,14±0,35 cm) lateral al portal, y medial el nervio obturador (0,87±0,62 cm). Los portales laterales tienen un amplio margen de seguridad, el portal con el margen más reducido es el portal anterior en relación al nervio cutáneo femoral lateral, presentando un elevado riesgo de lesionarlo, los portales mediales tienen un alto riesgo de lesionar las estructuras neurovasculares femorales y el nervio obturador.

Safe areas for the placement of standard shoulder arthroscopy portals: an anatomical study / Áreas seguras para la colocación de portales artroscópicos estándar de hombro: un estudio anatómico

The abundant vascular structures that surround the shoulder joint are complex and variable, complicating arthroscopy approaches. The aim of this study is to determine safe and risky areas around standard posterior and standard anterior portals, and accounting for the distribution of neurovascular structures of small and medium diameters that can lead to intra-articular bleeding during surgery. The standard posterior portal, and standard anterior portal were placed as described in the literature, and punch dissection was performed 2.5 cm around the trocar in situ. The arrangement of each identified structure was photographically documented and digitalized for each anatomic plane; the distance to the trocar and the diameter of each structure were measured. Based on each digitalized anatomic plane, safe and risky tissue areas were determined, and a clock face coordinate system was used to represent these areas. The safe area around the standard posterior portal was located between 11 and 1 o´clock for the left shoulder and 11 and 2 o´clock for the right shoulder. For the standard anterior portal, the safe area was located between 2 and 3 o´clock for the left shoulder and between 9 and 12 o´clock for the right shoulder. However, we did document a risk of injuring the cephalic vein 5 times, the axillary artery 3 times and the deltoid branch of the thoracoacromial artery once. This study reports quantitatively the total number of small diameter structures present in the two shoulder arthroscopic portals evaluated. The safe areas proposed in this study must be evaluated to propose new access points for performing arthroscopic procedures on the shoulder.

Las abundantes estructuras vasculares que rodean la articulación del hombro son complejas y variables, y dificultan los abordajes artroscópicos. El objetivo del estudio fue determinar áreas seguras y en riesgo en relación al portal posterior estándar y el portal anterior estándar y cuantificar la distribución de estructuras de diámetro pequeño e intermedio que puedan conducir a sangrado intraarticular durante la cirugía. El portal posterior estándar y el portal anterior estándar fueron colocados según su descripción en la literatura y fueron realizadas disecciones en sacabocado de 2,5 cm alrededor del trocar in situ. La disposición de cada estructura identificada fue documentada fotográficamente y digitalizada para cada plano anatómico. La distancia hacia el trocar y el diámetro de cada estructura fueron medidos. Basado en cada plano anatómico digitalizado, áreas de seguridad y riesgo tisular fueron determinadas y un sistema de coordenadas de manecillas de reloj fue utilizado para representar estas áreas. El área segura alrededor del portal posterior estándar fue localizada entre las 11 y las 1 en el sistema de las manecillas del reloj para hombros izquierdos y entre las 11 y las 2 para hombros derechos. Para el portal anterior estándar, el área segura fue localizada entre las 2 y 3 horas para hombros izquierdos y entre las 9 y 12 horas para hombros derechos. Aun así, se documentó el riesgo de lesionar la vena cefálica en 5 ocasiones, la arteria axilar en 3 ocasiones y la rama deltoidea de la arteria toracroacromial en una ocasión. Este estudio reporta cuantitativamente el número total de estructuras de pequeño diámetro presentes en los dos portales artroscopicos evaluados. Las áreas seguras propuestas en este estudio deben ser evaluadas para proponer nuevos puntos de acceso para la realización de procedimientos artroscopicos en el hombro.

Antimicrobial activity and identification of potential antimicrobial compounds from aquatic pteridophyte, Azolla microphylla Kaulf.

Azolla microphylla Kaulf. is an aquatic nitrogen fixing pteridophyte commonly found in aquatic habitats including paddy fields. Methanolic extract of the fronds of A. microphylla was subjected to partial purification by solvent partitioning with diethyl ether and ethyl acetate followed by hydrolysis, and further partitioning with ethyl acetate. The two fractions, thus obtained were tested for antibacterial activity. It was observed that the ethyl acetate fraction inhibited the growth of the pathogenic bacterium Xanthomonas oryzae. The GC-MS analysis of the ethyl acetate fraction showed several prominent peaks with retention time ranging from 8.83 to 45.54 min. A comparison of these peaks with the GC-MS libraries revealed that it could be eicosenes and heptadecanes with potential of antimicrobial activity.

Epidemiological investigation of an acute case of Chagas disease in an area of active transmission in Peruvian Amazon region / Investigação epidemiológica de caso agudo da doença de Chagas em área de transmissão ativa na região da Amazônia peruana

The study objective was to investigate an acute case of Chagas disease in the San Pedro de Shishita community, Pebas District, in the Peruvian Amazon basin, a non-endemic area. Both parents of the index case (acute case) were thoroughly interviewed, a seroepidemiological survey was carried out in the community, parasitological exams were carried out only in relatives of the index case, and triatomine bugs were searched for inside houses, peridomiciliary, and in wild environments. Seroprevalence for IgG anti-T. cruzi antibodies was 1/104 (0.96 percent), using an ELISA test and an indirect immunofluorescence assay. Panstrongylus geniculatus and Rhodnius pictipes adults were found. The index case is autochthonous from San Pedro de Shishita, but the source of transmission is unknown.

O objetivo deste trabalho foi estudar caso da doença de Chagas aguda na comunidade indígena de San Pedro de Shishita, sem conhecimento da origem da transmissão. San Pedro de Shishita, distrito Pebas, região da Amazônia peruana é uma área não endêmica. Foram entrevistados os pais do paciente e feito inquérito soroepidemiológico dos participantes e estudos parasitológicos da família e procurou-se também triatomíneos no ambiente doméstico, peridomiciliar e silvestre. A soroprevalência de anticorpos IgG anti-T. cruzi foi 1/ 104 (0,96 por cento) por ELISA e imunofluorescência indireta. Foram encontrados adultos de Panstrongylus geniculatus e Rhodnius pictipes.

Aspectos entomológicos de la enfermedad de chagas en Huallaga y Picota, San Martín, Perú / Entomological aspects of chagas disease in Huallaga and Picota, San Martin, Peru

Introducción: Existe escasa información y no actualizada sobre la presencia de triatominos en el departamento de San Martín, zona amazónica de nuestro país, y es importante actualizarla, ya que hay reportes recientes de casos de enfermedad de Chagas procedentes de la amazonía peruana cuyos vectores serían triatominos silvestres. Objetivos: Conocer la distribución geográfica de triatominos hematófagos en Huallaga y Picota, San Martín, Perú. Determinar los índices entomológicos, sus hábitos alimenticios y caracterizar los tripanosomatídeos que portan. Diseño: Investigación descriptiva observacional. Lugar: Red de Salud Huallaga y Picota, Laboratorio Regional de la Región de Salud San Martín. Laboratorios del Instituto Nacional de Salud. Participantes: Viviendas de 6 distritos de las provincia de Huallaga y 9 de Picota, del Departamento de San Martín. Intervenciones: La búsqueda de triatominos fue en 3 362 viviendas de áreas periurbanas y rurales. Mediante la prueba de precipitina, se determinó la fuente de alimentación. Se aisló tripanosomatídeos mediante infección en ratones Balb/C e inoculación en medio agar sangre, y por PCR se caracterizó el genoma por amplificación del espaciador intergénico del gen miniexón. Principales medidas de resultados: Determinar si Huallaga y Picota, San Martín, Perú, son zonas de riesgo de enfermedad de Chagas. Resultados: En 46 viviendas, de 3 362 muestreadas se capturó 53 triatominos adultos pertenecientes a Rhodnius pictipes (56,6 por ciento), Panstrongylus geniculatus (41,5 por ciento) y Eratyrus mucronatus (1,9 por ciento). Se reporta P. geniculatus por primera vez para las dos provincias. Los índices de infestación para ambas provincias fueron 1,4 por ciento y 3,8 por ciento, respectivamente, y corresponden al índice de infección natural; mientras que el índice de dispersión fue 30,1 por ciento. En R. pictipes se identificó cinco fuentes de alimentación (pollo, humano, perro, cobayo y gato) y en P. geniculatus un perfil alimentario mixto: perro/gato/pollo. Los Trypanosoma spp. aislados de R. pictipes, procedente de Sacanche (Huallaga), corresponden a TCI (350 pb); resultado similar se obtuvo en los 10 clones de este aislamiento. Conclusiones: Los resultados nos indican que, en las localidades estudiadas, R. pictipes y P. geniculatus estarían pasando por un proceso de domiciliación y que en las localidades de Huallaga R. pictipes sería el principal vector de Trypanosoma cruzi TC1; por lo que, dichas localidades estarían consideradas como zonas de riesgo de enfermedad de Chagas.

Introduction: There is little and not recent information on the presence of triatomine bugs in San Martin department, Amazon area of our country where Chagas disease has been reported by wild triatomine insects as vectors. Objectives: To determine the geographic distribution of hematophagous triatomine insects in Huallaga and Picota provinces, San Martin department, Peru. To determine the domiciliary infestation by triatomine vectors indexes, trypano-triatomine infection as well as their dispersion. To determine the insects feeding source and to genetically characterize the tripanosomatidae they carry. Design: Observational and descriptive study. Setting: Health and Laboratories region networks. National Institute of Health laboratories. Participants: Houses from 6 districts of Huallaga province and 9 from Picota province (San Martin department). Interventions: Triatomine insectÆs collection was carried out in 3 362 homes located in semi-urban and rural zones accounting for 30 per cent of the total area of studied provinces. Feeding preferences were assessed by a precipitin test using specific antibodies against guinea pig, dog, cat, chicken and human beings sera. Trypanosomes were isolated by inoculation of stool samples from infected insects in Balb/c mice and using axenic culture media. Genetic characterization was done by PCR amplification of the genome by gene intergenic spacer of the miniexon. Main outcome measures: To assess if Huallaga and Picota, San Martin, Peru, are Chagas disease risk areas. Results: In 46 of the 3 368 homes visited, 53 triatomine adults were collected belonging to the species Rhodnius pictipes (56,6 per cent), Panstrongylus geniculatus (41,5 per cent) and Eratyrus mucronatus (1,9 per cent). For the first time, P. geniculatus was reported in both provinces included in the study. Domiciliary infestation index was 1,4 per cent, trypano-triatomine infection index was 3,8 per cent and dispersion index was 30,1 per cent. For R. pictipes 5 sources of food were identified (chicken, human, dog, guinea pig and cat) and for P. geniculatus, a mix feed: dog, cat and chicken. Trypanosoma spp. isolates of R. pictipes from Sacanche (Huallaga) belonged to T. cruzi TCI (350 pb); similar result was obtained in 10 clones studied. Conclusions: Results indicate that R. pictipes and P. geniculatus are undergoing colonization of the regions included in this study. Within the province of Huallaga, R. pictipes is the predominant vector of T. cruzi; therefore these locations must be considered high risk areas for Chagas disease.

The risk factors and outcome of fungal peritonitis in continuous ambulatory peritoneal dialysis patients.

AIM: To determine the risk factors and outcome of fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients over a 7-year period. PATIENTS AND METHODS: This retrospective study was conducted on 30 cases of fungal peritonitis in CAPD patients during a 7-year period (2000-2007). The diagnosis was based on elevated CAPD effluent count and isolation of fungi. Patients were evaluated for previous episode of bacterial peritonitis. RESULTS: The incidence of fungal peritonitis was 16.2%. Age varied between 8 and 75 years, with a mean age of 57 years. Twenty-three were males (76.7%) and seven were females (23.3%). Seventeen patients (56.6%) had previous episodes of bacterial peritonitis that was treated with multiple antibiotics. The common fungus was Candida species (50%). CAPD catheter removal and initiation of antifungal therapy was done for all patients. Reinsertion was done for three (10%) patients. Mortality rate was 20%. CONCLUSION: Patients with previous bacterial peritonitis and antibiotic usage are at greater risk of developing fungal peritonitis.

Fuentes de alimentación de panstrongylus herreri (hemiptera: Triatominae) capturados en utcubamba, amazonas - perú / Food sources of panstrongylus herreri (hemiptera: triatominae) collected in utcubamba, Amazonas - Peru

Objetivo. Identificar las fuentes de alimentación de Panstrongylus herreri, procedente del distrito de Cajaruro, provincia de Utcubamba, departamento de Amazonas. Materiales y métodos. El estudio se realizó en dos etapas: primera, se estandarizó la prueba de precipitina usando como antígenos sueros sanguíneos de: humano, perro, gato, cobayo y pollo, y anticuerpos específicos obtenidos por inoculaciónde los antígenos en conejos. Se alimentaron ninfas de Triatoma infestans del IV y V estadio criadas en laboratorio con sangre de perro,cobayo, pollo y humano para luego determinar la sensibilidad y especificidad de la prueba. Segunda, se aplicó la prueba de precipitina a 102ejemplares de P. herreri domiciliarios, procedentes de la zona de estudio. Resultados. Se obtuvo títulos de anticuerpos desde 1:10 000 a1:30 000. La especificidad de la prueba fue 100 por ciento para todos los intervalos de tiempo evaluados; mientras, que la sensibilidad varió de 70 a 100 por ciento. De los 102 P. herreri, en 93 ejemplares se detectó contenido intestinal y se encontró la fuente alimenticia en 77 de ellos, la sangre de cobayo (36,3 por ciento) fue la principal fuente de alimentación, seguido de humano (18,2 por ciento) y pollo (14,3 por ciento). El índice de infección tripano-triatomíno fue 62,4 por ciento. Conclusiones. La prueba de precipitina mostró mejor especificidad que sensibilidad. En las áreas de estudio, la fuente principal de alimentación de P. herreri es la sangre de cobayo, seguido del humano y pollo. El elevado índice de infección a Trypanosoma sp. relacionado con la fuente de alimentación por cobayo, nos indicaría que es el principal reservorio.

Objective. To identify the food sources of Panstrongylus herreri from district of Cajaruro, province of Utcubamba, department of Amazonas. Material and methods. The study was performed in two steps: in the first, a precipitin test was standardized using as antigen, blood sera from human being, dog, cat, guinea pig and chicken and the specific antibodies obtained by inoculation of the antigens in rabbits. Nymphs of Triatoma infestans (IV and V instars)maintained in the laboratory were fed on dog, cat, guinea pig, and human being to determine the sensitivity and the specificity of the precipitin test. In the second step, 102 P. herreri specimens collected from houses of the two villageswere submitted to the standardized precipitin test. Results. The developed test permitted good titles of antibodies in the range from 1:10 000 to 1:30 000. The specificity was 100 per cent and the sensitivity was 70 per cent to 100 per cent. Of the 102 P. herreri specimens were detected intestinal content in 93 and found the food source in 77 of them, the blood of guinea pig (36.3 per cent) was the main source of food, followed by human (18.2 per cent) and chicken (14.3 per cent).The Trypano-triatomine index was 62.4 per cent. Conclusions. The precipitin test showed better specificity than sensitivity. In this study sites, the main food source of P. herreri was guinea pig follow by the human being and chicken. The high rate of insects carrying Trypanosoma sp. was related to the insects fed on guinea pig pointing it out as reservoir of the parasite.

Description of Culicoides pseudoheliconiae sp.n. from Peruvian Amazon and revalidation of Culicoides contubernalis Ortiz & Leon (Diptera: Ceratopogonidae)

A new species of the Culicoides hylas species group, Culicoides pseudoheliconiae Felippe-Bauer is described and illustrated based on female specimens from Peruvian Amazon, and Culicoides contubernalis Ortiz & Leon from Ecuador is resurrected and redescribed as a valid species. A systematic key, table with numerical characters of females of species of the Culicoides hylas group are given.

Características morfométricas, genéticas, alimenticias y vectoriales de Panstrongylus herreri procedentes de Jaén (Cajamarca) y Cajaruro Amazonas), Perú / Morphometric, genetic, FEEDING and vectorial characteristics of Panstrongylus herreri from Jaén (Cajamarca) and Cajaruro (Amazonas), Peru

Objetivo. Comparar las características morfológicas, alimenticias y genéticas de dos poblaciones de Panstrongylusherreri, de los distritos de Jaén (Cajamarca) y Cajaruro (Amazonas). Materiales y métodos. Se colectó especímenes adultos de P. herreri, 42 (Jaén) y 68 (Cajaruro). Se utilizó la morfometría geométrica para evaluar el dimorfismo sexual de tamaño y conformación. El perfil genómico se realizó por amplificación del espaciador interno transcrito del ADNr(ITS-2). La amplificación del espaciador intergénico del gen mini-exón, permitió la caracterización molecular de lostrypanosomas aislados. Se utilizó la prueba de precipitina para conocer las fuentes de alimentación de los vectores y así poder asociarlos a posibles reservorios del parásito. Resultados. El análisis morfométrico demostró que el dimorfismo sexual de tamaño fue similar (p > 0,05); no ocurrió lo mismo con el dimorfismo de la conformación; asimismo no se encontró diferencias de tamaño al comparar por separado hembras y machos de Jaén y Cajaruro. Por ITS-2, se evaluó cinco especímenes de cada distrito, en ellos se observó una banda de 960 pb aproximadamente. Sólo en Cajaruro se encontraron triatominos parasitados, que fue caracterizado como Trypanosoma cruzi TCI (350 pb). Se identificó al cobayo como la fuente de alimento más frecuente. Conclusiones. Ambas poblaciones de P. herreri por morfometría geométrica e ITS-2, no evidenció diferencias, indicando que se trataría de una misma población y por consiguiente de la misma procedencia. La sangre de cobayo fue la más frecuente fuente de alimento, pudiendo ser el principal reservorio para la enfermedad de Chagas en esta zona del Perú.

Objective. To compare the morphology, feeding and the genetic profile of specimens of Panstrongylus herreri from districts of Jaen (Cajamarca) and Cajaruro (Amazonas). Material and methods. Adult specimens of P. herreri were collected, 42 from Jaen and 68 from Cajaruro. Geometric morphometrics was used to evaluate the sexual differences in size and form. The genetic profile was done using the PCR amplification, second internal transcribed spacer (ITS-2) of theribosomal ADN. The molecular characterization of the isolated trypanosomes was made by the amplification the parasite. We used the precipitin test for identification the feeding sources and thus be able to associate them with the potential reservoir of the parasite. Results. The morphometric analyses showed no difference (p > 0,05) in sex between the insects from both departments, but there was difference in the form between females. The genetic profile showed by ITS-2 similar bands of 960 pb in both groups (five insects) from Jaen and Cajaruro. The trypanosoma isolated from P. herreri (only in Cajaruro) was identify as Trypanosoma cruzi TCI (350 pb). Guinea pig blood was the main source of food for the insects. Conclusions. P. herreri from both localities no showed important differences under geometric morphometry and genetic studies. These results indicate the same population with similar origin. The guinea pig blood was the main source of food of P. herrei, may be the principal reservoir for the Chagas disease from this Peruvian area.

Description of Micropygomyia (Micropygomyia) ancashensis sp. nov. and the female of Lutzomyia (Helcocyrtomyia) chavinensis Pérez & Ogusuku (Diptera, Psychodidae, Phlebotominae) from Ancash department, Peru

A male of a new species Micropygomyia (Micropygomyia) ancashensis sp. nov. and a female of the Lutzomyia (Helcocyrtomyia) chavinensis Pérez & Ogusuku, 1999 captured in the Antonio Raymondi province, department of Ancash, Peru are described and illustrated. The new species belongs to the cayennensis series, being closest to Mi. lewisi (Feliciangeli Ordoñez & Férnandez) though presenting highly sclerotized pseudotracheae on the labella that seem to constitute an autapomorphy among American Phlebotominae, and a clypeus almost completely covered with setae, as in Warileya. The female of Lu. chavinensis is close to those of Lu. blancasi Galati & Cáceres 1990, Lu. noguchii (Shannon, 1929), and Lu. pallidithorax Galati & Cáceres 1994.

Case report of orbital lymphoma associated with polycystic disease: a coincidence?

The most common known extra renal malignancy associated with polycystic kidney disease (PKD) is of pancreatic origin. Here we report a case of orbital lymphoma in a patient with PKD. This might just be a co-incidence or there might be some genetic interaction.

Correlation of anemia, secondary hyperparathyroidism with left ventricular hypertrophy in Chronic Kidney Disease patients.

AIMS: To demonstrate the correlation of anemia and intact parathormone with left ventricular hypertrophy in a cohort of Chronic Kidney Disease (CKD) patients in a tertiary care centre. METHODS: A cross-sectional study was done over 2 years on 230 renal failure patients (160 males, 70 females), aged 15-75 years, who had elevated serum creatinine and reduced GFR. The patients were assessed based on clinical history and a number of laboratory parameters including serum creatinine, calcium, iPTH level, Hb, Hct, GFR and LVMI. Settings : Patients were seen as inpatients and outpatients in a tertiary care centre. RESULTS : In CKD stages I, II and III, 51% of the patients had anemia Hb<11gm/dl), 16%of the patients had elevated iPTH, 79% of male patients and 71% of female patients had LVH. In Stage IV CKD, 55% of the patients had anemia, 25% of the patients had elevated iPTH, 74% of male patients and 100% of female patients had LVH. In stage V CKD, 76% of the patients had anemia, 31% of the patients had elevated iPTH, 77% of male patients and 96% of female patients had LVH. In all five stages, 78% of male patients and 71% of female patients with elevated iPTH had LVH, 81% of male patients and 90% of female patients with anemia had LVH. Systemic hypertension was present in 69% of the patients. CONCLUSION: Anemia is widely prevalent in our cohort of CKD patients. Severity of anemia is correlated to LVH and secondary hyperparathyroidism in these patients.

Renal abscess.

This study analyses the pre-disposing factors, diagnostic modalities, therapeutic options and prognostic factors involved in 7 subjects with renal abscess. Most often they presented with high fever and flank pain. USG and CT were used to establish the diagnosis. Urine culture yielded organisms in five cases and hence empirical antibiotic therapy for Gram-negative organism was offered. Complicated abscess in our series carried high mortality especially in immuno suppressed and cachectic patients.

A new Culicoides (Diptera: Ceratopogonidae) of the subgenus Diphaomyia from Peru

A new species of Culicoides of the subgenus Diphaomyia, Culicoides jurbergi Felippe-Bauer, is described and illustrated based on female specimens collected biting man and with light traps in Peruvian Amazonia. The species is compared with its similar congener mirsae Ortiz.